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Cause for severe headache spreading accross back and neck?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
User rating for this question
Excellent
Answered by

Neurologist
Practicing since : 1994
Answered : 5395 Questions
Question
Hi Doctor, I am having a complaint for severe headache since 2 months. Most of the times I get the pain only in the morning hours. Following are the characteristics of the pain 1) It starts emanating from back side of the neck/head. 2) The pain rises towards the center of the head. 3) When it gets severe the pain goes around the face, like eyes, teeth and sometimes nose also. 4) Since 4 - 5 months while only sitting in Car whther Ac/non-AC I am gettin nausea Regarding this on 28th December 2013 I have consulted Optician & ENT initially to rule out Eye or Sinus problem which might cause the pain. Since Optical and ENT was OK, I decided to consult Neurologist on the same day. The reports, prescription, CT Scan report, EEG report, Spine X Ray Report is attached in PDF "Dr's Report 28th December 2013". After starting with the medicines as prescribed I was facing extreme confusion, lack of being conscious sense of environment, following are the more specific characteristics: 1) Will find difficult to form sentence with the right word. 2) Will repeat the same sentence multiple times(Although I would become aware of this shortly) 3) Confusion, like addressing somebody with different name. 4) Activities has become very slow. 5) Confusion, forgetting the way to get back to home and getting stuck with a right or left question. After that I re-consulted the Doc, and was advised to stop Topirain 50 and Exzilor for 5 days, followed by which I needed to talk to him, whence he would have advised to restart the same with reduced dosage( half tab). As most of the medicines were Psychotic in nature and involves seizure and dementia, I was afraid and couldnot wait for 5 days and wanted a second opinion, thus I consulted another Doc today. The Prescription, report & EEG Scan for the same if attached with PDF file 'Dr's Report 6th XXXXXXX 2014' Unlike the earlier Doc, the advise of this Doc is totally different, and I was advised to stop all the previous Tabs. This Doc only advised 3 Tabs for me currently. So I am totally confused, following are my question: 1) What has happened to me, what is the name of the aliment. 2) How much confidence level you can attribute to the both the Doc's diagnosis. 3) Is the diagnosis based on the exact diseases, on only preventive. History: Borne a child on April 16th 2012. Thyroid in normal. Delivery is normal. Height: 5 Feet 3 Inches Weight: 74 KG Lifestyle: Works on corporate world, have to take care of Kid myself. Sometimes lack of sleep. Please help.
Posted Fri, 24 Jan 2014 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 14 minutes later
Brief Answer: My reply is below. Detailed Answer: Dear XXXX, Thank you for describing your symptoms in detail and asking for second opinion. Unfortunately, the two doctors' reports have not been attached here. I request you to re-upload them. Best wishes, Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist Apollo Hospitals, Hyderabad, For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar My blog: http://bestneurodoctor.blogspot.com/
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Follow-up: Cause for severe headache spreading accross back and neck? 5 hours later
PFA attached the reports
 
 
Answered by Dr. Sudhir Kumar 7 hours later
Brief Answer: My reply is below. Detailed Answer: Thank you for getting back, and uploading both the prescriptions. The first doctor (Madurai), has diagnosed migraine and started you on anit-migraine medications (topiramate and propranolol). These are preventive medications, which reduce the severity and frequency of headaches. Topiramate is also used for treating epilepsy. The second doctor (Bangalore) has diagnosed depression, and has started you on anti-depressants. Based on your symptoms, I would agree more with the first doctor. It is just that he started too many medicines and you had side effects due to that. It may be better to start on a single drug to prevent migraine headaches. The best medicine could be sibelium (flunarizine), or propranolol or topiramate (only one of them) and at the lowest possible dose. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
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Follow-up: Cause for severe headache spreading accross back and neck? 2 hours later
Hi Doctor, Thank you for your kind response. My aunty also have an Migraine head ache and she gets it in front. And i have a complain of getting the pain on back side. Is the Migraine head ache will be there anywhere in head or only in some parts of the head? Also, I have been suggested by the second doctor to take the below mentioned medicines. Sarotena -10Mg Synaptol SR 450 Can i also take Topiramate (Lowest Dosage) along with the below mentioned medicines?
 
 
Answered by Dr. Sudhir Kumar 7 hours later
Brief Answer: Thank you for getting back. Detailed Answer: Thank you for getting back with more information. The headache in migraine can be either in front or back of head or even the whole head. As I suggested, sarotena is used more for depression and tension, so, you can take it, as it is a small dose. Also, you can take topiramate 25 mg along with that. I hope it helps. Best wishes, Dr Sudhir Kumar MD DM
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Follow-up: Cause for severe headache spreading accross back and neck? 5 hours later
thanks for your prompt reply Dr. I have 1 more doubt Dr. After consulting with Dr. T.R. Gnaneswaran, D.R. XXXXXXX Gadre & with you, now I am a bit confused with the medicines. But first, a thing which I forgot to mention previously which might be important was: Dr. T.R. Gnaneswaran also suggested me to avoid few things like sour,cheese chocolates. Now my question is as you suggested to me to take medication of Migraine(Toprain 25mg). But how can I take this medicine without prescription. I am not sure as how this works with HealthMagic, but what if I want to produce your diagnosis as reference to my local Doc( Would like to show him), can I take a print out of our conversation, and will this be generally accepted. Since online consultation is a new thing, I am not sure how this works. Please help.
 
 
Answered by Dr. Sudhir Kumar 1 hour later
Brief Answer: Thank you for getting back. Detailed Answer: Yes, you are correct. Online consultation is for guidance and for second opinion. The medication can not be purchased from pharmacy based on this conversation. However, you can take a print out of our conversation on healthcare magic and show it to your doctor. However, the final prescription would be given by the doctor who has seen you in person (he may or may not agree with other doctors, including myself). For patients with migraine, headaches can get aggravated by certain food items, so, I would agree with the advice given by Dr Gnaneswaran. I hope it helps. I would be please to help you further if needed. Best wishes, Dr Sudhir Kumar MD DM (Neurology)
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