Severe daily chronic headache - Please help

[786HC]

I have been suffering  from severe constant headache since October 2007. The pain was initially mainly on the crown area, feeling tight with sharp pain.

Other symptoms: Constant nausea, vomitting, reduced appetite, digestion problems, feeling very full after eating anything, bloating, unsettled stomach, regurgitation, dizzy spells, vertigo, vision cuts out occasionally (for a few seconds), lack of sleep and very disturbed sleep, some sensitivity to sound and light, occasional loss of balance, unable to focus on concentrate properly, not able to go out, need assistance in shower and generally feel weak and run down.

My GP initially diagnosed migraine and prescribed Co-codimal (for the headache) and Buccastem (for nausea and vomitting). The medication had no effect.

The GP then prescribed Zolmitriptan to take along with the above medication. The medication still had no effect.

My GP then referred me to yourself. You then diagnosed Chronic headache and prescribed Amitriptyline.

The medication made many of my symptoms worse and left me with some unpleasant side effects but did not give any pain relief.

The MRI scan revealed a slight abnormality at the back of the brain as you said, which you believe I have had since I was a child. He will do a further MRI in 3 months to check if there has been any change in this. If not, he will disregard it.

The Lumbar puncture results were clear but they made the headache alot worse and the pain has not subsided since. Felt alot tighter all over head and made head very very sensitive - cannot comb hair, touch head , lie on pillow or put any kind of pressure on head without it really hurting.

I was also an in-patient in hospital for 1 week due to the severity of the headache and other symptoms. The neurologist there diagnosed transformed migraine (Migraine transformed into a daily chronic headache).

The neurologist prescribed various analgesics (for pain - Including Brufen,Voltarol and Tramadol) and antiemetics(for sickness - including Cyclizine and Metachlorpramide) but failed to improve any of the symptoms. The medication made some of the symptoms worse and again left me with unpleasant side effects.

IV Morphine was the only treatment that slightly eased off the headache but left me with too many bad side effects. Morphine is obviously not a long term solution as It can lead to long term rebound headaches, addiction etc. and it only really numbs the pain for a short while.

I was discharged after a week and prescribed Tramadol, Nortriptyline and Prednisolone. The medication still had no effect.

I have since tried acupuncture, chinese herbal medicine and homeopathy. Nothing has helped so far.

Overally I feel the pain is getting worse and I really cant cope with it anymore. The lumbar puncture made it alot worse. It is causing so much pain and discomfort and I cannot function properly because of it. I am unable to focus or concentrate properly and go about my daily life or even sleep because of the severe pain. It is really affecting everything. The only times I have left the house since October is to attend appointments or go for a slow walk for which I need someone with me. I had to leave my work due to this. I really cannot express the severity and discomfort of the constant pain.

Pain and symptoms now:

Headache: Constant severe pain, very tight pressure all over head - feels very deep - not on surface, head is very sensitive - feeling of being bruised all over - any type of pressure, even light really hurts, stinging/burning sensation, some facial pain, increased pain and feeling of tightness in neck, shoulders and back. Very severe all day but can get more severe any time of the day.

Other Symptoms:Constant nausea, occasional vomitting, reduced appetite, digestion problems, feeling very full after eating anything, bloating, unsettled stomach, regurgitation, dizzy spells, vertigo, vision cuts out occasionally (for a few seconds), lack of sleep (only 5-10 mins here and there- no solid sleep at all), some sensitivity to sound and light, occasional loss of balance, unable to focus on concentrate properly, not able to go out - only for slow walks with Mum, need assistance in shower and generally feel very weak and very run down, getting very upset daily - unable to cope with the constant severe pain.

I can generally tolerate alot of pain but I cannot cope with this pain anymore as it is constant and very severe and nothing has helped with the pain. I am willing to try anything to get rid of or at least help with the pain. It has been 4 months+ now and it just seems to be getting worse both in severity and symptoms.

I am in alot of pain and your assistance will be much appreciated.

Many Thanks

H

[Abhijeet Deshmukh, MD]

Hello.

It is important to know what that abnormality is. Chiari malformation, by definition, needs some parts (tonsils) of the cerebellum to protrude out of the skull cavity through the foramen magnum. If this is not mentioned in the report, it may not be a Chiari malformation.

Have you discussed the possibility of a bilateral Trigeminal Neuralgia with your Neurologist ? It is rare, but might as well consider it. Tegretol helps a lot in TN.

Regards

[786HC]

The abnormality couldnt be a chiari malformation could it? Would this be pretty easy to spot/diagnose? The neurologist said he will disregard it if no change in 3 months. Should I be worried or it it normal to have small abnormalities without any problem? Is there anything I can do personally to help with the pain? I have tried all the obvious - cutting out trigger foods, no preserved food with additives, eating more fruit and veg and concentrating on drinking more water etc. And is there anything I should avoid doing which could be making it worse? What other checks should be done to rule out potential causes? Is there checks that can be done to check the digestive system? Would colonic therapy be a good idea? I was also considering seeing a chiropractor or osteopath for possible spine problems. I just want to find the cause so I can get rid of this horrible pain. I'm only young and I'm stuck in the house.

Appreciate your assistance

[Abhijeet Deshmukh, MD]

Hello.

To start with, you will have to consult an ENT specialist to rule out the Meniere's disease. Ask your Neurologist if he can give you a referral for this.

Keep on trying. You will soon get to the root of this.

Regards

[786HC]

MRI showed small abnormality in left cerebellar hemisphere, thats all i've been told.


Who can I ask to arrange those other tests? My doctor and neurologist dont seem to be much help, all they do is give me strong analgesics and opiates.

I obviously want to find the cause so I can be headache free, rather than trying to treat the symptoms and getting nowhere.

Please reply

Thanks for your assistance

[Abhijeet Deshmukh, MD]

Hello.

Have you thought of Meniere's Disease ? Most of the symptoms can occur in this. Even if the possibility is less, there is no harm in getting it ruled out. You will have to get an oto-neurological examination and an audiometry done.

Tension headaches can cause this tight band like sensation round the head. But all the other symptoms are not explained solely by tension headaches.

And what about the brain MRI report ? Can you narrate the report here ? Was there any abnormality seen (posterior part ? )

Regards