Brief Answer:
Need details of your complaint

Detailed Answer:
Hi XXXX, thanks for asking from HCM.


I can understand your concern. You are having pain on left side head and tingling on same side cheek. I need more details of your complaint so that I can suspect something and advise further. Kindly tell me

: What is exact location of pain on head? whether it is over forehead/temple/behind ear

: What is the duration of headache?

: Any relation of pain with exposure to air, touch, eating?

: Do you feel nauseous or vomiting with headache?

: Any eye problem, regular nasal blockade, running nose, hearing loss?

Your pain and other symptoms could be due to

: Migraine
: Left side trigeminal neuralgia
: Sinusitis
: Same side tumor like Cerebellopontine angle mass

Kindly provide me answers of above mentioned questions. After that, I will tell you most probable cause and investigations required to confirm it.

Hope you will understand my point. If any doubt, do let me know.
Thanks. Take care.

---

Brief Answer:
Differential Diagnosis of disease and management

Detailed Answer:
Hi XXXX, welcome back. Thanks for providing me the details.


I have read your clinical history. I assume that the tooth cavity has been taken care by dentist. Your pain is more of dull kind, intermittent episodes of sharp pain, mainly at temple and back of head. Such headache is

: Stress or tension headache - This is the most common type of headache. It is dull, mostly bilateral, band like sensation around forehead, no nausea, heaviness of head and eyes, occurs after mental stress/working in bright light/excessive focusing of eyes, persists for hours, even occurs before and after sleep. Usually it is less responsive to medication.

If your rest features are similar to it, it is the cause. It can be treated by
; bed rest
; avoid mental stress/laptop or computer or XXXXXXX use for long duration/non stop working.
; close eyes after every 45 min while working/reading/writing
; maintain 8 hour sleep routine
; avoid late night TV, alcohol.
; you can have 2-3 cups of coffee/tea if no contraindication. Caffeine is considered good for pain relief.
; Head massage
; you can take Tablet Paracetamol/Aceclofenac/Diclofenac/Ibuprofen after proper prescription. As I told you that it is less responsive to painkiller, better change life style.
; if you are using numbered glasses, wear them while reading/writing.
; maintain healthy diet to avoid any deficiency. As pain increases if haemoglobin is low.

: Another cause could be Atypical Migraine - It is lesser possibility as there is no nausea/vomiting/visual problem and pain episodes are of long duration. However it can be suspected if pain is occurring in some specific season, aura symptoms before pain like bad taste/bad smell.
It is treated by
; Abortive therapy - Consult neurologist for it. He may prescribe you any of following medication
Sumatriptan
Ergotamine
Naproxen
Oxycodone

These medication aborts pain attack

; Preventive therapy - There are few medications which prevent attack of Migraine like
Propranolol
Pregabaline
Gabapentine
Amitriptyline

Anyone medication is sufficient.

Tumor has been ruled out as it mostly presents with vomiting, blurring of vision, progressively increasing pain. Also CT head was suggestive of no mass lesion.So there is no need of MRI brain. However if you do not get relief, pain increases, nausea and vomiting along with blurring, MRI brain may be needed.

Before following above mentioned treatment, I advise you to get few investigations to rule out secondary headache

: Haemoglobin level - Low Hb can cause unexplained headache
: BP - Hypertension presents as headache at nap of neck.
: Vision - Refractive error or Glaucoma can cause left eye heaviness/pain.
: Evaluation of left Molar tooth cavity - Dental pain can cause tingling on left cheek, radiation on pain at temple.

Hope it will help you. Do not worry.

If still in doubt, do let me know.
Thanks. Take care.

---