I am the mother of a 31-year old daughter who suffered a concussion over 1 year ago. Since then, she feels she has sustained multiple concussions from multiple small impacts. Currently she is 2 weeks out from her last one, and her migraines are now being caused from any sound, no matter how slight. She is currently on Topamax 25 mg., but it is not helping.

Does anyone have advice as to how to lessen sound for her (she has tried earplugs). And does any one have advice as to what medication may help her migraines. Thank you for your help and assistance.

JudyAnn,

Welcome to NeuroTalk. Sorry to hear about your daughter's struggles.

Headache/migraine meds are different for each person. You have to just keep trying.

But, headaches are often caused by unresolved subtle upper neck injuries. These can cause muscle spasms that cause the headaches. A simple test is to press against the bony parts behind the ears. If this area is tender, a neck issue is likely a problem.

Her sensitivity to minor impacts suggest an upper neck sensitivity.

Sound problems are common. Avoidance is important. Ear plugs should help if she avoids the loud sounds. The Mack's brand of foam ear plugs appear to be the best. Some use Bose Electronic Noise Canceling earplugs or ear phones.

What kind of diagnostics has she had ? What treatments have been offered ?

Can you tell us anything about her original concussion and her subsequent impacts ?

Thank you Mark. My daughter has had us read information to her from this website, and your name has come up very often. She did tell me that one of the sounds that bother her is her neck cracking (even swallowing), so she may very well have had a neck injury.

She was out of the country in Vietnam over a year ago, when she had a very violent massage in which the woman's hands slipped and hit her twice in the head. She had suffered a concussion about 2 years previous to that, when she slipped and fell in her apartment. That previously took her out of commission for about 1 year.

Since then, she has bumped her head on the wall when getting out of bed, a man's elbow hit the back of her head on a bus, and numerous impacts like that. Recently she moved to California and I went to help her get settled in. We bumped into each other, and a pan I was holding hit her in the brow. It was not a very bad impact, but of course all her symptoms have resurfaced. She was previously living in the state of Washington and had to use doctors from their disability system. She told me the doctors did not specialize in concussion or seem to know much about it. She was given Sumatriptan tablets which helped a little, but nothing has gotten rid of her migraines. I don't know about any diagnostic tests, but I will ask her about that. I know she saw a vision doctor who could document problems with her vision, but her neurologist indicated they had no hard evidence of her concussion so her complaints were subjective, and therefore she probably won't get the disability which she has applied for.

My daughter is unable to read because her concussion has affected her vision. She also cannot tolerate much light. She stays in bed all day, although presently she can only sleep about 3 hours a day. Obviously, I am very worried about her, and I also feel helpless. She has gone to the ER in the past for her migraines, and they dismiss her and say she is just trying to score narcotics, so now she is reluctant to go to the hospital for help. She had started on Topamax (25 mg.) 1 1/2 weeks ago, and now is weaning off of it because she feels her migraines are worse, not better.

She was referred by her doctor in Washington to a headache clinic down here, so I will call them Monday and I will definitely make sure she has them look into the neck injury aspect. Thank you so much for your help!!

If she has a neck injury, lying in bed can be a problem. It is easy to have bad head and neck posture in bed. From what you say about her impacts, I would not be surprised that her primary issues is her neck and not her head.

The subtle neck injuries require consistent discipline with head and neck posture. One study showed that 80% of concussion had a neck injury component with the neck injury often being the cause of the majority of the symptoms.

A headache clinic may dismiss the neck injury issue. A pain clinic might be better.

Where in Calif is she ? I can research doctors for her to seek out. Is she on Medi-Cal or another health plan ?

Is she able to work at all ?

Has she applied for Social Security Disability ?

Was her concussion 3 years ago documented by a doctor ? Those records would be valuable so her current condition is considered in context with her concussion history. From what I understand, the ER is not a good place to go for migraine pain meds. An Urgent Care Clinic would be better. A regular doctors clinic would be the best.

She needs to establish a history with a clinic so they regulate her access to pain meds. This way, she does not show up looking like she is shopping for narcotics. She may benefit from a muscle relaxant like Soma (carisoprodol). It is not as strong as oxy but may help if she has muscle spasms in her neck.

It would be good if you put together a binder with her medical records. I doubt she has the focus to do that accurately. Her Washington medical records can be requested. They will want a "Release of Medical Records" form filled out first.

It is great that she has an advocate like you. This can be a tough road to go alone.

My best to you both.

Thank you so much for your advice, Mark!

My daughter is now living near San Diego. Her stepmother is helping her apply for Medi-Cal (I live almost 2 hours away). She has not been able to work at all, but her Social Security disability was turned down, so her dad and I have been helping her financially. She is appealing the disability, but has not heard anything yet. Her neurologist told her she cannot give her a letter for disability because there are no tests that document what she is telling them she feels. Her stepmother is trying to get her into a Kaiser Medi-Cal program, and her neurologist in Washington referred her to a headache clinic at UC San Diego.

I don't know about any MRIs or tests that they did in Washington; my daughter doesn't even like to talk at the moment because concentration is hard for her, so I cannot ask her. But thank you for the info about the medical release form, because we will absolutely get her medical documentation from Washington, and if my daughter can tell me what doctors or facilities she went to 3 years ago, we will obtain those records as well.

Again, thank you for your concern and your offer to help. I am just out of my depth with knowing what to do.

It is normal for SSDI to turn down the first application. 80% of first time apps are denied. Her doctor does not determine her disability. The SSDI Blue Book sets the standards. Likely, she cannot maintain the Pace and Persistence of a job. Has she contacted an SSDI attorney ? They get paid a percentage of her back pay with a maximum limit (25% or $6000, which ever is less )

If she has the same neuro doctor who said there are no tests, she needs to find another doctor. A Neuro Psychological Assessment can tell a lot. A DTI MRI can show problems. An fMRI can too.

Medi-Cal should be easy. It just looks at income. The Kaiser Medi-Cal should not be hard to get. But, if she can afford the $80 to $100 per month to get the non-Medi-Cal health insurance, she may have access to more services. I have family on both systems. She would need to inflate her income to $16,000 to get the better plan then it will cost a bit.

She should have some medical records for her SSDI application. Did they award her SSI payments when they denied her SSDI ? The SSDI app includes an application for SSI. It is a stop gap payment system for those with no other resources.

For her future medical needs, her history does not matter so much. With concussions you treat the symptoms, not the medical history.

Thank you so much for your valuable insight and advice. I will keep you posted on her case.