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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Pain In Head?

My brother has been suffering from headache since last 6months. Few are saying migraine few are saying that it is due acidity. Headache occurs randomly at any time and for few minutes the pain in unbearable that he can t even sit stable .rest of the time headhache occurd to the bearable level.even after meal also n before meal too headache occurs. The few minutes headache is so much severe that he has started taking disprine tablet almost daily. What Is it n how it can be cured.?
Mon, 11 Apr 2016
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Internal Medicine Specialist 's  Response
Thanks for asking at Healthcare Magic. I read your question and I understand your concern.
Headache has many different types. It may be primary or secondary.
Primary headache:
Migraine, cluster headache, tension type headache
primary cough headache
Secondary Headache:
Acute/Chronic sinusitis, Glaucoma, Brain tumour, uncorrected
refractive error of eyes.
Most common in primary Headaches is migraine.
It is of two types:
1. Migraine without aura
2.Migraine with aura
Migraine without aura:
A. At least 5 attacks fulfilling criteria B-D
B. Headache attack lasting 4-72 hours (untreated or successfully treated )
C.Headache has At least 2 of the following.
unilateral, pulsating, moderate to severe pain, aggravating or causing avoidance of routine physical activity like walking.
D.during headache attack At least one of the following.
Nausea and /vomiting
photophobia and/phonophobia
E. Not attributable to another disorder

Migraine with Aura:
A.At least 2 attacks fullfiling criteria B-D
B. Aura consisting of atleast one of the following but no motor weakness
1.Fully reversible visual symptoms :flickering, lighting, vision loss, zigzag lines appearance
2. Fully reversible sensory symptoms:numbness
pins and needle sensation
3. Fully reversible dysphasic speech
C. atleast 2 of the following
1. Homonymous visual symptoms /unilateral sensory symptoms
2. atleast one aura symptom develop gradually over greater than 2 minutes
D.Headache fulfilling criteria B-D for migraine without aura or following aura within 60 minutes
E. Not attributable to another disorder
In nutshell The symptoms you mentioned are fitting into migraine but needs additional symptoms and elaboration.
The treatment of migraine consists of two Types.
Symptomatic therapy or abortive therapy in acute attack:Triptans are drug of choice
just 5mg of zolmitriptan is sufficient.
Besides antiemetic like Prochlorperazine can be used.
Preventive therapy :
includes topiramate 50 mg BD or
valproic acid 500mg BD
Besides there is a list of medication.
I would suggest you to have his Xray Paranasal sinuses, Fundoscopy to ruled out organic cause.
Then go for above treatment if investigations were normal.
Hope it helps best.
Don't forget to rate this answer.
Take your best care.
Regards
Dr Ejaz

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What Causes Severe Pain In Head?

Thanks for asking at Healthcare Magic. I read your question and I understand your concern. Headache has many different types. It may be primary or secondary. Primary headache: Migraine, cluster headache, tension type headache primary cough headache Secondary Headache: Acute/Chronic sinusitis, Glaucoma, Brain tumour, uncorrected refractive error of eyes. Most common in primary Headaches is migraine. It is of two types: 1. Migraine without aura 2.Migraine with aura Migraine without aura: A. At least 5 attacks fulfilling criteria B-D B. Headache attack lasting 4-72 hours (untreated or successfully treated ) C.Headache has At least 2 of the following. unilateral, pulsating, moderate to severe pain, aggravating or causing avoidance of routine physical activity like walking. D.during headache attack At least one of the following. Nausea and /vomiting photophobia and/phonophobia E. Not attributable to another disorder Migraine with Aura: A.At least 2 attacks fullfiling criteria B-D B. Aura consisting of atleast one of the following but no motor weakness 1.Fully reversible visual symptoms :flickering, lighting, vision loss, zigzag lines appearance 2. Fully reversible sensory symptoms:numbness pins and needle sensation 3. Fully reversible dysphasic speech C. atleast 2 of the following 1. Homonymous visual symptoms /unilateral sensory symptoms 2. atleast one aura symptom develop gradually over greater than 2 minutes D.Headache fulfilling criteria B-D for migraine without aura or following aura within 60 minutes E. Not attributable to another disorder In nutshell The symptoms you mentioned are fitting into migraine but needs additional symptoms and elaboration. The treatment of migraine consists of two Types. Symptomatic therapy or abortive therapy in acute attack:Triptans are drug of choice just 5mg of zolmitriptan is sufficient. Besides antiemetic like Prochlorperazine can be used. Preventive therapy : includes topiramate 50 mg BD or valproic acid 500mg BD Besides there is a list of medication. I would suggest you to have his Xray Paranasal sinuses, Fundoscopy to ruled out organic cause. Then go for above treatment if investigations were normal. Hope it helps best. Don t forget to rate this answer. Take your best care. Regards Dr Ejaz