Brief Answer:
Headaches need to be classified/diagnosed using symptom diary

Detailed Answer:
Hello. My name is Dr. Saghafi. I am a neurologist and headache specialist from the XXXXXXX OH region of the world. I'd like to comment on your question.

I'm sorry that your wife is suffering from what seem to be very debilitating and intractable headaches for what seem to be no reason whatever.

The possibilities abound as to the type of headache this could be which ranges from severe tension type to migraine or even an entity little spoken of since it represents a relatively new category of problem referred to as NEW DAILY PERSISTENT HEADACHE (NDPH). This last type of headache is interesting since it happens to occur in older individuals (mostly men but does occur in women), usually has a very discreet onset (i.e. she can point to an exact date and even time that the headache began) and cannot be found to be caused by anything else. There is usually no other symptom except very bad pain (i.e. no nausea, vomiting, flashing lights, sensitivity to light/sound/smells).

However, in order to give a solid diagnosis patients need to document their episodes on a headache diary over a period of 2-4 weeks at which time a physician expert in analyzing the data can make a much more firm diagnosis. In the mean time, I would make sure that your wife is not overindulging or overusing Over the Counter Medications such as Tylenol, Motrin, Naprosyn, Excedrin since Medication Overuse Headaches (MOH) are commonly precipitated by people who don't seem to respond well to other medications and so they start taking OTC pills more frequently than recommended. This will serve to initiate headaches by themselves and make it much more difficult to recgonize what her real baseline headaches are from the medication induced ones.

If your wife is having any type of neurological symptom such as weakness, numbness, or tingling in an extremity, or slurred speech, difficulty comprehending things, and so on then, I would recommend an immediate consultation with a neurologist or even an ER visit so that a proper workup including an imaging study of the head can be performed.

A headache specialist will also know the types of labs, bloodwork, or urinalysis to order for such headaches as we know that things such as low thyroid hormones or severely imbalanced chemistries having to do with sodium, potassium, and magnesium can lead to severe headaches. Again, a headache specialist may check her for these types of things and correct whatever needs to be corrected in order to try and remediate the problem.

If this answer satisfactorily addresses your question then, I'd appreciate the favor of a HIGH STAR RATING with some written feedback.

Also, CLOSING THE QUERY on your end (if there are no further comments) will be most helpful and appreciated so that this question can be transacted and archived for further reference by colleagues as necessary.

Please keep me informed as to the outcome of your situation by writing me at: bit.ly/drdariushsaghafiAll the best.

The query has required a total of 20 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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