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What Causes Headache, Feeling Of Lump In The Throat And Back Pain?
Question: Hi Neuroscientist doctor, I had headache since 5 years ago doesn't stop with pain in my back XXXXXXX I also sometimes get some symptoms like cold or flu or fever. A year ago I've got cricopharyngeal spasm with feeling like a lump in my throat. In addition to that, I feel depressed and can't sleep well at night and when I sleep I get a very bad nightmares. I went to the doctor who asked to me to do EEG which I have attached them with this message. I did three EEG in different dates as per the name of the files attached. He diagnosed it as epilepsy and prescribed topiramate with lyrolin at nigh and lustral at morning and cerepromab after lunch and Depovit B12 twice per week. From XXXXXXX to March, I took the medicines and it went fantastic but I've got some problems with topiramate in my skin. So when I went back to the doctor, he reduced the medicines to be lustral at morning and Depakin at night (instead of topiramte because of its side effects) and lyrolin when needed and Depovit once per week. I started to take these medicines and after a while the symptoms started to get back to me again with same pain in my back XXXXXXX the depression, the nightmares, and the headache (but the headache is not sever like before). Now my questions: did the doctor diagnosed it right? is it really epilepsy? If so, am I taking the right medicines? Should I get back to topiramate? Depakine on the other side affects my bones and causes pain in my left arm. Lyrolin also has side effects on my sexual relationship like it makes it very long and sometimes with no orgasm. If it is epilepsy, when do I expect to recover fully if I will recover? do I have hope to recover anyway or it will be forever? Thanks XXXXX
Brief Answer:
Provide more details and reports
Detailed Answer:
Hello XXXXX,
I have gone through your question and understand your concerns.
Your uploaded eeg is not available, kindly upload again.
The symptoms need more clarification. Is there any loss of consciousness, frothing, tongue bite, urinary incontinence during such episodes?
Any jerking in body?
The drug prescribed are mostly for headache and neck pain.
Depakine is used both for epilepsy and headache.
What is the type of headache: throbbing, Bursting, pulsating?
Any associated nausea or vomiting or sensitivity to light or sound?
Any aggravating factors?
You can continue drugs with addition of calcium supplements.
If epilepsy is diagnosed on eeg, then drugs need to be taken for 2-3 years.
Lyrolin can be reduced and stopped in few weeks when neck problem is resolved.
Hope you found the answer helpful.
Please upload eeg and provide more details.
Regards
Dr N Kumar
Neurologist
Provide more details and reports
Detailed Answer:
Hello XXXXX,
I have gone through your question and understand your concerns.
Your uploaded eeg is not available, kindly upload again.
The symptoms need more clarification. Is there any loss of consciousness, frothing, tongue bite, urinary incontinence during such episodes?
Any jerking in body?
The drug prescribed are mostly for headache and neck pain.
Depakine is used both for epilepsy and headache.
What is the type of headache: throbbing, Bursting, pulsating?
Any associated nausea or vomiting or sensitivity to light or sound?
Any aggravating factors?
You can continue drugs with addition of calcium supplements.
If epilepsy is diagnosed on eeg, then drugs need to be taken for 2-3 years.
Lyrolin can be reduced and stopped in few weeks when neck problem is resolved.
Hope you found the answer helpful.
Please upload eeg and provide more details.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Yogesh D
Dr. XXXXXXX
Thanks for the reply. To answer your questions:
Is there any loss of consciousness, frothing, tongue bite, urinary incontinence during such episodes? No at all.
Any jerking in body? It's like the fever when I have flu and rise in temperature not jerking as such.
What is the type of headache: throbbing, Bursting, pulsating? Can't decide, but tends to be pulsating (not sure)
Any associated nausea or vomiting or sensitivity to light or sound? sensitivity to light and sound when I have headache but not that much.
Any aggravating factors? Not specific one, but when I go into long discussions and debates I might get this fever feeling and when I take panadol extra I feel well after half an hour.
You can continue drugs with addition of calcium supplements. Why calcium? should I do calcium analysis or vitamin D? please advise.
If epilepsy is diagnosed on eeg, then drugs need to be taken for 2-3 years. Will it be cured completely afterwards?
Please upload eeg and provide more details. I have uploaded them twice and they are already attached to my profile.I will upload them again. But please, very important to me, I need interpertation to all the details in that EEG for all these signals and circles and colors in those circles with different frequency...etc. Actually this is my main objective.
Thanks
Thanks for the reply. To answer your questions:
Is there any loss of consciousness, frothing, tongue bite, urinary incontinence during such episodes? No at all.
Any jerking in body? It's like the fever when I have flu and rise in temperature not jerking as such.
What is the type of headache: throbbing, Bursting, pulsating? Can't decide, but tends to be pulsating (not sure)
Any associated nausea or vomiting or sensitivity to light or sound? sensitivity to light and sound when I have headache but not that much.
Any aggravating factors? Not specific one, but when I go into long discussions and debates I might get this fever feeling and when I take panadol extra I feel well after half an hour.
You can continue drugs with addition of calcium supplements. Why calcium? should I do calcium analysis or vitamin D? please advise.
