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Diagnosis of Migraine & Headache Types

10+/day throbbing & stabbing w flashing lights

  • By 4Erin

    I’m seeking ideas about my 15yr old daughter who had no history of headaches. Two weeks ago she started symptoms that happen randomly from each other:
    1. flashing lights and grey lines in only right eye for duration of a second or two, dozens of times a day especially evening.
    2. Stabbing headache in both temples with duration of 1-4 minutes, started six times a day now up to 12 times/day
    3. Throbbing one sided temple headache that last 2-10 minutes, 10 times/day although she is starting to get one a day that last about an hour.

    Opthomologist found nothing unusual. Neurologist diagnosed idiopathic stabbing headaches, insisting that she must be mistaken that they last more than a minute–she is not! This doesn’t account for the vision disturbances. He said second headache is not migraine. Said aura would not be one eye only. Prescribed Melatonin and Aleve.

    The severity of both headaches is increasing and the duration of the throbbing headache is increasing as well.

    Anyone know what kind of short term throbbing headache happens a dozen times a day?

    What could account for these quick flashes of lights/lines?

    Ten weeks of this suffering before returning to the neurologist. This mom is a bit concerned.

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  • By GardensatNight

    Hi 4Erin, I think you need to get your daughter to a good headache specialist, ASAP. Maybe also a neuro-opthamologist with a headache specialist certification. Are you in the US? You may have to go to a different city, but there are N-O’s who are headache specialists.

    I have no idea what is going on, as I am not a medical professional. I’m not sure if the first type of headache sounds like cluster headaches or not, as I do not happen to have those. I do know cluster headaches come in short, severe, repeated attacks. Do you have any family history of headaches? Did they do any scans, bloodwork or MRI or just prescribe Aleve and Melatonin? (What did the doctor say those are supposed to be doing? Did the doctor warn you that people with headache disorders are not supposed to take painkillers like Aleve more than 2-3 times per week or it can cause more headaches?–MOH)

    I went from perfectly healthy to sick as a dog overnight, and it took going to 15 doctors and 3 years before we could get an accurate diagnosis because I have chronic migraine and a comorbid condition which happens to be rare and causes severe visual involvement, and it flummoxed all the neurologists (who are great doctors, but trained to deal with hundreds of diseases a little bit, rather than specialize only in headache disorder like a headache specialist) who kept trying to write off my symptoms as something they had heard of, or worse, at times accused me of making them up. It finally took random luck, spouse and I researching, and a coworker suggesting I be tested for something (while I continued to deteriorate) before we stumbled across the right answer. Keep pushing on behalf of your daughter.

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  • By Nancy Harris Bonk Moderator

    Hi 4Erin,

    GardensatNight is exactly right – time for a true migraine expert ASAP! Here are two articles on how these expert doctors are different and how to find one; http://migraine.com/blog/how-are-migraine-specialists-different/ and https://migraine.com/blog/really-find-headache-specialist/.

    When a doctor doesn’t believe a patient, to me that’s a red flag. Time for a new one!!

    Keep us posted on how you and your daughter are doing,
    Nancy

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  • By Nancy Harris Bonk Moderator

    Hi 4Erin,

    GardensatNight is exactly right – time for a true migraine expert ASAP! Here are two articles on how these expert doctors are different and how to find one; http://migraine.com/blog/how-are-migraine-specialists-different/ and https://migraine.com/blog/really-find-headache-specialist/.

    When a doctor doesn’t believe a patient, to me that’s a red flag. Time for a new one!!

    Keep us posted on how you and your daughter are doing,
    Nancy

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  • By 4Erin

    Thank you both for your responses!! We are going to a pediatric neurologist at one of the top rated US hospitals, who lists his specialty as headaches. I will check out your link to see and investigate what qualifies him to say that.

    Still, the fact that his diagnosis doesn’t explain many of her symptoms concerns me so my husband asked his friend–the head of this department, for a recommendation of someone else to see. He advised us that we won’t find a better doctor and to be patient with results of the melatonin as a good alternative to medications with bad side effects. I did find info on the website supporting melatonin for ideopathic stabbing headaches and we have just upped her dose. She isn’t taking the Aleve because it made her incredibly tired. I didn’t want to risk medication overuse headaches anyway.

    I have quickly read a lot about headaches and I do think she probably does have these stabbing headaches, albeit of longer than listed duration, but am searching for an explanation for the visual disturbances. I keep thinking migraine aura makes the most sense and stabbing headaches often come with a second headache, most often migraine (which the Dr says this is not). But a dozen short migraines/auras per day?

    Gardensatnight’s mention of cluster headaches led me back to relook and I did discover that children tend to have different symptoms than adults and they can have a good number of cluster headaches per day. She has none of the runny eye type symptoms though. Do cluster headaches always have these as I have read?

    She has only had basic neurological testing, no scans, MRIs, blood work etc. The doctor assured us it is not serious or dangerous. I forgot to ask him if we should still follow up with the opthomologist who said return in a month if symptoms remain. It seems clear the flashing lights are related to the headaches but I am thinking I should persue all angles and keep the eye doctor appointment?

    Again, thank you!! I truly appreciate being able to ask the experts in the trenches for advice.

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  • By GardensatNight

    Here is the UCNS list of diplomates in headache medicine: https://www.ucns.org/globals/axon/assets/12748.pdf

    This list includes neurologists, pediatric neurologists, and neuro-opthamologists. And hopefully the melatonin does the trick (he went to medical school, not me.) If things aren’t better in a month or two, you can always consider whether you want to get a second opinion.

    A neuro-opthamologist deals with disorders of the vision caused by the nervous system. Of the ones I’ve been to, the two who are on that headache specialist list I linked? So helpful. Complete migraine/vision workup. The other two who weren’t headache specialists… meh. That’s why it’s really important to make sure your daughter’s caregivers are people who really specialize in headaches.

    Also, have you been able to identify anything that triggers her? Light, sound, smell, weather changes, hormonal changes (right before her period, middle of her cycle), foods (Kerrie Smyres has a really comprehensive list you can google), stress, eyestrain. Some triggers are hard to avoid, but there are others that have work-arounds.

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  • By GardensatNight

    Another thing I thought of… could the visual aura/lights/disturbances (whatever we call them) proceed the longer headaches?

    It is hard to find drugs that affect headache that come without side effects. One thing to consider before you completely write a med off, is that sometimes side effects get more manageable as you take the med. And also, migraine (if it’s that) causes a lot of weird symptoms. One of the common ones is that “hit by a garbage truck” feeling of fatigue. Of course, they’re saying no migraine. But I know I sometimes can’t always be sure whether something is a side effect of a med I’m taking, or just part of my migraine.

    There are lots of really great doctors out there. As someone who it took 3 years and 15 doctors (and me really deteriorating during that time) to come up with the right co-diagnosis and start getting the right treatment, I really, really, strongly recommend second opinions especially in unusual cases, or if someone isn’t improving. In the months before I was finally diagnosed, when my husband and I suggested in appointments the thing we thought could be wrong with me based on the findings of one awesome neuroradiologist, several neurologists outright dismissed us. They said no way. They spelled out why that could not possibly be it. Then, what do you know, multiple tests confirmed that was exactly what was wrong, and everyone changed their tune. These were really smart doctors (although none were headache specialists.) But all doctors are human and humans are fallible. That’s why if a patient isn’t improving, getting more brains on the case is IMHO a smart idea.

    I really hope your daughter starts feeling better. Hugs.

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