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Suggest treatment for head pressure - Online Doctor Chats

Date : 07-Apr-2014
User rating for this question
Very Good Posted in: Headache and Migraines
Answered by

General & Family Physician
Practicing since : 2002
Answered : 106 Questions
User:I have been having head pressure for four months. wraps around my head and gets worse with movement (i.e. turning head, etc.) I also feel pressure in my ears that comes and goes. I've been to two neurologists and have had two MRIs which are clean. I started neurontin two nights ago. I'm slightly dizzy and tired. This morning I experience momentary numbness on the left side of my mouth. Last week I was in the Caribbean and had two episodes of numbness around my lips. It only lasts for less than 5 minutes. I was wearing bug spray at the time and attributed it to that but I'm not wearing that today as I am back in the U.S.
when the numbness occurs, I can still move my lip - it just feels numb. I'm concerned about stroke and wondering about a nerve impingement of some sort (or a neuralgia??) that is causing both the head pressure and this?? thanks.
Doctor:Hi
User:hi
Doctor:Give me a moment to read your query
Doctor:ok I have read your query
Doctor:It seems that you may be experiencing transient ischemic attacks that are not evident on MRI
User:are they evident on CT?
Doctor:It usually happens when the blood supply to a part of brain stops for a moment
User:what should I do?
Doctor:If the area supplied is small then it may not be evident
Doctor:Actually a thorough neurological exam is needed within 2 hours
Doctor:also ct scan and other tests are needed within 2 hours
Doctor:carotid artery imaging can also be useful
Doctor:Do you have problems with vision?
User:no - my eyes aren't great but i'm not having any vision trouble
Doctor:There is another possibility
Doctor:That the nerves of face are getting affected by some virus
Doctor:Do you get throat infections when you are having numbness of face
Doctor:?
User:no
Doctor:ok
Doctor:Do you get herpes infections?
User:i think i had facial numbness many many years ago which went away after awhile - they attributed it to allergies
User:I haven't
User:i do get parasthesias and have for 15 years
User:tingling, twitching, hot/cold sensations
Doctor:ok
Doctor:Another possibility if Migrainic hemisyndromes
Doctor:In which migraine like headache is accompanied with one-side numbness of face
User:yes -
Doctor:So these are the three possibilities I can think of
User:in the past two years I have had four ocular migraines with auras.
Doctor:ok
User:the new neurologist says that makes me more prone to a stroke - thus my nervousness
Doctor:Does this headache feel like the nigraine you have had?
User:my head does not hurt at this moment -
Doctor:ok
Doctor:I meant the one with numbness and the one with aura feel the same?
Doctor:From your history it seems that you are having migraine with associated perioral numbness of facial numbness
User:i never got a "headache" with the auras - just the aura itself. I'm not having a "headache" right now - just the brief numbness that passed.
Doctor:ohk
Doctor:Does propanolol work for you?
User:is that neurontin?
User:I don't think I've taken propanolol
Doctor:ok
Doctor:neurontin is gabapentin
User:ah
Doctor:Maybe you can try propanolol to see if it works for you
Doctor:If it does then it is migraine
User:i will ask. i assume i should contact my neurologist and tell her about the numbness?
Doctor:To rule out any chance of future stroke you may get a carotid imaging done
Doctor:Yes you may
Doctor:Carotid artery may sometimes become narrow due to plaque deposition and may lead to such symptoms
User:ok
Doctor:It should be done within 2 days
Doctor:Do you have any doubt
Doctor:?
User:i'm nervous about it all -
Doctor:There is no need to be
Doctor:If it is migraine it can be controlled with medicines
Doctor:If it is transient ischemic attack then attaempt canbe done to remove the plaque
User:yes - i've had multiple stress tests this past year which have been fine. Just wore a holter monitor which was fine and have a scheduled echocardiogram coming up.
Doctor:ok
Doctor:This is a good sign
Doctor:that tests are normal
User:yes
Doctor:so mostly it seems like migraine
Doctor:Let us see
User:migraine is weird. it's weird that you can have symptoms (aura, ear stuff, dizziness) and not have pounding
Doctor:Yes it is possible
Doctor:Even perioral numbness is a part of migraine
User:so very strange
Doctor:I know
Doctor:All part of this world
Doctor:Anything is possible when it comes to health
User:so weird. i've had chin pain on and off for the past year and next week have a root canal starting.
Doctor:You may adopt some lifestyle changes
User:yes
Doctor:Like drinking pure water
User:(bottled?)
Doctor:and exercising for 20 min a day
Doctor:It will improve your health
User:yes - the exercise has been difficult with the head pressure
Doctor:reverse osmosis technique
User:but i know i have too
Doctor:you can try yoga
User:yes
Doctor:it does not cause rushing of blood
User:true
Doctor:ok
User:doc suggested stationary bike. wants me to get my serotonin up
Doctor:You also need to avoid triggers
Doctor:ok
Doctor:Trigger can be something like surprise news etc
Doctor:You need to keep your calm
User:easier said than... ;0
User:;)
Doctor:I know
Doctor:Yoga will help with that
Doctor:It is done by controlling your breath
User:i will start. i've also started some meditation
Doctor:which helps control emotions
Doctor:good
User:thanks doctor
Doctor:learn it in a 5 day course and then you can practice at home
Doctor:ok
User:yes
Doctor:Thanks for consulting
User:i'm using an app
Doctor:ok
Doctor:Take care
User:thank you
Question is related to
Diseases and Conditions
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