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Suggest treatment for headaches

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Posted on Tue, 23 Sep 2014
Question: I am suffering with a typical headache since last 22 years. The symptoms/features of this headache are as follows:-
1.     It occurs at both the sides above ears.
2.     Sometimes it happens like throbbing pain which seems to be unbearable.
3.     Whenever it happens the whole body weakens and I feel giddiness and unable to walk.
4.     This pain remains days together. (some times months also)
5.     None of the pain killer works on it.
6.     It goes automatically but it doesn’t disappear fully.
7.     It remains somewhat (say in percentage) and any time it increases. The frequency increased
now a days.
8.     It has been clearly observed that the pain does not depend on life style/food pattern or any
other thing related to me.
9.     The Dr. prescribed me Naprosyn tablet but it also doesn’t work. All my reports like C.T Scan, MRI
and blood reports do not show any discrepancy. All are normal. One neurologist say there is
chemical imbalance in the body but there is no remedy for that.
10.     Since last 22 years I have been shown to so many specialists (M.D./Neuro physicians
/Psychiatrists /others) but I did not get benefited by either of them. Everybody gave it different
name like Migraine/Cluster headache/Chronic Cluster Headache etc. Last year one neurologist
suggested me to get admitted at hospital. She tried for 5 days and declared that I don’t have
Migraine and psychiatric problem. She wrote in diagnosis column of my file as “ daily type
headache”. Whether this is true in medical field?
11.     I am a well educated person and being a scientific officer running a well equipped chemical
laboratory for a nuclear power plant. People know me for my memory power and my knowledge.
So as such I also don’t have any adverse effect so far mentally or by other way but this pain is
unbearable and I have become weaker. I remain more absent from office due to this. Also I
cannot plan anything because it can appear any time without any intimation.

Pl. reply if there is any remedy.

doctor
Answered by Dr. Vishal Garala (1 hour later)
Brief Answer:
Hi XXXXXXX , Headche has multiple etiolgy.

Detailed Answer:
Hi

I admire you for positive outlook.
Very glad to see you.

I appriciate that have explained it in detail and I understand your concern.

Three primary investigation that we prefer in daily practice.

1. Eye sight refraction.
2. Fundus examinations.
3. Blood pressure.

These three rule out many physical illnesses that lead to headache.

Did u do that.???


If you said that your doctors ruled out migraine and other neurological headache then you do not mentioned treatment that have you received tull date.

Have you ever been diagnosed as tension type headache??

What other features do you have apart from giddiness and difficulty in walking??

Please revert back with features and treatment till date.

Have ever been tried with amitryptiline ?? In what dose???

Have ever been tried with lithium? ?

Please reply back with this details and I will get back to you.

Thank you
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Vishal Garala (1 hour later)
Dear Doctor,
Thanks for reply. Followings are reply of your all queries.

All the Three primary investigation that we prefer in daily practice have been ruled out as follows
1. Since last 30 years I am using spectacles and every year I get it checked up with doctor and prepare new glasses. The same is ruled out by doctor also.
2. My stomach is also very normal and does not have any problem. My digestion is very much OK. That cause is also ruled out by doctor.
3. I was suffering with blood pressure in 2009. Dr. started tablet Amlopin -M and I take daily one tablet before going to bed and my BP remains normal (120/80).
Hence all the three primary investigations are ruled out.
I have taken following medicines prescribed by various doctors.
- Tab. Trika, Cap. Sinepin & Voveran (1992 - 1995)
- Tab. Sibelium, Ciplar, Cap . Betacap, Prodep, Flexinol, Sumitrex, Vasograin,
Lithium Carbonate - 300 mg. & Tryptomer -10 mg (1996 - 1999)
- Tab. Zosert, Indaral, & other pain killers like naprosyn, Dolopar etc. till date
- As & when required I was given injections like Voveran, Contramol, Tramadol
etc. so many times.
Yes, One of the doctor diagnosed and mentioned it as tension type headache
but he put question mark against it.
Apart from giddiness I feel weakness. I cannot walk due to feeling of
weakness. I don’t go out side due to this. I feel very much tiredness and
stretching in my legs. Hardly I could walk in this case.
I never been tried with amitryptiline.
One in 1997 I tried with lithium Carbonate – 300 mgs. Dose but it was
prescribed with some other medicine for short period.

Hope I have given all the replies.
doctor
Answered by Dr. Vishal Garala (56 minutes later)
Brief Answer:
Hi find detail answer below.

Detailed Answer:
Hi dear

Good to see you again.

I understand and go through all details.

I appriciate that you have done all this and had a lots of problems in health.

You have done almost all investigations so nothing more require.

Chronic and resistant headache can be treated with amitryptiline 25 to 150 mg doses.

Dose should increase gradually depends on responses.

Weakness can be part of physical or psychological.

Healthy food and vitamin suppliments make you more energetic.

Psychological weakness may be due to same etiology as headache. In which medicine like duloxetine or desvenlaflaxin preferable.

Maintaining healthy lifestyle and exercise make difference in health.

Thank you.

Take care.

Happy to help you.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
Answered by
Dr.
Dr. Vishal Garala

Psychiatrist

Practicing since :2009

Answered : 1714 Questions

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Suggest treatment for headaches

Brief Answer: Hi XXXXXXX , Headche has multiple etiolgy. Detailed Answer: Hi I admire you for positive outlook. Very glad to see you. I appriciate that have explained it in detail and I understand your concern. Three primary investigation that we prefer in daily practice. 1. Eye sight refraction. 2. Fundus examinations. 3. Blood pressure. These three rule out many physical illnesses that lead to headache. Did u do that.??? If you said that your doctors ruled out migraine and other neurological headache then you do not mentioned treatment that have you received tull date. Have you ever been diagnosed as tension type headache?? What other features do you have apart from giddiness and difficulty in walking?? Please revert back with features and treatment till date. Have ever been tried with amitryptiline ?? In what dose??? Have ever been tried with lithium? ? Please reply back with this details and I will get back to you. Thank you