Very chronic tension-type headache with confusion, dizziness

[Dbran4024]

Greetings-- 28 yr old male, good health record,  I have been diagnosed with a chronic tension-type headache "with some unusual features" as my neurologist put it.  

Extensive blood tests normal.
CT brain w + w/o contrast...  negative
MRI brain w + w/o contrast... 4 cm lesion suspected fibrous dysplasia adjacent to right orbit with evidence of internal trajeculation (brain compression)
MRI c-spine  w/o contrast only...   mild-moderate upper-mid level spondylosis
MRA brain and neck   w/o contrast only...  negative
EEG... no seizure activity but slowing of Delta waves is noted
No spinal tap done yet

Inderal, Topamax, Lexapro,have been no help.

Headache has been constant, unchanging, for 6 months strait, with tension in forehead, and muscles on top of head extending into the back area.   Constant swolen turbinates with no evidence of sinus inflamation (inflammation), the swelling goes down during cardio-vascular exercise and shortly thereafter, only to come right back.

THE WORST SYMPTOM "BY FAR" I have is feelings of confusion.  Quite literally feel like I am breathing high doses of nitrous oxide (dental- happy gas).

Also I have random spells of constant, violent dizziness that is normally much worse in the lying-down position.   This dizziness lasts for as long as I am lying down, it does not get better or subside over a matter of minutes or even hours,  but only gets better when I sit or stand back up.

Would it be a good idea to get a formal opinion from the Cleveland Clinic by sending my films and records in? Cant really afford, but if it would help..

[CCF-Neuro-M.D.-PW]

With all your negative scans (the fibrous dysplasia probably is not related to your headache), the chance that a second review will help is low, but I cannot tell you this for sure - I cannot tell whether sending your information in will help or not. An actual physical visit to our headache center (or another specialized headache center) is probably the best way to deal with the problem and to identify medications to avoid and which might help.

Good luck

[Dbran4024]

Yea, I thought it might have been due to the injury too.    The thing that makes me wonder though is that my back or neck don't hurt now, my back straitened out on its on in a weeks time and then this headache and confusion developed;  first the headache, then a month later  i started feeling like i was breathing dental happy gas all of the time,  very scary feeling   and disabling,  people don't understand how this effects me and think i'm crazy

[Dbran4024]

PS-  I also have a peculiar "squishing" sound coming from the base or my head or upper neck when I move my head around that was never there before.    About a week before this all started, i had a very stiff upper back that constantly needed "cracking"   this was caused by a weight-lifting incident where I pulled my back in a strange way while working out.    don't know if this is relavent.

[missmellie]

cetainly sounds like this is due to the injury to your back, go see an orthopedic or neurologist.  Headaches can be caused by cervical injury.  good indication is when you say you lay down and it is worse.  good luck

[missmellie]

HI AGAIN
WHEN I WAS 15 I INJURED MY BACK, DIDN'T GO TO THE DOCTOR, JUST GOT UP AND WENT TO SCHOOL, FELL ON BLACK ICE, HAD TO GET THERE I WAS TAKING MY FINALS AT SCHOOL.  TWO YEARS LATER I WAS AN APPRENTICE HAIRDRESSER, I GOT UP OUT OF BED AND COULDN'T WALK. THE THING IS I DID RECOVER FROM FALLING ON MY BACK, BUT UNKNOWNST TO ME I WAS WALKING AROUND WITH A RAISED HIP. WENT TO DOCTOR, MY MUM HAD TO GET A TAXI AND HELP ME INTO THE DOCTORS, THEY SEND ME UP TO THE HOSPITAL AND TAKE X RAYS.  WHERE THEY DISCOVERED THAT WHEN I FELL I HAD RAISED THE HIP WHICH CAUSED THE LOWER BACK TO CURVE AND A DISC TO HERNIATE.  TWO YEARS I WALKED AROUND FEELING LIKE I WAS WALKING ON WOODEN LEGS, I HAD SCIATICA, JUST DREADFUL PAIN.
I ALSO HURT MY NECK WHEN I WAS 15, ALL AROUND I WAS A RIGHT plo**KER,  20 YEARS DOWN THE ROAD, I AM GOING TO THE DOCTORS BECASUE THEY THINK THAT I MIGHT HAVE MS.  THE THING IS THOUGH I DON'T KNOW BECAUSE I HAD THAT INJURY SOMETIMES I HOPE THAT ITS THE INJURIES.
I HAVE NUMBESS IN MY FACE, HEAD, ARMS HANDS, LEGS AND FEET, ALL ACCOMPANIED BY BURNING AND A COLD SENSATION THAT GOES ACROSS MY FOREHEAD.  I AHVE PAIN IN MY LEGS. I HAVE MEMORY FOG.  VOCAL CORD DYSFUNCTION, FOOD GOES DOWN MY WIND PIPE INSTEAD OF GOING TO MY STOMACH.

