headaches

[nimi345]

i am 25 years old male, having headaches for the last 1 month along with confusion, irritability, dizziness and nausea
the nature of the headaches is such that they start after few mins i wake up and remain 24/7, at first it was throbbing in nature at my occipital region and i could pinpoint it , then after few days it shifted to left side and then right side and finally at my frontal region. my head feels heavy soon after i wake up in the morning and remains like that till evening,
i was also having trouble with my vision for the last 4 months, i am a myopic and wear glasses for the last 12 years. i stated to have difficulty focusing on moving objects especially while driving and difficulty concentrating. i went to many opthalmologists, had refraction may times and changed my glasses frequently but could not find relief.
when the headaches started i again consulted my ophthalmologist, he said that there is nothing wrong with my eyes and that the headaches are not due to the glasses
finally i consulted neurologist, he said that he thinks that the headaches are due to neck muscle spasm. he put me on tizanidine 1 tab twice daily and amitryptyline 1 tab at night and ibuprofen (SOS). i used it for 1 week my headaches got slight better but the nausea and confusion was still disturbing me also now i was having palpitations so i visited him again . he stopped amitryptyline and put me on clonazepate 5mg 1 tab at night and inderal(propanolol)20mg twice daily and tizanidine 2mg twice daily.he didn't advised any MRI or CT brain. i have been using this prescription for about 15 days now.i am not using any painkillers now ,just the above mentioned drugs and i am getting better. i feel good every day. its hard for me during the early hours of morning cause i still fell little confused, lack of concentration, heaviness in the head and the dizziness is still there but not that much
i want to know what is causing all these symptoms, is it tension headaches, cluster headaches, migraines, anxiety or depression.it could be anxiety or depression both because there is history of depression in or family and i have also suffered from acute depression many times but haven't taken any medicine for it, plus i am jobless for past 4 months.
please help

[nimi345]

can all this problem caused by sinusitis, i have done ST PNS(para nasal sinus)and it reports that i have right maxillary sinusitis with polyp at posterior wall

[nimi345]

thanks foe your views and suggestions
no i don't snore and i get full sleep of 8 hours daily and i don't have sleep apnea

[geminigirl1963]

I would also suggest having them check you for sleep apnea, especially since you say that your symptoms begin right after you wake up in the morning.  If you do have sleep apnea, your oxygen levels could be dropping too low at night, which can cause the headaches, dizziness, confusion, etc.  If you are diagnosed with it, you may need to use the CPAP machine or extra oxygen at night.

Do you snore?  Has anyone ever said that you stop breathing while asleep?

[nimi345]

i visited my neurologist again and he has advised me to continue the same treatment
i also visited ENT specialist as i am suffering from chronic maxillary sinusitis for the last 8 months which is not responding to antibiotics and other medications. he has advices me to do CT PNS(para nasal sinuses)without contrast.

[glogirl173]

GET a CAT scan or MRI of your head right away.............

[nimi345]

thank you very much for your views and suggestions, i am going to visit my neurologist soon and i will let you know about the progress

[Dr. Kokil Mathur]

Hi
Welcome to the MedHelp forum!
This could be a case of occipital neuralgia. This usually happens due to spinal nerve compression because of overuse of computers, work involving straining of neck, herniated disc, canal stenosis, bone disease, spondylosis, poor posture. You should have a MRI focusing mainly on C1-3 and also look at C1-2 instability. Along with this there could be a component of migraine too in the headache. Since you have a headache almost daily, what you have is in all probability not a simple migraine but a chronic daily headache (CDH). The CDH could also be secondary to trauma, raised intracranial hypertension, high blood pressure, temporal arteritis etc. If the headache lasts for less than 4 hours then it could be a chronic cluster headache or a chronic paroxysmal hemicranias. If it lasts for more than 4 hours it could be chronic tension headache, chronic migraine or altered migraine or hemicranias continua. Indomethacin is the drug of choice in hemicranias continua. In fact the diagnosis is considered confirmed if a patient responds to Indomethacin. Please discuss this with your neurologist.
Hope this helps. Please let me know if there is any thing else and do keep me posted. Take care!