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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Having Severe Head Ache. Diagnosed With Migraine. Other Conditions Are Sarcoidosis Of The Lungs, And Narcolepsy. Treatment?

My husband has not been headache free for more than 12 hours at a time for two weeks. This is a sudden occurrence as he hasn't had headaches before. Prior to this beginning three months ago, he was treated for pneumonia twice with antibiotics and steroids he was on the last of his taper dose when the headache with congestion suddenly hit in the middle of the day within a couple hours. The headaches came on suddenly and severe. He also has a droopy right eyelid, and metallic taste that is bad enough that he is not eating much. He went to the er on the 4th day and after normal ct scan and xray was diagnosed with migraine, given a shot and sent home. He was in more pain through the night and next morning. After home dose of my migraine medication, foricet, the headache was gone. He also has had high blood pressure ( is normal is a low normal reading). After a second visit to an er ( this one a large university hospital) his pressure was 180/140 the dr dismissed the reading as white coat syndrome ( has never happened to him before). Dr there diagnosed a cold! He takes readings at home now and are consistently high with a unusual for him higher pulse rate 90+ . The headaches are so severe he cries. He is taking 1/2 or 1 tablet of leftover codeine pain medication which usually stops the pain for a while. He is really foggy today, answering no knowing what he said when answering questions, ect... His other conditions are sarcoidosis of the lungs, and narcolepsy. What next? a cardiologist or neurologist? MRI with contrast? MRA?
Tue, 23 Apr 2013
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Cardiologist 's  Response
Hi friend,
Welcome to Health Care Magic

You are right / MRI and MRA should be done - Confusion, brain involvement in the background of sarcoid; mid-brain or cavernous sinus problem because of ptosis...need evaluation
High pressure, fast rate, episodic nature - needs to investigate for Pheochromocytoma

Take care
Wishing speedy recovery
God bless
Good luck
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Internal Medicine Specialist Dr. omz's  Response
hi

your HUSBAND has benign intracranial hypertension(BIH) due to steroids ,narcolepsy and sarcoidosis...+ increased coagulopathy due to these diseases.+ptosis...........you need to do post contrast MRV +MRI BRAIN.I think BIH with SINUS THROMBOSIS IS THE CULPRIT FOR YOUR HUSBAND HEADACHE NOT MIGRAINE.

TAKE CARE
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  User's Response
Dr. Rajinder Singh's  Response
Hi,
At times the turmoil in brain is not completely understood even with symptoms and investigations, because marked relevant changes are not there in the investigations. It seems your husband developed all complaints during or after the treatment for Pneumonia for which he was diagnosed for Migraine. Now Migraine makes it presence feel generally through symptoms only and it may resemble as a case of Hypertension or Cervical Spondylosis also. sever headache with nausea, vomiting, photophobia, violence, shrieking etc.

The only thing which is dragging my attention more is the drooping of eyelid and metallic taste in mouth, i think you shall better see a Neurophysician/ Neurosurgeon and then only go for anyother investigations, about which i think nothing much abnormal will be found.

At times it has been seen that the disease plane shifts from one system to another and i guess this is what happened in his case. the disease shifted from respiratory to Central nervous System, but this could only be said if he doesnt had the Headache and all symptoms earlier in his life time.

You can also consult a Homoeo Physician because Homoeopathy also has good results.

Regards
Dr.Rajinder Singh
Homoeopathic Physician

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Having Severe Head Ache. Diagnosed With Migraine. Other Conditions Are Sarcoidosis Of The Lungs, And Narcolepsy. Treatment?

Hi friend, Welcome to Health Care Magic You are right / MRI and MRA should be done - Confusion, brain involvement in the background of sarcoid; mid-brain or cavernous sinus problem because of ptosis...need evaluation High pressure, fast rate, episodic nature - needs to investigate for Pheochromocytoma Take care Wishing speedy recovery God bless Good luck