Brief Answer:
Needs headache specialist

Detailed Answer:
Good afternoon. My name is Dr. Saghafi and I practice Neurology as a Headache Specialist in the XXXXXXX OH region of the world.

I'm sorry your son is feeling so badly with his headaches. the good thing is they seem to be somewhat garden variety migraine headaches and as such should be fairly easy to treat.

You didn't mention whether or not these headaches are ONLY as of 3 months ago or they've just gotten particularly worse in the past 3 months. If he's got a history of headaches, even if not severe, then, this makes it all the more likely that he is suffering from what we would refer to as a PRIMARY TYPE of headache meaning, "not due to anything else."

If, however, these are brand new and he truly never had ANY TYPE of headache prior to 3 months ago then, we should look hard for something that could be triggering or precipitating them. This might include taking either a CT or MRI of the brain. You say that he has a "sinus" infection but as I tell all of my headache patients, sinusitis as a true cause of HEADACHES is actually only seen in about 0.5% of all headache patients. What this means is that migraine headaches or other forms of severe headaches frequently...VERY FREQUENTLY....masquerade as if they were sinus related but in fact, they are not. As a result both patients and patients are fooled into believing that they are in need of antibiotics, decongestants, and other remedies which ultimately never really work and may cause more problems than solutions. So, I would be tentative about that diagnosis as a cause of his headaches without more concrete evidence that he truly has a sinus infection. Leaking eyes and swollen cheeks can be consequent effects of the autonomic disturbances that are produced by migraine headaches or other forms of severe headaches like migraines.

The biggest red flag for me that he is not receiving appropriate treatment for the headache and is being incorrectly labeled as sinus infection headache is the fact that he is now on his 2nd round of antibiotics without any relief. Routinely speaking sinus infections of a bacterial nature in an immunocompetent should not be so resistant to TWO rounds of antibiotics.

Therefore, I believe the best solution for your son is to consult a local headache specialist. I would be happy to carry the consultations with him since I am a headache specialist myself and if so then, I would want him to fill out a specific headache diary or log for a period of 30 days in order to really identify his headaches and then, decide upon the best regimen which may turn out to be 2 pronged as both a prophylactic as well as abortive set of recommendations. If you would like to pursue this option then, please send me his email (or yours) and I will send back by return email a .pdf version of the Headache Log that all my patients fill out.

Of course, please keep in mind that we do not prescribe medications to patients through this network therefore, in the end he is still going to need the prescription ability of a doctor who is in the Florida area where he lives.

If this information has been helpful and I've answered your questions would you do me the favor of some written feedback and a STAR RATING of the answer?

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In the future I'm happy to answer questions personally if you'd allow me this privilege by going to the following website:

bit.ly/drdariushsaghafi

This query required 21 minutes of physician specific review, research, and final draft documentation for envoy.

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