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Suggest Treatment For Recurrent Episodic Headache And Throat Pain
Question: Hi,
My wife is having continuous severe headache since 5 days now. She caught cold during this winter when she went out with friends on 23rd December. She also had tonsil pain in her throat. We consulted our local physician who prescribed her antibiotic Taxim-AZ 200, a Multivitamin and Trump A (cough syrup); plus he also gave Signoflam (anti-inflammatory) for tonsil. But after taking those, from the next day she grew severe headache which didnt go away. Till now she is having the headache. Two days later the physician replaced Signoflam with Zerdol-SP (paracetamol). The headache was still on.
Next we visited an ENT, who suggested continuing with the antibiotic Taxim-AZ 200, plus prescribed Cetzine-A (cetrizine hydrochloride & ambroxol hydrochloride) and also PUC-650 (paracetamol) instead of Zerodol-SP. The ENT doctor also told that she might be suffering from migraine.
She undertook CT-Scan of brain (plain) yesterday and we are awaiting the result. How to confirm what's the source of this headache? Or is she really suffering from migraine? Or did the medications not suit her?
She is suffering from this continuous headache like hell. Any help?? Please...
My wife is having continuous severe headache since 5 days now. She caught cold during this winter when she went out with friends on 23rd December. She also had tonsil pain in her throat. We consulted our local physician who prescribed her antibiotic Taxim-AZ 200, a Multivitamin and Trump A (cough syrup); plus he also gave Signoflam (anti-inflammatory) for tonsil. But after taking those, from the next day she grew severe headache which didnt go away. Till now she is having the headache. Two days later the physician replaced Signoflam with Zerdol-SP (paracetamol). The headache was still on.
Next we visited an ENT, who suggested continuing with the antibiotic Taxim-AZ 200, plus prescribed Cetzine-A (cetrizine hydrochloride & ambroxol hydrochloride) and also PUC-650 (paracetamol) instead of Zerodol-SP. The ENT doctor also told that she might be suffering from migraine.
She undertook CT-Scan of brain (plain) yesterday and we are awaiting the result. How to confirm what's the source of this headache? Or is she really suffering from migraine? Or did the medications not suit her?
She is suffering from this continuous headache like hell. Any help?? Please...
Brief Answer:
Provide more information as I questioned.
Detailed Answer:
Hello,
Welcome to HCM.
I have read your whole query and understand the concern.
Let me explain you in some details regarding migraine since you have asked about it and your doctor is also suspecting it.
Migraine is a recurrent episodic headache (pain over one side of head or throbbing pain) associated with nausea,vomiting or photo-phobia (sensitivity to light).
It generally occurs at only one side of head and characterized by pulsating over head and usually not relieved by OTC pain killers.
Few things i want to know from her like,
1) Is she having any other symptom (like nausea,vomiting or light sensitivity) apart from just a headache?
2) Was it aggravated by her daily work?
3) Was she having a similar episode in the past?
4)Is she having any triggering factor (which I have mentioned below)?
Here,I will not be in the favor of this continuous headache to consider/treat it as a 'migraine' without taking complete medical history of the individual.
Mostly,in more than 90% cases of continuous headache,this CT brain (plain) investigation comes normal.
This seems more to be a tension headache which is a primary or simple headache caused by some precipitating or triggering factor which is relieved by OTC analgesics (ibuprofen or diclofenac) and at the same time eliminating any of this triggering factor like dehydration or heavy sunlight exposure or sleep deprivation or wrong or uncomfortable posture or eye strains or stress or long working hours in one position or even severe gas trouble etc.
But I would like to discuss it further once you will provide me more clinical history and associated symptoms of your wife.
Awaiting your response.
Regards,
Dr.Sandip kabra
Provide more information as I questioned.
Detailed Answer:
Hello,
Welcome to HCM.
I have read your whole query and understand the concern.
Let me explain you in some details regarding migraine since you have asked about it and your doctor is also suspecting it.
Migraine is a recurrent episodic headache (pain over one side of head or throbbing pain) associated with nausea,vomiting or photo-phobia (sensitivity to light).
It generally occurs at only one side of head and characterized by pulsating over head and usually not relieved by OTC pain killers.
Few things i want to know from her like,
1) Is she having any other symptom (like nausea,vomiting or light sensitivity) apart from just a headache?
