Is it a migraine?

[stacy76]

I have had a headache/migraine almost constant since october of 08.  I have seen a PT, family doctor, and a neurologist.  My neuro doctor keeps calling them migraines but I have no "typical" migraine symptoms.  All of the pain is in the occiptal area and very low on my skull sometimes going across the right side of my head into my right eye.  I wake up with it and go to bed with it.  It does go in waves throughout the day but never fully goes away.  I have had a negitive head CT and a "normal" cervical MRI.  I am on my 4th or 5th medication and having little to no positive results.  Could it be that it is not a migraine at all.  I also have some issues with my blood pressure when bending over and standing up and my normal blood pressure is usually about 95/66.  I also feel like my heart is beating very fast of skipping a beat about once a day but can not pin point what causes that.  I am not very old and want to have more kids so I need to get to the bottom of this and my doctor seems to just want to keep trying medications.  Not sure what else to do.

[DrNoopurMD]

Hi,

Yes, I would suggest you to increase your salt intake and do deep breathing exercises every day. There is also a possibility that your symptoms could be due to generalized anxiety disorder. It would help to seek a second opinion. Thanks

[stacy76]

I have not been checked by a doctor for postural hypotension but often (not all of the time) when I go from squat to standing or if I am bending over reaching something off the ground and stand up I will have increased pain in my head or see spots.  When I was on one of the medications my doctor put me on I would have to hold on to stuff because my vision would black out.  But it quickly goes away.  I have also had difficulty with pain in my rib/sternum joints.  My neuro and regular dr are not at all looking at my BP they said low is good.  My head hurts less if I am standing or moving around it drives my family nuts.  If I am driving or sitting watching a movie or laying trying to go to sleep the head ache increases.  Currently I am on Klonopin and not sure how long to wait until I can say it is not working.  Should I push looking into the BP more?  I do drink alot of water, eat no red meat, am not over weight, all my labs are "normal" but I do not eat very much salt.  I do not salt an of my food.   Should I try and get a second openion from a different neurologist?  Thanks for you input.

[DrNoopurMD]

Hi,

While you do not have typical symptoms of migraine, your present symptoms still indicate a migraine variant. However it is important to rule out sinusitis, since your CT is normal, this is also very unlikely.
It would help if you can elaborate on BP issues. Do you suffer from postural hypotension? In this condition there is sudden fall in BP when standing from a sitting position. Headaches can be caused by both high and low BP and your BP is on the lower side. I would suggest you to maintain your fluid and salt intake throughout the day and makes sure you raise your lower limbs while lying down. Hopefully these measures will help alleviate your symptoms to some extent. Thanks