Dr. Hitesh Kumar
Neurology
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Patient's Query
Hello doctor,
I am an 18 year old male. I am fairly active. For three to four months now, I have been experiencing random sharp pains behind my right ear on the back of my head. This has also been followed by increased head pressure and regular throbbing headaches. Few weeks, these symptoms only occur a handful of times, and others, it is a daily occurrence. When these sharp pains occur, they last for about 5 to 20 seconds and can be pretty shocking, making me stop what I am doing at the time. Usually, lying down in bed will make it better I have noticed. I am not sure if this is relevant, but I have had chronic upper back pain since last year, and jaw discomfort as I grind my teeth at night. I am unsure if I need to visit the doctor. I just want to get some feedback.
Hello,
Welcome to icliniq.com. I would like to know further details about your problem: 1. Did you have these headaches any time before the last three or four months? 2. In which other areas of your head, have you felt the pain? 3. What kind of a headache is it? Does the pain feel like a heaviness, throbbing, stretching, bursting, shooting, electric current, or some other kind? 4. Is it mild, moderate or severe? 5. Is the headache episodic or persistent? If it is an episodic headache, for how long does a single episode last? That is, what is the time duration from the onset, to complete relief without medication? 6. How frequent were these headache episodes before? Now, how many times in a week do you get them? 7. Do you have nausea, vomiting, watery eyes, redness of the eye, ornasal congestion during the headache? 8. How is your mood in general? How is your sleep? 9. Do you have any alterations in vision? 10. Have you noticed any triggering factors? 11. Do you have any ear discharge or hearing impairment? 12. What medicines have you taken before and in what dosages? Get the following tests done to arrive at a diagnosis: Magnetic resonance imaging (MRI) brain contrast, ophthalmology examination to look for intraocular pressure and fundus, ear nose and throat (ENT) examination. From your description it looks like it could be short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT or SUNA) or Trigeminal autonomic cephalalgia (TAC). Revert with the above-mentioned information for my better understanding and judgment.
Patient's Query
Hello doctor,
Thanks for replying. It has been going on for a maximum of five months. I feel the pain in the same spot every time. I would describe the pain as a heaviness, throbbing, and like an electric current. The severity is moderate sometimes, but mostly mild. It is episodic and, on average it takes two to five minutes to go away. On some weeks, it occurs every day, multiple times in the day, and on others, it occurs only a few times the whole week. My general mood and sleep pattern is alright. I have noticed it gets triggered when I am tired, but it does not occur only when I am tired. Also, I have noticed that I had to pop my ears more often, but did not experience any discharge or impairment. I am not on any medications. I take 200 mg Ibuprofen occasionally for my back and headaches.
Hello,
Welcome back to icliniq.com. As per your description, there is a high possibility of it being short-lasting unilateral, neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) or SUNA syndrome. But other secondary causes like a vascular headache must be ruled out. I suggest you get an Magnetic resonance imaging (MRI) brain with contrast done including temporal bone windows and magnetic resonance (MR) angiogram intracranial vessels. I also recommend you visit an ophthalmologist for an examination to look for refraction,intraocular pressure, and fundus, as well as an ear, nose throat (ENT) specialist for an examination, to look for any ear pathology. Meanwhile, I suggest you try tablet Indomethacin 25 mg thrice a day for a week, observe your response and revert.
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Neurology
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