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Hi, I M Writing On Behalf Of My Wife. We

Posted on Tue, 6 Oct 2020

Question: Hi, I'm writing on behalf of my wife. We're looking for a different opinion. For the past 45 days she's had non-stop pain in her temple area (both sides) along with other symptoms such as sharp "shock" pains that in the same area that come and go. Her entire head will either feel "wet" or very warm at certain times and when she stands up it's much worse. She has to lay down most of the day due to the pain. We have been to the ER/Urgent Care 7 times in the past 45 days and they don't have any answers. She's had a CT scan, MRI and Temporal Arteritis biopsy and all have come back negative. Over the counter medications have not worked along with various prescriptions she' been given for migraines (which we do not believe it is). Next up this week she will have an MRI w/ contrast. We are looking for any answers that can help her feel better. Thank You.

Answered by Dr. Dr. Erion Spaho (17 hours later)

Brief Answer:
Further evaluations are necessary for a correct diagnosis.

Detailed Answer:
Hello and welcome to " Ask a Doctor" service.

I have read your query.

Since the CT scan and MRI results came back negative, you should not be worried about anything serious.

In my opinion, hormonal changes as in the premenopausal phase, or even menopause should be taken into consideration.

Besides the biopsy for temporal arteritis, blood tests for this purpose (ESR rate, autoantibodies levels, etc.) should be evaluated too.

A trial treatment with corticosteroid drugs for temporal arteritis (this may help in achieving the diagnosis too and could relieve the symptoms) should be tried also.

In conclusion, hormonal changes, temporal arteritis, and primary headaches are diagnoses to take into consideration and to be evaluated further.

Hope this helps.

Feel free to ask if you have further questions.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Dr. Erion Spaho (13 hours later)

She has taken prednisone for several weeks but it did not help, so we believe it is not temporal arteritis. Below are some of her recent lab tests. Today she was given infusion therapy but with very little success.

ESR     44 mm/Hr
WBC'S AUTO     25.4 x1000/mcL
RBC, AUTO     4.55 Mill/mcL
HGB     13.1 g/dL
HCT, AUTO     39.9 %
MCV     87.7 fL
MCH     28.8 pg/cell
MCHC     32.9 g/dL
RDW, BLOOD     14.2 %
PLATELETS, AUTOMATED COUNT     443 x1000/mcL

Answered by Dr. Dr. Erion Spaho (8 hours later)

Brief Answer:
Seems of inflammatory origin.

Detailed Answer:
Welcome back.

her WBC, ESR, and platelet count are high, so, it may be a problem of inflammatory origin.

I suggest you discuss the possibility of an autoimmune disorder with the Doctor.

In my opinion, autoantibodies levels, (ANA, XXXXXXX etc.) are necessary to be evaluated further.

Hope this helps.

Feel free to ask if you have further questions.

Above answer was peer-reviewed by : Dr. Kampana