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My daughter is complaining of a headache, blurred vision and…

My daughter is complaining...

My daughter is complaining of a headache, blurred vision and her nose is burning. SHe has a history of migraines with vision problems, but the nose burining is new. Last week sudefed helped but not today

Doctor's Assistant: Is the headache episodic or daily? And what about nausea?

Was daily for 2 months last year, but periodic the past week. She has also been having stomach issues for a month or so that we think we have connected to the ibuprofen use from the headaches. I know her stomach hurts today, but she hasn't eaten and have taken meds

Doctor's Assistant: Anything else in your medical history you think the doctor should know?

Not that I can think of

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Answered in 1 minute by:
3/20/2018
Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 9,912
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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Hi,
Welcome to JA and thanks for this question. Im sorry to hear about your daughter's symptoms. Can i ask what is your daughters age? Any vomiting or nausea? Any numbness or weakness in the face, arm or leg? Difficulty speaking? Burning or shooting pain over the face or jaw along with the nose?

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Customer reply replied 4 months ago
She is 14. No vomiting, but mild nausea which could be from the meds and not eating. Her stomach often hurts when she eats so its not her favorite thing to do at the moment. None of the other things

Thanks for the additional information, let me just write down an answer for you and ill get back to you in a few mins.

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Actually, the presence of nausea along with the burning nose can both be an indication of a severe migraine attack. The fact that she does have these sort of attacks in the past, means it is more likely that these current symptoms are also due to a Migraine. Migraines can cause the burning nose sensation that she has as migraines tend to vary or add symptoms as time goes on. Some attacks of a severe migraine can even cause symptoms which are consistent with a stroke in that they can cause transient paralysis of a limb or a side of the body. So I think this current symptom can also be explained by her Migraines.

HOWEVER that being said, the presence of blurred vision, headache and nausea should be evaluated at least once in the ER or in urgent care or even at your doctor's office. While I believe this is a migraine and the nausea is being caused by gastritis (inflammation of the lining of the stomach caused by repeated use of ibuprofen - as your rightly surmised), it is still important to get a clinical examination in order to rule out other causes. That would be the wisest and most prudent course of action. At the same time, I would also suggest that you also discuss prophylactic measures to prevent further attacks of migraines in the future. Many medications can be used such as propranolol, calcium channel blockers, topiramate, valproic acid among others. These medications should allow your daughter to have much less frequent attacks.

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Customer reply replied 4 months ago
Unfortunately we have tried all of the preventative medications for her migraines. They either did not work or the side effects were too sever to continue taking them. Also, none of the medications to help with the actual onset of the migraines work for her either. We hospitalized her last year due to a rebound headache that lasted 2 months. We were able to aleiviate the pain with her getting a daithe piercing, but the blurred vision has never gone away and recently has been getting worse.

Persistent blurred vision requires a MRI as soon as possible. Blurred vision due to migraines should disappear as soon as an attack is over, and if it persists then it can be due to other causes. Also can you list the names of the preventive medications which have been tried if possible?

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Customer reply replied 4 months ago
She has had an MRI and her optical nerves have been checked. Everything has been normal. I honestly can't remember the names of all the meds we have tried. They have been different kinds topiramate, propranolol, there was also an anti depessant one, but I can't remember the name, I just remember that it was supposed to help her sleep (becasue she was not able to from the pain) and it actually kept her awake instead. There were several others, but I can't remember the names. We also tried nerve blockers, but after getting 20 shots in her face and head ir only worked for about 10 hours instead of the 6 weeks we were told.

I think that would have been amitriptyline. So botox has been tried as well. I think then we can consider the less common alternatives siuch as,

Acupuncture

Trancutaneous nerve stimulation

ACE inhibitors like lisinopril or candesartan (which are blood pressure medications) which were shown to be effective in small studies

Verapamil/nifedipine

Pizotifen

Riboflavin (which is a vitamin)

Erenumab which is a newer drug and initial results have been promising

Also consider using Acetazolamide which can be effective in young females who have migraines

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Customer reply replied 4 months ago
I think we did try lisinopril, that sounds familar and we also tried acupunture which is what led us to the piercing. If this is a migraine it will be the first one she has had since getting the piercing in December. Thank you for the other alternative medications. I will look into them.

You're welcome, I hope I have earned a 5 star rating today, do remember to rate me by clicking on the stars above your screen as that is how we are compensated for helping you today.

Dr. Muneeb Ali
Category: Medical
Satisfied Customers: 9,912
Experience: MBBS, MD, MCCM. Currently working in Critical Care Medicine with 10 year experience in Medicine
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