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Having headaches, starting from eye and spreading to head. Done with eye test. What else could be the reason?

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I have been having headaches quite frequently for a long time now. They usually start from my left eye, towards left ear, through the back left side of the neck and then spread in the head. It usually follow this same trend. I got my eyes checked a couple of times but apart from some dryness (for which i use some tear drops) and minor number, they couldn't diagnose anything else. could you please help me out here regarding what could be the exact reason behind this. For some time now, the frequency has increased and my head feels quite heavy most of the time.
Posted Sat, 6 Jul 2013 in Headache and Migraines
 
 
Answered by Dr. Prasad 3 hours later
Hi,

Headaches are related to number of factors. Chronic headaches such as yours is common among many individuals in this century. Some more details can help me understand and address the problem better; therefore please answer the following questions:

- Is the headache localized to only left side or does it involve both sides?
- Can you describe the pain - is it a dull ache or throbbing in nature?
- Is there any factors that aggravates headache?
- Do you feel you are able to predict before you get the headache?
- Do you have nausea, vomiting, visual disturbances, nasal congestion, sorethroat or any other symptoms associated with the ache?
- Does headache lasts overnight?
- Have you been evaluated in the past for such headaches? If yes, may I know what test and treatment was given.
- Does anyone in your family suffer from similar headaches?

Please answer each of my questions and I can guide towards the right treatment.

Best Wishes
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Follow-up: Having headaches, starting from eye and spreading to head. Done with eye test. What else could be the reason? 36 minutes later
Hi Dr. XXXXXXX

Below are the answers to your questions..

- Is the headache localized to only left side or does it involve both sides?
It mainly involves the left side, but sometimes it spreads to right side as well, and in some rare occurrences, it starts from the right side. Also, since yesterday, something on the left of my forehead from left eye till above left ear starts to throb for a few moments. I stay still for that time and then it goes away leaving a heavy head.

- Can you describe the pain - is it a dull ache or throbbing in nature?
The pain is throbbing in nature, although my head feels heavy usually.

- Is there any factors that aggravates headache?
My eyes are dry and many a times when I dont have my tear drops, my left eye starts to pain and then it goes on as described before. Walking in the heat is a trigger sometime. Very crowded or noisy place, or listening to very loud music. Whenever i dont get a proper sleep, I almost always get headache (sometimes as soon as i wake up, and sometimes later during the day). Also, something between my shoulder and neck, when ever it is pressed, i get similar kind of pain towards my ear (mainly on the left side, but also on the right side)

- Do you feel you are able to predict before you get the headache?
I feel most of the times i can because i start feeling heavy on the head, pain in the eyes, sometimes nausea.

- Do you have nausea, vomiting, visual disturbances, nasal congestion, sorethroat or any other symptoms associated with the ache?
Above statement answers this question too. Though I do feel nasal congestion and uneasiness while looking at my laptop screen during aches. I feel like just closing my eyes and try to sleep.

- Does headache lasts overnight?
Dont really understand this question.

- Have you been evaluated in the past for such headaches? If yes, may I know what test and treatment was given.
Not exactly for the headaches, but as explained earlier, I got my eyes checked. Have a minor number, and wear spectacles (.75 and 1.5).

- Does anyone in your family suffer from similar headaches?
My mother gets headaches but that happens mainly when she has indigestion problems
 
 
Answered by Dr. Prasad 15 hours later
Hi,

This sounds like migraine to me.

Migraine is a type of chronic headache characterized by moderate to severe throbbing headache usually localized to one side and sometimes both sides associated with nausea, vomiting, etc. They are triggered by lack of sleep. Even fasting can be trigger. Sound and light would worsen the pain. I hope your symptoms match this description.

Severe cases of migraine can last for more than 24 hours. It could make a person sleepless. This is what I meant if the headache lasts overnight.

Anyway, as I am convinced that headaches are related to migraine, I'll proceed to answer your questions:

Migraine is caused by unknown reasons. It is sometimes could be familial - your mother had it, so you got it. Whatever the unknown reasons are, it is well known that lack of sleep, skipping meals, physical/mental stress, sometimes strong/pungent smell, infection, etc., can trigger the headache. It may be good idea to keep a diary and note down all the factors that you think may have triggered an episode of headache. Comparing the triggers and finding a common one will be the key to preventing migraine attacks in the future.

As far as medical treatment is concerned, acute painful episode is treated with pain killers. We have mild ones like paracetamol to stronger ones such as ibuprofen / diclofenac sodium / naprosyn, etc. Opioid drugs like tramadol and morphine are sometimes used to treat very painful episodes. Other than these usual pain killers, drugs like sumatriptan/rizatriptan can be helpful.
In addition to these, preventive drugs might be needed, when the headaches are very frequent.

To summarize
1. I think what you have is a migraine headache.
2. You can take care of it by using one of the painkillers as mentioned above. Note that, amongst the medications mentioned only paracetamol which is available in India as Tab. Dolo 650mg is over the counter. Others are prescription only medication.
3. Since the headaches are frequent, you will need a preventive drug that has to be taken every day until you do not get any more headaches. I suggest amitriptyline to my patients with migraine. Your doctor will know about this one.
4. Try to figure out all your triggers and avoid them. Keeping a headache diary is one of the methods to learn about your triggers.


I apologize for this lengthy answer. I hope you got my point. Let me know if you need clarifications.

Good luck!!
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