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What is the cause and treatment for headache with dizziness?

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Neurologist
Practicing since : 1988
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Question
Hello.

I'm having a headache right now. But the thing is, my head feels like spinning around and I feel warm inside my head. When I woke up, my head starts to spin around. I tried to lay down for few minutes and can only lay down facing one position. If I move my whole body face to the left or right, My head will feel spinning around again. Then I got up, but it feels quite nice but my head is still feel dizzy. And now, whenever I tried to lay down again, my head feels dizzy (feel heavy).

This also happened a month ago. I was in the same pain for a week. I did put ice in a towel and put it on my head. it feels so good tho.

Now, I'm doing the ice in the towel thing again. It feels nice but my head is still heavy. I just want to know what's wrong with my head.
Posted Mon, 4 Aug 2014 in Headache and Migraines
 
 
Answered by Dr. Dariush Saghafi 4 hours later
Brief Answer:
You may have migraine headache or BPPV

Detailed Answer:
Good morning. My name is Dr. Saghafi and I would like to make several comments which I hope will help you understand your condition a little bit better.

First of all it is important to know whether or not these symptoms of headaches and dizziness are brand new or you've been having these for awhile. If they have never occurred before and this is something which just recently started and especially if your symptoms include nausea, vomiting, or changes in your vision then, I recommend you find a physician right away who can order either a CT scan or preferably an MRI of your brain because we will need to make sure you do not have anything going on inside the head that could be causing these symptoms.

If your symptoms are longstanding then, what you describe can fall into 2 possible categories. The first is migraine headache with a major component of vertigo (spinning feeling). These are sometimes referred to VERTIGINOUS MIGRAINES. The 2nd category you may be suffering from is BENIGN PAROXYSMAL POSITIONAL VERTIGO or BPPV. This is a condition where changes in your head position will trigger a sudden spinning sensation possibly with nausea/vomiting and sometimes even bad headaches.

My feeling is that your headaches are likely in the first category and that is to say VERTIGINOUS MIGRAINE headache.

The first thing, however, is to seek out a neurologist or headache specialist who can help instruct you on how to keep a good headache diary so that all the important aspects of these headaches and spinning sensations can be well documented.

Secondly, you need to determine whether these headaches are new or old so that proper imaging may be ordered if appropriate.

Thirdly, appropriate medications for these sorts of headaches can include things such as triptans for the headaches, promethazine and/or hydroxyzine for symptoms related to the dizziness, and then, if appropriate exercises to do so that your body doesn't misinterpret the movements of your head every time you change position as you describe.

All the best and please let me know if I can be of further assistance.
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