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Sudden Onset Of Headaches, Neck Pain, Spot In The Eye Hurts. This Is Different From Migraine. What Is It?

Posted on Mon, 25 Jun 2012

Question: Male, age 31, started having very intense, sudden onset headaches this week, Sneezed with head turned and heard a sound like styrofoam ripping, if that make sense, and had neck pain for several days afterwards, then headaches began a few days after the neck pain subsided. Pain in head is sharp, burning, throbbing and on one side of the head, but not the same side every time. Starts with a turn of the head that makes a tiny spot behind the eye radiate pain out to that side of the head. Scalp is tender, pain is only behind one eye yet both temples hurt. Vision blurs; nausea and vomiting accompany pain. Extreme light sensitivity. Headaches gets a little better then come back in waves throughout the day. The first headache caused a strange numbness sensation to the roof of the mouth which lasted a couple hours. Hurts badly to move eyes during headache. Has migraine headaches but this is very different than migraine. Unsure what to do to relieve pain or if symptoms indicate emergency/life threatening situation. Would greatly appreciate advise/opinion. Thank you.

Answered by Dr. Shiva Kumar R (5 hours later)

Hello,

Thanks for posting your query.

From the description that you have provided, it looks like you are suffering from migraine headaches and probably a neck sprain as well. The myriad of symptoms that you have described are suggestive of classical and severe migraine.
Treatment of migraine involves non-steroidal anti-inflammatory drugs like ibuprofen and naproxen and triptans like sumatriptan. Certain preventive strategies include beta blockers and avoiding certain triggers like stress, sleep disturbances, fasting, hormones, bright or flickering lights, odors, cigarette smoke, alcohol, aged cheeses, chocolate, monosodium glutamate, nitrites, aspartame, and caffeine.
However, any headache which changes its character needs a detailed evaluation to rule out co-existing structural problems and the occurrence of more than one kind of headache.
So, I personally recommend you to XXXXXXX your neurologist for a detailed clinical examination and consultation. I would also like headache seen with analgesic abuse also needs to be excluded.
Let me know if I have missed out any other concern in your question.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.

Sincerely,

Dr Shiva Kumar R
Neurologist & Epileptologist

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Shiva Kumar R (16 hours later)

This headache is actually very different from the migraines I have. I have researched online and found "Occipital Neuralgia" to be a match to the symptoms I am experiencing; the research suggested the pain is caused by irritation or injury to the nerves in my neck. Can nerve irritation/injury repair itself or does that require a surgical repair? I have no insurance and limited funds, so I do not have access to a neurologist.

Answered by Dr. Shiva Kumar R (6 hours later)

Hello and Thanks for the query.

Regarding occipital neuralgia, there are two different school of thoughts. Some consider it as part of migraine (Transformed migraine) and some as totally different problem. Amitryptylline or Botox injection is best for treatment of occipital neuralgia.

Surgical option is considered only when Botox and oral medicines fail.

So I personally feel trying Amitryptylline or Botox injection is worth both for occipital neuralgia and migraine if not responding to the conventional medications. Sometimes differentiating these is difficult.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you. Please accept my answer in case you have no follow up queries.

Wish you good health.

Sincerely,

Dr Shiva Kumar R
Neurologist & Epileptologist

Above answer was peer-reviewed by : Dr. Jyoti Patil

Follow up: Dr. Shiva Kumar R (20 hours later)

What would be the surgical option should Amitryptylline and/or Botox injection fail?

Answered by Dr. Shiva Kumar R (9 hours later)

Hello and Thanks for the query

Various surgical procedures are available and the commonest one is decompression (removing vessels or other soft tissue strucutures) of the greater auricular nerve and rarely sectioning of it. Sectioning of the nerve may cause sensory loss over the occiput.

So I personally feel trying Botox injection is worth before considering surgical options.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you. Please accept my answer in case you have no follow up queries.

Wish you good health.

Sincerely,

Dr Shiva Kumar R
Neurologist & Epileptologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar