H &P- 40 yo female, 5ft5, 200 pounds, average BP 139/89. Nonsmoker, s/p RNY Gastric bypass, Iron defficiant anemia (Venofer infusion every 8weeks), Vit D deficient, Copper Defficiant. S/P HX Hep C (resolved w 12w tx interferon, sovaldi, ribvirin-LFT WNL- no virus), Lipid panel WNL, .....25 year HX migraine headaches. Always right sided behind the right eye. Within past 3months increase in; occurrence 3-4 x per week, duration is 12-24 hours, intensity is nearly debilitating (pounding, sharp pain, sensitive to sound, with nausea), new onset word search issues, short term memory loss, difficulty completing thoughts/sentences, fatigue, & insomnia, numbness to the face & top of right foot. Current treatment-topamax 20mg at HS (has helped decrease migraines to 2-3per week and they last 8 to 10hours) Zomig DOES NOTHING.... Imitrix gave me SEVERE chest pain which radiated through the left shoulder within minutes of taking it. MRI -nonsepcific white matter T2 hypersensitivity. Differential consideration migraine headaches, microvascular ischemic changes, less likely demylenating process given distribution.... what does this even mean????????