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(Message started by: Wapitihunter on Oct 27^th, 2003, 10:45am)

Title: Newbie with Questions
Post by Wapitihunter on Oct 27^th, 2003, 10:45am

I have had a history of frequent headaches throughout my life, normally treated by visits to my chiropractor. About a month ago I started getting sharp pains on my right temple. Some days there would only be one epsiode lasting only a second or so, followed by kind of a general headache. They seemed to stop for a week or so then resumed with sharp stabbing pains over my right eye - sinus area. I've kept track of them and sometimes they will be about 5 minutes apart then diminishing to about ten minutes apart, then stopping. They may or may not resume an hour or two later. They last only a second but are very uncomfortable. This morning at 2:30 AM I had 4 or 5 in a row, then they stopped. Because of the short duration I'm not sure they are cluster headaches but from some of the info I've read, could be. Any help out there would be appreciated.

Thanks - Larry

Title: Re: Newbie with Questions
Post by BarbaraD on Oct 27^th, 2003, 10:54am

Wap,
Go over to the left and take the Cluster Quiz. If it shows up that you MAY have clusters, see a doc about it. From what you described, ????? Could be anything.

Hugs BD

Title: Re: Newbie with Questions
Post by Margi on Oct 27^th, 2003, 10:59am

Hi Larry,
I definitely agree with Barb that you should solicit a medical opinion here. There are so many different kinds of headaches - you may want to research into CPH (Chronic Paroxysmal Headache) - if that's what you have there is good cure rate using indocin/indomethacin for treatment.....
here's a link to info on CPH:
http://www.headachepainfree.com/chronic_paroxysmal_hemicrania.htm

Best of luck to you Larry

Title: Re: Newbie with Questions
Post by Wapitihunter on Oct 27^th, 2003, 12:49pm

Thanks for the advice. I've made a doctor appointment for tomorrow. Hopefully, we'll find out what this darn thing is.

Larry

Title: Re: Newbie with Questions
Post by Tom on Oct 27^th, 2003, 1:10pm

some informations:

from: www.upstate.edu/neurology/haas/hpstab.htm

Idiopathic Stabbing Headache:

Non-official terms: jolts and jabs; ice-pick pains

Clinical presentation:

Each paroxysm strikes the head as quickly as an electric shock, is moderately to severely painful and lasts from a split second to some 10 seconds. Some patients say the pain is akin to a forceful prick or stab, while others say it's like a jolt or smack. The pain is most often felt in the orbital region on one side and it often recurs in the same place, but it may move to other places on the same side of the head or, less commonly, to the opposite side. The frequency of occurrence of the painful paroxysms varies greatly: Some folks may recall but one attack in a year, others may be besieged by 50 per day. Severe sieges don't usually last more than a few days, but paroxysms occurring one or several times on most days can endure for months.
Medication of First Choice: indomethacin
-----------------------------

Diagnostic criteria of the International Headache Society (1988):

1.Pain confined to the head and exclusively or predominantly felt in the distribution of the first division of the trigeminal nerve (orbit, temple and parietal area).

2.Pain is stabbing and lasts for a fraction of a second. It occurs as a single stab or a series of stabs.

3.It recurs at irregular intervals of hours to days.

4.diagnosis depends upon the exclusion of structural changes at the site of pain and in the distribution of the affected cranial nerve.
--------------------------

Who gets these paroxysms?

Basically healthy people experience idiopathic stabbing headache, for it has not been associated with serious intracranial diseases. Many of the afflicted are migraine sufferers and less suffer from tension-type headache. More of the afflicted are women than men. The incidence of this headache is higher after the age of 40, but children are also afflicted by it.

---------------------
TREATMENT of the ISH:

Indomethacin is the only drug known to affect idiopathic stabbing headache. According to a
recent study by Pareja et al. (1996), one 25 mg capsule three times daily eliminated paroxysms
in roughly one third of the treated, lessened them in another third, and was inefffective in the
remaining third. If this dose were ineffective, I would double it. If indomethacin were not
tolerated, then I would try celecoxib (Celebrex) at a dose of 200 mg twice daily, since this drug
has been shown to substitute adequately for indomethacin in another indomethacin-responsive
headache, "chronic paroxysmal hemicrania," (Mathew et al., 2000) and I have a patient whose
"hemicrania continua" is suppressed by this drug as well as by indomethacin.
---------------------------------

DIFFERENTIAL DIAGNOSIS:

SUNCT syndrome:

SUNCT stands for "short-lasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing." Although these attacks often occur more than once a day and in the orbital region, they are longer lasting (15-120 seconds) than ISH, briefer than CPH (see above) and are accompanied by redness and watering of the ipsilateral eye, as are CPH attacks. They have not, in contrast to IHS (see below) and CPH, been suppressed by indomethacin. The only drug reported to prevent their occurrence has been lamotrigine, an anti-epileptic drug which also can suppress trigeminal neuralgia. D'Andrea, et al. (1999) reported the case of a 66-year-old woman whose attacks (up to 15/day) were completely abolished by 150 mg of lamotrigine daily.
-------------------------------

Trigeminal neuralgia: The intensly painful paroxysms of this condition are very like those in idiopathic stabbing headache, in their intensity, quality, and duration, but trigeminal neuralgia is rare in the region of the first division of the trigeminal nerve (orbit and forehead) where ISH appears. In addition, the paroxysms of trigeminal neuralgia can be triggered by a mild stimulus to the face or mouth, whereas ISH can not be set off by such stimuli.
--------------------------------

Chronic paroxysmal hemicrania:

Attacks of this headache occur multiple times daily, but are much longer in duration than ISH in that they persist for 2 to 25 minutes. Moreover, the pain is accompanied by redness and watering of the ipsilateral eye.
------------------------------

Title: Re: Newbie with Questions
Post by lisamchlmartin on Oct 27^th, 2003, 1:30pm

Hey Larry, when I initially went to my previous doctor about my headaches he prescribed the indomethicin to me and made me very nauseated. I then had to deal w/ the headache and the nausea made it worse!! So you may want to ask your doc if that's right for you. I haven't had these headaches myself so it probably wouldn't be a bad idea to get checked out. Keep us posted - hope you feel better! :)

Title: Re: Newbie with Questions
Post by juvy on Oct 27^th, 2003, 3:52pm

Larry,

Off hand it sounds like SUNCT syndrome. (short unilaterial forgot the rest) It's described as short stabbing pains usually lasting only a few secons. It can sometimes occurs with people who suffer from CPH. Try researching it on the web. I'll look up an address about it tomorrow and post it here.

Cheers,
Juvy

never mind Tom beat me to it. :)

Title: Re: Newbie with Questions
Post by Wapitihunter on Jan 14^th, 2004, 11:09am

Hi All;

Here's an update on my case. I went to the doctor who ran some tests and by the time I received the results the headaches were all but gone. The closest thing I could describe them was an ISH.

Now here's the strange thing. Just a few days before I first experienced these jabs I had been to the dentist for a crown prep and received a shot of novacaine. After a couple of weeks they were gone. Last week they returned two days after visiting the dentist again and getting a shot of novacaine. I don't know if it's coincidence or something in the novacaine triggers a nerve in the sinus area. This time it started over the right eye closest to the nose. In the last couple of days it has moved more to the temple area over the right eye.

Anyone heard of drugs like novacaine triggering this?

Larry