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Persistant right sided headache.
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Persistant right sided headache.

I'm a 28yr old female, 5ft 6in, 130lbs. W/persistant right sided head pain, behind ear. Progressively worse over the past year. W / WO Auroa, nausea, vomiting. Left arm tingles and goes numb. Some neck pain on right side. Pain varies in intensity. Use very little pain killers, because they only dull the pain. Saw a neurologist, who placed me on Atenolol 50mg, even tho my B/P is normally around 110/80. Done MRI Brain w/+w/o Contrast, Results = punctate T2 hyperintensities seen within the subcortical deep white matter in the upper left parietal region. Nonspecific and could represent chronic small vessel ischemic changes. Otherwise unremarkable. On the Atenolol B/P runs about 90/55, HR 55. He instructed me to NOT take any sort of painkiller, and if the pain gets to bad to go to the ER. While on the Atenolol, headache has improved. Despite side effects of dizzyness, weakness, tiredness, cold hands & feet due to the drug. My question is, does this treatment sound reasonable, and what does the MRI results mean for me? Thank you for your time and insite.
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Avatar_n_tn
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
   The symptoms that you describe are consistent with migraine headaches.  The MRI changes that you describe as well are often seen in patients who suffer from migraines and should not alarm you.  I agree with your neurologist that starting a preventative medication is the right thing to do.  The atenolol is not used for blood pressure is serves to prevent headaches.  However in young people, we tend not to prescribe beta-blockers (like atenolol) because of the unwanted side effects (mostly fatigue, but also poor exercise tolerability and lightheaded/dizzy feelings).  Fortunately, there are many migraine preventive medications to choose from, including Elavil, Topamax, Verapamil, Neuronitin, Zanaflex, etc. to name a few.  Topamax and Elavil are the two that I have had the most success with and I would encourage you to present these to your doctor.  It is important to not overuse painkillers (no more than 2 doses per week), because they can give you headaches (called rebound headaches).
I hope this has been helpful.
11 Comments
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Avatar_m_tn
your issues may be myofascial-- ie spasms/tightness/imbalance of neck muscles. do you work on a computer?- how's your posture? I know this sounds simple for a debilitating problem but before delving into serious complex things like white matter MRI findings as the cause you may want to consult with a myofascial specialist. look into John Barnes, sharon sauer. I'm not commenting at all on your MRI findings. Just beware that simply becasue something is found on a test that may not be normal, it does not mean that this finding has anything to do with your symptoms.
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Avatar_n_tn
Mike,

Can I get your email, would like to ask you some questions privately about MPS.  Thanks.
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Avatar_n_tn
Mike,
  Thank you for your post. I'll take that into consideration. Although, my posture is fine, and I barely have time to be at the computer. I work 40+ hours a week in a busy operating room, and I have two kids. I've been to a chiropractor, had accupunture, accupressure, massage, and electric shock therapy. Needless to say, despite many visits, there was little to no relief.
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Avatar_m_tn
etc---- ***@****
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Avatar_m_tn
***@****
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Avatar_m_tn
firstly, keep in mind that unless you have studied posture, you do not know that your "posture is fine". For instance,  try right now to stand back against a wall with your butt, backs of your feet, mid/upper back all against the wall. now, does the back of your head touch the wall?????  If it does not, you have forward head posture which is a major cause of upper back, head and neck pain. often w associated headaches and upper limb paresthesias. As a dentist who became diabled due to these problems, I studied this stuff for over a year, and once I learned what was wrong I fixed it myself after seeing dozens of MDs, accupuncturists, chiros etc. I'm not making a diagnosis of your case at all-- I haven't even seen you and besides I am not an MD. but what I can tell you is that it cannot hurt to see a myofascial specialist like John Barnes(Myofascial Release in Philly) or Sharon Sauer (Myopain center in chicago) and have your posture evaluated professionally. Check out Upper Crossed Syndrome on the net-- see websites by Erik Dalton and Jolie Bookspan. Do you lean over the operating table in the OR??? If so, your head during that time is not positioned over the spine.... what do you think keeps it from falling on the floor???? answer---- the very small and intricate muscles of the neck--when they go into spasm from being overworked they pinch the nerves that run thru them to your arms. Again I am not making a diagnosis-- just some food for thought and maybe some education for other readers.
Keep in mind also that if this is your problem, seeing doctors will probably not help. You cannot get better from this by lying on a table and having someone do stuff to you. It takes months and months of posture correction, trigger point release, and stretching/strengthening exercises. I got no results for 4 months of 3x per day 45 minute sessions. MY neck muscles were a mess. Ps-- did you say you do or do not get nausea/vomiting?
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178107_tn?1315951230
Have you ever had a MRI of the cervical spine?  Your symptoms sound a lot like mine before and still after having a two level cervical fusion.  I had herniated disks at C5-C7 and even after the surgery I still have a bulging disk at C4 and C5.  I am also on Altenolol.
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Avatar_n_tn
Hi there,

Over the last couple of days I have been getting a somewhat throbbing pain at the bottom right hand side of my head, it comes and goes, then the pain seems to effect my eye, it feels swollen and then it calms down, then it feels like the right side of my nose is stuffed and swollen, this all happens to the right side - I have no other pains just that. it doesnt feel like a headache just a throbbing pain. sometimes it would effect my ear also I havent been to the doctors yet; but just wondering if you had any idea what it could be.
Many thanks
Shell, Dublin  
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187193_tn?1199928423
Request a crevical MRI. You need the whole picture. Lois
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Avatar_n_tn
Hi.  I just found this forum, read your comments and thought my recent searches re: Chiari Malformation might be of interest to you.  Typical symptoms of Chari problems include one sided headaches that come and go and throb, pain radiating down arms, hands, tingling fingers, and a whole host of other things that can be attributed to compression in the brainstem area and interruption of cerebral spinal fluid flow.  Pain is "referred" -- showing up all over the body.  Folks with this often go years without accurate diagnosis.  Go to websites for The Chiari Institute and "wacma.org" for more info.  Is easily seen by neurologists who are familiar with Chiari (which most are NOT) viewing an MRI of skull base/upper cervical vertebrae.  Hope this is helpful.  The vast majority of doctors know nothing about this rare problem and will dismiss it as not contributing to symptoms.  Don't believe them without Chiari expert opinion and MRI.
Lynda
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