Re: migraine headaches

Posted By CCF Neuro MD on July 06, 1997 at 12:09:09:

In Reply to: migraine headaches posted by cheryl on June 24, 1997 at 20:08:43:








I have been diagnosed with migraine and tension headaches.  I usually have a headache every day of my life.  Some are much worse than others and seem to build each day until I reach a point of it being absolutely unbearable.  My usual headache is a pressure feeling  in the frontal and R parietal area, this is usually constant then I will have episodes of a very sharp, stabbing pain in my R parietal area that is very intense and it will stop me in  my tracks.  With these headaches I am forgetful, confused, blurred vision, light sensitive at time, noise sensitive and occasionally nauseated with no emesis.  I was hit in this region of my head  in sept 95, by a confused patient, I had a black eye for about 6 weeks.  Approx. 6 months later is when I started with these headaches.  Do you think this could be related and could this be serious.?  I had a cat scan done in july 95 which was negative.  I have no further diagnostic workup other than assessment in the neurologist office.  I am so afraid there is more to this.  My headaches are getting must worse and much more frequent.  I currently take calan sr 240 mg 1 1/2 tabs qd and effexorer 75 mg 1 1/2 tabs bid, this  was increased just 2 wks ago, I had been on 240 mg and 75 mg bid since the end of March.  This past weekend after  having a headache for about 7-9 days each day getting a little worse finally by Friday it was unbearable.  I went to the er where I was given compazine ivp with  a slight relief and the reglan ivp ( I don't know the dose of either), but i did get reasonable relief from the reglan and was sent home.  I was exhausted the whole weekend and had experienced the feeling of a build up of lactic acid in my arms and legs with  walking or carrying of items. prior to the er visit.  Is there  something more I should be doing , is there someone else I should see.  Is there any investigation study's that I would maybe a candidate.?  I am desperate for relief and and to be assured that the dx I have in proper. It is affecting my job and my family.  I feel my whole life is  revolving around how bad my headache is one that day. Thank you.




Hello, Cheryl,
  It sounds like you have a mixed type of heahaches with a strong flavor of migraine.  As you may know, the classic migraine usually has its onset at childhood, adolecent (adolescent) years or early adulthood.  A typical episode is oen that has iits onset soon after awakening, followed by visual changes such as flashing lights and zigzag lines, then evolve into an one sided headache.  However, a lot of people do not have thier migraines as this "classic".  This poses a great deal of difficulty in diagnosis and management.  
  Despite the fact that migraine is a relative difficult condition to control clinically due to its recurrent nature, the increased frequency of your headaches in the face of long term preventive medication is concerning.  Furhter investigation may help to differentiate from other conditions such as vascular malformation or arteritis.
  Given the rather complicated history, in my opinion, you will benefit the most from a comprehensive evaluation at the referral center.  This is exactly what we can offer at the Headache Center at Cleveland Clininc Foundation.  We will thoroughly investigate the cause of your headaches and work with you until we find a treatment program that helps. Please call toll free [phone] ask for ext. 5665 or local [phone].  Hope to see you at the Clinic soon.
  This information is provided for general medical education purposes only.  Please consult your primary physician for the diagnostic and treatment options of your specific condition.