2) Was it aggravated by her daily work?
3) Was she having a similar episode in the past?
4)Is she having any triggering factor (which I have mentioned below)?
Here,I will not be in the favor of this continuous headache to consider/treat it as a 'migraine' without taking complete medical history of the individual.
Mostly,in more than 90% cases of continuous headache,this CT brain (plain) investigation comes normal.
This seems more to be a tension headache which is a primary or simple headache caused by some precipitating or triggering factor which is relieved by OTC analgesics (ibuprofen or diclofenac) and at the same time eliminating any of this triggering factor like dehydration or heavy sunlight exposure or sleep deprivation or wrong or uncomfortable posture or eye strains or stress or long working hours in one position or even severe gas trouble etc.
But I would like to discuss it further once you will provide me more clinical history and associated symptoms of your wife.
Awaiting your response.
Regards,
Dr.Sandip kabra
Above answer was peer-reviewed by :
Dr. Prasad
Hello Doctor,
Thanks for your prompt reply.
Please find your queries answered below:-
1) Is she having any other symptom (like nausea,vomiting or light sensitivity) apart from just a headache? -- She thinks she has grown a slight sensitivity to light these few days, which was not there before. She doesnt like the light of the room to be switched on suddenly when she lies in prolonged darkness.
2) Was it aggravated by her daily work? -- She is at rest at home for the last 5 days since 24th Dec. She has taken medical leave from office. She finds it most comfortable to lie down at bed and does that ll the time now. And she complains that suddenly changing her posture (turn to the other side), or getting up off the bed and start walking actually increases the headache.
3) Was she having a similar episode in the past? -- Let me tell you her clinical history in brief. She never had a similar continuous and prolonged headache patch in her life. She suffers from occasional headaches after a long tiring & tight day at office, but most of us suffers like that. But she gets these stress headaches nevertheless. She also gets headaches once she catches cold. She is very vulnerable to catching cold, and in every change of weather conditions she suffers with cough n cold. She always coughs, sneezes and suffers from running nose. In those times, she gets headaches sometimes. Plus she suffers from gastric problems. She gets this problem when she eats triggering foods like Gobi or Moong Dal etc. She used to take one Pantocid DSR on empty stomach at morning in the past for a period of nearly 1 month, but that has now stopped. Now she occasionally takes one Gelusil after a sumptuous meal. Again, she is allergic to dust.
4)Is she having any triggering factor (which I have mentioned below)? -- She suffers from eye strains, long working hours stress in one position; and as I already mentioned she suffers from chronic gas troubles. She doesnt apparently suffer from dehydration, heavy sunlight exposure or lack of sleep etc.
I agree with you in considering this continuous headache as a tension or stress headache which is caused by long & tiring stressful office hours and life style issues. But why this time its so prolonged? Why its continuing for more than 5 days now? Why its not stopping?
How will we stop the headache? She is in deep trouble right now, thats why we seek your help. Please suggest a solution.
My wife is a regular gym-goer for the last 6 months and has reduced 2 kgs since then.
My number: 0000 / 0000. If you have any queries, plz respond. You can share your number if no prob, I will call you.
Regards.
XXXX, XXXXXXX
Thanks for your prompt reply.
Please find your queries answered below:-
1) Is she having any other symptom (like nausea,vomiting or light sensitivity) apart from just a headache? -- She thinks she has grown a slight sensitivity to light these few days, which was not there before. She doesnt like the light of the room to be switched on suddenly when she lies in prolonged darkness.
2) Was it aggravated by her daily work? -- She is at rest at home for the last 5 days since 24th Dec. She has taken medical leave from office. She finds it most comfortable to lie down at bed and does that ll the time now. And she complains that suddenly changing her posture (turn to the other side), or getting up off the bed and start walking actually increases the headache.
3) Was she having a similar episode in the past? -- Let me tell you her clinical history in brief. She never had a similar continuous and prolonged headache patch in her life. She suffers from occasional headaches after a long tiring & tight day at office, but most of us suffers like that. But she gets these stress headaches nevertheless. She also gets headaches once she catches cold. She is very vulnerable to catching cold, and in every change of weather conditions she suffers with cough n cold. She always coughs, sneezes and suffers from running nose. In those times, she gets headaches sometimes. Plus she suffers from gastric problems. She gets this problem when she eats triggering foods like Gobi or Moong Dal etc. She used to take one Pantocid DSR on empty stomach at morning in the past for a period of nearly 1 month, but that has now stopped. Now she occasionally takes one Gelusil after a sumptuous meal. Again, she is allergic to dust.
