Re: Can blood patch cause headache?
Re: Can blood patch cause headache?
Posted by ccf neuro M.D.* on November 15, 1997 at 01:03:47:
In Reply to: Can blood patch cause headache? posted by Richard Price on October 30, 1997 at 09:02:54:
I would be grateful to learn if anyone has experienced--or knows of someone who has experienced--long-term headache following an epidural blood patch. My wife has suffered for nearly 5 1/2 years with continuous head pain after she received an epidural blood patch that was administered to combat a post-dural puncture headache following spinal anesthesia. Although her head pain was position-dependent prior to the blood patch, it became position-independent following the patch (that is, her pain is continuous regardless of whether she is upright or lying down). I know that blood patches are supposed to be effective in stopping the pain associated with post-dural puncture headaches, but in this case, it appears that something went wrong with my wife's patch. She has been seen by numerous physicians, and three times she has been diagnosed as having pseudotumor cerebri without papilledema. However, none of the standard pseudotumor treatments--including drugs and lumboperitoneal shunt--have been efficacious. My wife's pain is accompanied by what has been diagnosed as "central intracranial tinnitus"--a high-pitched ringing sound that, like the pain, is continuous. Recently, she was taken off MS-Contin following a trial of several months; that drug, like all the others, had no effect on her pain. From the time her withdrawal from the MS-Contin began, she has complained of numbness and tingling in the hands and feet. When she awakens in the morning, she cannot close her fingers to make a fist. If she raises her arms over her head, her hands go to sleep. Could this recent development of numbness/tingling be tied to the removal of the MS-Contin? As for the continuing problem of the head pain, can you think of any way that an epidural blood patch might cause such a condition? I would appreciate any advice you can offer on how I should proceed in trying to find help for my wife.
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Richard,
To the best of my knowledge, there is no medically plausible connection between a blood patch and any of your wife's symptoms. It sounds as if she is suffering from a chronic pain syndrome, and such syndromes usually start off with some sort of somatic pain producing event, and are turned into self-perpetuating monsters via the continuous inappropriate use of narcotic analgesics such as MS-Contin, and other pain relievers, all of which will serve in the long term to perpetuate and even worsen the pain long after the original reason for it has vanished, by resetting the body's "pain thermostat" to extraordinarily high levels. From your desription of things, I would suggest in the strongest possible way that your wife seek a pain management evaluation and an accompanying chemical (narcotic in this case) dependency evaluation. There are few problems in medicine that will give you continuous symptoms for 5 1/2 years and end up being medically serious/life-threatening. Most major medical centers have pain management units, most often run by the department of psychiatry but sometimes by anesthesia or neurology departments. Your wife sounds like an ideal candidate for one of them. I hope she gets the help she needs. These types of problems NEVER get better on their own without such directed intervention and motivation on the part of the patient. Good Luck to you and her!!! Remember that information provided in the forum is intended for general medical informational purposes. The actual diagnosis and treatment of your wife's specific medical condition should be strictly in conjunction with her treating physician(s). We hope you find the information helpful.
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