Could the doctor be right?

[PastorDan]

Recently some of the assorted neuro people I've been seeing have toyed with the thought that migraine might be at the root of my problems.  Let me give a synopsis, and then please tell me what you all think.

In July 2008, I woke up one day with very strong vertigo.  The room was spinning clockwise, intensely.  I got up from myt bed and fell on the floor, falling to the left.  I tried several times before I was able to stand up without immediately falling down.  My doctor prescribed meclizine, which seemed to do nothing but make me sleepy.  However, after a few days, the dizziness seemed to go away.

In October it came back, stronger than ever, and it has yet to fully go away for more than an hour or so at a time.

Soon afterward, I began to notice an odd patch in the upper right corner of my visual field.  It reminds me of the ghost image you see after having a flash photo taken.  Sometimes it seems brighter than the rest of the picture, sometimes dimmer, and sometimes it just seems as though the colors are rather washed out.

In February I experienced a classic migraine with aura, squiggly lines running perpendicular to the shape they filled, which was kind of a snake-like sliver across the center of my view.  The lines were moving like those of a barber pole, though I think they were all black and white.  The visual part lasted about 10 minutes, and then a killer headache came on, primarily on the right side.  This experience was similar to my several episodes diagnosed as migraine in one summer about 12 years ago.

I've had bizarre sensations of vibrations on various parts of my body, feeling just like a cell phone when it is set to vibrate instead of ring.  I've had hot and cold patches on my skin, at least as far as I sensed them being hot or cold.  I've had the sensation of electric shocks moving across my back.  I am horribly fatigued much of the time, and have been noticing that I forget more things than I used to, and more often have difficulty finding the word I need to describe a well-known object or action.  Concentration is nothing like it once was, either.

I've had two CT scans of the head, an ultrasound of the carotid arteries, a 24 hour Holter monitor, an EKG, an ENG, a VNG, a BAER, an MRI, all sorts  of blood work, a neuropsychological assessment, a visual evoked potentials test, and probably other things too, but I can't remember them all.  So far, they've found four tiny bright spots on my T2 MRI images, subcortical, but not periventricular.  They also found that I was low on testosterone.  I've been prescribed Androgel for that, and for the other things, they've tried meclizine, Xanax, Depakote, clonazepam, amitriptyline, and now we're adding Neurontin.  I also underwent vestibular rehabilitation therapy for eight weeks.  So far, symptoms remain unchanged, though they wax and wane somewhat from hour to hour, day to day, and maybe from week to week.

I have been under a lot of stress during this season.  In addition to being a pastor, I work fulltime in county government, where we've gone through a complete changing of the officeholders to whom we report.  The budget is in serious freefall, and my department is managed by people whose judgment is debatable at best.  In April, my wife underwent surgery, came home, and then passed away four weeks ago this morning.

All of the symptoms combined led me to think of possible brain tumors, but the various imaging tests have pretty conclusively ruled that out.  I've been thinking multiple sclerosis, but the multiple sclerosis specialist I saw is pretty skeptical.  The neuro-ophthalmologist I saw Friday acknowledged that MS seems like a possibility, but that migraine was a much more likely suspect in my case.  He described it as an "odd" migraine, certainly atypical, and absent the severe headache that I've always associated with migraine (though I've had a wide range of headaches this year, and rarely had them before).

So, anyone care to comment?

[PastorDan]

Thank you for your reply, Pita.  I want to be sure I understand what you are suggesting.  I've had eight weeks of vestibular rehab, a VNG and an ENG that were both normal, normal BAER, and perfectly fine images of the whole vestibular system, resulting in my PCP, two audiology specialists, and at least two neurologists all saying that there's nothing wrong in the vestibular system.  The PT who did the therapy acknowledged that any change from the time I started until the eight weeks were up was minimal.  You must be speaking of something with which I am unfamiliar.  How would your suggestion do what the previous vestibular rehab failed to do?

[PITA702]

Hi,
You may want to try Occupational Therapy  (need referral from your doctor) to help your vestibular system.  I am a special education teacher and spinning (tire swing in your case not sit and spin) and swinging could help.
Pita702