Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Severe Pain In Eye And Head, Depression, Dizziness And Imbalance?
Question: Hi there. I am looking for relief. I have been suffering from severe eye and headache on one side of my head. It's been affecting my personality, sleep and relationship with others. It has sometimes caused problems at work and I al in need of relief fast. I don't know what to do. I'm getting depressed, paranoid, dizzy and off balance sometimes. My speech gets affected by it as well and I'm afraid of the worst. I was on wellbutrin during this time and I continue to have problems with irritability and crying spells for no reason. I sometimes feel like I am having a psychotic break, but the psychiatrist believes it's more physiological than psychological. Help. Please
Brief Answer:
Many types of headache possible, management varies with the type.
Detailed Answer:
I read your question carefully and I understand that you are in great distress.
The description of pain in the eye and head on one side can respond to different types of headaches with different causes. Their treatment varies from one type to the other as well. To determine the type of headache in your case, some more info on the characteristics of the headache and history would be useful, such as:
-Onset, how long has the pain been present.
-Is it continuous or episodic
-If episodic how long do the episodes last: seconds, minutes, hours, days
-How frequent are the episodes (approximately how many times per hour, day, week, month)
-Character of the pain: stabbing, pulsating, constant pressure like, squeezing etc
-Location, areas involved in the head. Is it always on the same side or does it switch side?
-Accompanying symptoms in the face like: lacrimation, flushing in the face, red eyes, drooping eyelid.
-Other symptoms like nausea, vomiting, increased sensitivity to light and noise, fever, nasal discharge etc. What do you mean by speech being affected, any limb weakness, balance issues, etc?
-Aggravating/triggering factors like head position, time of day, lack of sleep, certain foods or drinks, physical activity, odors, chewing, speaking etc.
-Any other medical conditions you might have, other medication apart from wellbutrin (which can have headache as side effect).
-Have you had any tests for the headache till now?
-Family history for headache.
If you provide that or any additional info perhaps I might be of more help.
Base only from what you've given till now several possible diagnoses like: cluster headache, migraine, paroxysmal hemicrania, idiopathic stabbing headache, trigeminal neuralgia just to name a few.
I might be more specific and suggest tests or management with more data.
I remain at your disposal for further questions.
Many types of headache possible, management varies with the type.
Detailed Answer:
I read your question carefully and I understand that you are in great distress.
The description of pain in the eye and head on one side can respond to different types of headaches with different causes. Their treatment varies from one type to the other as well. To determine the type of headache in your case, some more info on the characteristics of the headache and history would be useful, such as:
-Onset, how long has the pain been present.
-Is it continuous or episodic
-If episodic how long do the episodes last: seconds, minutes, hours, days
-How frequent are the episodes (approximately how many times per hour, day, week, month)
-Character of the pain: stabbing, pulsating, constant pressure like, squeezing etc
-Location, areas involved in the head. Is it always on the same side or does it switch side?
-Accompanying symptoms in the face like: lacrimation, flushing in the face, red eyes, drooping eyelid.
-Other symptoms like nausea, vomiting, increased sensitivity to light and noise, fever, nasal discharge etc. What do you mean by speech being affected, any limb weakness, balance issues, etc?
-Aggravating/triggering factors like head position, time of day, lack of sleep, certain foods or drinks, physical activity, odors, chewing, speaking etc.
-Any other medical conditions you might have, other medication apart from wellbutrin (which can have headache as side effect).
-Have you had any tests for the headache till now?
-Family history for headache.
If you provide that or any additional info perhaps I might be of more help.
Base only from what you've given till now several possible diagnoses like: cluster headache, migraine, paroxysmal hemicrania, idiopathic stabbing headache, trigeminal neuralgia just to name a few.
I might be more specific and suggest tests or management with more data.
I remain at your disposal for further questions.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello Dr. Taka,
I will answer your questions to the best of my abilities and if there is any preceding follow-ups and if I have to pay more, I will. I am in a deal of distress and it is not good for the body considering I just landed a new job and I don't want to lose it. It is a good job.
The description of the eye pain that I can come up with is it feels like something is pulling and constant pain. On a scale from 1-10, it is about an 8 on a daily basis. It has been continuous since December, while I was taking the Wellbutrin.
