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Help with diagnosis... please :(

Hi... a bit more than three weeks ago I started getting headaches that are one sided, running around or behind the eye, and lasting between 30 and 90 minutes depending, I think, on when I take the painkillers. The headaches can at times strike at night and wake me up from sleep. In the first few days they seemed to come at the same time every day so I immediately thought of cluster headaches. Since then, the pattern has been rather mixed up.

When the headaches strike I am restless and can hardly sit still. They can at times be so intense, and my reaction to them so distressing, that my wife starts weeping because she feels helpless. I have not identified any triggers and do not have any other symptoms. No vomiting, body aches, nausea, etc. Aside from the headaches, I lead what I think is a very health lifestyle. I am 35 years old and work out daily, jog a lot, hike, etc. I believe I am the fittest and in the best shape of my life at the moment.

I also eat very healthily. Lots of veggies, fruits, good sources of protein and carbs. My one weakness is chocolate although I can control the cravings (sometimes!). But the chocolate thing has been a lifelong thing, I sure hope I have not suddenly started developing a reaction to them.

Before the headaches started, I was hardly ever getting headaches. And definitely nothing as intense as these headaches I am getting now.

Blood works all came out normal. A CT scan of the brain and sinuses was a bit controversial. Brain appeared normal, but the the scan of the sinuses suggested rhino-sinusitis which my doctor grabbed on and put me on strong antibiotics. I tried to argue that sinusitis would not, anyway, cause such intense headaches, and I don't have any other symptoms to suggest it. Still, the headaches continue, some days they seem to be less frequent or I may have a whole day with no headaches before it strikes again the next day.

The headaches are taking their toll on me. I am anxious and tired which I know does not help. The next idea would be to do an MRI although I doubt it will show anything.

Can migraines carry on for nearly a month ? and cluster headaches ? I understand the latter usually runs in shorter cycles although chronic forms are not unheard of.

I am really very very tired. I am sorry I am venting like this. I know no one can offer a definitive diagnosis. But can anyone suggest alternative diagnoses ? Does it really sound like migraine or GH ?

Please help : (

  1. Hi amohanna,

    Thank you for your question and sharing your story with us. I bet your tired. Being in chronic pain is exhausting and debilitating and please don't worry about venting - this is a safe place to do so.

    Yes, migraine disease can carry on for a month, even longer for some of us. Migraine disease can't be found on any image study or blood test, its a diagnosis of exclusion. This means a qualified doctor will determine whether or not you have it after you've had a complete exam, gone over your medical history and discussed your symptoms. Let me share information about this; https://migraine.com/living-migraine/diagnosing-ichd-3-versus-icd-9/.

    You are also right on the money suspecting your sinuses are not the issue. Almost 90% of people who complain about sinus issues are having migraine attacks. Here is information on that; https://migraine.com/blog/facial-pain-explained/.

    May I ask if you are taking anything on a regular basis to help relieve this pain? One problem we can run into is called medication overuse headache or moh. MOH was formerly called rebound and can occur if we take migraine medications AND/OR pain relievers, whether they are over-the-counter or prescription, more than two to three days a week. If we are in an moh cycle, our migraine attacks may be more difficult to treat and we can end up in a daily cycle of pain that is hard to break. I've been here from drinking too much caffeine, a stimulant. One cup a day is all I can have without getting into a moh cycle. Let me share this information on moh that will hopefully help; https://migraine.com/living-migraine/stop-rebound-headaches/.

    I'll stop for now so I don't overwhelm you. Let me know what you think
    Nancy

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