Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Severe Headache And Dizziness
Question: Have had severe headache and dizziness for a week. Have suffered from bbpv and migraines in the past. But the headache has never been as severe or lasted this long . Also tingling in hands and feet
Went to doctor put on amoxicillin for Suspected sinus infection.
But headache dizziness and nausea from dizziness still really bad
Went to doctor put on amoxicillin for Suspected sinus infection.
But headache dizziness and nausea from dizziness still really bad
Brief Answer:
A head CT is necessary considering the severity and duration.
Detailed Answer:
I read your question carefully and I understand your concern.
There are several elements in your history which can be related to the symptoms. There are severe migraine attacks which can last over 72 hours called status migrainosus. Sensory symptoms such as tingling in the extremities may also present (generally such tingling is benign and may be related to anxiety as well).
Also sinusitis can cause headache and dizziness as well, so if accompanied by nasal congestion and discharge, facial pain etc it may well be the cause.
That being said though having a diagnosis of migraine doesn't render you immune to other neurological conditions such as stroke, tumor etc. So since you state this headache as more intense than anything before and it has gone over the duration of a typical migraine attack, as well as on the other hand not responding to sinusitis treatment I believe some more probing is necessary. I think imaging evaluation by head CT is necessary. It would exclude both brain lesions as well as evaluate the sinuses.
Afterwards treatment will depend on the results, if nothing is found intravenous treatment for status migrainosus may be needed with antiemetics and intravenous analgesics.
I remain at your disposal for other questions.
A head CT is necessary considering the severity and duration.
Detailed Answer:
I read your question carefully and I understand your concern.
There are several elements in your history which can be related to the symptoms. There are severe migraine attacks which can last over 72 hours called status migrainosus. Sensory symptoms such as tingling in the extremities may also present (generally such tingling is benign and may be related to anxiety as well).
Also sinusitis can cause headache and dizziness as well, so if accompanied by nasal congestion and discharge, facial pain etc it may well be the cause.
That being said though having a diagnosis of migraine doesn't render you immune to other neurological conditions such as stroke, tumor etc. So since you state this headache as more intense than anything before and it has gone over the duration of a typical migraine attack, as well as on the other hand not responding to sinusitis treatment I believe some more probing is necessary. I think imaging evaluation by head CT is necessary. It would exclude both brain lesions as well as evaluate the sinuses.
Afterwards treatment will depend on the results, if nothing is found intravenous treatment for status migrainosus may be needed with antiemetics and intravenous analgesics.
I remain at your disposal for other questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much for your prompt reply. I have had a CT on sinus before and they said there is swelling but an operation cannot be done as its too close to the optic nerves on the scan. This current situation started when I had a facial and the beautician twisted my neck which started the dizziness and I think restarted the bppv vertigo . Which my ent consultant fixed with the epley position . Have tried the exercises again myself but they make me more sick and dizzy . Also I do not remember having such a bad long term headache with this before , could it be a combination of sinus/ migraine and vertigo. Just worried as it is not going away at all, any recommendations for stronger painkillers ?
Brief Answer:
Read below.
Detailed Answer:
Thank you for the additional information.
As you yourself say headache is not usually part of bppv, so it is a alert signal to consider other causes. I must say that the fact that the symptoms started after a neck maneuver has me worried as it may trigger a dissection, a tear in the wall of a cervical blood vessel, which in turn can cause a stroke. So since from what I understand prior CT was done before this severe headache, my recommendation remains, actually now would recommend doing a CT including contrast angio exam for the vessels.
Whether it can be simply a combination of the sinus and migraine issues, yes it certainly can, the two can combine in perpetuating the pain. In terms of painkiller at home, since you already take Cocodamol (which contains acetaminophen and an opioid such as codeine) I would add an over the counter anti-inflammatory pain killer such as Ibuprofen, as while Maxalt is more effective for migraine it doesn't do much good for sinus headache. Otherwise there are intravenous analgesics which could be applied at the ER if you're going to head there to be evaluated for the possibility of the CT.
Let me know if I can further assist you.
Read below.
Detailed Answer:
Thank you for the additional information.
As you yourself say headache is not usually part of bppv, so it is a alert signal to consider other causes. I must say that the fact that the symptoms started after a neck maneuver has me worried as it may trigger a dissection, a tear in the wall of a cervical blood vessel, which in turn can cause a stroke. So since from what I understand prior CT was done before this severe headache, my recommendation remains, actually now would recommend doing a CT including contrast angio exam for the vessels.
Whether it can be simply a combination of the sinus and migraine issues, yes it certainly can, the two can combine in perpetuating the pain. In terms of painkiller at home, since you already take Cocodamol (which contains acetaminophen and an opioid such as codeine) I would add an over the counter anti-inflammatory pain killer such as Ibuprofen, as while Maxalt is more effective for migraine it doesn't do much good for sinus headache. Otherwise there are intravenous analgesics which could be applied at the ER if you're going to head there to be evaluated for the possibility of the CT.
Let me know if I can further assist you.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
If it was a tear in a blood vessel would a stroke have happened immediately ? As its been a week with a headache . This has me worried ,
Also very thirsty and feeling a bit floaty , but they could be the painkillers.
Any reassurance would be greatly appreciated . Thank you again
Also very thirsty and feeling a bit floaty , but they could be the painkillers.
Any reassurance would be greatly appreciated . Thank you again
Brief Answer:
Read below.
Detailed Answer:
In the case of a dissection stroke may happen immediately in 1/3 of cases or in the following days, the risk is higher in the first week, though it may happen later as well. Usually stroke has other manifestations such as speech issues, double vision or visual field restrictions, balance and coordination problems, weakness and numbness of the face and limbs etc, so if you have none of the kind should feel heartened that the risk of stroke is lower. I do not want to scare you, as I said with your background of migraine and known sinus issues it might well turn out to be nothing serious.
But still I believe that any headache which is either new or of more severe intensity than prior episodes and which lasts for this long without showing some sort of improvement from treatment should be evaluated with imaging. I hope it will come back normal, but would feel more reassured after it.
Read below.
Detailed Answer:
In the case of a dissection stroke may happen immediately in 1/3 of cases or in the following days, the risk is higher in the first week, though it may happen later as well. Usually stroke has other manifestations such as speech issues, double vision or visual field restrictions, balance and coordination problems, weakness and numbness of the face and limbs etc, so if you have none of the kind should feel heartened that the risk of stroke is lower. I do not want to scare you, as I said with your background of migraine and known sinus issues it might well turn out to be nothing serious.
But still I believe that any headache which is either new or of more severe intensity than prior episodes and which lasts for this long without showing some sort of improvement from treatment should be evaluated with imaging. I hope it will come back normal, but would feel more reassured after it.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