4)Is she having any triggering factor (which I have mentioned below)? -- She suffers from eye strains, long working hours stress in one position; and as I already mentioned she suffers from chronic gas troubles. She doesnt apparently suffer from dehydration, heavy sunlight exposure or lack of sleep etc.
I agree with you in considering this continuous headache as a tension or stress headache which is caused by long & tiring stressful office hours and life style issues. But why this time its so prolonged? Why its continuing for more than 5 days now? Why its not stopping?
How will we stop the headache? She is in deep trouble right now, thats why we seek your help. Please suggest a solution.
My wife is a regular gym-goer for the last 6 months and has reduced 2 kgs since then.
My number: 0000 / 0000. If you have any queries, plz respond. You can share your number if no prob, I will call you.
Regards.
XXXX, XXXXXXX
Brief Answer:
Tension headache from all history and clincal symptoms.
Detailed Answer:
Hello,
Thanks for sharing more information.
From all these facts that you shared here, it is more likely to be having tension type of headache rather than migraine and it usually relieved by taking over the counter appropriate pain killers and at the same time eliminating the triggering factor or precipitating factors (gastric problem, eye strain or long working hours could be in your wife's case).
Tension headache may last for few hours to some days occasionally depending on triggering or precipitating factor.So,there is no need to get panicked much if she had headache for last 5 days.
Therefore, in my advice, she should take alternative pain killer combinations like Tab.Ultracet (acetaminophen and tramadol combination) with muscle relaxant like metaxalone (Brand name:Skelaxin) if she did not get relieved from paracetamol alone.
Anti-anxiety medication (ex.Recita forte) would also be helpful to reduce stress level and for adequate sleep.
Give her antacid which suits her like pantocid-DSR with gelusil which she usually takes.
Also, continue to take complete bed rest for couple of more days.
Give her plenty of fluids (simple water or lemon water) with lots of fruit juices (apple juice and sapota milkshake or chikoo shake would be best) for next 2 to 3 days more. It would be important to maintain proper hydration and electrolyte balance which in turn will help to reduce headache.
Avoid oily/spicy/fatty food or even routine diet and give her bland diet only.
We may expect to see improvement within 2 or 3 days and till that time her CT brain report will also come.
Hope this help and let me know if you have more questions.
Regards,
Dr.Sandip Kabra
Tension headache from all history and clincal symptoms.
Detailed Answer:
Hello,
Thanks for sharing more information.
From all these facts that you shared here, it is more likely to be having tension type of headache rather than migraine and it usually relieved by taking over the counter appropriate pain killers and at the same time eliminating the triggering factor or precipitating factors (gastric problem, eye strain or long working hours could be in your wife's case).
Tension headache may last for few hours to some days occasionally depending on triggering or precipitating factor.So,there is no need to get panicked much if she had headache for last 5 days.
Therefore, in my advice, she should take alternative pain killer combinations like Tab.Ultracet (acetaminophen and tramadol combination) with muscle relaxant like metaxalone (Brand name:Skelaxin) if she did not get relieved from paracetamol alone.
Anti-anxiety medication (ex.Recita forte) would also be helpful to reduce stress level and for adequate sleep.
Give her antacid which suits her like pantocid-DSR with gelusil which she usually takes.
Also, continue to take complete bed rest for couple of more days.
Give her plenty of fluids (simple water or lemon water) with lots of fruit juices (apple juice and sapota milkshake or chikoo shake would be best) for next 2 to 3 days more. It would be important to maintain proper hydration and electrolyte balance which in turn will help to reduce headache.
Avoid oily/spicy/fatty food or even routine diet and give her bland diet only.
We may expect to see improvement within 2 or 3 days and till that time her CT brain report will also come.
Hope this help and let me know if you have more questions.
Regards,
Dr.Sandip Kabra
Above answer was peer-reviewed by :
Dr. Yogesh D
Answered by
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