Monday, June 11, 2012

Headache

A generally very happy thirty-four year old female came in for a followup. She feels tired but attributes this to allergy medicines. In fact, Astepro causes drowsiness. She presented for ongoing care for migraine headaches. The headaches seem to originate in her neck and radiate up into her head. These are classic migraines: unilateral,  pounding in nature, associated with nausea and classical visual changes. Migraines run in the family and she has had a longstanding history of migraines. But the headaches have been difficult to control.

By far, the best migraine prevention medicine is Topomax. However, its nick name is "dopomax", because it is frequently associated with brain fog.

She has been off antibiotics for a year and insists her Lyme is "cured."

She presented in 2008 with an illness that went back 12 years.

Previous symptoms have included: memory loss, disorientation, anxiety, depression, nightmares, joint pain, numbness and tingling, night sweats, flu-like symptoms, dyslexia -  problems with writing and reading, brain fog, getting words mixed up and others.

She was previously treated with an aggressive program which included several months of intravenous antibiotics.

When pressed a bit further she admits to some mild muscle and joint pain but all other major symptoms have been  banished.

I would have to agree with her that her Lyme disease is largely in remission.

But headaches frequently persist after Lyme treatment, at times disabling.

Ironically, this patient works in medical research and studies Botox which can be used to treat migraines. (She has given me permission to publish her story).

Some patients are  treated "forever" -  with the thought the headaches are due to Babesia or perhaps another infection. I have found this akin beating a dead horse.

Standard treatments for migraine are usually effective. A new FDA approved treatment which frequently works is Botox which she is reticent to try.

8 comments:

Alice McNally said...
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Tapp's Tip said...

Does that mean you think that he botox doesn't work for the headaches? That is one of my issues and was an approach I was interested in trying. Please let me know.

livingbygrace said...

This just happened, my son in law was bitten a week ago in the armpit. He thought nothing of it and by Sat. Night, 3 days later he had what felt like the flu. Sunday he was dizzy and headache hit with his arm where he was bit began shaking uncontrollably, that might he had chills and fever. Monday they called us to say he was feeling very sick and started mentioning symptoms, because we have been researching Lyme because of my illness, we asked was he bit by a tick recently? On Thursday he had, quite sick by Sunday, by Monday slurring speech, couldn't walk a straight line, sleeping all the day. I said try getting him to a walkin clinic, he went and they said go to a hospital, you have encephalitis. They didn't examine him at all, just based on symptoms. I said to them, he needs a LLMD, we knew a doc who knows about Lyme that hadn't helped me with chronic, but we heard he treats early infections. He and the other dr in office both examined him. They couldn't believe it, he presented like a stroke victim, only he is 26 and in good health til now. I am grateful he's on treatment and stands a good chance of beating it since he's been pit right on doxy.We need to band together like cancer, aids, ms, md, and scores of other illnesses that get studies done to improve the quality of life for all.

Unknown said...

Lyme MD, we are in the process of consulting with a doctor in D.C. who does nerve surgery for head pain. Your patient may be interested in taking a look
http://www.georgetownuniversityhospital.org/body_dept.cfm?id=555836

and the doctor's site
http://drducicplasticsurgery.com/Ducic_Plastic_Surgery/Home.html

My son has had a constant frontal pain, between his eyes, under the nasion for over ten years. He will be having nerve blocks done soon to determine if one of the facial nerves is responsible for the pain. If so, then he may be a candidate for surgery.

lymie said...

Lyme headaches and visual aura were different for me from the migraines I used to have. With lyme, the headache and aura were separated in time, whereas with a classic migraine, the aura immediately preceded the headache.

A school nurse once gave me a buffered aspirin with a caffeine pill, which stopped the headache. Ever since then, I was able to do this when the aura started (flashing lights, blind spots) and then the headache did not come on. I used a buffered aspirin washed down with a caffeinated drink. Doesn't seem to work if you don't do it immediately with the visual stuff.

Unknown said...

Have you any experience with the Advanced Lab Services culture test? It would be great if you wrote a blog on your thoughts. The growing of the spirochetes from your blood is the ultimate test. As long as there is no contamination, errors in paperwork and proper ID, wouldn't a positive be absolute. I had their culture test come back positive twice, 2 months apart. I also had an IGenex positive but it didn't meet the CDC 5 band surveillance criteria. Could you share your thoughts on the ALS culture? I've been told its irrefutable proof of my diagnosis and that it a sham and the people who run the lab don't even publish their names nor any real data on their culture. What do you think? Please Blog on this?

Jessica Dark said...

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O. said...

Botox did not help my chronic 10+ year frontal headaches and brain fog that occurred 1 year after spine surgery. Now I'm looking into abx treatment for the past 4 month but no improvement yet.