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Pressure in head - what is this?
My 17 year old daughter has been sick since Oct. of 2007, she had a few months of vertigo caused by a virus that attacked her vestibular nerve. Well she is recovering from but about 2 months ago she started to feel severe pressure in her head, like it is being squeezed or that her head is going to explode. In seeking the cause of the vertigo we saw an ENT, 2 neurologists, endocrinologist and had a brain MRI and CT Scan. All normal. Also extensive bloodwork, all normal. But the"pressure' in the head persists and is ruining her life. Is this migraine? Why wouldn't it be detected by a neurological exam? Anyone have any advice? It was also suggested that she may have anxiety, but she has been to 2 mental health professionals who state she does not have anxiety. Thank you so much for any input/advice.
Hi Jae01.
I really wish you and your daughter the best. She is so young to be having such painful symptoms. That must be very hard for you.
With my daughter being much older (almost 18) of course the docs are going to bring in the emotional/psychological side of things. High School senior, all that stress, boys, etc, etc, etc. But as I have said in the past, she is not a high anxiety or stressed out kid. Actually the opposite, really laid back. So we have been going the route of trying "relaxation" aids for her to help with the head pressure - accupressure, she was going to start yoga.... and then today the neuro said , No! what she needs is 4 days a week of good aerobic exercise to relieve the tension. So we will try that and see.
Please update me on your daughter's progress. And again, I hope everything turns out alrright.
I really wish you and your daughter the best. She is so young to be having such painful symptoms. That must be very hard for you.
With my daughter being much older (almost 18) of course the docs are going to bring in the emotional/psychological side of things. High School senior, all that stress, boys, etc, etc, etc. But as I have said in the past, she is not a high anxiety or stressed out kid. Actually the opposite, really laid back. So we have been going the route of trying "relaxation" aids for her to help with the head pressure - accupressure, she was going to start yoga.... and then today the neuro said , No! what she needs is 4 days a week of good aerobic exercise to relieve the tension. So we will try that and see.
Please update me on your daughter's progress. And again, I hope everything turns out alrright.
My daughter is actually underweight. But she has pain in her eyes, dizzy spells then she has really blurry vision. We saw the neurologist but that didn't prove much. We will be trying to go somewhere else. She tends to be on sort of a cycle. She goes into the hospital for several days, gets pumped with IVs and antibiotics and is fairly good for 2 to 3 weeks and it starts all over again. She has begun to have severe headaches again so I assume the cycle is beginning. Her pediatrican said this is rare in children but it can happen. I read something online about a 14 year old that also had this condition. If I were you, I would just watch your daughters progress and if you do not notice her getting better just be persistant. That is exactly what I am having to do now. Not because her Dr. doesn't think that something is wrong but the specialist just haven't found it yet. Everyone in the hospital that saw her could agree that something is wrong with her but didn't know what. I believe to rule out many things a lumbar puncture is the only option left.
hi again jaed01. This appears to be a condition primarily in obese young women. Is your daughter overweight? My daughter is not, nor has she had any vision problems or pain in her eyes. Good luck to you too.
jaed01,
does your daughter have any vision problems? We saw a neurologist today and he said she has classic tension headache symptoms.
does your daughter have any vision problems? We saw a neurologist today and he said she has classic tension headache symptoms.
My daughter has had a lot of the same symptoms although she is just six. She has seen several specialists and also had an MRI, MRV and CT Scans. Her pediatrician believes that she may have Psuedotumor Cerebri. The only way that this can be detected is to have a lumbar puncture. Good luck.
MEDICAL PROFESSIONAL
Hi,
Yes, I do understand how you feel. If it may help, I have seen some patients improve with alternative medicine. Some patients request referral for alternative medicine specialists to supplement their medical therapies. You may want to look into acupuncture and reiki (japanese palm healing). You may also want to discuss with your physician if you may be referred to a nutritionist just to look into your child's diet. A diet of vegetables and fruits and good exercise may help. My point here is that, illnesses may not be only explained by organic factors. A person has to be treated holistically. A vacation or a change of environment may even help. If your child is cooperative ,she may want to engage in relaxation exercises like tai chi. Wellness has to be emphasized here especially if a psychological cause is being considered. You may want to look into this.
Constant communication, affection and understanding not only from you but from other members of the family are also very important.
