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Trigeminal Neuralgia.

Resolved Question:

What is causing my headaches and could it be cardiac or vascular in origin?

For that last two years, when walking upstairs or under exertion, I get a brief intense headache that subsides quickly (<60 secs) once I and take a break (though I somehow feel that there is some 'tenderness' and it is waiting to restart if I push myself). Its almost always on the right side behind or above my eye and its very immediate once it starts and very strong.

I also recently got this when sitting in a hot spring in New Zealand; it subsided once I moved to cold water. I do not otherwise get headaches and never have other than brain freezes from eating cold foods. I did concuss myself 3 years ago. I turned my ankle and clipped my right temple. I had blurred vision and light sensitivity for several weeks. CT scan in the ER did not show anything overly concerning and eye doctor examined eye and pronounced them clear.

I went to a neurologist 3mos ago and he did do an MRI of my head including focusing on my eyes which was all normal. He recommended taking ibuprofen for 6 weeks in case its residual swelling from the old concussion. I have taken it intermittently but he did not sound overly convinced and he was quite confused at various points in our discussion so I think he may not have remembered that the concussion was some time ago.

I am 45, female, overweight with asthma. When I first noticed getting short of breath 5 years ago when climbing stairs I did have a cardiac stress test and also wore a halter monitor for 48 hours and all was well.

A chest CT to check on my enlarged thymus gland did reveal some aortic hardening/calcification but I don't believe it was noteworthy as we did not discuss it, it was just in the write-up from the radiologist.

Other than this I don't have any other symptoms or disorders likely related.


Category: Neurologist, Medical

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Category: Pediatric Neurologist
Dr. Sudhir Kumar is online now

Expert:  Dr. Sudhir Kumar replied 4 Days.

Hi,

Thank you for posting your query at DoctorSpring.com.

First of all, I would like to reassure you that your episodic headache is not due to any serious cause, as both CT and MRI scans of the brain have been normal.

Based on the information given, the most likely cause for your symptoms could be trigeminal neuralgia, affecting the right trigeminal nerve. This nerve has three branches, your symptoms are in the ophthalmic division (also called as V1 division of the trigeminal nerve).

Initial treatment is with medications such as carbamazepine and oxcarbazepine tablets.

In some people who do not respond to these tablets, botox injections, radiation and surgery are other treatment options.

I hope it helps. Please get back if you have any more queries.

Best wishes,

Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist


Dr. Sudhir Kumar
Category: Pediatric Neurologist
Experience: 
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
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