Demylination disease and chronic migraine

[avrd9]

I am a 45 yr old female and recently went to neurologist for a migraine headaches that lasted 30 days in a row with a sudden change of sharp jabs in the back of my head lasting for a few seconds. Have family history of aneuryisms and stroke. During the neurological exam the physician noticed brisk reflexes and lack of pain sensation in a few fingers in either hand. EMG came out normal, and MRI  of the spine.result showed increased intensity in STIR images (without contrast) in C2 - C3 C5-C7 , however no events showed in images with contrast. No sign of  primary tumor in spinal cord, nor  a sign of enlarged spinal cord either. Possiblities of tranverse myelitis and demylination without known etiology was noted. Looking back I have had some other unusal findings that may or may not be related , but hopefully may be a piece to the puzzle. September had BP of 95/56 (usually normal for me), but HR of 45 and short P wave in EKG and abnormal ST wave. Had stress test, and echo showing normal results. Had Asthma also until December - again no etiology but uncontrolllable coughing. I do have symptoms of numbness tingling in arms and legs and chest tightness from time to time. Also experience ache near the ribs - all these symptoms only at night when asleep. Could I possibly experiencing a demylinetion disease in begining stages? What other tests should I take to rule things out. What could these symptoms signify? Should I have an MRI of the brain? Would that show anything?

[Dr. A. Srivastava]

Thank you for your question. Sometimes any of the underlying disorder like cervical spondylosis may aggravate the migraine headache but it is difficult to say that it is the sole reason of your migraine.
It will be best that you consult a neurologist who would like to examine you and prescribe Pain killers, steroid and muscle relaxants. Other treatments could be cervical orthosis such as a soft cervical collar/stiffer neck brace to restrict neck movement. In addition, cervical traction may also be suggested by the doctor, if condition is severe. Hope this helps.

[avrd9]

Thank you so much for your response. Your information was very helpful. Actually the MRI report mentioned mild cervical spondylosis. Considering  that the numbness and stiffness only occurs during sleep and when seated in the same position for a long period of time. I have been suffering from Migraines for 18 years and perhaps it was a fluke that had so many in that particlar month. I am more confident that it may not be a demylineation disease. Do you think that it's necessary to get a brain MRI? What can I do to resolve or improve my condition due to the Cervical Spondylosis? Could this be contributing to my migraine headaches?

[Dr. A. Srivastava]

Thank you for your question. Although without being able to examine you I can not offer you the specific advice on diagnosis and treatment that you need, but I would try to provide you some relevant information about your health concern.

There might be two possibilities here that need to be evaluated thoroughly. First, one sided throbbing (or sharp) headache & orbital pain (eye pain) with numbness symptoms could be suggestive of migraine. Other factors that may induce your migraine attack may be contraceptive pills, stress or depression, bright lights, loud noise and traveling. Few women experience headache more commonly during the time of their menstrual periods & at the time of hormonal imbalance. The mainstay of the migraine treatment is always to identify the triggering factors and to avoid them. Triggering factors could be different foods such as cheese, chocolate, alcohol and even few fruits. I would suggest careful record of events that have proceeded with the attack and avoid those factors. In addition, try to rest in a dark & quiet room, meditate, have a balanced diet and avoid taking unnecessary drugs.

Another possibility is Cervical spondylosis or pinched nerve in cervical spine in which pain may be referred and perceived as occurring in the back of head, shoulders, arms or chest, rather than just the neck. Other symptoms may include vertigo, nausea (dizziness). Even then if you suffer continuous headache, please arrange an appointment with a neurologist right away who will evaluate the further underlying disorders by clinically examine you & ordering MRI or CT scan here that may be the main reasons of your headache attacks & other symptoms and can provide you an appropriate treatment. Hope this information proves helpful to you. Take Care & Regards!!!