Yes, I do understand how you feel. If it may help, I have seen some patients improve with alternative medicine. Some patients request referral for alternative medicine specialists to supplement their medical therapies. You may want to look into acupuncture and reiki (japanese palm healing). You may also want to discuss with your physician if you may be referred to a nutritionist just to look into your child's diet. A diet of vegetables and fruits and good exercise may help. My point here is that, illnesses may not be only explained by organic factors. A person has to be treated holistically. A vacation or a change of environment may even help. If your child is cooperative ,she may want to engage in relaxation exercises like tai chi. Wellness has to be emphasized here especially if a psychological cause is being considered. You may want to look into this.
Constant communication, affection and understanding not only from you but from other members of the family are also very important.
Vanessa, I really appreciate your responses. As far as the neurologist consult, as I stated in my original post my daughter has already been seen by 2 neurologists, so this is really a "third" opinion. The first neuro she saw it was more for the dizziness/vertigo. The 2nd neuro was in an emergency room visit (this was at Boston Children's Hospital, so I have every confidence their exam was complete). This is more to pursue the migraine avenue.
We do communicate regularly, but lately that communication has revolved around health issues and how good/bad she is feeling that day. She is very "hyper-focused" on her health. As far as other issues in her life.... no significant changes at home, at school well she is a high school senior and this did start during the college application process but she is a great student and got accepted to every college that she applied to but one (she was waitlisted there).
I am really worried about not getting her the psychological help that she needs, but don't know where to turn. I am afraid Psychiatrists will just try to medicate, while psychologists/therapists may not be able to understand if her physical symptoms are real or somatic.
We do communicate regularly, but lately that communication has revolved around health issues and how good/bad she is feeling that day. She is very "hyper-focused" on her health. As far as other issues in her life.... no significant changes at home, at school well she is a high school senior and this did start during the college application process but she is a great student and got accepted to every college that she applied to but one (she was waitlisted there).
I am really worried about not getting her the psychological help that she needs, but don't know where to turn. I am afraid Psychiatrists will just try to medicate, while psychologists/therapists may not be able to understand if her physical symptoms are real or somatic.
MEDICAL PROFESSIONAL
Hi,
Does your daughter have any other associated symptoms like change in bowel movement, bloatedness, change in the appearance and caliber of stools, frequent burping , vomiting?
A psychologic component should only be considered when all possible organic or physical conditions have been ruled out. In your daughter's case there seems to be no organic focus at this point since examination results came back normal. A psychological cause seems to be a primary working diagnosis while further work up is being done.
Anxiety disorders are not the only disorders that may present with somatic presentations. There are certain classes of somatic or somatoform disorders and each of these follows a criteria before a diagnosis is made.
Let us wait for the neurologic consult. Continue to assure your daughter and communicate with her. At the age 17, we are all vulnerable and there may be some unknown stressors that may be causing her conditions.
Are there any significant changes at school or at home that may be contributing to her condition?
Does your daughter have any other associated symptoms like change in bowel movement, bloatedness, change in the appearance and caliber of stools, frequent burping , vomiting?
A psychologic component should only be considered when all possible organic or physical conditions have been ruled out. In your daughter's case there seems to be no organic focus at this point since examination results came back normal. A psychological cause seems to be a primary working diagnosis while further work up is being done.
Anxiety disorders are not the only disorders that may present with somatic presentations. There are certain classes of somatic or somatoform disorders and each of these follows a criteria before a diagnosis is made.
Let us wait for the neurologic consult. Continue to assure your daughter and communicate with her. At the age 17, we are all vulnerable and there may be some unknown stressors that may be causing her conditions.
Are there any significant changes at school or at home that may be contributing to her condition?
Thank you again. We are scheduling a neuro visit. As far as this being a psychological disorder....does one just default to this diagnosis if nothing medical can be found? I also did not mention before as this is a migraine forum, that she suffers from chronic nausea and stomach upset. Has lost 12 lbs. Endoscopy was normal. So between the head pressure and the stomach upset/nausea, she pretty much has something going on all the time.
Her primary care doctor believes the symptoms are somatic. How can we get a firm diagnosis of this. As I said previsously a psychotherapist and a neuro psychologist both stated they did not feel anxiety was the issue.
Her primary care doctor believes the symptoms are somatic. How can we get a firm diagnosis of this. As I said previsously a psychotherapist and a neuro psychologist both stated they did not feel anxiety was the issue.
