For the past several days I have been experiencing a sore neck with intermittent non localized severe head pain with nausea. Two days ago I felt very light headed and disoriented to the point of almost losing consciousness. 911 was called and I was treated and released from the hospital. Because I have seizure disorder and take dilantin, a CATSCAN was performed followed by a spinal tap. The results were clean. My Dilantin level was 11.
After my release about 6 hours later, there was really no diagnosis or treatment plan other than taking a magnesium supplement as my level was low.
This morning the pain and nausea are worse than ever and I am at my wits end as to what to do!! I have been taking 800 mg of ibuprofen, but they do little to help.
If anyone has any suggestions, they would be very much appreciated.
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.
Without the ability to examine and obtain a history, I can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.
The symptoms you describe are vague, but I will elaborate a little on neck pain and headaches.
Cervicogenic headache is a headache that is "referred" to the head from bony structures, muscles, and other soft tissue in the neck and shoulders. Symptoms are usually one-sided and include: precipitation of head pain by neck movement or awkward neck positions, head pain when external pressure is applied to the neck or occipital region, restricted range of motion of the neck, and neck, shoulder and arm pain. Treatment for cervicogenic headache includes physical therapy, medications, behavioral therapy, and other modalities.
Occipital neuralgia is caused by irritation or injury to two nerves that run from the upper neck to the back of the head. The irritation could be due to neck trauma, pinching of the nerves (by muscles or arthritis), and other causes. Symptoms include a piercing sharp pain that travels from the upper neck to the back of the head and behind the ears. It is usually a one sided pain but can be on both sides of the head. Treatment includes physical therapy, medications, and in some cases injections, "nerve blocks", during which a physician injects the irritated nerves with an anesthetic.
A concerning cause of neck pain associated with headache is a dissection: a small tear in the blood vessels that travel up the neck to the brain. This can occur spontaneously in people with certain conditions that affect the blood vessels, after neck trauma, or after chiropractic manipulation of the neck. The pain is often but not always associated with some sort of neurologic deficit as a dissection can often lead to a stroke. A dissection is diagnosed with a specific type of MRI test (MRA with fat saturation) or a CT angiogram.
Another potential cause of temple pain is inflammation or arthritis of the temporo-mandiublar joint, commonly called the TMJ. This can sometimes occur due to bruxism, biting down at night or during the day, and other stresses to the joint. This is best diagnosed/managed by an orthodontist or an ENT, and treatment includes braces and other dental fixtures and sometimes muscle relaxants, depending on the exact cause.
If you are older than the age of 55, one potential causes is called giant cell arteritis or temporal arteritis. This is due to an inflammation in the temporal artery and other arteries in the body. Symptoms include one sided headache pain in the temple and jaw that may be triggered by chewing. This condition can be diagnosed by a blood test called an ESR and a biopsy of the artery. It is very important to rule this diagnosis out as it is highly treatable and if left untreated it can lead to vision loss. It is exceedingly rare in people younger than 55, and is more common in even older age groups.
Without further information about your headache, it is difficult to provide you with adequate information. I suggest that if your neck pain/ headache persists and/or becomes more severe, and/or if you develop neurologic signs like weakness on one side of the body, slurring of speech, double vision, difficulty speaking, and so on that you be seen immediately by a doctor. If you frequently experience headaches or neck pain and are not finding relief, evaluation by a neurologist, and perhaps a headache specialist, might be helpful for you.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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