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Dr. David, Board Certified Physician
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Headache and lightheadedness causes

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I am having severe headaches with lightheadedness (feeling like passing out). What could be wrong? Long story but I will keep it short. It started in July 2011 with what I thought was a head cold. It later progressed to head pressure headaches, vice like, so went to urgent care and the doctor thought it was sinus infection and put me on antibiotic which didn't really help. I continued to have the head pressure headaches, took over counter pain meds which gave some relief. I only took when I could no longer tolerate the pain. I went to urgent care again and a different doctor thought it was still a sinus infection and prescribed another antibiotic. I only took only one or two pills of that round of meds because I went to ER for blood in urine (later found out I have kidney stones) and was told to stop the antibiotic. Because the headaches continued I finally went to see my internal medicine doctor and he set me up for MRI of brain. That came back normal. Since the MRI, I have had severe headaches with episodes of overwhelming feeling like I am going to passing out. I had two of these while sitting at work. I had once last week and went to urgent care and they prescribed Topomax. And another yesterday when I when to Emergency Room. They did work up of blood work which all came back normal. They suggested not driving until I see my internal medicine doctor on Friday in follow up due to the feeling like I am going to pass out. I had one another episode and that was while shopping. I started getting a severe headache and then the overwhelming feeling like I was going to pass out. I then sat down and drank some water. Since this has started in July I have complained about tiredness. To the point of wanting to nap which is unusual for me as I don't nap. Another thing to add which I do not know if it relates is that around Christmas the left side of my neck was swollen and lasted for about two days. I don't know if any or all of this is related but I am getting frustrated especially when it is now affecting my job.

You need to have your thyroid and vitamin D and B12 levels checked. These could be off.

You need to have your glucose measured during one of these episodes. It could be due to low blood sugar. Have you tried to eat during one of these headache episodes? Does that help?

You need to get an ultrasound of your neck to see if there are enlarged lymph nodes still there. sometimes when a mass is pressing on the neck, they can press on barrow receptors which can tell your brain that your blood pressure is too high and then your brain tries to drop your blood pressure and this can make you feel like passing out with headaches.

It could still be a sinus infection; I would try a second course of antibiotics different than the first just in case.

Customer: replied 5 years ago.

I had my thyroid test done and they came back okay. I also had the 24 urine test and salvia tests done. I did try to eat while I was having the last episode at work and also drink a small amount a sugary drink to see if that would help. When I was in the ER they test my glucose and it was not low. I have been home all day and limited my activity and as long as I am not moving a lot I appear to be somewhat okay. Could I have a sinus infection for that long of a time? My concern is long term antibiotic use when I may not have a sinus infection.

Would you suggest a CT scan of the sinus or other test to confirm? I really think it may have something to do with my neck. Would a pinched nerve in the neck cause the symptoms I am experiencing? Any further input will be greatly appreciated.

A course of antibiotics would be for 2-3 weeks. If you took that and it didn't help, then most likely you don't have a sinus infection.

It could be something going on in your neck like a lymph node pressing on barrow receptors or a pinched nerve. Instead of the sinus CT scan, you should get a CT scan of your neck or MRI of the neck to see if you have a pinched nerve or something else going on.

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