i never used to get headaches, but over the last few months i had this headache that keeps coming back and now is constant. it wont go away when i take paracetamol. my left pupil is now also gone larger than my right, and my left leg often has spasms. occasionaly when these headaches is at it's worst, i find it hard to keep my balance and feel sick, but have never actually been sick. Please can you advise me on what this might be.
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 your doctor.
Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your 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. Primary headache disorders are much more common than secondary ones. There are several primary headache disorders. For example migraines, which usually a pulsating throbbing one-sided pain with nausea and discomfort in bright lights that lasts several hours. Tension type headaches are another type.
Your headache may very well be a primary headache disorder, but the finding of an enlarged pupil and leg weakness could be significant, indicating a secondary headache disorder (though in some primary headache disorders, such as a type of headache called cluster headache, pupil changes can occur. In 20% of people, there is some asymmetry between pupils as well).
Without further information about your headache, it is difficult to provide you with adequate information regarding your headaches. It is important for you to understand that if you have not experienced headaches in the past and you are now having new head pains, seeing a neurologist is a good idea, just to make sure there is nothing serious causing this pain, particularly since you report the pupil changes and leg weakness. Imaging of the brain and sometimes then neck may be indicated depending on your exact symptoms, your physical examination, and other factors.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
GB removed in 5/09. In June, thought I had bilateral shin splints from trying to get back into exercising as every time I did, both calves hurt and hips and buttocks as well. At the end of June had bilateral calf pain, which I went to the ER for. Told I had hyperreflexia, + Hoffman and clonus. MRI of my brain (normal) MRIs of my back showed cervical bulging, herniations indenting cord at T5-6 and T2-3 with L5-S1 bulge with annular tear. I had 4 EMG/NCVs with the first on July 2/09 showing mild right carpal tunnel, the 2nd on July 16 showing polyphasic with normal motor recruitment in extensor hallucis longus consistent with mild L5 radiculopathy. 3rd done at John hopkins on 07/28/09 of 3 extremities was normal. 4th done 9/1 of 3 extremities and was normal. Skin biopsy for neuropathy and spinal tap were normal. Blood work normal. During this time pain I had in my calves had moved up my body with severe bilateral leg burning and tingling, I thought I would go in sane. I developed horrible burning groin and rectal pain with pain on bilateral buttocks and underneath & diminished sensation when having to use bathroom. Toes go numb and tingling when I sit at all. For 2 months I have had widespread muscles twitches in legs, feet, hands, face, back, chin arms & abdomen. Hands very stiff and neck is very sore. I think I see atrophy in my feet and hand, but am not sure. Three neurologists said I dont have ALS. My symptoms getting worse I am terrified. I saw 4 surgeons who said the leg symptoms could be from the T5-6 herniation but not arms. I have facial tingling and it will feel tight. I know ALS is not sensory and I try to keep that in mind as this exacerbation started with the bilateral pain. When flex my feet I feel pins and needles in big toes. Have pins and needles in feet on bottom when I walk. I am going to go to the Mayo clinic because I dont know where to turn. Does this sound like ALS or my back? I had aches and pains before and I remember that several months before this I felt like muscles were tight, but I thought it was from exercising. I am scared I have ALS and it is just too early for it to show on EMG.
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