Tuesday, December 02, 2008 emma asks

Q: I am unsure what type of headache I have and have used many medications prescribed by my neurologist

I am a 28 year old female and 6 months ago suffered from a headache which has never gone away. It occured suddenly one day and has never changed. It is left sided mainly behind my eye but also above my brow and towards my jaw. It is a dull throbbing ache which changes in severity but never disappears.

At best it is a dull throb, at worst a very intense pain which feelS like I have been kicked in the head. I saw my neurologist 2 months ago now and he diagnosed chronic migraine. I have eye symptoms also - pain when looking up, an intermittent eyelid twitch, occasional differing pupil size and double vision when reading.

I have no nausea, vomiting, photo/phonphobia or aura. I have tried anti depressants, beta blockers and gabapentin, none have worked to remove or even improve the headache.

I saw my doctor today and he has instructed me to wean off the gabapentin, I am then to try topomax. He is also going to refer me back to the neurologist. I am short sighted and suffered from graves disease 3 years ago. I was treated successfully with radioactive iodine. I have never suffered any eye problems from this disease. I have a happy home life and work is work but not an overly stressful environment. I have been told that it could be due to my glasses (by an optician), could be referred pain (by a chiropracter), could be mould (lay person), could be the contraceptive pill (which I ahve now stopped), but paying attention to all of these criteria have not helped.

I'm not even sure what I have is migraine, as i'd never suffered from one before this very lengthy episode, aren't migraines no longer than 72 hours by nature? Any advice/helpful suggestions/personal stories would be appreciated as i'm starting to suffer badly now and don't know who to trust and where to turn. Thank you very much.

Answers (1)

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Teri Robert

12/ 3/08 3:01pm

Emma,

I see a number of issues here. First is that you need a diagnosis. Is there any history of Migraines, "sick headaches," or "sinus headaches" in your family? Migraine tends to be inherited, but in your family history, you may remember Migraines having been called "sick headaches" or Migraines that were mistaken for sinus headaches.

You've tried antidepressants, beta blockers, and gabapentin -- all in the last six months? It often takes up to three months to know if a medication is going to work for prevention.

You're right that Migraines generaly last no longer than 72 hours. However, they can and do last longer sometimes. A Migraine that lasts 72 hours or longer with less than a solid four-hour pain-free period, while awake, is termed status Migrainous. You should see your doctor or go to the emergency room if a Migraine lasts that long. See Status Migrainous - The Basics for more information.

At this point, stopping this headache or Migraine that you've had for six months needs to be a priority. When oral medications have failed, IV infusions will often break the cycle. For more information about this, see IV Treatment of Refractory Migraines.

Something you don't mention is if you're taking Migraine abortive medications or pain medications for this "headache." Taking Migraine abortive meds such as triptans (Imitres, Maxalt, etc.) or ergotamines (Migranal, DHE) or any kind of pain med more than two or three days a week can make matters worse by causing medication overuse headache (MOH), aka rebound. See Medication Overuse Headache - When the Remedy Backfires for more information on this.

If your doctor isn't able to help you, it may well be time to consult a Migraine and headache specialist. It's important to note that neurologists aren't necessarily Migraine and headache specialists. Take a look at the article Migraine and Headache Specialists - What's So Special? If you need help finding a Migraine specialist, check our listing of Patient Recommended Migraine and Headache Specialists.

Good luck,

Teri

Q: I am unsure what type of headache I have and have used many medications prescribed by my neurologist

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