ONE THING THAT YOU SAID ABOUT FEELING AS YOU HAVE BREATHED IN DENTAL GAS STRIKES A NOTE WITH ME, YOU COULD BE HYPERVENTILATING WHICH CAN BE QUITE NORMAL WHEN YOU ARE ANXIOUS, HOW IS YOUR BLOOD PRESSURE, IF HTIS IS LOW YOU CAN GET THOSE FEELINGS. IF SO INCREASE YOUR WATER INTAKE, AND MODERATE SALT INTAKE IS GOOD IF IT IS LOW.
I CERTAINLY WOULD GO AND SEE A DOCTOR, DO YOU AHVE A FAMILY MEMBER WHO COULD GO WITH YOU IF YOU ARE HAVING A BAD DAY OR WRITE DOWN YOUR SYMPOMS TO GIVE TO THE DOCTOR AS SOMETIMES MENTAL FOG OR JUST PLAIN STRESS CAN MAKE YOU FORGET EVERYTHING ONCE YOU STEP INTO THE DOCTORS OFFICE, IN ENGALND WE CALL IT WHITE COAT SYNDROME. WELL ANYWAYS GOOD LUCK AGAIN GO SEE SOMEONE,WHEN IT EFFECTS YOUR EVERYDAY LIFE IT AIN'T FUN

[Dbran4024]

I too have been short on breath.   Not when I walk up stairs or whatever, but just sitting or laying around it feels like I can't get a refreshing breath of air.  Sometimes I wake up when Im about to fall asleep thinking i'm drowning or something.   Sort of feels like I have "dead lungs"  like there's no air to blow out, and the lung capacity isn't what it used to be.   I don't smoke anymore and exercise frequently.   However lately i have gained about 25 pounds since i started feeling ill I haven't been quite as active.   But i dont know if that's it or not.  I hope so.   next thing I'll be pushing for a lung MRI.  Doc allready thinks I'm obsessive about my health but its only because I truley feel very ill.

[Mother Margaret]

What has been going on differently these past 6 months?  Are the red blood cells small sized?  Is there blood in urine?  There is a common cleaning/degreaser product, also in paints, etc that can cause headaches & fatigue  like CFIDS

I was looking for which gland causes rise in blood sugar ... & checked this thread http://www.medhelp.org/forums/neuro/messages/30314a.html

I suspect the harm they were talking about in this thread could be from a chemical which causes CFS, CFIDS, FM ... www.valdezlink.com/pages/foryourdoctor.htm#for would be signs of direct exposure

Notice info on this link ... that glyconutrients are helpful ...

Check these things for 2-butoxyethanol harm http://www.valdezlink.com/pages/questionnaire.htm

It can cause severe headaches ... I think the nutritional guidelines of researcher Roger J. Williams in which trials for many autoimmune issues are now ongoing ... would be hope for help:  glyconutrients.  Check the nutrition topic, this forum

[lmroswell]

I get a lot of headaches.  Some are tension headaches and some I would call migraines.  It doesn't take much to set off a tension headache for me, and when I get either type I can't think straight.  Another thing, besides your injury, you might want to consider are rebound headaches, which you can get from taking certain medicines for pain and headaches.  Hope you feel better soon.

[no_hands]

dbran - regarding the squishing neck, I advise the following. Place a few pillows behind you and sleep upright for two nights and try not to stretch your neck too much. It may just be me, but since I've had my problems I've found this gets rid of the tension and squishing in my neck.

