Expert: Claes-Gustaf Nordquist, M.D. - 1/22/2010

Question
Hello, I am a 36 year old female.  Throughout my younger years I was plagued with migraine headaches every few months.  At the time, I was put on Immetrex and pain killers. The decreased in frequency as I aged.

About 8 months ago, I began getting migraines every afternoon along with fatigue throughout the day.  I checked with my primary doctor who put me on motrin 800mg.  Needless to say, I returned a month later.  My migraines were no longer occuring in the evenings but every morning when I open my eyes.  Sometimes I will get the edge off one just to have it return in the afternoon.  He then put me on Fioricet and took me off the motrin.  A few weeks later I was back in the office because my migraines were just as bad if not worse.  I was taking the maximum daily dose of Fioricet before noon and then tylenol extra strength the rest of the evening.  He took me off that and placed me on Maxalt-MLT.  I am now taking the daily dose of this medication before early afternoon just to take the edge off and tylenol extra strength every evening to try to hold off the morning headache.

These migraines begin in the right side of my head behind my eye and may sometimes travel to the left side.  Or, the base of my neck may get stiff and sore with the right side hurting.  I am also sick to my stomach with them.

Today I went in for an MRI but they only requested the pituitary gland be checked.  I talked directly to the radiologist who told me that the pituitary is fine but he saw "unspecific spots" in the part of the right frontable lobe and he is requesting a full MRI ASAP.

I was just wondering.  Can these spots be simply migraine related or a sign of something else.  And, if it's simply migraines why wont migraine medicine make them stop?  BTW, motrin is no longer an option as it caused me to have an ulcer from long term daily use.

Thank you so much for taking the time to read my question!

Answer
Your case is not a case for a primary care doctor at all! You need a neurology specialist. It is unlikely that "spots" - whatever they may be - have anything to do with ordinary migraine. It is also unusual for ordinary migraines not to be influenced by medication at all. Let a neurologist check you! Please do keep me posted - especially with regards to your full MRI result!



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