It is always on the same side and never switches sides. One thing I did notice is that on the same side, I hear ringing and the other side, I hear a swishing or a pulsating sound in my left ear. I cant distinguish certain background noises and yesterday I had about 30mins of relief from these symptoms and then again, these symptoms came back.
What I mean by speech being affected is that I slur my words. This was on Wednesday I believe. Again, I was fine for about 30 mins, then symptoms returned.
I have seen a bit of an eyelid droop, but nothing substantial. I get confused with noises and I do get weakness in my limbs sometimes, like a real sharp neural pain. For example: I will have a glass in my hand sometimes and without control, I get a very mild pain in my arm and I have to grab it with my other hand. I have, in the past, have had my leg sort of buckle underneath me. Nothing major, but these are past symptoms that have happened off and on for several years.
when I am in pain, sounds aggravate me; people talking aggravate me; my mother cooking when I am visiting irritates me. I don't drink crap drinks, although, I do drink beer about 3-4 times weekly and will usually only drink 1-2 beers, but nothing major.
I have not had these problems that I am describing prior to taking the wellbutrin, but I haven't taken the medications in 2.5 months. I still have crying spells and I almost lost it while waiting to do a drug test for a job and too many sounds going on and I almost lost it.
I will answer your questions to the best of my abilities and if there is any preceding follow-ups and if I have to pay more, I will. I am in a deal of distress and it is not good for the body considering I just landed a new job and I don't want to lose it. It is a good job.
The description of the eye pain that I can come up with is it feels like something is pulling and constant pain. On a scale from 1-10, it is about an 8 on a daily basis. It has been continuous since December, while I was taking the Wellbutrin.
It is always on the same side and never switches sides. One thing I did notice is that on the same side, I hear ringing and the other side, I hear a swishing or a pulsating sound in my left ear. I cant distinguish certain background noises and yesterday I had about 30mins of relief from these symptoms and then again, these symptoms came back.
What I mean by speech being affected is that I slur my words. This was on Wednesday I believe. Again, I was fine for about 30 mins, then symptoms returned.
I have seen a bit of an eyelid droop, but nothing substantial. I get confused with noises and I do get weakness in my limbs sometimes, like a real sharp neural pain. For example: I will have a glass in my hand sometimes and without control, I get a very mild pain in my arm and I have to grab it with my other hand. I have, in the past, have had my leg sort of buckle underneath me. Nothing major, but these are past symptoms that have happened off and on for several years.
when I am in pain, sounds aggravate me; people talking aggravate me; my mother cooking when I am visiting irritates me. I don't drink crap drinks, although, I do drink beer about 3-4 times weekly and will usually only drink 1-2 beers, but nothing major.
I have not had these problems that I am describing prior to taking the wellbutrin, but I haven't taken the medications in 2.5 months. I still have crying spells and I almost lost it while waiting to do a drug test for a job and too many sounds going on and I almost lost it.
Brief Answer:
Possible hemicrania continua, but brain imaging recommended as well.
Detailed Answer:
Thank you for providing some more info. So the pain has been present only from December, you didn't suffer from headaches before and hadn't been taking painkillers frequently.
Looking at those symptoms one possible diagnosis might be that of hemicrania continua. It is characterized by persistent daily headache, always on the same side. Often it can also have signs such as ptosis (drooping of eyelid), pupil constriction, lacrimation etc. Characteristic of this headache is that it responds very well to a drug called Indomethacin.
Migraine would also be a possibility, but usually the pain switches sides, is pulsating and becomes chronic persistent in people who have suffered attacks for a long time, so less likely although can't be totally excluded due to many different presentations.
However I believe that considering some of the symptoms your refer such as speech slurring, weakness of the limbs and also because hemicrania continua is not such a common diagnosis, brain imaging by CT or MRI should be scheduled to exclude brain lesions.
In the meantime, I suggest a two week course of Indomethacin for hemicrania continua. Dosage may vary, since you are a young person, if there are no issues such as gastric ulcer, kidney or liver problems or high blood pressure, I would suggest a dosage of 150mg a day (75 mg twice daily, or 50 mg thrice daily).
I hope to have been of help.
Possible hemicrania continua, but brain imaging recommended as well.
Detailed Answer:
Thank you for providing some more info. So the pain has been present only from December, you didn't suffer from headaches before and hadn't been taking painkillers frequently.
