A couple of weeks ago I was started on Nortriptyline for daily headaches. I can finally say that I am headache-free throughout the day. What I am now experiencing and did before seeing my neurologist is constant throbbing on my temples and my eyes. Sometimes it actually hurts to touch my right temple. The throbbing doesn't hurt, just really annoying. It does it all day, but at night when I am trying to get to sleep is when I feel it most. Has anyone experienced this with their PCS? I got on the headache thread, but they are making it sound like migraines. I have had migraines and this is definitely not a migraine.

Hi sheds,

Yeah, throbbing around the temple is characteristic of migraine, especially if the throbbing is consistent with your heart beat. Migraines are thought to be a vascular disease. I suppose there are other types of headaches with throbbing pain. Often migraine sufferer's have increased sensitivity to light and sound, experience visual problems, irritability, and concentration problems. Usually migraines are unilateral, but not always. And, sometimes the pain involves a whole hemisphere of the head (from the temple to the back of the neck). Head Pain behind the eye orbits with (tearing and redness) is cluster headaches. The third predominant subtype is tension headaches, which are usually bilateral, characterized by a "pressure" or "vice-like" feeling against the forehead or the back of the head and neck. Migraines and Tension headaches are common symptoms of a post concussion syndrome, even caused by a mild concussion. Migraines are treated with abortive (Immetrex, NSAIDS) or preventative medications (antidepressants, antihypertensives, anticonvulsants), and tension headaches are treated with abortive (NSAIDS) or preventative medications (Elavil and Pamelor[antidepressants]). I've heard of other types of headaches called "ice pick" headaches, but I know nothing about them.

Are they still considered migraines if there is no pain?

Technically, it's possible according to the ICHD, although I don't think that's common. Refer here for more details.

I wonder about the criteria for the label of migraine. Is there a benefit to getting the label 'migraine' or is it just so the doctors can use a CPT code in their billing?

So much of diagnostics today is oriented toward getting paid by insurance companies. Regardless of the diagnosis, the head ache still hurts. Drug therapy is a " try it and if it works, continue the drug therapy. "

Just wondering and glad my frequent headaches respond to Tylenol and rest.