About 4 years ago I began having some problems and began the process of MRI's and different doctors and tests. I was diagnosed with Trigeminal Neualgia and Narcolepsy. The doctors also found a syrinx of 11mm at my C6-C7. It was noted then (I didn't know it) that I had low lying cerebellar tonsils. In the past few months I began having extremely bad headaches in the back, lower part of my head, near the top of my neck, I've also been experiencing nausea so much I took a pregnancy test to be sure that wasn't why! I've also had problems with numbness and tingling in my extremities. Plus more of the symptoms associated with ACM. My recent MRI (last week) noted the cerebellar tonsils at 6mm below. My recent call from the nurse said basically it all looked the same from my last MRI and I should see my neurologist about migraines. I told her I had experienced migraines in the past and this wasn't the same thing. I am concerned because he's not even addressing the ACM and she said they don't do anything til it's beyond 8mm. I don't want surgery, but I do want some relief from my symptoms to be able to get back to my every day life. I'm not sure whether to seek a second opinion or not. I wonder if extreme fatigue and facial pain (diagnosed as TN) could be associated with the ACM and if surgery would fix everything. I have a follow up appt next week with my NS and am trying to prepare my questions for him. I am currently on neurontin and carbatrol. Any suggestions?