MEDICAL PROFESSIONAL
Hi,
A lumbar puncture is usually indicated if an inflammation of the brain covering called meninges is being considered. That is lumbar puncture is used to diagnose meningitis. This may present with fever, vomiting,increased sensation of head pressure, and neck stiffness just to name a few.I believe there is nothing like this in your daughter's case.
"Agents used in abortive migraine therapy treat the intensity and duration of pain, as well as the associated symptoms. New treatment options have been developed, including such newly approved medications as sumatriptan. Sumatriptan is a very effective agent that has joined the ranks of other effective abortive migraine treatments, such as ergotamine, dihydroergotamine, and nonsteroidal anti-inflammatory agents, as well as narcotic analgesics. "(http://www.ionchannels.org/showabstract.php?pmid=7911231).
An underlying anxiety or psychological disorder may still be a differential however.A neurologist is the best person to consult with regards to headaches.
A lumbar puncture is usually indicated if an inflammation of the brain covering called meninges is being considered. That is lumbar puncture is used to diagnose meningitis. This may present with fever, vomiting,increased sensation of head pressure, and neck stiffness just to name a few.I believe there is nothing like this in your daughter's case.
"Agents used in abortive migraine therapy treat the intensity and duration of pain, as well as the associated symptoms. New treatment options have been developed, including such newly approved medications as sumatriptan. Sumatriptan is a very effective agent that has joined the ranks of other effective abortive migraine treatments, such as ergotamine, dihydroergotamine, and nonsteroidal anti-inflammatory agents, as well as narcotic analgesics. "(http://www.ionchannels.org/showabstract.php?pmid=7911231).
An underlying anxiety or psychological disorder may still be a differential however.A neurologist is the best person to consult with regards to headaches.
Thank you for replying. I will answer your questions in order.
The sensation of pressure is constant, sometimes very mild and not that noticable, sometimes very very bad.
She has an appointment with an opthamologist this week... one of the only professionals she has not seen yet. A lumbar puncture was not done..... what would indicate the necessity fo this?
What are abortive or preventive migraine medications? She was prescribed ativan for anxiety and meclizine for the dizziness and nausea.
Nothing relieves the pressure, the only medication she has been given for this is the ativan for anxiety. And that doesn't seem to help.
Nothing in particular seems to aggravate her symptoms, she can be relaxing at home on the couch watching TV and it will get bad, or she could be in school and it will get real bad.
Is a neurologist the best doctor to diagnose migraine or other forms of headache that this could possibly be?
Thank you so much for any help.
The sensation of pressure is constant, sometimes very mild and not that noticable, sometimes very very bad.
She has an appointment with an opthamologist this week... one of the only professionals she has not seen yet. A lumbar puncture was not done..... what would indicate the necessity fo this?
What are abortive or preventive migraine medications? She was prescribed ativan for anxiety and meclizine for the dizziness and nausea.
Nothing relieves the pressure, the only medication she has been given for this is the ativan for anxiety. And that doesn't seem to help.
Nothing in particular seems to aggravate her symptoms, she can be relaxing at home on the couch watching TV and it will get bad, or she could be in school and it will get real bad.
Is a neurologist the best doctor to diagnose migraine or other forms of headache that this could possibly be?
Thank you so much for any help.
MEDICAL PROFESSIONAL
Hi,
How is your daughter?
Is the sensation of increased pressure still present ?
Her scans and blood tests were all normal. I suggest that she has a complete examination by an ophthalmologist just to rule out any eye involvement. To further evaluate her case, was a lumbar puncture done? Was there any indication for this?
When all examinations have been performed and they showed within normal results, migraine headaches and tension headaches may be differentials.
Has your daughter been managed with abortive or preventive migraine medications?
If yes, did these in any way relieve her symptoms?
What relieves her symptoms aside from given medications?
What aggravates her symptoms?
How is your daughter?
Is the sensation of increased pressure still present ?
Her scans and blood tests were all normal. I suggest that she has a complete examination by an ophthalmologist just to rule out any eye involvement. To further evaluate her case, was a lumbar puncture done? Was there any indication for this?
When all examinations have been performed and they showed within normal results, migraine headaches and tension headaches may be differentials.
Has your daughter been managed with abortive or preventive migraine medications?
If yes, did these in any way relieve her symptoms?
What relieves her symptoms aside from given medications?
What aggravates her symptoms?
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