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Aswad -> RE: Migraine Medications (10/2/2009 12:13:00 AM)
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quote:
Never really talked to a doctor about it but I'm thinking it might be related.
You really should talk to both the doctor and the neurologist about it.
You'll have to pardon the short and scattered reply. I'm a bit short on time and low on sleep.
The problems you describe are almost certainly related. And it may be indicative of a focal seizure. Focal seizures have very specific effects, down to the level of repeating a single planned action over and over, or a single routine action over and over, or having a specific sensation occur repeatedly, or losing one part of your reasoning ability, and so forth. A long lasting focal seizure must be treated in the same manner as status epillepticus: with immediate medical care. OCD is a possibility, but you aren't really describing any feeling of palpable compulsion, nor trepidation at the prospect of stopping. Rather, if I read you correctly, it is more like you have temporarily lost the ability to stop repeating one fairly normal action (e.g. biting lips, etc.) over and over until it becomes harmful (i.e. until you bleed, etc.). That is not how OCD works, but it is how a certain kind of focal seizure works. Those can be triggered in many different ways, which a neurologist can figure out.
As a general rule, when the diagnoses start piling up, someone needs to go looking for the root cause, the one that all or most of the diagnoses are the direct result of. It's my corollary to Occam's Razor: do not needlessly multiply diagnoses. The smallest set of diagnoses that will account for the symptoms is probably correct. Not always, but often enough that looking for an underlying condition is usually justified when the list gets a bit long. Like a focal seizure in one part of the brain causing a behavior that accounts for the remainder of the symptoms, apart from depression (which can certainly be hormone related, or nutritional, or environmental, or ...).
As for CT, that is mostly a tool for imaging the structure. It does not say so much about function. You would probably want an EEG and a scan that deals more with the function of the brain, i.e. MRI, PET or SPECT. Again, as the resident med student pointed out, you should talk to your doctor and have the neurologist determine what to have a look at. The doctor is not a substitute for a neurologist, however, so ask for a referral.
That nicotine affects you is not a surprise. Five minutes is a pretty short duration, however. The elimination half life of nicotine is on the order of 2 hours, unless you happen to be taking medications that accelerate the breakdown (like a barbiturate or over the counter herbal medicine, for example). It does, however, take a shorter amount of time for the receptors to adapt to a nicotine rush. If you have a low density of nicotinic acetylcholine receptors, you may also have caused a temporary blockade, which invokes a response that is related to the hypoxia response of the brain, which is mediated by the same systems that cause the migraines, but nobody ever does a binding assay outside a study. There isn't any reason why you can't switch to a less harmful delivery system for your nicotine, though...
And the chickenpox vaccine is live virus, so if you were on the pill while you got the vaccine, then it is not unlikely that the virus is present in the trigeminal ganglion, albeit as a purely latent infection. Unless you can think of some serious hormonal or immune system event from the time when the migraine started, there doesn't seem to be any likely reason why HSV, VZV or E-B virus should be the cause of the reaction. Rule might have additional information to the contrary, I've only read briefly up on it in the context of genetically altered rabies (Koreans have been experimenting with that for metastatic brain cancers of a particular type).
Any history of blunt trauma to the head or spinal cord, varicose veins, blood clots, diabetes, etc., etc.?
Also, any history of sudden spikes in heart rate, say 20-30 extra beats per minute, with no apparent reason?
Again, sorry if this seems disjoint. I've had to edit things a few times to even get it a little bit consistent. Busy day. As usual, I'm not a doctor, or even med student, so this is idle speculation, pretty much. You have to run it by your doctor and ask for a referral to a neurologist. A qualified professional can fix the problem. I can't. Don't have the expertise, nor the gear, nor the access. Meanwhile, get a gag or other tooth-friendly mouth restraint that can keep you from chewing anything other than food, and have a nurse or manicurist treat your fingers and apply some medical acrylic glue to them while they're at it, then put on some fingered gloves. That medical acrylic works for lips, too, if it's allowed to dry with the lips parted. It does not work inside the mouth, fortunately. Throw out the aspirin, and replace it with some tabs that are called gaviscon instead. They're used for reflux, but are harmless and may be beneficial while your esophagus gets a rest from the aspirin.
If that doesn't work, I'll see if I can scrounge up a spare straight jacket and bit somewhere. [:D]
More seriously, though, you need to get your body some rest. These are barriers to the environment you are tearing down. They are there for a good reason. It needs to stop long enough to heal, at the very least. If that means getting tied down to the bed, or walking around with mittens and a bit, so be it. Once they've healed, you have time to deal with it properly. Then you can use that time to get somewhere with the doc and neuro. Meanwhile, harm reduction is better than doing nothing.
'nite.
Health,
al-Aswad.
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