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.