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KarayanMD, Neurologist (MD)
Category: Neurology
Satisfied Customers: 801
Experience:  Board Certified Neurologist with Subspecialty in Clinical Neurophysiology. Private Practice.
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Daughter (21) having headaches. Seeing neurologist. Originally

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Daughter (21) having headaches. Seeing neurologist. Originally rebound headaches from taking daily dose of Aleve too long. Got off Aleve. Headaches worse. Tried nortriptylene, and other meds without much relief. CT scan showed meningioma but neurosurgeon didn't feel that any action needed, and doubted it was cause of headaches. Past two days have been hell. No true signs of migraines. Just pain in both temples, jaw and neck pain, and some nausea. Should I take her to ER? Could they even help?

KarayanMD :

Hi. Are you available to chat?

Customer: Yes
Customer: Are you still there?
KarayanMD :

Yes. Welcome

KarayanMD :

Any sensitivity to light with your daughter's headaches?

KarayanMD :

Is this the worst headache she has ever had?

Customer: No light sensitivity. Not the worst.
KarayanMD :

It has been constant the last couple days?

KarayanMD :

And any fevers?

Customer: Pretty constant. No fever
KarayanMD :

What has she tried at home the last 2 days?

Customer: Nortriptylene (at night) and imitrex (1/2 tab)and just now a procorperazine. Helps minimally then comes back in about hour
KarayanMD :

Imitrex is safe in a dose of 100mg at a time as a general rule, and some people may need this dosage to have maximal effect, assuming this is a migraine. Actually the dose of 100mg can be repeated in 2 hours for a maximum of 200mg in 24 hours. Again, this is a general rule for adults, if there are no contraindications to this medication.

KarayanMD :

It would be important to know if the headache is the same quality as her usual headaches.

Customer: Quality? And no no one is certain they are migraines. Just trying different things.
KarayanMD :

Meaning does the headache feel the same as her usual headaches?

Customer: Same type just worse. I read about giant cell arteritis and it kind of sounds like that.
KarayanMD :

With the temporal pain that occurred to me too, but her age would be very unusual for this condition. There usually is pain with chewing with giant cell or temporal arteritis, as well as often body aches or muscle aches. This would be evaluated for initially with a blood test called a sed rate.

Customer: I think I will check on that next time we see doctor. So I guess ER couldn't give her any relief? Because of the rebound headaches do you think we could try one Aleve just to see if that could give some temporary relief? And yes her jaw hurts when chewing, worse the past two days
KarayanMD :

To answer your question, the ER can certainly provide more relief than Aleve would provide. They have more potent medications available, often through the IV, which sometimes can eliminate migraines or other type headaches. They also would be able to check a sed rate if needed. However, if she has not tried using doses of Imitrex as I had mentioned, this could be a consideration, even with an Aleve at the same time (they can work well together for migraines), but you must keep in mind this site is for informational purposes and is not a substitute for actually seeing a doctor (not intended to actually treat).

KarayanMD :

These are the options that I think could be considered at this time.

KarayanMD :

Best of luck. Please let me know if there are more questions. Please don't forget to click on Accept (happy faces) if I have been helpful to you today. Bonuses always are appreciated.

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