Hi,
   a microangiopathy in a younge who is not over weight, doesn't smoke,and no other illness (I assume not on pills? not mentioned or hurbal meds esp for energy or losing weight?) associated with headache , which sounds more like  late onset basilar type migraine or a transformed from a childhood one (in kids is on both side and more nausea)..with a residual perminant sensory findings in one half of the body between the attacks ....Is somthing I usually follow up closly ,
Any  family history of headache or early onset stroke??

I see your  neurologist has done  it properly by ruling out a primary or even a secondary vasculitis and  hypercoagulable screen ( did you have  ESR or CRP , protein C, S, antithrombin III, activated protein C resistance, thrombin time (dysfibrinogenemia), antiphospholipid antibodies, homocysteine, cryoglobulins, ANCA, lipoprotein (A) ) I will add sickle cell testing if you are african american?
   CADASIL is an abreviation of  cerebral autosomal dominant arteriopathy caused by a gen mutation and associate with migraine (Basilar-type migraine) is some thing we keep in mind in younge patients ,  though your MRI is not typical

    Cerebral vasoconstriction syndromes. may be seen in  postpartum angiopathy, or if on vasoactive drugs (ephedrin/cocaine ), or a patient with migrain migraine (the MRI is different than yours)

  The above one as well as the complicated migraine (a migrain resulting in stroke especially if on oral contraceptives) are diagnosis of exclusion (meaning we have to exclude every thing before thinking of them)

Having said all that its worth knowing that 14% of migraineurs have  white matter abnormalities seen usually in the periventricular white matter or near grey-white matter junctional areas, as compared to 4% of control subjects.

  In the management of basilar type migraine the patient can not use the usual abortive therapy and will need a good prophylaxis therapy.

  Bob

Sorry for not clarifying better, I've always had generalized headaches with nausea growing up, but last year they changed to pain in back of head, and pressure/pain behind eyes. I would rate some of the headaches 8-10, VERY INTENSE. I often have nausea and vomiting with them, Neuro gave me Midrin, but it doesn't really help. I feel like I take way too many,(took a bottle of 40 in as many days, not a pill every day but several pills a day, several days throughout) but it helps keep it from getting so bad, Midrin does not stop it, it runs its course over a 2-3 day period at a time.Left hemibody tingling has been basically constant since the onset, anywhere from a mild tingling, to a more intense pins and needles, and even  a tight feeling esecially the face, my tongue feels like I have drank a super-hot cup of coffee LEFT SIDE ONLY.The dizziness is random, and the visual disturbances are more episodic.  Voice has been consistently lower since early Dec.
Neuro first thought "something in the thalamus" then mentioned MS, Sjogren's, B-12 deficiancy and Diabetes, but all test were normal.
He performed Lumbar Puncture, I don't think he actually checked pressure, I was sitting on table bowed over for the procedure, I would think to check pressure you would need to be lying down on side????
I know they did CSF cell count,protein,MS profile, and checked for bands.....had Elisa and Western Blot for Lyme, ANA & RA, CBC, B-12, Factor V....
All they told me was "normal" and that MRI's "looked good."
Neuro said most consistent with microangiopathy....Do you concur?
Any other thoughts, advice????

Sorry its not clear to me if these symptomes are episodic and you are fine in between or progressive? what is the time correlation between the sensory symptomes, nausea, eye things, and the headache?how bad the headache could get out of 10...did you have a migraine as a child? ..what do u mean by a normal CSF , what was the neuroradiologist openion about the changes?

    Your medical terminology is good are in the medical field?

     Bob

I am 42 yrs/o, 5'6", 120 lbs, don't drink alcohol or smoke, I do not have hypertension, nor diabetes.
All blood work came back basically normal.
Lumbar puncture was also normal.