Looking at those symptoms one possible diagnosis might be that of hemicrania continua. It is characterized by persistent daily headache, always on the same side. Often it can also have signs such as ptosis (drooping of eyelid), pupil constriction, lacrimation etc. Characteristic of this headache is that it responds very well to a drug called Indomethacin.
Migraine would also be a possibility, but usually the pain switches sides, is pulsating and becomes chronic persistent in people who have suffered attacks for a long time, so less likely although can't be totally excluded due to many different presentations.
However I believe that considering some of the symptoms your refer such as speech slurring, weakness of the limbs and also because hemicrania continua is not such a common diagnosis, brain imaging by CT or MRI should be scheduled to exclude brain lesions.
In the meantime, I suggest a two week course of Indomethacin for hemicrania continua. Dosage may vary, since you are a young person, if there are no issues such as gastric ulcer, kidney or liver problems or high blood pressure, I would suggest a dosage of 150mg a day (75 mg twice daily, or 50 mg thrice daily).
I hope to have been of help.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much. Could this also contribute to my sensitivity to sounds and some of the visual disturbances I am experiencing?
I currently do not have any insurance and was wondering if you can recommend anything to get some CT scans or MRI done.
Thanks again.
XXXX
I currently do not have any insurance and was wondering if you can recommend anything to get some CT scans or MRI done.
Thanks again.
XXXX
Brief Answer:
Read below.
Detailed Answer:
Sensitivity to sounds and visual disturbances are often a feature of migraine, that is one of the causes I suggested it as a possible diagnosis even though it lacked other migraine typical features.
Another possible cause for those would be the anxiety and mood disorder that you describe for which you were on wellbutrin.
Actually I considered in my previous answer of suggesting taking amitriptyline as well, which is an antidepressant with very good antianxiety properties. It is a first choice medication in migraine prevention as well. The reason I didn't suggest it in the end was because if there was improvement it would be hard assess whether it was due to Indomethacin (which would confirm the diagnosis of hemicrania continua) or due to the effects of amitriptylin so thought it better to delay it and be tried later if indomethacin was not effective.
As for CT or MRI, it's hard for me to make recommendations, because not practicing in the US I am not familiar with the regulations regarding tests.
In my country since your pain is described as severe I would recommend you headed to the Emergency Department, refer your pain and hearing and vision issues and if the emergency doctor there during neurological exam found other possible neurological signs, he would make a CT (which doesn't require insurance if in ER). But I am not sure how does it work in the US as I said.
Wishing you good health.
Read below.
Detailed Answer:
Sensitivity to sounds and visual disturbances are often a feature of migraine, that is one of the causes I suggested it as a possible diagnosis even though it lacked other migraine typical features.
Another possible cause for those would be the anxiety and mood disorder that you describe for which you were on wellbutrin.
Actually I considered in my previous answer of suggesting taking amitriptyline as well, which is an antidepressant with very good antianxiety properties. It is a first choice medication in migraine prevention as well. The reason I didn't suggest it in the end was because if there was improvement it would be hard assess whether it was due to Indomethacin (which would confirm the diagnosis of hemicrania continua) or due to the effects of amitriptylin so thought it better to delay it and be tried later if indomethacin was not effective.
As for CT or MRI, it's hard for me to make recommendations, because not practicing in the US I am not familiar with the regulations regarding tests.
In my country since your pain is described as severe I would recommend you headed to the Emergency Department, refer your pain and hearing and vision issues and if the emergency doctor there during neurological exam found other possible neurological signs, he would make a CT (which doesn't require insurance if in ER). But I am not sure how does it work in the US as I said.
Wishing you good health.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Just to clarify. I have not had mood problems prior to taking wellbutrin. Aside from the regular anger we all experience. I was taking Wellbutrin for ADD and was not taking solely for mood, depression or anxiety.
I do, howevery, experience panic attacks a lot and it is probably due to the transition of a new job and moving all in the same month. thanks for your recoomendations. I really appreciate your help.
XXXX
I do, howevery, experience panic attacks a lot and it is probably due to the transition of a new job and moving all in the same month. thanks for your recoomendations. I really appreciate your help.
XXXX
Brief Answer:
Thank you!
Detailed Answer:
Thank you for clarifying that and your appreciative words!
I hope you'll get better soon.
Thank you!
Detailed Answer:
Thank you for clarifying that and your appreciative words!
I hope you'll get better soon.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
