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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5330
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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My husband is 31 years old and is currently suffering from

Customer Question

My husband is 31 years old and is currently suffering from severe headaches. A couple of years ago he had surgery for a bulging disk and it helped with his headaches for a few months. The headaches were almost unbearable before the surgery. He now continues to suffer from headaches everyday and has knots come up on his forehead about every other day. He has been to a couple of ENTs and they have done a CT scan but don't know a cause or cure. He does have a lot of sinus trouble also and has had swelling in one of his eyes a couple of times. He is beginning to feel hopeless and I would be glad to take any advice possible.
Submitted: 1 year ago.
Category: Neurology
Expert:  Dr. Bob replied 1 year ago.

Is he in good health otherwise? Is he on any medications?

Customer: replied 1 year ago.
He does take Blood Pressure medicine. He's a dentist and does stay stressed a good bit. Other than that, he seems to be in good health.
Expert:  Dr. Bob replied 1 year ago.

Did he have a CT of his sinuses?

Customer: replied 1 year ago.
about a year ago. The ENT that did it said his sinuses looked fine.
Expert:  Dr. Bob replied 1 year ago.

Was his bulging disc in the neck?

Customer: replied 1 year ago.
Expert:  Dr. Bob replied 1 year ago.

Does he continue to have neck pain?

Customer: replied 1 year ago.
No, sir. Before the surgery he had headaches and pain from his neck down his right arm and a place on his hand would go numb. Now, it's just pain in his temples and the swelling on his forehead. He is however very tense on the back of his neck and doesn't have the range of motion he did before his surgery.
Expert:  Dr. Bob replied 1 year ago.

There are many different types of headache syndromes. Many overlap. Some occur together. It can be very challenging to pinpoint the exact diagnosis. Once this is done, however, the headaches can almost always be treated successfully. I would suggest he see a headache specialist (typically a neurologist) for a complete evaluation. If he can see one at an academic medical institution, this would be best.

Expert:  Dr. Bob replied 1 year ago.

Keep in mind also that taking pain killers everyday, including tylenol and advil and the like, can actually trigger headaches and create an ongoing "vicious circle." These are called "medication overuse headaches" or "rebound headaches" and the treatment is tapering off the medications to break the cycle and then using the mildest meds that work, but only on an intermittent basis. An alternative to this is to find a preventive medication that can keep the headaches from occuring in the first place.

Customer: replied 1 year ago.
What are some preventive medications? I understand he would have to get a prescription, but I would like to know a few names to get him to ask the doctor about.
Expert:  Dr. Bob replied 1 year ago.

Amitriptyline, desipramine, propranolol, topamax, depakote to name a few.

Expert:  Dr. Bob replied 1 year ago.

Were you able to do some research on these meds? Do you have any follow up questions about them? Different doctors have different preferences as to which one to try first. All else being equal, a neurologist generally goes with the one that has been most successful in his or her practice. If the desired result is not obtained within a couple months, a different medication may be tried.

Expert:  Dr. Bob replied 1 year ago.

Hi there. Did you have any follow up questions? Let me know if you do and I would be happy to help further. If you have no additional questions, please don't forget to provide a rating. This is the only way I get credit for helping you. Thank you.