Could my 'migraine' be related to old head injury?

[fliss]

Hi. I'm a 39 year old woman who suffers from reccuring 'headaches', well it's more like external preassure and numbness which radiates out from the base of the skull behind my right ear and spreads over the right side and into the right side of my face when bad. I have this every day to some degree. There are no clear days. I have days when it flares up and that is when the sickness starts. I can be sick hourly for up to 27 hours. Possibly longer, I stopped it through medical intervention (small pill disloved under tounge). Once sickness has passed I just fall into a very deep sleep. Normally however, sleep is very difficult. I dont seem to get a feeling of tiredness and can easily be awake at 3/4 in the morning. I am on Topromax to try to help the 'Migraines' at 75mg a day and this does induce a feeling of tiredness if I take it correctly but it's not great and I've found that my hair has started to fall out! There are no patterns to the bouts of sickness. Sometimes it happens when I'm really tired or under the weather, sometimes just before a period, sometimes not. About 3 years ago I was hit at close range on the right side of my head (in the position where the pain radiates from) by a football. It nearly knocked me out but I managed to stay concious, if a little dizzy. I had neck problems for a while due to the football incident. I also have an old shoulder injury on that side. where my shoulder meets the spine. I did have some pysio at the time but none since. I have seen a nurologist who dismissed the injury as being related to anything football and diagnosed Migraines. I did not have migraines befor the incident. He did send me for an MRI scan which thankfully came back clear. Could it be spinal? or perhaps nerval damage? Or is it just Migraine?Does anyone else have these symptoms? Thanks

[fliss]

Hi. My G.P had instructed a bood test (20th) to rule out any other cause than Topramax causing the hair loss. We discussed the possibility of trying other triptines after I've tried a few sessions with a chiropractor. I'm now looking into local chiropractors to choose a suitable one. Unfortunately I have had another attack. That afternoon, after seeing the doctor. Shorter and less severe. Some vomiting and blacking out inbetween but only for 12 hrs. But disapointing as I only had the last attack a couple of weeks ago. I'm trying hard to take my medication at regular intervals now and get to bed before midnight, even though I don't always feel tired. I'm also using the tracker to see if there might be a pattern of some kind? Doctor was vague when I asked about about testing for possible nerval damage. She said and I quote to the best of my recolection - "it is difficult as the nerves are so short and delicate and normally to test nerves they would need a start and end point to take a reading from. This would be a difficult area to test and I may never know the cause. Having said that, if the other triptines are tried and we still have no sucess maybe I could be re refered to the nurologist to enquire about the possibility of testing" Will wait for blood test and I suspect  it will not be anything untoward andI will be put onto a different triptine. I will let you know what that is and when I start chiropractor i will keep you posted as to it's progress. Here's hoping it's the x factor I'm looking for!

[Dr Santos]

Hi,
How was your appointment with your GP? Further tests as mentioned above may also help rule out other differentials including neurological causes for the numbness. Hope to hear from you soon!

[fliss]

Thank you.  To answer your question - The only other test was an external examination by the nurologist. This involved checking my eyes, reflexes and range of movement of head - as far as I remember but none of the othe diagnostic tests have been done. I've done a bit of research into Biofeedback Therapy too  and it sound interesting but, as you say I need to diagnose exacly what the root cause is first beforeI embark on any particular line of treatment. I've got an appointment with my GP next week to discuss. Interesting as I do indeeed get tingling in my hands and my face feels numb, sometimes my arm feels dead on the same side and I don't know if this is related but I've noticed that I have very little sensation in my big toes, particularly the same side, the right. I massage them daily to try to improve the circulation! Will keep you posted. Thanks again.

[Dr Santos]

Hi Fliss,
I wanted to ask at the start of my post if there were other diagnostic tests done aside from the MRI but it was deleted somehow. Further evaluation includes blood work-up, complete neurological examination and other diagnostics such as nerve conduction studies, electromyography, myelography, and other imaging studies (depending on the initial test results). Symptoms of hemiplegic migraine include one-sided  throbbing pain, pins-and-needles feeling, numbness on one side of the body (including the arm, leg, and/or one side of your face), weakness or paralysis on one side of your body, nausea, vomiting and sensitivity to light and sound. You can initially check with your GP and have a referral done to a neurologist first to rule out nerve issues. Take care always and feel free to write back if you have additional queries.

[fliss]

Hi. Thank you for your reply. It sound as though I need to find out what  type of further evaluation needs to be done? Are there specific tests to evaluate nerve damage? I assume I need to see the GP to ask and to get the ball rolling. In the mean time it sounds like Ineed to do some research on biofeedback therapy and Hemiplegic migraines as I don't know what either of these are! but it's good to know that there are other possible causes for constant headaches than a pure simple migraine. Would you suggest it worth my while seeing a chiropractor to rule out any spinal issues? I haven't done as yet for fear of making it worse, or are my fears unfounded? Thanks Fliss

[Dr Santos]

Hi,
How are you? Aside from IT is good that the MRI was fine. Post-Traumatic headaches which present as localized or generalized pain  can occur on daily basis and are frequently resistant to treatment. Possible treatment is by use of anti-inflammatory drugs or biofeedback therapy. Hemiplegic migraines are often associated with numbness also. To rule out neurological issues such as nerve damage, further evaluation needs to be done. Take care and do keep us posted.