I don't think you should worry about your lungs. Headaches, dizziness, confusion all sound like an issue with your upper neck and you probably caused this from the weights.

I'm 27 and did 75 pushups 3 months ago and have been suffering ever since. After a week I couldn't sleep flat and my neck squished. I had extreme lathargy that hasn't disappeared and every few days I wake up to a small popping sound in the back of my head, upper neck. On bad nights, I wake up to something actually sounding like a squirt due to pressure (something rupturing?). I also find if I lie flat I wake up to a pulpatating heart after a couple of hrs. If I sit up most symptoms subside. Had MRI's of neck and head and they cannot find anything wrong but each time I hear the squirt, 12 hrs later I just want to sleep and then 3-4 days later I'm ok again. My Neuro is baffled but I think a Angiogram my tell all.

Our symptoms aren't exactly the same but it sounds like you have strained something in your neck that is slowing down blood flow and causing you to feel dizziness etc. The thing is, when I ask people if I have a bleed they say "impossible, you'd be in pain and in hospital". I'm not in much pain at all, just sooo tired.

Also, be weary of anxiety. I don't believe I'm suffering from it because I "hear" popping sounds which tells me it can't be mental, however if you went into this injury worrying about the headaches (which were likely just due to the back injury), then you could have set the whole chain of events off and once anxiety starts, it doesn't simply switch off. Not saying that's what you have, but have a think about it.

[Dbran4024]

I found the following excerpt.   Due to the fact that my symptoms have been constant for so long and constant, I probably assume that if this is the case, that I have Basilar artery thrombosis and not the migraine (see the differential diagnosis below).

I hope the doctor who answers my questions scrolls down and reads this...I would certainly like to know if my MRA would have shown any thrombosis of the Basilar artery!

The following is courtesy of:  
http://www.usdoctor.com/sym2.htm

BASILAR ARTERY MIGRAINE

Many patients with a specific form of complicated migraine, basilar artery migraine, are often misdiagnosed in the ED because basilar artery migraine is manifested by several neurological deficits. The headache is characteristically severe and paroxysmal[11], and occurs predominantly in females during adolescence and the third decade. The diagnosis can be established by the presence of any three of the following symptoms: 1)bioccipital headache; 2)impairment or loss in the temporal and nasal fields of both eyes; 3)Disturbed oculomotor function, such as diplopia or nystagmus; 4) Dysarthria; 5) Vertigo; 6)Tinnitus or impaired hearing 7)Ataxia of gait; 8)Bilateral paresis; 9)Bilateral paresthesia; or 10) Altered consciousness, such as amnesia, confusion, somnolence, stupor or syncope.

Due to the variety of symptoms, basilar artery migraine may be confused with a mental disorder, brain tumor or drug abuse. Differential diagnosis includes tumors of the posterior fossa, thrombosis of the basal artery or cerebral veins, cerebellar hemorrhage or infarction, drug intoxication, or metabolic disorders. It is essential that the emergency physician obtain a history of similar headaches in the patient or in the patient's family. Once the diagnosis is established, treatment with standard migraine prophylactic agents is recommended; and the patient should be referred for follow-up care.

[Dbran4024]

Specifically, I wonder what the treatment for partial thrombosis would be?  Is there even a treatment?    What about the smaller blood vessels the MRA cannot detect?    Should they be ultra-sounded, or a conventional x-ray angiogram be preformed in that case?      

This is merely speculation on my part - but if the blowflow is turbulent due to partial thrombosis, that could cause the squishing sound when we move our heads around?    

Wow I've been reading alot of past posts, and I see this same undiagnosed problem  very similar alot.

I can be reached at ***@****   for anyone who wishes to talk about this more.  I am more than happy to  hear from you.

[Med Help]

It is against the rules to post copyrighted information in an Med Help forum. However, it is OK to post a link (URL) to information.

Med HElp International

[pd245]

Confusion/dizziness, swollen turbinates - you may have allergies, an inner ear infection, a sinus infection.

If it hurts lying down and the headaches started after weight lifting, perhaps you tore something in your spine (spinal membrane, meninges).

These are just alternate possibilities