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Suggest Treatment For Headaches And Chronic Migraines
Question: I am a 65 year old male. I begun having headaches at age 31. Most Drs. say they are vascular or vascular tension. I have a history of getting some long headaches that can last from one week to 3 months daily.
I would say the severity is a 2 on a 5 scale..noticeable but I continue on with regular activities, Can start on both sides but generally ends up on right side of head into cheekbone…a little burning at times…my neck feels tight and massage helps for a short period…food helps for short period…shower helps for short period. My last MRI was 2 years ago nothing but a very small pituitary tumor that no Neurogist feels has any bearing on headaches…say I may have had it for long time. My last drs appt one week ago…normal neuro…headache same pattern as priors…tried Pregnsdone and Reglan…didn't abort…just tried nasal spray of tegretol…didn't abort…sometimes these work and sometimes not. How to abort??? I also take Cymbalta 2x 60 mg
No other symptoms.
I would say the severity is a 2 on a 5 scale..noticeable but I continue on with regular activities, Can start on both sides but generally ends up on right side of head into cheekbone…a little burning at times…my neck feels tight and massage helps for a short period…food helps for short period…shower helps for short period. My last MRI was 2 years ago nothing but a very small pituitary tumor that no Neurogist feels has any bearing on headaches…say I may have had it for long time. My last drs appt one week ago…normal neuro…headache same pattern as priors…tried Pregnsdone and Reglan…didn't abort…just tried nasal spray of tegretol…didn't abort…sometimes these work and sometimes not. How to abort??? I also take Cymbalta 2x 60 mg
No other symptoms.
Brief Answer:
Tension type headache/Chronic migraine.
Detailed Answer:
Hi XXXX,
Thanks for being on Healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
I summarise your clinical history as-
You are apparently having episodes of headache which are chronic now.Headache often start unilaterally(mostly on right side),are associated with neck tension and hunger may be acting as a trigger factor.MRI brain shows a very small pituitary tumor.
My interpretation-
These can be either Tension type headache(more chances) or migraine.
Tension type headache(TTH)-TTH can present with episodic headache,almost everyday or several times a day,headache can be associated with tension or tightness in neck muscles.
Migraine-is an episodic headache,unilateral(can change sides from episode to episode),usually associated with nausea,headache increases on exposure to bright light and sound,can be associated with a visual aura(seeing flashing zig-zag lights),and headache is usually associated with a trigger factor like hunger,stress,sunlight,smoking,alcohol,food items like tea,coffee,cheese or any other food item.
You,so far, have not tried medicines specific for migraine or TTH.Medicines like amitriptyline can take care of both.Anti-migraine medicines like propranolol,triptans,anticonvulsants(topiramate or valproate),calcium channel blockers(flunarizine) can be tried.
Please visit your physician, and discuss him regarding giving a trial to the anti-migraine/TTH medicines which suits you.
Hope I have answered your query.If you have follow-up queries,I shall be glad to answer else,please close the thread-rate it and write a review.
Dr.Ajay Panwar,
MD,DM(Neurology)
Tension type headache/Chronic migraine.
Detailed Answer:
Hi XXXX,
Thanks for being on Healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
I summarise your clinical history as-
You are apparently having episodes of headache which are chronic now.Headache often start unilaterally(mostly on right side),are associated with neck tension and hunger may be acting as a trigger factor.MRI brain shows a very small pituitary tumor.
My interpretation-
These can be either Tension type headache(more chances) or migraine.
Tension type headache(TTH)-TTH can present with episodic headache,almost everyday or several times a day,headache can be associated with tension or tightness in neck muscles.
Migraine-is an episodic headache,unilateral(can change sides from episode to episode),usually associated with nausea,headache increases on exposure to bright light and sound,can be associated with a visual aura(seeing flashing zig-zag lights),and headache is usually associated with a trigger factor like hunger,stress,sunlight,smoking,alcohol,food items like tea,coffee,cheese or any other food item.
You,so far, have not tried medicines specific for migraine or TTH.Medicines like amitriptyline can take care of both.Anti-migraine medicines like propranolol,triptans,anticonvulsants(topiramate or valproate),calcium channel blockers(flunarizine) can be tried.
Please visit your physician, and discuss him regarding giving a trial to the anti-migraine/TTH medicines which suits you.
Hope I have answered your query.If you have follow-up queries,I shall be glad to answer else,please close the thread-rate it and write a review.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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