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What Causes Recurrent Headache In Left Temple, Vertigo, Occasional Nausea And Vomiting?

Posted on Tue, 2 Feb 2016

Question: For nearly 18 months, I have experienced a very localized, recurrent headache near my left temple. It is so localized that I feel as though I can touch it with the tip of my finger. The headache varies from a throbbing pain, a dull ache, to a painless pressure. I can only describe the painless "pressure" as if I gently pushed my finger against my temple. I can feel this headache, or variety of headache, nearly every day with it only being considered a headache I would want to take pain medication for probably one day out of the week. I had an MRI one year ago with and without contract and the results came back negative because the headache began to wake me up in the middle of the night and that was concerning to my physician. Since the results came back clear, I decided to live with it since it wasn't negatively affecting my daily life or activities. I have recently (within the past two months) been experiencing vertigo and occasional nausea and vomiting. My headache continues to me in the middle of the night or in the morning and prevents me from falling back to sleep every once in a while. It also now hurts sometimes after coughing or sneezing. I returned to my neurologist out of concern with the recent changes and was given a migraine prescription which hasn't helped my headaches yet. The neurologist said it was unnecessary to do another MRI since the one from last year was clear. I'm wondering if I need a second opinion? I do not have any family history of brain tumors, but of course that is a concern even though the MRI came back negative just one year ago. I can't imagine a tumor growth changing so quickly, but I am struggling to understand this very strange, constant localized headache.

Answered by Dr. Neeraj Kumar (1 hour later)

Brief Answer:
Possibility of migraine headache

Detailed Answer:
Hello,
I have gone through your question and understand your concerns.
Headache in young are usually migraine or anxiety related. In some cases it may be other type of primary headache like cluster headache.
Treatment for migraine headache are many and Topiramate is one of the drugs.
You can also try amitryptiline 10 mg in night as it will decrease anxiety, Increase sleep and helps in headache too.
Possibility of tumor at this age is less common cause of headache.
In tumor, headache occurs due to raised intracranial pressure with also vomiting, constant headache, blurring of vision. Tumor is also associated with other features like seizure, loss of consciousness, cranial nerve involvement, motor weakness, sensory loss, facial deviation.
You should follow instructions of your treating neurologist. No need for second consultation at present. If you don't get expected benefits in 4-6 weeks then consult another neurologist.
Avoid sleep disturbances, fasting, coffee, skipped meals.
Take medicines, rest and let the worry go.
Hope you found the answer helpful.
Do get back to me for further queries.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Neeraj Kumar (10 hours later)

Thank you. I will continue my current treatment and your suggestions as provided. My original contact, last night, was during a particularly painful headache which lasted all day ( as you may assume, since I reached out for help) and felt a quick pulsing or twitching feeling in the localized area after sending my original question. It only happened once and it wasn't painful, but i felt a very distinct pulsating feeling in my temple. Is this anything to be of concern? My headache has significantly improved upon waking continued today.I just want to ensure there wouldn't be any emergency signs that I would be ignoring.

Answered by Dr. Neeraj Kumar (38 minutes later)

Brief Answer:
Take pain killer if symptoms persist and continue rest treatment

Detailed Answer:
Hello,
I don't think it is serious issue.
Migraine headache sometimes progresses with throbbing, beating sensation in head.
You can take pain killer like naproxen, aceclofenac for relief.
Regards
Dr N Kumar
Neurologist

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Neeraj Kumar (50 minutes later)

Could this type of headache potentiallybe caused by TMJ? I do have occasional clicking of my jaw.

Answered by Dr. Neeraj Kumar (8 hours later)

Brief Answer:
Seems less likely but can be evaluated by a dentist

Detailed Answer:
Hello,
Tmj joint pain is mostly felt in front of ear and increases on jaw movement. There may be tenderness on touching the region also.
But no other symptoms like nausea, vomiting.
You can consult a dentist for evaluation and xray of TMJ region.
Regards
Dr N Kumar
Neurologist

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