If epilepsy is diagnosed on eeg, then drugs need to be taken for 2-3 years. Will it be cured completely afterwards?
Please upload eeg and provide more details. I have uploaded them twice and they are already attached to my profile.I will upload them again. But please, very important to me, I need interpertation to all the details in that EEG for all these signals and circles and colors in those circles with different frequency...etc. Actually this is my main objective.
Thanks
Brief Answer:
Continue medication as advised
Detailed Answer:
Hello,
I have gone through your eeg and tcd reports.
No abnormal epileptic discharges are present in eeg.
I have doubt about epilepsy as a diagnosis.
Headache can be due to tension type headache.
You need to continue medication.
Topiramate can be stopped for now.
Wishing you good health and early recovery.
Regards
Dr N Kumar
Neurologist
Continue medication as advised
Detailed Answer:
Hello,
I have gone through your eeg and tcd reports.
No abnormal epileptic discharges are present in eeg.
I have doubt about epilepsy as a diagnosis.
Headache can be due to tension type headache.
You need to continue medication.
Topiramate can be stopped for now.
Wishing you good health and early recovery.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Naveen Kumar
Thank you doctor.
Regarding the EEG on 24th XXXXXXX there is on red point in the first circle in the upper left corner. Doctor said this is evidence of the epilepsy. In the same time, the last line in the same report says "DQEEG awake record showed evidence of left occipital slowness as evident on the BEAM, together with many vascular artifacts as evident on raw tracing". What does it mean?
I also feel good when I take topiramate with Lyrica (yesterday I was feeling so bad and when I take them I turn to be really good and slept well and wake up really nice at the morning).
In the same time, if it's not epilepsy, why should I continue medication? and what kind of medication you are referring to? and till when? what is this pain in my back nick? why did you advised the calcium supplement? what do I do with the anxiety, tension and nightmares?
I really appreciate detailed answer doctor since I'm really concerned about my case.
Thanks and best regards,
XXXXX
Regarding the EEG on 24th XXXXXXX there is on red point in the first circle in the upper left corner. Doctor said this is evidence of the epilepsy. In the same time, the last line in the same report says "DQEEG awake record showed evidence of left occipital slowness as evident on the BEAM, together with many vascular artifacts as evident on raw tracing". What does it mean?
I also feel good when I take topiramate with Lyrica (yesterday I was feeling so bad and when I take them I turn to be really good and slept well and wake up really nice at the morning).
In the same time, if it's not epilepsy, why should I continue medication? and what kind of medication you are referring to? and till when? what is this pain in my back nick? why did you advised the calcium supplement? what do I do with the anxiety, tension and nightmares?
I really appreciate detailed answer doctor since I'm really concerned about my case.
Thanks and best regards,
XXXXX
Brief Answer:
Medications for headache and neck pain
Detailed Answer:
Hello XXXXX,
The EEG tracing is graphically represented in the color coding map.
The tracing is not showing any abnormal discharges. Only a localized area of slowing is present in left occipital area in first eeg but in absence of any mri abnormalities, its significance is doubtful.
Lyrica is pregabalin, which cause muscle relaxation and benefit in neuropathic pain. It also has sedation effect. Topiramate is helpful in headache and neuroapthic pain too. Only depakine is for epilespy and antiepileptic doses of topiramate are higher than 200 mg per day. Even depakine can be used for headache.
All your medications are best given in tension type headache with migraine(Topiramate, depokine,lustral). Lustral will be helpful for anxiety and sleep problems.
Calcium supplementation is advised for neck pain due to cervical radiculopathy. You can get Vitamin D, serum calcium, phosphate before supplementation.
At last, I am still not convinced with diagnosis of epilepsy. Upload any prescription if available for additional notes of your condition. Upload MRI brain report too.
Wishing you good health and early recovery.
Regards
Dr N Kumar
neurologist
Medications for headache and neck pain
Detailed Answer:
Hello XXXXX,
The EEG tracing is graphically represented in the color coding map.
The tracing is not showing any abnormal discharges. Only a localized area of slowing is present in left occipital area in first eeg but in absence of any mri abnormalities, its significance is doubtful.
Lyrica is pregabalin, which cause muscle relaxation and benefit in neuropathic pain. It also has sedation effect. Topiramate is helpful in headache and neuroapthic pain too. Only depakine is for epilespy and antiepileptic doses of topiramate are higher than 200 mg per day. Even depakine can be used for headache.
All your medications are best given in tension type headache with migraine(Topiramate, depokine,lustral). Lustral will be helpful for anxiety and sleep problems.
Calcium supplementation is advised for neck pain due to cervical radiculopathy. You can get Vitamin D, serum calcium, phosphate before supplementation.
At last, I am still not convinced with diagnosis of epilepsy. Upload any prescription if available for additional notes of your condition. Upload MRI brain report too.
Wishing you good health and early recovery.
Regards
Dr N Kumar
neurologist
Above answer was peer-reviewed by :
Dr. Yogesh D
Thank you Dr XXXXXXX
What a relief :)
Now, till when should I be taking the medication?
