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Suggest treatment for severe headache, tingling sensation in the hand and dizziness

Answered by
Dr. Dariush Saghafi


Practicing since :1988

Answered : 1822 Questions

Posted on Fri, 3 Mar 2017 in Headache and Migraines
Question: A couple of weeks ago I had severe headache. Took excedrin for a couple of day and got better.

Now (last three days) I have tingling in my right arm and a flushing feeling across inside my head. Like I am getting dizzy. This has been getting worse. Any thoughts.
Answered by Dr. Dariush Saghafi 2 hours later
Brief Answer:

Detailed Answer:
Good afternoon. I've read your information and based upon the history of a severe headache last week for which you took Excedrin that improved the symptoms you're describing right now could be those of what is referred to as an ATYPICAL MIGRAINE ATTACK. This would be a type of headache that can present itself as simply out of the ordinary symptoms not related to anything in particular except for the fact that your head and neck are involved and you had a severe headache 2 weeks ago. In ATYPICAL types of migraine headaches people don't necessarily have the symptoms of nausea, vomiting, or other classic migraine features. In fact, sometimes headache pain is actually replaced with feelings such as lightheadedness, dizziness, numbness, odd feelings that are indescribable.

To make such a diagnosis it is best to be examined by either a neurologist or headache specialist since treatment usually is equivalent to that of conventional or commonly seen migraine headaches. In my headache clinics I have patients fill out and keep headache diaries for at least 2-4 weeks before determining what types of headaches they are having and deciding upon definitive treatment. A neurologist or headache specialist may possibly be inclined to do an MRI of the brain with gadolinium contrast based upon the sensory symptoms your having on the heels of a severe bout of headache a couple of weeks ago but I don't know for sure since they'd have to get a lot more history plus do a good physical examination on you to make that decision. It may be entirely unnecessary to get any imaging study of the head if the headache logs and neurological examinations are clean for any high suspicion for intracranial abnormalities.

Other things to consider other than this sort of headache type might be some time of arthritic or degenerative change going on in the cervical spine and causing what is referred to as a radiculopathy which can present with headaches or symptoms associated with headaches.

Also, to consider would be some type of metabolic disturbance such as either Vitamin B12, folate, or Vitamin D deficiencies causing the tingling and flushing feelings which can be diagnosed with laboratory studies of your blood. I would also recommend doing some thyroid function tests and perhaps an inflammatory marker or 2 such as an ESR or C-reactive protein (CRP) in case that turned out to be highly elevated which could lead to other investigations.

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This query has utilized a total of 15 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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