Patient's Query
Hi doctor,
My wife has been complaining about intense migraine and headaches between her eyebrows. If I massage her eyebrows and gently hit her forehead between the eyebrows, she would say it feels good and helps a bit with the intense pain. The medications doctor provided us did not seem to do anything, so after a year, we finally decided to do a MRI to see what was causing the migraine and headaches. The doctor told that there may be excess mucus buildup in the ethmoidal sinuses or frontal sinuses that may be causing the migraine and headaches between the eyebrows. So I would like you to look at the MRI pictures and tell me what is happening. Thank you.
Hi,
Welcome to icliniq.com.
I understand your concern. Unfortunately, MRI (magnetic resonance imaging) is perfect for soft tissues like the brain and eyes, while the CT (computed tomography) scan suits bony tissues like the nose and sinuses. I have gone through the report, (attachment removed to protect the patient's identity). Anyway, two things appear clearly in the MRI. The first one is the hypertrophied inferior turbinates, which can cause headaches and nasal obstruction. The second thing is minimal inflammation in the ethmoid sinuses. The treatment is acceptable, but I need to add something to it. I recommend an intranasal corticosteroid spray such as Avamys spray (Fluticasone), one puff in each nostril once daily. This spray will decrease the size of the hypertrophied turbinates and help heal the sinus inflammation. Consult a specialist doctor, talk with them, and take migraine prescription pills and other medications with their consent. Also, let me know if she is allergic to odor, food, or medicine. Does she suffer from excessive sneezing or rhinorrhea? Thank you.
Patient's Query
Hi doctor,
Thank you so much for helping to address our concerns. You said the medication she was prescribed was fine treatment. Do you know if they are safe for pregnant women to take? My wife is 7 weeks pregnant and she stopped using the treatment because we are worried that it may not be safe. Next, you recommend an intranasal corticosteroid spray, do you have any specific ones you can recommend that are safe for pregnant women? My wife is not allergic to any odors, or medications that I know of but she is allergic to beef. She cannot eat any part of a cow. My wife does not suffer from excessive sneezing or rhinorrhea either. We will try and see a neurologist if they have one in our place. My wife tells me that her headaches and migraine does not feel like normal one (like it is coming from the brain). She always just points to the middle of her forehead where the hypertrophied inferior turbinates and the ethmoid sinuses are. She said it feels a bit of relief when I gently hit her forehead, and massage her eyebrows because it helps relives some of the pressure but I have to do this consistently throughout the day. What treatment or medications would you recommend other than the ones that were prescribed to my wife? And if the prescribed medications do not work, what then? Lastly, is my wife's hypertrophied turbinates grown to a point where we would probably have to consider removing them surgically, or is it treatable with the medications? This is a lot of questions, and I want you to know how appreciative and grateful I am to have you help give us some answers.
Hi,
Welcome back to icliniq.com.
It is a good step to stop treatment because of pregnancy. Avamys and Momentasone spray are both safe for pregnancy. She can use one of them, not both. Intranasal corticosteroid spray can be used daily for years as long as the patient needs it. Her hypertrophied turbinates can be treated by local spray, if it did not shrink in size she should undergo surgery, but this can be decided after one month of medical treatment.
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