HealthCareMagic is now Ask A Doctor - 24x7 | https://www.askadoctor24x7.com

question-icon

Suggest Treatment For Severe Headaches

default
Posted on Tue, 8 Sep 2015
Question: I am experining shocking head aches in my right temple. The frequency is increasing. Please tell me what I could possible ask my doc to check for I have an apppt at 1000 today.
I am on a plethora of medicines for hbp, ambiens, cpap, atenolo, maxide, cardora, calcium, cymbalta, gabapanten, visacare-bladder med, (potasium/,m-over the counter), nexium/zantac, aspirin,
doctor
Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Several possible causes

Detailed Answer:
I read your question carefully and I am sorry about the symptoms you are experiencing.

Shooting pain in the temple can be due to several causes:

Temporal arteritis is one possible cause of intense pain in the temple, related to inflammation of blood vessel. It manifests usually at an older age though. Erythrocyte sedimentation rate is an easy test to screen for this condition.

Glaucoma can also manifest with unilateral pain in its acute angle closure form, due to increased pressure in the eye, with pain which can irradiate in the temple, usually has some eye redness and vision changes. Eye pressure test is the initial test.

Trigeminal neuralgia, involving only the upper branch of trigeminal nerve is another possible cause. No specific tests, only symptoms make diagnosis, pain is sharp/lancinating/electrical shock like, lasting for seconds, can be triggered by facial massage, speaking, eating etc

Temporo-mandibular joint dysfunction or tooth infection may cause pain irradiating in the temple as well. Symptoms, physical exam and if deemed necessary imaging makes the diagnosis.

In brain lesions like stroke, tumor etc the pain is more diffuse than only in the temple region and usually there are other symptoms as well, so unlikely

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Olsi Taka (5 hours later)
Trigeminal neuralgia sysmtons seems to be the best describe of my systoms. My doctor gave me a turodal shot 60mg at 1130 and said go to ER if pain persist which it still is. Is there any treatment recommeded for Trigeminal neuralgia.
doctor
Answered by Dr. Olsi Taka (1 hour later)
Brief Answer:
Read below.

Detailed Answer:
Thank you for your feedback.

So your doctor think it's trigeminal neuralgia. If located only at the temple would be somewhat unusual, usually involves the face as well.

Regarding treatment, usually medication consists in anticonvulsant medication. So looking at your medication you seem to already be taking one suitable medication which is Gabapentin. I wonder what do you take it for and at what dosage, perhaps it can be increased if pain persists. If unsuccessful and the diagnosis looks certain (those other causes I mentioned are excluded), other antiepileptics can be tried (carbamazepine, lamotrigine, phenytoin), or baclofen.

An MRI should also be scheduled. Most of trigeminal neuralgia cases are idiopathic (no identifiable cause), but in some rare cases may be due to a tumor, multiple sclerosis, nerve compression from a blood vessel etc. As I said rare, no panic, but should be scheduled.

If medication doesn't work there are other more invasive measures, like percutaneous procedures (by injecting a needle or tube guided by imaging, and injecting substances or emitting heat etc), in some cases where there is a compression on MRI surgery may be used as well. But I think it's too early to discuss those, as I said diagnosis must be made sure and medication is tried first.

I hope you'll get better soon
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Olsi Taka

Neurologist

Practicing since :2004

Answered : 3672 Questions

premium_optimized

The User accepted the expert's answer

Share on

Get personalised answers from verified doctor in minutes across 80+ specialties

159 Doctors Online

By proceeding, I accept the Terms and Conditions

HCM Blog Instant Access to Doctors
HCM Blog Questions Answered
HCM Blog Satisfaction
Suggest Treatment For Severe Headaches

Brief Answer: Several possible causes Detailed Answer: I read your question carefully and I am sorry about the symptoms you are experiencing. Shooting pain in the temple can be due to several causes: Temporal arteritis is one possible cause of intense pain in the temple, related to inflammation of blood vessel. It manifests usually at an older age though. Erythrocyte sedimentation rate is an easy test to screen for this condition. Glaucoma can also manifest with unilateral pain in its acute angle closure form, due to increased pressure in the eye, with pain which can irradiate in the temple, usually has some eye redness and vision changes. Eye pressure test is the initial test. Trigeminal neuralgia, involving only the upper branch of trigeminal nerve is another possible cause. No specific tests, only symptoms make diagnosis, pain is sharp/lancinating/electrical shock like, lasting for seconds, can be triggered by facial massage, speaking, eating etc Temporo-mandibular joint dysfunction or tooth infection may cause pain irradiating in the temple as well. Symptoms, physical exam and if deemed necessary imaging makes the diagnosis. In brain lesions like stroke, tumor etc the pain is more diffuse than only in the temple region and usually there are other symptoms as well, so unlikely I remain at your disposal for further questions.