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Suggest Treatment For Severe Headache

Posted on Tue, 12 Apr 2016

Question: Hello, I have a female adult with a headache, low to high intervals for over a week now, lym% mid% are high and gra# low. She has a general pain.

Answered by Dr. Neeraj Kumar (35 minutes later)

Brief Answer:
Take pain killers and provide more details

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
Headache at this age may be due to migraine or tension type headache.
Please provide more details regarding headache.
1) Duration of headache, severity
2) Location, nature throbbing or Bursting pain
3) Associated features like nausea or vomiting, sensitivity to light or sound
4) Fever, ear discharge, visual loss
5) Response to pain killers or rest
6) Family history of migraine
Provide these details.
For pain relief take Naproxen.
Upload reports of counts also to evaluate any abnormalities.
Hope you found the answer helpful.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Neeraj Kumar (16 minutes later)

Thanks for your answer, here are more details :

1. Pain increases during the night
2. General pain on the left side of the body, similar to fibromialgia
3. No migrane history
4. Treatment so far has been ketorolaco trometsmine which has been the only that aliviates, at least a little of the pain
5. One important thing about the pain is that at the beginning, whenever she sits down the pain is higher, or when doing a sudden move of the head
6. Additional to the pain, please note that there are some nauseas, lost of appetite and she's very cold on arms, hands and legs.
7. The general body pain has a history of appearing and dissapearing from time to time, but besides pain killers, there isn't much we have done.

See the attached blood tests done this week.

Answered by Dr. Neeraj Kumar (50 minutes later)

Brief Answer:
Take pain modulator drugs like amitryptiline or gabapentin

Detailed Answer:
Hello,
I have gone through reports .
complete report with total counts and general blood picture for any abnormal cells is required.
consultation and examination by a neurologist will be reassuring to rule out any features of meningitis.
Bodyache and headache may get benefit if amitryptiline or combination with gabapentin is administered.
Hope she improve soon.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Deepak

Follow up: Dr. Neeraj Kumar (17 hours later)

Thank you Dr XXXXXXX

She took a similar medication, carbamazepine, and she improved from yesterday. Thanks for that.

We plan to take her with a neurologist this week, in the meantime, I have attached the full blood test.

A few additional notes, the pain increases during the night, and she usually gets hands and feet cold.

A surgeon that we know and saw the results suggested to do a test for Epstein bar virus and citomegalovirus, would you recommend that? Or any other test?

Regards,
Daniel Alarcon

Answered by Dr. Neeraj Kumar (11 hours later)

Brief Answer:
Get the test repeated

Detailed Answer:
Hello,
I have gone through full report.
I will recommend to repeat the test along with manual general blood picture for any atypical cells.
No need to go for EBV, cytomegalovirus at present.
Is there any enlarged lymph nodes in body, neck, armpit or inguinal area?
Any history of fever?
Get her examined by a physician/hematologist if repeat test shows similar results.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Neeraj Kumar (16 hours later)

Thanks Dr, we'll follow up later, after we go to the hematologist.

Answered by Dr. Neeraj Kumar (6 hours later)

Brief Answer:
Wishing good health

Detailed Answer:
Hello,
Do get back with the report and hematologist opinion.
I am here to help you out.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Yogesh D