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Headache, nausea, dizziness standing or sitting
Hi my wife, 33 years old, is experiencing very acute headache, nausea and dizziness. All the doctors we have seen seems to not have an answer for us.
The lead up to the onset of the headache is as follows: My wife had been breastfeeding our 11 month daughter exclusively. My wife had a cough for about two weeks prior to the onset of the headache. She started experiencing some back pain near her left scapula one month prior to the headache. She also flew 4 days before the headache began. On the onset of the headache she had cough several times and after the coughing spell she complained that she felt like her head exploded. A few hours later we decided to take her to the ER to be examined. She had an abnormal EKG and a slightly elevated troponin level. Due to this they admitted her to the hospital. They did a CT scan and everything was normal. They did bloodwork several times during her stay in the hospital and her troponin levels came back to normal. There were no other significant EKG readings so the cardiologist cleared her. In the meantime her headache persisted. The headache was all over the place. Sometimes it was in her sinuses, other times it was on the top or back of her head. She also started to experience neck pain and stiffness and upper back pain. They did a lumbar tap and it came out negative for meningitis. Soon after she was admitted she started to get bouts of nausea and dizziness. The doctors thought that it was from the pain meds (dilaudid and morphine). They gave her antivert and zofran. The only comfort that she could get from the headache was lying down. They did an MRI scan of the head and neck and it came out negative. There was a slight misalignment of her C6-C7 but noting that would explain the pain she was in. While in the hospital she saw a whole slew of specialist (infectious disease - who concluded that she might be postpartum, ENT - conclusion menieres, neurologist - migrane, etc). They couldn't agree since her symptoms where non conclusive. After 7 days in the hospital they discharged her (since she was stable) but the pain in the head was still there. They gave her a short course of steroids (4 days total), antivert and a script for physical therapy and follow-up with ENT. The first few days after the hospital the pain was not as severe (although it was still there) and the nausea and dizziness was under control. In fact, when she went to PT, there was also an acupuncturist in the office who told us that she might be suffering from some form of arthritis that is aggravating her occipital nerve (occipital neuralgia). After a few pins, my wife felt like she was 90% better. This only lasted for a few hours. The on going physical therapy session seemed to have helped as well. He noted that the there she was very tense in her upper back and neck. Any way, the effects of the PT and the acupuncture only lasted for a few hours. When she woke up the next morning the effects would diminish and her pain would reappear (again mostly when she sat down, a little standing up- and no pain lying down). Anyway a few days later, she started to get extremely nauseated and dizzy (she is no longer on any pain meds at this point except motrin- no more than 800mg a day and the steriods had also stopped). She also started to experience some sinus pressure on both sides of her face (this would come and go and we started her oh sudafed which did not help). The PT and acupuncture only relieved the pain in her head and neck. She also mentioned that there are ringing in her ears, the sounds that she hear have an echo. She also feels like there is water in side the ears. So basically thats were we are now. The nausea is extremely bad (zofran doesn't seem to help), the dizziness is still there and there is ringing and echos in her ear. There is pain in her neck and head when standing up or sitting down.
So far these are the possibilities
menieres
occipital neuralgia
migrane
sinus infection
if its menieres/migraine attack do they last this long (2weeks)???
My wife's symptoms seems to follow another post:
http://www.medhelp.org/posts/Undiagnosed-Symptoms/Headache-only-when-standing-or-sitting-up/show/980567#post_4583783
unfortunately, I was not able to get hold of the original poster and there was not answer from the forum.
thank you so much for the help....
The lead up to the onset of the headache is as follows: My wife had been breastfeeding our 11 month daughter exclusively. My wife had a cough for about two weeks prior to the onset of the headache. She started experiencing some back pain near her left scapula one month prior to the headache. She also flew 4 days before the headache began. On the onset of the headache she had cough several times and after the coughing spell she complained that she felt like her head exploded. A few hours later we decided to take her to the ER to be examined. She had an abnormal EKG and a slightly elevated troponin level. Due to this they admitted her to the hospital. They did a CT scan and everything was normal. They did bloodwork several times during her stay in the hospital and her troponin levels came back to normal. There were no other significant EKG readings so the cardiologist cleared her. In the meantime her headache persisted. The headache was all over the place. Sometimes it was in her sinuses, other times it was on the top or back of her head. She also started to experience neck pain and stiffness and upper back pain. They did a lumbar tap and it came out negative for meningitis. Soon after she was admitted she started to get bouts of nausea and dizziness. The doctors thought that it was from the pain meds (dilaudid and morphine). They gave her antivert and zofran. The only comfort that she could get from the headache was lying down. They did an MRI scan of the head and neck and it came out negative. There was a slight misalignment of her C6-C7 but noting that would explain the pain she was in. While in the hospital she saw a whole slew of specialist (infectious disease - who concluded that she might be postpartum, ENT - conclusion menieres, neurologist - migrane, etc). They couldn't agree since her symptoms where non conclusive. After 7 days in the hospital they discharged her (since she was stable) but the pain in the head was still there. They gave her a short course of steroids (4 days total), antivert and a script for physical therapy and follow-up with ENT. The first few days after the hospital the pain was not as severe (although it was still there) and the nausea and dizziness was under control. In fact, when she went to PT, there was also an acupuncturist in the office who told us that she might be suffering from some form of arthritis that is aggravating her occipital nerve (occipital neuralgia). After a few pins, my wife felt like she was 90% better. This only lasted for a few hours. The on going physical therapy session seemed to have helped as well. He noted that the there she was very tense in her upper back and neck. Any way, the effects of the PT and the acupuncture only lasted for a few hours. When she woke up the next morning the effects would diminish and her pain would reappear (again mostly when she sat down, a little standing up- and no pain lying down). Anyway a few days later, she started to get extremely nauseated and dizzy (she is no longer on any pain meds at this point except motrin- no more than 800mg a day and the steriods had also stopped). She also started to experience some sinus pressure on both sides of her face (this would come and go and we started her oh sudafed which did not help). The PT and acupuncture only relieved the pain in her head and neck. She also mentioned that there are ringing in her ears, the sounds that she hear have an echo. She also feels like there is water in side the ears. So basically thats were we are now. The nausea is extremely bad (zofran doesn't seem to help), the dizziness is still there and there is ringing and echos in her ear. There is pain in her neck and head when standing up or sitting down.
