atypical migraine or something else?

[markb67]

I'm a 43-year old male who is not new to headaches.  I can't remember when I first got them, because they were fairly uneventful and seemed triggered by driving longer distances, long time spent at the computer, or "just because." The ache/pain waxes and wanes over the course of the headache, which could last from minutes to hours.  It's usually not at a constant level, nor does it usually pulsate or throb with any regular rhythm.

In June, a neurologist diagnosed migraines, which surprised me becuase I don't have the "typical" migraine symptoms people read about (except for the one-sidedness and that it's affected by head or body movement).  I walked out of the neuro's office with a prescription for Topamax.  The GP office had ordered the MRI with contrast, but the insurance company would only approve it without contrast. By this time, I was just desperate to have it done, and about a week later, I finally did.  I drove the CD of the images to my neuro's office who called that afternoon and told me that the MRI was generally normal except for evidence of white matter changes that are consistent in someone with high BP (which I don't) or possibly someone with migraines.

Anyway, I stopped taking Topamax because I was tired of the side effects, although it did seem to help a bit in that I didn't have any really sustained headaches.  For a couple of weeks, I was a pretty happy camper.  I went back to the neurologist for a follow up about a week after the MRI, he did a shorter version of the neuro exam, and discussed either going back on the Topamax or trying another one (he mentioned Depakote) if the headaches became a problem and made a follow-up appointment for this coming Friday.

The headaches came back last week, so I started taking the Topamax again but don't think I'll stay on it.

My main questions are:  1.  Does this really sound like migraine?  2.  Is the MRI contrast/non-contrast issue a significant one in diagnosing primary tumors?

Mark

[KenMoss]

I have bad migraines that can sometimes (twice now) present like a stroke. Treximet gets rid of all of it. I go through about 50 a year. Mine started after a wisdom tooth extraction and got worse in Alaska, but are terrible and frequent in San Antonio. The weather always triggers them for me. I would recommend giving it a try at least. All the other drugs they gave me had crazy side affects.

[hava]

This breathing technique will gradually help to reduce the headache.
Build up your timing gradually.If you feel tired or dizzy, stop and resume after one minute.
Anulom Vilom –
Close your right nostril with thumb and deep breath-in through left nostril  
then – close left nostril with two fingers and breath-out through right nostril  
then -keeping the left nostril closed  deep breath-in through right nostril
then - close your right nostril with thumb and breath-out through left nostril.
This is one cycle of anulom vilom.
Repeat this cycle for 15 to 30  minutes twice a day.
Children under 15 years – do 5 to 10 minutes twice a day.
You can do this before breakfast/lunch/dinner or before bedtime or in bed.Remember to take deep long breaths into the lungs.You can do this while sitting on floor or chair or lying in bed.

[Abhijeet Ghosh]

Dear Friend,
Many thanks for the post and giving me an opportunity to guide you.
I would first like to answer your question and then give further comments -

1.  Does this really sound like migraine?
                     Well, YES. It really sound like migraine only.

2.  Is the MRI contrast/non-contrast issue a significant one in diagnosing primary tumors?
                   Not Really. If the treating doctor would had felt the need of Contrast as a MUST, then they would had surely intimated you.

Topomax is a FDA approved medicine is of a good value for the present condition. Migraine is a condition which is highly un-predictable and hence sometimes the course of the disease can't be predicted at all. It is due to this reason, sometimes the effects of the drug gets diluted. But the best way to tackle migraine is to have a continous support and follow up with the treating doctor as the dosage and the drugs may be needed to titrated on time to time basis.
Feel free to discuss further.
Regards.