H &P- 40 yo female, 5ft5, 200 pounds, average BP 139/89. Nonsmoker, s/p RNY Gastric bypass, Iron defficiant anemia (Venofer infusion every 8weeks), Vit D deficient, Copper Defficiant. S/P HX Hep C (resolved w 12w tx interferon, sovaldi, ribvirin-LFT WNL- no virus), Lipid panel WNL, .....25 year HX migraine headaches. Always right sided behind the right eye. Within past 3months increase in; occurrence 3-4 x per week, duration is 12-24 hours, intensity is nearly debilitating (pounding, sharp pain, sensitive to sound, with nausea), new onset word search issues, short term memory loss, difficulty completing thoughts/sentences, fatigue, & insomnia, numbness to the face & top of right foot. Current treatment-topamax 20mg at HS (has helped decrease migraines to 2-3per week and they last 8 to 10hours) Zomig DOES NOTHING.... Imitrix gave me SEVERE chest pain which radiated through the left shoulder within minutes of taking it. MRI -nonsepcific white matter T2 hypersensitivity. Differential consideration migraine headaches, microvascular ischemic changes, less likely demylenating process given distribution.... what does this even mean????????
                                                        
                                                     
                                                    
                                                        
                                                            
                                                            
                                                            
                                                                posted on
                                                            
                                                                Sat, 29 Apr 2017 
                                                            
                                                            
                                                            
                                                            
                                                                
                                                                    
                                                                    
                                                                    Fri, 28 Sep 2018
                                                                    
                                                                    
  Answered on 
                                                                 
                                                                
                                                                    
                                                                    
                                                                    Sat, 29 Sep 2018
                                                                    
                                                                    
  Last reviewed on