Should I continue taking Cerepromab?
Should I continue taking Depovit B12? if so, if there is alternative for Ampoules
What is the alternative for topiramate if it affected my skin?
what is the alternative of Lyrica/Lyrolin if it affects my sexual life (erection OK but no orgasm).
what about food?
Coffee (he prevented me completely from coffee which I really love and can't stop it), nescafee, chocolate, ice cream, gateau, milk and dairy products (when feeling pain).
Work stress and long working hours. He said no no
Sleeping early (I can do this some time but not all the time) he said must do.
must not exposed to Sun or shining light.
Must not get exposed to very cold or very hot places.
Many thanks and I guess this will be my last question.
What a relief :)
Now, till when should I be taking the medication?
Should I continue taking Cerepromab?
Should I continue taking Depovit B12? if so, if there is alternative for Ampoules
What is the alternative for topiramate if it affected my skin?
what is the alternative of Lyrica/Lyrolin if it affects my sexual life (erection OK but no orgasm).
what about food?
Coffee (he prevented me completely from coffee which I really love and can't stop it), nescafee, chocolate, ice cream, gateau, milk and dairy products (when feeling pain).
Work stress and long working hours. He said no no
Sleeping early (I can do this some time but not all the time) he said must do.
must not exposed to Sun or shining light.
Must not get exposed to very cold or very hot places.
Many thanks and I guess this will be my last question.
Brief Answer:
Precautions to be taken as advised
Detailed Answer:
Hello XXXX,
All these advices are part of lifestyle modifications for migraine headache.
These are triggers and best avoided.
Adequate sleep, decreased stress leads to decrease in episodes of headache and the need for prolonged medications.
Coffee 1-2 daily, sleep atleast 7-8 hours.
Wishing good health and early recovery.
Regards
Dr N Kumar
Neurologist
Precautions to be taken as advised
Detailed Answer:
Hello XXXX,
All these advices are part of lifestyle modifications for migraine headache.
These are triggers and best avoided.
Adequate sleep, decreased stress leads to decrease in episodes of headache and the need for prolonged medications.
Coffee 1-2 daily, sleep atleast 7-8 hours.
Wishing good health and early recovery.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Naveen Kumar
Dr. XXXXXXX
The following question is not yet answered (don't know if you received it):
Now, till when should I be taking the medications?
Should I continue taking Cerebromap?
Should I continue taking Depovit B12? if so, if there is alternative for Ampoules
What is the alternative for topiramate if it affected my skin?Should I stop it and take any pain relief instead such as panadol extra?
what is the alternative of Lyrica/Lyrolin if it affects my sexual life (erection OK but no orgasm).
Finally, we are fasting in Ramadan (next month) for around 16 hours a day prohibited completely from food and drinks, does it affect me or I shouldn't fast at all?
Many thanks and I guess this will be my last question.
The following question is not yet answered (don't know if you received it):
Now, till when should I be taking the medications?
Should I continue taking Cerebromap?
Should I continue taking Depovit B12? if so, if there is alternative for Ampoules
What is the alternative for topiramate if it affected my skin?Should I stop it and take any pain relief instead such as panadol extra?
what is the alternative of Lyrica/Lyrolin if it affects my sexual life (erection OK but no orgasm).
Finally, we are fasting in Ramadan (next month) for around 16 hours a day prohibited completely from food and drinks, does it affect me or I shouldn't fast at all?
Many thanks and I guess this will be my last question.
Brief Answer:
Try to get your medications adjusted under neurologist guidance
Detailed Answer:
Hello XXXXX,
I like to treat my patients with such complaints as mentioned below.
1) sertraline 25 mg at night
2) divalproate 500 mg at night
3) flunarizine 10 mg at evening
4) naproxen 500 mg for pain on sos basis.
If topiramate is causing problem then avoidor reduce dose.
If pregabalin is having significant effect on sexual life then better to avoid.
No need for cerebromap or depovit B12 (Indicated if vitamin b12 levels are low).
Fasting may increase headache episodes during ramadan.
All these medications are to be started at low dose and increased gradually as needed in follow up of a neurologist.
Wishing your early recovery.
Please put any other queries if needed.
Regards
Dr N Kumar
Neurologist
Try to get your medications adjusted under neurologist guidance
Detailed Answer:
Hello XXXXX,
I like to treat my patients with such complaints as mentioned below.
1) sertraline 25 mg at night
2) divalproate 500 mg at night
3) flunarizine 10 mg at evening
4) naproxen 500 mg for pain on sos basis.
If topiramate is causing problem then avoidor reduce dose.
If pregabalin is having significant effect on sexual life then better to avoid.
No need for cerebromap or depovit B12 (Indicated if vitamin b12 levels are low).
Fasting may increase headache episodes during ramadan.
All these medications are to be started at low dose and increased gradually as needed in follow up of a neurologist.
Wishing your early recovery.
Please put any other queries if needed.
Regards
Dr N Kumar
Neurologist
Above answer was peer-reviewed by :
Dr. Sonia Raina
Answered by
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