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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for headaches, nausea and dizziness

Answered by
Dr. Dariush Saghafi


Practicing since :1988

Answered : 1936 Questions

Posted on Fri, 24 Mar 2017 in Headache and Migraines
Question: hello doctor rynne,
my husband has been suffering from a headache (back of head, middle to base of the skull and the paid can be very severe), mild nausea (mostly morning), dizziness when he moves his head suddenly or bends over and fatigue. this has been the case for the past 2 1/2 days. he suffered allergy migraines when he was a child and the occasional migraine as an adult, but never at this length. we are starting to become concerned and are wondering if we should visit the emergency room or would a walk-in clinic be sufficient?

thank you so much for you time :)
Answered by Dr. Dariush Saghafi 1 hour later
Brief Answer:
Occipital headache

Detailed Answer:
Good afternoon.

As a headache specialist I always tell patients to follow their instincts when it comes to a headache unlike anything they've had before.

In your husband's case I'm not sure but from your brief description it sounds as if he is having a 2.5 day severe occipitally based headache which may be radiating upward from the base of the neck. This is the usual place from where cervical headaches of the Bickerstaff type originate and this type of headache is NOT caused by anything awful such as a tumor or aneurysm.

However, enter what I tell my patients up above......if yours or his instincts are that this headache is entirely out of the ordinary from anything he's ever had before and if this headache has no chance of being a COMPLICATION from MEDICATION OVERUSE as so many headaches of this nature are...(i.e. excessive OTC meds taken in rapid succession to one another in the hopes that "something's gonna work".....bad idea on how to treat an acute headache).

At any rate, if his headache is clearly out of the nowhere and not getting better and not due to medication overuse and nothing like anything he's ever had THEN, I believe a trip to an ER or an URGENT CARE CLINIC that can do a CT scan of the head and have a doctor lay hands on his neck to make sure he doesn't have some kind of strange presentation of meningitis is completely reasonable.

The fact that you're not referring aggressive symptoms such as nausea, vomiting, sensitivity to light, sound, and smells gives me a bit more confidence that this in fact is JUST A HEADACHE and not the reflection of some intracranial mass or obstructive lesion within the ventricular system but then, he will at least need some intervention to break the cycle of the headache such as an IV fluid of some sort.

Please don't let them dope him up with narcotics or worthless drugs like that.....consider Toradol injections as well as warm and/or cold compresses to the base of the neck in addition to either some high dose steroids IV for a few hrs. or a Depakote drip for about an hour as well. But not narcotics, no butalbital nasal sprays, fioricets, etc. etc. or any other addictive and useless pain medications that should not be near headache patients.

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This query has utilized a total of 17 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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