Q. Kindly explain the treatment for severe headache in right temple.

Answered by Dr. Aida Quka and medically reviewed by Dr. Divya Banu M

 

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Hello doctor,

My daughter is 9 years old and has a typical headache at right temple. The headache, she says, is more or less constant and not severe in the day but is intense at night. She sleeps at around 10:00 PM and wakes up around 12:15 AM to 12:30 AM. This is when she cries as she is not able to bear the pain. She gets up from the pain itself. We have already done head X-ray and sinuses is ruled out.

Even though the medicine is for antibiotics and I am not sure that it is working, as there is no improvement for last four nights (saving the first night when there was no pain and she could sleep the entire night). During her night pains when we give her Crocin, she is better after 10 to 15 minutes and then typically sleeps the rest of the night.

We are trying to get appointment for silent MRI and have our fingers crossed. However, as you are very experienced and could identify a pattern or known case or cause, please do share. Again, the pain is only at right temple and nowhere else


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Dr. Aida Quka
FACULTY OF MEDICINE, UNIVERSITY OF TIRANA., NEUROLOGY POST GRADUATION DEGREE, UNIVERSITY HOSPITAL CENTER
Neurology

Hello,

Welcome to icliniq.com.

I understand your concern and would explain that this type of headache could be related to hipnic headache. Anyway, a brain MRI or CT scan is necessary in order to exclude a possible brain lesion, as the headache is always located in the right temple.

I would also recommend performing PCR and ESR for inflammation. Temporal arteritis is another possible disorder, which could lead to pain in this region. In such case steroids would be needed. A Doppler ultrasound of the temporal artery is needed too.

In case the brain MRI, inflammation tests and transcranial doppler of the temporal artery is normal, I would recommend considering hipnic headache as a possible cause. In such case Flunarizine or Topiramate would help improve her situation.

 

Thank you doctor,

I would like to give you a fresh observation. Please bear with me.

Today, after reading your advise I went back from office to collect my daughter from her grandparents. The drive is 30 minutes. The AC was on and sometime between 15 to 18 minutes I changed the wind direction. Two minutes after that my daughter started complaining of headache. The headache went from bad to worse in 10 minutes. When we reached home she was all in tears and wanted to lie down.

10-15 minutes after reaching home the situation became from bad to worse. At this time we told her in order to give you Crocin you need to eat. She had some food and I gave her Crocin and an antiallergic by the name Practin, which has some anti-allergic and sleep inducing chemicals. Within 10 minutes she was fine. Fine like no headache ever existed. I have given her Crocin before but this time it was not midnight, also last times she took about 20 minutes to be fine and also we have given her antiallergic for the first time, on recommendation of a general physician. Also, a distinct factor in this bout of pain was that the pain was not localized to temple, it was in right side of the head.

Kindly tell me that can cold air cause severe headache. Can this severe headache be because of some allergic reaction? Headache that is severe and goes away within minutes of having antiallergic. If she again comes with headache, can I give her another Crocin within four hours?

 

Dr. Aida Quka
FACULTY OF MEDICINE, UNIVERSITY OF TIRANA., NEUROLOGY POST GRADUATION DEGREE, UNIVERSITY HOSPITAL CENTER
Neurology

Hello,

Welcome back to icliniq.com.

Let me answer your questions as follows:

1. Wind can trigger tension type headache and migraine headache, as it can lead to muscle spasms in the neck and also changes in blood flow in the brain, due to vessels spasm (narrowing).

2. An allergic reaction can trigger sinus headaches, due to the increased pressure in the sinuses (blocked drainage) or trigger migraine.

As the headaches are relieved by an anti-allergic or Crocin, it indicates a benign type of headache. I hope everything will be fine with the MRI result. I would be glad to give a second opinion as soon as you will be able to upload the MRI report.

 
 
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