Aa
No one can find an answer..
I am a 26 year old female. I am 5'4" and just under 200 pounds. While prenant with my 2nd child (who is now 18 months) I started getting headaches and frequent SEVERE migranes. I thought they would stop once he was born but they have only worsened and added symptoms. I now continue to have daily headaches, I have the severe migranes once every week or two and I have some loss of periferial(?) vision (possibly due to low lying lids) in both eyes, severe dizziness and motion sickness, and shortness of breath. I have been to several doctors, a neurologist and a neuro-opthomologist and no one has any answers. They have also done an MRI and CAT scan on my head but nothing showed. I was hoping someone on here might have a new idea. Thank you so much for your time.
MEDICAL PROFESSIONAL
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.
There are several causes of headaches. Headaches can be divided into primary and secondary. Primary headache disorders are headaches without a direct cause. These are diagnosed after secondary causes have been excluded. Secondary headache disorders are due to an underlying problem, there are many many causes but some include medication side effects, systemic illness, nervous system infection, tumors, bleeds in the brain or clots in the veins of the brain, and others. A normal MRI as you mention you had above excludes several of the secondary causes of headache, but not all of them.
In a woman who is above normal body weight, benign intracranial hypertension, also called pseudotumor cerebral, or idiopathic intracranial hypertension, is a diagnostic possibility. This is a disorder characterized clinically by headaches and vision loss, and sometimes tinnitus (ringing in the ear that is synchronous with the pulse). Dizziness may also be a symptom. The headache is usually global (all over the head) and pressure-like; the headache presentation can be variable. BIH predominantly occurs in people who are overweight, women, and those taken specific medications such as retin-A (the acne medication), vitamin A, and tetracycline antibiotics.
This disorder is best diagnosed with a test called lumbar puncture (also commonly known as a spinal tap) which measures the pressure of fluid around the brain and spine.
Opthalmologic evaluation is recommended in someone suspected of having this disorder. The finding of papilledema implies increased pressure of the fluid around the brain (called cerebrospinal fluid), causing the optic nerve (the nerve to the eye) to be swollen. Prolonged pressure on the nerve can lead to vision loss, so if papilledema is present for prolonged periods (days to weeks), vision and visual fields should be closely monitored.
An MRV, which is like an MRI but for the veins of the head, is sometimes indicated in patients with IIH to ensure the cause is not narrowing of the veins in the head or clots in the veins causing the headaches.
The treatment of IIH is usually with medications to decrease the amount of fluid around the brain, and these are mainly diuretics though other medications are also used. Patients who do not respond to medications or who have vision loss require procedures to relieve the cerebrospinal fluid pressure or at least the pressure around the nerves to the eye (to prevent vision loss). If a problem with the veins in the brain (cerebral venous stenosis is found), treatment for this may be indicated as well.
If this disorder is not suspected by your physicians based on imaging and other tests, and you are felt to have migraine disorder, then an appropriate medication regimen should be sought. In treating chronic headaches such as in yourself, the treatment should include two types of medications: preventative therapy and abortive therapy. Preventative therapy is a medication that would be taken every day regardless of whether or not a headache is prevent. This type of medication is used to prevent headaches from occurring, and there are several types including but not limited to beta blockers such as propranolol, calcium channel blockers such as verapamil, and others including topamax, depakote, elavil, etc. A lot of these medications were invented for other uses and are used not only for headache but also epilepsy and depression. They have proven very effective in preventing headaches. The second medication is abortive, meaning it is used when a headache is coming on. The medication used depends on the nature of a headache. If it is a migraine type headache, a group of medications called triptans can be used. And so on. However, with frequent use of abortive medications including triptans, tylenol, advil, and others, medication overuse headache occurs. This requires a specific treatment in which the over-used medications are slowly stopped and replaced with more long-acting medications. Tylenol with caffiene, fiorinal, or even just advil and similar medications, can cause medication overuse headache if used too frequently. This is a common cause of chronic severe headaches such as in yourself.
