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    What causes headaches and extreme weakness when diagnosed with polymyalgia rheumatica?

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Posted on Wed, 9 Aug 2017 in Lupus
Question: Thanks! Male, age 75. Diagnosed 2 years ago with polymyalgia rheumatica. Initial treatment good - prednisone in decreasing doses. Recently symptoms increasing again, plus additional headaches (pre-migraine type) and extreme weakness. Currently on 15mg prednisone daily. Treatment monitored by a rheumatolgist. Saw a neuro-diognostician yesterday at XXXXXXX University medical center. She saw nothing new, but focused ONLY on musclo-skeletal symptoms. Lab results show nothing abnormal. VERY discouraged at this point and feel everyone is missing something.
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Answered by Dr. Naval Mendiratta 12 minutes later
Brief Answer:
PMR management

Detailed Answer:
good evening.

Thank you for writing on health care magic. Well headache coming in PMR is always a concern as want to rule out associated Giant cell arteritis. I So it will be Important for us to do a ultrasound of the temporal artery if it is not been performed already. Secondly I would also like to have a look at your eyes(fundus exam) so to make sure there is no inflammation there causing your headache

Thirdly, we need to add a new drug. Since symotoms are flaring on tapering steroids, it means a new drug is needed to tackle it. So I woild suggest you discuss with your rheumatologist and consider starting on methotrexate as it will give us a longer remission period when we reduce steroids

Hope the information was useful

Do let me know for more queries. would would be happy to help out

Regards
dr naval
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Naval Mendiratta

Rheumatologist

Practicing since :2007

Answered : 748 Questions

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