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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Headache, Pain Behind Eyes To Face. Diagnosed As Migraine. Opinion?

I have headaches - I have been diagnosed with migraines and at first I thought the diagnosis was accurate, however, now I have head pain almost daily, the pain starts behind my eye, goes down the side of my face and in to my neck. The migraine meds don't really work anymore and I just believe that a nerve is twisted or something, could that be possible? I just don't feel like this is migraine headaches that I am dealilng with. How do I urge my doctor to do some type of exploratory surger to go in and actually see what's happening in there?
Fri, 18 Oct 2013
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Addiction Medicine Specialist 's  Response
Hi,

It is possible for migraine to become chronic and cause pain every day, but if you feel that the character of headache has also changed, then it may be possible that some thing else is causing this pain. If it were nerve related, then the pain follows the distribution of the nerve, is often associated with numbness, tingling or paraesthesia and so, can be diagnosed from the history itself, without any need for surgical exploration. In my opinion, rather than urging your doctor for surgical exploration, you should tell him that this pain is different from the previous pain of migraine and ask him if it can be neuropathic. If your doctor concurs with this, he can prescribe medicines like pregabalin, gabapentin, carbamazepine etc which work well in neuropathic pain.

Hope this helps you. Best wishes.
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General & Family Physician Dr. Namala Bharadwaj's  Response
hello dear
thanks for your query at HCM
there are some set criteria for diagnosing case of migrane as following
Headache lasting 4 hours to 3 days (untreated)
At least two of:
1 Unilateral pain
2 Throbbing type pain
3 Moderate to severe in intensity
4 Motion sensitivity (headache made worse with head
movement or physical activity)
At least one of:
1 Nausea/vomiting
2 Photophobia/phonophobia
3 Normal examination and no other cause of headache
this is simplified ciriteria.
check yourself weather your symptoms belong in here .
if not fitting in to any of these criteria other possible causes for headache have to be ruled out and further investigation might be needed.
also get visual examination done most of the times visual abnormalities causes headaches.
regards
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Headache, Pain Behind Eyes To Face. Diagnosed As Migraine. Opinion?

Hi, It is possible for migraine to become chronic and cause pain every day, but if you feel that the character of headache has also changed, then it may be possible that some thing else is causing this pain. If it were nerve related, then the pain follows the distribution of the nerve, is often associated with numbness, tingling or paraesthesia and so, can be diagnosed from the history itself, without any need for surgical exploration. In my opinion, rather than urging your doctor for surgical exploration, you should tell him that this pain is different from the previous pain of migraine and ask him if it can be neuropathic. If your doctor concurs with this, he can prescribe medicines like pregabalin, gabapentin, carbamazepine etc which work well in neuropathic pain. Hope this helps you. Best wishes.