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Suggest treatment for sore throat, nausea, dizziness when diagnosed with gastric reflux

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Posted on Thu, 3 Dec 2015
Question: Hello, about 6 weeks ago I had a headache that lasted 3 weeks. The pain was constant pounding also with sharp pains in random spots on my head but mostly in and behind my eyes, ears, and top of my head. At 3 different times the headache was so bad I thought I was dying. It was a 15 on a scale of 1-10. I also had a sore throat, sore esophagus when I swallowed (not acid reflux), my face swelled on one side, went down and then the other side swelled, blurry vision, nausea, dizziness, weakness, exhaustion. I went to the ER twice and my GP. The 1st er dr diagnosed sinuitis and gastric reflux even though I know neither were the case. I asked for X-rays and they revealed I did not have fluid in my sinuses, sent home with antibiotics and antacid. 2nd time they prescribed tension headache meds. They did nothing. The only thing that worked was rotating acetamenophen 1000mg and ibuprofen 800mg about every 4 hrs which took it from a 10 to about a 4. I then went to my GP and she prescribed imitrex and celexa. The imitrex did not work at all and the celexa made me feel more depressed and extremely tired. I stopped the imitrex but continued the celexa. My mom came to take care of my kids and I spent three days in bed and the headache went almost away. It stayed at like a 1 or 2 still with random sharp pains. I still felt weak, had blurry vision, nausea, and would get dizzy if I moved to fast, bent over, turned my head. About a week later i quit the celexa and immediately felt emotionally better with more energy and then about a week after that I worked out, not sure if related but the next day the headache came back starting with a pounding debilitating 15, I stayed on the acetamenophen and ibuprofen and the constant pounding went away after a week but I am now left with the sharp random spots that last just a few seconds in each spot every 2-15 seconds between them constantly. And this is the point I am left at. Any help would be appreciated.
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Answered by Dr. Neeraj Kumar (39 minutes later)
Brief Answer:
Possibility of primary headache like migraine

Detailed Answer:
Hello XXXX,
I have gone through your question and understand your concerns.
The headache described by you may be migraine attacks with features of throbbing, pulsating, peaking in hours and debilitating with nausea, photophobia.
In most cases pain killers abort the attack and long time treatment is not required but if it recurs periodically and unbearable then I prefer treating it with prophylaxis treatment in the form of Flunarizine, amitryptiline or beta blockers. Celexa (citalopram) isn't my first choice.
If you feel sleepy and drowsy with those preferred medication, then other drugs like Valproate or Topiramate may be used too.

Since you have no fever, neurodeficit, vision loss I would treat you as primary headache. Please discuss with your treating doctor if he/she shares my views. If yes, then we can start a trial with aforementioned options.

In addition, it is important that you take timely meals and sleep.
Avoid fasting, chocolate, coffee.

Hope you found the answer helpful.
Do get back to me for further queries.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Neeraj Kumar (3 hours later)
Hi thank you so much. Im sorry i forgot to mention the fevers. When this all first started with the first major episode i had a fever of 102 and it was also at 99/100 for the first 3 days. The second episode the fever was 101. I was also having nightsweats in the beginning to the point of being completely drenched. Im sorry i dont know how i forgot that. Also ive been taking klonipin 5mg at night to sleep and stress for about 5 months. The celexa she prescribed because I'm going through a really stressful time. I also had a CT scan at the second ER visit which came back normal.
doctor
Answered by Dr. Neeraj Kumar (20 minutes later)
Brief Answer:
Possibility of brain infection to be evaluated , visit a neurologist

Detailed Answer:
Hello,
In view of fever you have to be examined by a neurologist for possibility of any brain infection.
Is the fever continuous or responded to treatment?
Any history of ear discharge?
Was Ct brain done with contrast sequence?
Any fundus examination of eye was done?
Any history of severe neck pain or restriction of neck movements?
If all has resolved and only issue is headache then you can continue celexa and add flunarizine 10 mg night time.
Take naproxen 500 mg sos.
Do get an evaluation by a neurologist once.
Regards
Dr Neeraj Kumar
Neurologist

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

Neurologist

Practicing since :2006

Answered : 2263 Questions

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Suggest treatment for sore throat, nausea, dizziness when diagnosed with gastric reflux

Brief Answer: Possibility of primary headache like migraine Detailed Answer: Hello XXXX, I have gone through your question and understand your concerns. The headache described by you may be migraine attacks with features of throbbing, pulsating, peaking in hours and debilitating with nausea, photophobia. In most cases pain killers abort the attack and long time treatment is not required but if it recurs periodically and unbearable then I prefer treating it with prophylaxis treatment in the form of Flunarizine, amitryptiline or beta blockers. Celexa (citalopram) isn't my first choice. If you feel sleepy and drowsy with those preferred medication, then other drugs like Valproate or Topiramate may be used too. Since you have no fever, neurodeficit, vision loss I would treat you as primary headache. Please discuss with your treating doctor if he/she shares my views. If yes, then we can start a trial with aforementioned options. In addition, it is important that you take timely meals and sleep. Avoid fasting, chocolate, coffee. Hope you found the answer helpful. Do get back to me for further queries. Regards Dr Neeraj Kumar Neurologist