Hi, everybody:

I have had very strong headaches almost every day for a very long time. I feel like my head is going to explode. I do not know how to describe these headaches; I just do not find the right words. All I can say is that I almost always feel sluggish, weak, and very tired when I have these headaches. I sometimes have a low key fever with these headaches. I also want to cry with anger when I feel these headaches.

What could it be? A "simple" headache? A migraine headache? A brain aneurysm? A blood clot in the brain? A brain tumor? Something else?

Could my epilepsy be responsible for my headaches, even when I am not having an attack? By the way, what is the difference between epilepsy and post concussion syndrome?

One of my grandmothers (my father's mother) died from a brain tumor a few years after the end of World War II when my father was still a toddler. My father, who is now in his late sixties, had a stroke a few years ago because a blood clot moved from one of his legs into his brain. He had a stent put in in New Zealand. Now, he has another blood clot (maybe more) in one or both of his legs. I do not know anything from my mother's side of the family because she refuses to tell me anything; it is as though she wants to think her family is perfect in every way, including health, even though no one is perfect in this world.

I tried Tylenol, but it does not work. I cannot take NSAIDs because I am allergic to all of them, except Vioxx and Celebrex, which I heard were pulled from the market. NSAIDs cause me asthma attacks. I tried medications from the triptan family, such as eletriptan (Relpax). At first, it seemed to help, but as time went by, I noticed it worked less and less.

MSIR works better, but no doctor prescribes strong narcotic painkillers for headaches. I have some MSIR capsules at home and some with me, in case I have breakthrough RSD pain (56 capsules per month, that is, two capsules per day). If I take these capsules for my headaches, I will have nothing left when RSD attacks strike. Besides that, my primary care doctor (the only doctor willing to take care of me) prescribed these MSIR capsules for my RSD breakthrough pain, so he would certainly not appreciate my taking them for other pains, including strong headaches, as strong as they might feel to me. If I do not use the MSIR capsules as indicated, he could wean or cut me off of not only the MSIR capsules, but also of the Duragesic patches. This would be a catastrophe for my RSD, which is generalized internal chronic RSD.

Physical therapy does not help. Cold or heat does not help. Massages help a little bit, but their effect does not last long.

Do you have any ideas what is going with my head (brain)? Do you have any suggestions of what to do to relieve this pain?

Thanks for your information.

[mrsD]

This is called MOH (Medication Overuse Headache).... and people on chronic painkillers can develop it, regardless of what type of pain is being treated.

There is no treatment, except for reducing or getting off pain killers.

It is a neurological condition generated in the brain in response to opiate or other analgesic use.

Thought initially to be mostly found in chronic headache patients, also chronic pain patients who use opioids daily, may develop headache as a side effect of opioid therapy.

This is thought to arise in the glial cells of the brain...those cells which support other brain cells. But its exact mechanism is not understood as yet. Much of the research is in Europe and slowly spreading to the US.
I've had two long seminars in this topic, in the last 3 yrs.

You can Google MOH headache, for more details. But it is quite complex, and one reason doctors are now hesitating to prescribe long term high dose opioids in most pain patients.

[Dr. Smith]

Kitty,

You may need to find a headache specialist. They're often neuros, but some have come from other specialties as well. Basically, they're doctors who limit their practice soley to headaches (and sometimes one particular type of headache, like migraine).

While you're looking for one, start keeping a headache log/journal (Google: headache log for examples). This will help you (and the doctor) identify the type and cause of the headaches (if one can be found).

If triptans once helped, migraine and/or cluster headaches are a possibility. You can also Google: headache diagnosis, headache identification, identifying headache type.... things like that may lead you to some clues as well. The better informed/prepared you are when you find a specialist, the sooner s/he should be able to help you.

Doc

[Peter B]

I'll throw in my 2 cents worth.
For over 25 years, while working with computers, I had the most awful debilitating headaches that nothing was able to relieve.
Massage, medication, injections, chiro.

A new pain doctor suggested that tight back and neck muscles were pulling on my neck and scalp, and causing the headaches.
Remedial massage was suggested and I found immediate relief.
Not a cure, but it helped me cope.
I now take magnesium oil for my muscles and don't need massage nearly so often.
Something to consider.
I was on maximum dose tramadol at this time as I was still a bit headachy and read about rebound headaches. So I stopped immediately -not recommended-and took a slow release paracetamol instead.
Headaches went. So I think I was getting headaches from the Tramadol.
Speak to your GP before changing meds though as if you are dependent on them you may suffer a reaction.
I had just twitchy legs for 2 days, so was lucky.
None of these things may help you, but it pays to keep an open mind and try different things.

[Dr. Smith]

Originally Posted by Peter B

For over 25 years, while working with computers, I had the most awful debilitating headaches that nothing was able to relieve.

Thanks for bringing that up. Computer Vision Syndrome (Google same) can also cause killer headaches.
http://www.mdsupport.org/library/cvs.html

I sometimes get them from that, sometimes from the same muscle strain as Peter, and a host of other causes. I've gotten relief from the stress-induced cervicogenic headaches with myofascial and deep massage (depending on what's messed up at the moment, and from those and migraines with physical therapy/exercises. The real buggers are the compound headaches (two or more types of headache concurrently) or the ones I call "foolies" cuz you think it's one type and after treating it accordingly for several hours, you figure out it's another type....

A good starting point I just happened across:
http://en.wikipedia.org/wiki/NIH_cla...n_of_headaches

On a humorous note, I just recalled a discussion I had with my PCP about my migraines. After describing them in detail (from my headache log ) I noticed him staring at his computer screen for a long moment. "I'm sorry," he said, "I'm supposed to categorize your headache from this list on the system. It lists over twenty types of migraine, and yours doesn't fit any of them." I sighed and shook my head, and he suddenly exclaimed, "Ah, there it is.... 'OTHER'," as he punched the ENTER key....

Doc