Evaluation by a headache specialist (a neurologist specialized in headache disorders) is recommended.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
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.
There are several causes of headaches. Headaches can be divided into primary and secondary. Primary headache disorders are headaches without a direct cause. These are diagnosed after secondary causes have been excluded. Secondary headache disorders are due to an underlying problem, there are many many causes but some include medication side effects, systemic illness, nervous system infection, tumors, bleeds in the brain or clots in the veins of the brain, and others. A normal MRI as you mention you had above excludes several of the secondary causes of headache, but not all of them.
In a woman who is above normal body weight, benign intracranial hypertension, also called pseudotumor cerebral, or idiopathic intracranial hypertension, is a diagnostic possibility. This is a disorder characterized clinically by headaches and vision loss, and sometimes tinnitus (ringing in the ear that is synchronous with the pulse). Dizziness may also be a symptom. The headache is usually global (all over the head) and pressure-like; the headache presentation can be variable. BIH predominantly occurs in people who are overweight, women, and those taken specific medications such as retin-A (the acne medication), vitamin A, and tetracycline antibiotics.
This disorder is best diagnosed with a test called lumbar puncture (also commonly known as a spinal tap) which measures the pressure of fluid around the brain and spine.
Opthalmologic evaluation is recommended in someone suspected of having this disorder. The finding of papilledema implies increased pressure of the fluid around the brain (called cerebrospinal fluid), causing the optic nerve (the nerve to the eye) to be swollen. Prolonged pressure on the nerve can lead to vision loss, so if papilledema is present for prolonged periods (days to weeks), vision and visual fields should be closely monitored.
An MRV, which is like an MRI but for the veins of the head, is sometimes indicated in patients with IIH to ensure the cause is not narrowing of the veins in the head or clots in the veins causing the headaches.
The treatment of IIH is usually with medications to decrease the amount of fluid around the brain, and these are mainly diuretics though other medications are also used. Patients who do not respond to medications or who have vision loss require procedures to relieve the cerebrospinal fluid pressure or at least the pressure around the nerves to the eye (to prevent vision loss). If a problem with the veins in the brain (cerebral venous stenosis is found), treatment for this may be indicated as well.
If this disorder is not suspected by your physicians based on imaging and other tests, and you are felt to have migraine disorder, then an appropriate medication regimen should be sought. In treating chronic headaches such as in yourself, the treatment should include two types of medications: preventative therapy and abortive therapy. Preventative therapy is a medication that would be taken every day regardless of whether or not a headache is prevent. This type of medication is used to prevent headaches from occurring, and there are several types including but not limited to beta blockers such as propranolol, calcium channel blockers such as verapamil, and others including topamax, depakote, elavil, etc. A lot of these medications were invented for other uses and are used not only for headache but also epilepsy and depression. They have proven very effective in preventing headaches. The second medication is abortive, meaning it is used when a headache is coming on. The medication used depends on the nature of a headache. If it is a migraine type headache, a group of medications called triptans can be used. And so on. However, with frequent use of abortive medications including triptans, tylenol, advil, and others, medication overuse headache occurs. This requires a specific treatment in which the over-used medications are slowly stopped and replaced with more long-acting medications. Tylenol with caffiene, fiorinal, or even just advil and similar medications, can cause medication overuse headache if used too frequently. This is a common cause of chronic severe headaches such as in yourself.
Evaluation by a headache specialist (a neurologist specialized in headache disorders) is recommended.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Also, forgot to mention. I never had a spinal tap however. When going to the neuro-opthomologist I was only but through a field vision test, and they dialated my eyes to check something inside. It was most like a normal routine eye exam but with more intensity it seemed like.
Thank you so much for that very helpful resonse. This illness you are mentioning is actually the reason I was sent to the neuro-opthamologist (sp) it was thought with most certainty by my doctor and neurologist that this was infact the situation. However, after seeing the neruo. It was concluded that I do not have this disorder and I am now back a square one. Unfortunately there seem to be no other leads for a direction to an answer on this. Any other ideas? Thank you again so much
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