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8 week plus headache, normal MRI
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8 week plus headache, normal MRI

My fiancée has had a headache since around the middle of November. it started as a nagging mild headache and then in one incident flared up into a headache with symptoms similar to migraine, including blurred vision, facial numbness on the left side, and photophobia. elitriptan gave her some relief the first time, but then failed to work again. barbituates and hydrocodone give her some relief, but cannot eliminate the headache. topamax made her headaches much more severe and the severity decreased markedly the first day after she stopped topamax, but was still there. NSAIDs and antihistamines do not provide relief or abate the symptoms. She has no history of migraines and neither does anyone in her family. She stopped birth control after roughly 3 weeks of the headache, and this has had no impact one way or the other. Her CT and MRIs were normal. Switching to a tyramine/nitrate free and discontinuing alcohol consumption have had no effect. The headaches seem to be worst when she wakes up, but on bad days the severe pain lasts all day. on good days her pain is a 1 or 2 but does not go away. The pain and numbness are localized to the left side of her face at or above the eye orbital. The numbness is general on the left side of the face while the pain typically has a smaller focus that varies, usually either the eye, above the eye, the ear, or in between the eye and the bridge of the nose. occasionally she is more sensitive to her hair being pulled. The blurred vision has worsened in the last few days after a few weeks of steady improvement, and keeping a headache diary hasn't revealed any obvious triggers. She isn't taking any medications other than hydrocodone when the pain is most severe. Her balance seems unaffected, though lately her sense of smell is less acute. She occasionally has mild to moderate nausea, but hasn't vomited other than one day when taking the highest dose of topamax. She had some neck stiffness early on but that has subsided. Her bloodwork was normal and she is not pregnant. She has had torn discs in her lower lumbar region last year, but is not currently experiencing back pain unless she sneezes, and then in the lower back. Any thoughts at all would be appreciated, we've stumped a few doctors already.

Brian
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1041839_tn?1278685446
Hi! I'm sorry she is going through all of this. You said the mri was normal, but what did the report say exactly? If you didn't get a report I would suggest that you or she get a copy of the mri and report and any other tests and keep these. Also, were her hormone levels checked? There are a lot of things that could be going on but it would be interesting to see what the mri report said. I'm sorry i dont have anymore insight for you. Blessings, Shannon
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Avatar_f_tn
Hi. Some of her symptoms sound like the one's I've been having. I had 4 tears in the dura(which is a sheath that surrounds the spine) in the lumbar area. The cause for me is unknown, but back surgeries, injuries, and even sneezing hard can cause tears. This causes Cerebrospinal Fluid to leak. When it leaks it lowers Cerebrospinal fluid pressure. The CSF is the cushion for your brain, so when it's low your brain sags. This can cause a wide variety of symptoms. Headache is the most common and numbness is also a known symptom. You should research Intracranial Hypotension and CSF leaks. This might not be your answer, but it sounds like a definite possibility.  Good Luck! I hope she feels better soon.
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1093617_tn?1279305602
Thank you for your question. Although without being able to examine her I can not offer you the specific advice on diagnosis and treatment that she needs, but I would try to provide you some relevant information about her health concern.

Generally, one sided headache with associated other symptoms like dizziness, numbness could be suggestive of migraine. Triggering factors could be different foods such as cheese, chocolate, alcohol and even few fruits. Other factors that may induce your migraine attack may be contraceptive pills, stress or depression, bright lights, loud noise and traveling. The mainstay of the migraine treatment is always to identify the triggering factors and to avoid them.  Few women experience headache more commonly during the time of their menstrual periods & at the time of hormonal imbalance. I would suggest careful record of events that have proceeded with the attack and avoid those factors. In addition, try to rest in a dark & quiet room, meditate, have a balanced diet and avoid taking unnecessary drugs. Even then if she suffers continuous headache, please arrange an appointment with a neurologist right away who will evaluate the further underlying disorders by clinically examine you & ordering MRI or CT scan here that may be the main reasons of your migraine attacks and can provide you an appropriate treatment. Hope this information proves helpful to you.

Take Care & Regards!!!


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