cervicogenic headache

[ajg33]

Hello all,
I have been dealing with headaches since christmas. i started with a "cluster headache cycle" and now have a different diagnosis with hemicrania continua. went to my headache specialist and we are in between the hemicrania and cervicogenic headaches. Does anyone suffer from cervicogenic headaches? Any input would be appreciated!
thanks
anthony

[Dr Santos]

Hi Anthony,
Thank you for your updates. If your headaches respond to Indomethacin, then the chance of hermicrania continua is likely. However, like any other medications, this can have side effects such as  dizziness, vomiting, diarrhea, constipation, constant feeling of the need to empty the bowel,  ringing in the ears and even headaches. Indeed primary headaches such as tension headaches can have associated tightness of the neck. Make sure that you try to avoid stress. It is great to hear that acupuncture is working for you. Continue with this complementary and alternative medicine because it does not have any side effects. I also would like to add that NSAIDs such as indomethacin may lead to a higher risk of heart attack or a stroke. Talk to your doctor about this. With regards to another specialist in South Florida, I'm afraid I can not help you with that aspect. But you can always ask for a referral from your primary physician. Take care always.

[ajg33]

Hello Dr Santos!
When I spoke to my headache specialist here in south florida named Dr Wheeler in Miami ,after seeing him on this past mon for the second time I spoke to him last night and he really believes I dont have cervogenic headaches and still believe's I have hermicrania continua! As for the Indomthacin I am on I do get relief but someday's I still get uncomfort in my right side of my head where I had my cluster headaches at Christmas till a month ago! question, do you think it's "normal" even on the indomethacin to get some uncomfort some day's? Not major pain just not a "normal feeling head! Also I get an uncomfortable feeling in the back right side of my neck slight spasm like tight feeling along with my right trapezius sometimes more than other's? My specialist said that migraine/cluster patience experience alot of neck and shoulder discomfort! Sorry for the long post but feel's good to have your expert opinion/dignosis! Also I went for accupuncture today for the 3rd time and she treated the affected area of my neck and shoulder and feel's really good! Would be great to find another migraine /headache specialist here in south florida I live in ft lauderdale and would be great to see another specialist in person if you know of any?
thanks again for listening!!
look forward to hearing from u!!
Anthony

[Dr Santos]

Hi Anthony,
How are you? Indomethacin provides immediate relief for hemicrania continua. If you do have a positive effect from this medication, then the chances of this diagnosis is high. Otherwise, you may need to have injections or nerve block for your cervicogenic headache. If you have relief from your chiroprator, continue doing so. And do keep us posted if the pillow is effective so it can also benefit other members of the forum. Take care always. Warm regards.

[ajg33]

Thank You for the response!
The way you describe the symptoms is exactly what I experience! I was diagnosic with hemicrania continuaa few weeks back! I am thinking its cervongenic headache because the hedache starts when i lay down in an awkward position ans if i sleep too propped up with my neck bent! I bought a temperpedic pillow yeasterday we will see! I am seeing a chiropractor on a regular basis, is this good for these headaches? i am also taking indomthecin 50 mg 3 times a day. thanks again and look forward to hearing from you
Anthony

[Dr Santos]

Hi,
How are you? Was there a previous history of head trauma? Cervicogenic headache is a controversial form of headache arising from structures in the neck. It is a unilateral fixed headache that presents with non-throbbing pain that starts in the neck and spreads to the front. Attacks of neck/head pain may be worsened by sustained neck movements or stimulation of  tender points in the same area. Diagnosis of cervicogenic headache can be made based on the criteria established in 1998 by the Cervicogenic Headache International Study Group. This usually responds to an appropriate nerve block. Differential diagnoses of this condition include hemicrania continua, chronic paroxysmal hemicrania, occipital neuralgia, migraine and tension headache. Medication and  invasive, surgical-based therapies may be indicated. Limited evidence suggests that therapy with repeated injections of botulinum toxin type A may be the most safe and efficacious approach. Discuss this with your doctor. Take care and do keep us posted.