Atypical migraines or something else?

[amela321]

I am a 42 year old female with past history of thyroid cancer.  2 weeks ago I began experiencing intermittent numbness and tingling in the left side of my head, radiating down to my jaw.  After 5 days of that being the only symptom, I woke up with a throbbing headache on the left side of my head and nausea.  I had never had a migraine before, so I went to the doctor.  He gave me a shot of Imitrex, and the pain in my head lessened, but the nausea remained.  I felt better the next day.  3 days after that, I began to get the headache and nausea again, took 100mg Imitrex and felt better within an hour.  That night, however, I experienced tingling and numbness in my right arm.  The next day, I could tell that my right arm was weaker than my left.  The numbness and tingling in the arm resolved the next day.  The day after that I had an MRI which came back negative.  

Throughout all of this time, the intermittent numbness and tingling in my head has remained.  I also feel "not quite right"....sort of mentally slow, having trouble finding words, having some trouble typing.  

I have been referred to a neurologist, with a tentative diagnosis of atypical migraine, but the first available appointment is in February.  In the meantime, I'm trying to do some research.    I was wondering if you have any ideas of what could be going on.  This is sort of an oxymoron, but am I describing typical atypical migraine symptoms?  I should add that I have gained about 20 pounds since March without changing my eating habits, and since these symptoms started, I have noticed an increase in urination.

Sorry this is so long.  I appreciate any insight you can provide.  

[amela321]

Just realized I had posted on this forum several months ago.  Turns out in re-evaluating all of my thyroid levels, I found out my thyroid cancer has come back.  I actually just had surgery today and will be having radioactive iodine ablation as well.  Interestingly enough,  I haven't had a migraine since finding out about the thyroid cancer, so I guess it's not stress related!!

[Godofredo MD]

Hi.

When was the last determination of your thyroid hormone levels? If you are still hyperthyroid, it is possible for some of your symptoms to be associated with this, which includes the tingling and numbness sensations and decreased mental alertness. It could also be possible that migraine symptoms are overlapping with the thyroid abnormality which would somehow present as an "atypical migraine". Other possible causes include neurological disorders such as Parkinson's disease, although this would be difficult to ascertain at this point without further work-up.

Hope this helps.

[amela321]

I forgot to put  to whom this response was directed.  Please see above.

[amela321]

Thank you for your response.  My thyroid cancer was treated with a subtotal thyroidectomy (right lobe and isthmus) and then two rounds of radioactive iodine.  I should also mention that since this all started, I've had a lot of blood work done and it turns out I'm getting too much thyroid hormone, so am hyperthyroid.  I don't know if this has gone on for a while, or what, but my primary physician showed me my pulse rates from visits in the last two years and they were all over 90.  The latest one was 120.  He  has reduced my Synthroid dosage and put me on the beta blocker Propranolol.  The beta blocker should not only slow my pulse down, but help in migraine prevention if that's what is going on with me.

I'm trying to get in to see a neurologist earlier, but haven't had any luck so far.  With the negative MRI, I guess they assume I'm not going to drop dead tomorrow, so I'm kind of low on the totem pole as far as appointment scheduling.  What other conditions are a possibility with these symptoms?

Thanks again for your response.  

[Godofredo MD]

Hi.

Was your thyroid cancer treated? If so, what was the treatment done? Some of your symptoms could be related to an endocrine abnormality but nothing is certain at this point.

There is really no "typical" atypical migraine presentation. While it is possible for you to be experiencing this condition, the other symptoms, especially the mental sluggishness, and trouble finding words and typing, might suggest some other underlying condition.

If it would be possible for you to schedule an appointment with a neurologist earlier, it would be better.

Good luck.