So far these are the possibilities
menieres
occipital neuralgia
migrane
sinus infection
if its menieres/migraine attack do they last this long (2weeks)???
My wife's symptoms seems to follow another post:
http://www.medhelp.org/posts/Undiagnosed-Symptoms/Headache-only-when-standing-or-sitting-up/show/980567#post_4583783
unfortunately, I was not able to get hold of the original poster and there was not answer from the forum.
thank you so much for the help....
MEDICAL PROFESSIONAL
Hi
Welcome to the MedHelp forum!
A headache that worsens on standing up and improves or disappears on lying flat is a spinal headache. This happens when the CSF pressure in the brain falls. This usually happens after spinal anesthesia, spinal taps, or spinal injuries. However in some people this happens without a cause. This is known as spontaneous intracranial hypotension.
A procedure called an epidural blood patch, if is successful, even temporarily, it generally means the patient does indeed have a spinal headache. A small amount of the patient’s own blood is injected into the space between the dura and the bony spine known as the epidural space. If this causes temporary or permanent cure of headache, the diagnosis of spontaneous intracranial hypotension is confirmed.
Other tests are a spinal tap and measuring the pressure. Although spinal fluid pressure is usually low in patients with spontaneous intracranial hypotension, it can be occasionally normal due to variations in the spinal fluid pressure.
A dye can be injected into the spinal fluid and entire spine’s CT scan is taken to locate the leak.
Please discuss this with a neurologist. This may help you cure your wife’s headaches. Of course a confirmed diagnosis cannot be given on net, but there is no harm in discussing this with a neurologist. Take care!
Welcome to the MedHelp forum!
A headache that worsens on standing up and improves or disappears on lying flat is a spinal headache. This happens when the CSF pressure in the brain falls. This usually happens after spinal anesthesia, spinal taps, or spinal injuries. However in some people this happens without a cause. This is known as spontaneous intracranial hypotension.
A procedure called an epidural blood patch, if is successful, even temporarily, it generally means the patient does indeed have a spinal headache. A small amount of the patient’s own blood is injected into the space between the dura and the bony spine known as the epidural space. If this causes temporary or permanent cure of headache, the diagnosis of spontaneous intracranial hypotension is confirmed.
Other tests are a spinal tap and measuring the pressure. Although spinal fluid pressure is usually low in patients with spontaneous intracranial hypotension, it can be occasionally normal due to variations in the spinal fluid pressure.
A dye can be injected into the spinal fluid and entire spine’s CT scan is taken to locate the leak.
Please discuss this with a neurologist. This may help you cure your wife’s headaches. Of course a confirmed diagnosis cannot be given on net, but there is no harm in discussing this with a neurologist. Take care!
my sister has gone through some of the things that your wife has gone through. specialists do not know what is wrong with her either. i do not know if i am right but it is good to get this checked out. your wife may be suffering from a part of her brain that may be hidden and the doctors cant see it, their could be a problem with too much pressure to the brain or even their could be a problem with the brain stem like it could be pressing hard aginst something e.g. a nerve or even have a leakadge. your wife could also be suffering from a problem with blood pressure which is blood flowing around the body and brain, it could be going slow and not at the normal rate. or it could be something to do with her spinal cord. her spinal cord could be damaged, have alot of pressure build up or a leakage. i hope your wife feels better soon. i would reccomend adding 2 teaspoons of vapour rub to a bowl of hot (not boiling) water and inhale the vapours for five to ten minutes. take a warm relaxing bath with bath salts and bubbles, listen to some calming and quiet music, then go to bed in a dark quiet room with the window open a little bit to make her feel cool and relaxed also put on a windowsill or on a bedside table put in a bowl some scented oils and lavander or rose to help her sleep comfortably and relaxed. if you have kids or animals make sure they do not disturbe her at all with their noise. if she fells like she has a temperature fells sick in any way then i would suggest a cool bath to help bring the temperature down.make sure your home is clean adnd tidy the washing is done and odd jobs are done around the house and anything else that could strees or worry her out. tell her to come off the painkillers for a couple of weeks because if she is on them all the time they will eventually stop working, then after a couple of weeks put her back on them or a stronger painkiller. please let me know if i have helped you both in any way. i know how she feels. i have been in pain scince the day i was born. i am disabled and i have been to great ormand street hospital as a child because of my feet and legs. i also was diagnosed with constipation in the bowls. the longest i have gone without getting rid of my waste is 2 months. i also have my period at the begining of the month so i know how she feels when it comes to chronic pain. i wish you both the very best. please tell your wife about this and show it to her. id love to know what you think. good luck. i hope i helped in some way.
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