Dr. Hitesh Kumar
Neurology
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Patient's Query
Hi doctor,
I am a 30-year-old male. I have been suffering from severe headaches and loss of memory sometimes. I get light headedness at times and mt throat dries up.
Did an MRI Brain.The contents are:
T1 hypointense, T2 flair hyperintense lesion on right peritrigonal region involving optic radiation, possibly an area of focal demyelination. MRI plates also show a bright white spot. Is it severe?
I am currently taking medicines for uric acid and headaches.
Hello,
Welcome to icliniq.com.
I would like to know some details about your problem:
Since when you started to have headaches? In which areas of head you feel that headache? What kind of headache is this? Is it heavy, throbbing, stretching, bursting or some other kind? Is it severe, moderate or mild? Does this headache happen persistently or episodically? Was it initially episodic and now turned to constant headache? If episodically, how long time one episode of it lasts?
How frequent are these headache episodes like how many times in a week? Do you feel any vomiting or watering from eyes or redness in eyes or nasal congestion during headaches? How is your day to day mood? How is your sleep and vision? Have you noticed any trigger factors for this headache? Have you ever took any regular medications for these headaches?
I suggest you to send the MRI images because I need to see the images.
Investigations to be done
Regarding follow up
Patient's Query
Thank you doctor,
Please find my answers below.
Since last October I got this headaches but in the last two months it has significantly increased. I do have a history of vertigo and headaches. I also had polyps operation. My headaches starts from the forehead, the temporal region and spreading through the back of the head. And I feel usually heaviness, throbbing, and painful and I cannot get up at times.
I get headaches two to three times a day and I get this every day. It usually lasts a while. During headache, my throat dries up and sometimes I feel vomiting. My eyes are usually a bit red. I do have nasal congestion as well.
Regarding my day to day mood, there is a lot of work pressure but I have taken leave for three weeks in order to get well. So I do not have much tension now. I do have a problem with concentration or focusing. I wear spectacles. I have a power of -5.25 and -4.75 in both the eyes.
When I get up it hurts a lot. Sunlight usually worsens it. If I try to think about a topic it starts throbbing. Stress increases as well but not always triggers it. I have attached the doctor's prescription and MRI report.
Hello,
Welcome back to icliniq.com.
I have seen the prescription and MRI report. (attachment removed to protect patient identity).
Your headache seems migraine headache which has converted into chronic daily headaches. But I feel need to see MRI images, if you are having problem uploading, you can talk to customer care of icliniq.
Differential diagnosis
Treatment plan
Preventive measures
Patient's Query
Thank you doctor,
I have attached the MRI files. I would also like to add that I am having frequent loss of memory. I am forgetting even the little things, I was not like this before.
Hello,
Welcome back to icliniq.com.
I have seen the attachment. (attachment removed to protect patient identity).
Your symptoms are matching for migraine headache. On MRI T2, flair lesion in right peritrigonal area can be an incidental finding. There is a high chance that it be a demyelinating lesion.
I suggest you start the medication as advised for migraine. Take Propranolol 20 mg BD, Amitriptyline 10 mg and Naproxen 500 mg SOS in case of severe headache.
For this MRI lesion, I suggest further investigations.
1. Contrast MRI brain study.
2. VEP (visual evoked potential), BAER (brainstem auditory evoked response).
3. CSF (cerebrospinal fluid) examination, Manometry, protein, sugar, TLC, oligoclonal band, myelin basic protein and NMO (neuromyelitis optica) antibodies.
4. Fundus examination by an ophthalmologist.
Regarding follow up
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