Headache getting worse

  I'm 20 years old.  About a year and a half ago I started getting muscle tension headaches.  After getting a CAT-scan (which came out okay) my neurologist put me on nortripyline.  In the past 6 months I've started getting jolts of pain in my head.  They only last for a few seconds and they don't happen very often.  Also, it seems like it's getting harder for me to recall things I know.  I know I know it, but I just can't always get to the information.  It feels like there's a barrier blocking it.  Does this make sense?  Could the CAT-scan not have showed something?  
    Suzanne

[CCF Neuro[P] MD RPS]

_
Dear Suzanne:
Sorry to hear about your headache.  Just a couple of questions, first is there a history of cluster headache in your family.  Second, is the headache unilateral or is it all over your head (the jolting pain).  Do you get them at night in addition, to during the day.  Is there a flucuation in intensity, some moderate some severe.  Is there a sorenes to the area (in the painful areas) between the attacks.  I would revisit your headache specialist with the answers to these questions.  If the answers are mostly yes to these questions then you might have a rare form of headache called chronic paroxysmal hemicrania.  The good news is that this headache is very responsive to indomethacin.  There is also a type of headache that may fit your description called "idiopathic stabbing headache.  This disorder of headache has jolts and jabs of intense pain that last only for a few seconds at most.  This headache may occur alone or with other types of headache.  This also responds to indomethacin.  I would let your headache
specialist review this headache with your answers to my question and devise the correct medical management.  Good Luck.
Sincerely,
CCF Neuro[P] MD