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Posted By La Dorna Goff on November 21, 1997 at 05:17:15:

Dear Sirs:
I have had a debilitating headache since March of '96.  The headache has been
constant since that time.  Although it does vary in intensity, it never
goes away.  The headache manifested after a severe blow to the head when
I fell down while rollerblading.  The pain has cost me a job, teaching
assistantship, a normal life, and has delayed my career plans. The headache
mostly affects the right side of my head except when the pain gets above
a level 8 (on a scale of 10) at which point the left side will begin to
hurt in the same pattern as the right.  That pattern involves extreme
pressure in the back of the head and severe, sharp, stabbing pain through
the head, temple and over the eye.
I have had numerous tests including a head and neck MRI and lumbar punch.
All were normal except for a slight reversal of the cervical lordosis. I
have an MRA scheduled in January of '98. I have no problem in accepting
that this headache may simply be a migraine but I feel that it is important
to know if it is a vasco-dialation or vasco-constriction problem.  Am I
correct in assuming that the MRA will determine the vascular condition (and
rule out or confirm a Basilar Artery Migraine)?  Also, I have had extensive
psychological testing done (through a Pain Clinic) which turned out quite
normal (they say I am a perfectionist who has a tendency to want to please
authority).  Otherwise, it indicated that I have a strong support structure
and I do not test out as depressed although I must admit that my physical
condition does discourage me and, at times, I do get depressed because
of my new limitations.
Secondly, after much discussion with several doctors, I believe that another
aspect of my headache is due to an irritated occipital major/minor nerve.
The pain is so bad that I would opt, if the option were avaliable, to
permenantly block the nerve.
I am currently also bothered by excessive night sweats where sweat rolls
off my entire body (chest, arms and legs).  I typically sweat through my
night clothes, sheets, and blacket.  However, even though I am sweating
to that degree, I get very cold (but still continue to sweat).  
Another symptom which I feel is related to my headache is that I have
developed severe motion sickness to the degree that driving my own car
makes me nauseated as well as sudden turns or movements when I walk. I
am a graduate student with a 4.0 GPA but as of March of this year, I became
unable to read due to motion sickness and pain associated with
movement of my right eye.  
In September I had an episode which no one has been able to classify.  
Since February I had been having these sweats and dizzy spells and, finally,
in September, I experienced some sort of attack which left me in severe
tremors, loss of hearing, loss of ability to walk, weakness in arms and
legs, level 10 headache, and inability to speak coherently or form or
recall words.  This "attack" lasted approximately a week and felt like
a seizure or stroke although I did not lose consciousness. Although, the
"attack" finally ended, I have no memory of the months of August and
The pain is very bad.  The doctor allows me to take Vicodin but it does
not help.  I'm also on:  Tofranol 100mg, Zoloft 50mg, Verelin 240mg,
DayPro 1200mg, and Cytotec 400mcg and I am still unable to lead a normal
or quality life.
My apologies for the long note but I felt the background was necessary for
my questions.  First, what is the difference between a neurologist (I've
seen four), a headache specialist, and a pain care center (I've seen two)?
Secondly, does my condition sound like anything you may know of?  Do you
know of any way to stop this cycle of pain so that the preventive treat-
ment could work?  Should I be concerned with the vascular nature of the
headache?  In terms of abortive treatments (which I haven't had any), what
is available that could stop this pain?  Any insight you could give would
be greatly appreciated.  Further, although I live in Arlington, TX,
my family and I will gladly travell to wherever to stop this pain and get
back to a normal life.  I would be very willing to make my medical records
available to any physician or clinic which you believe would be able to
help me.
Thank you.
LaDorna Goff
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