Suggest Treatment For Persistent Headache And Nausea

Posted on Wed, 14 Dec 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Wed, 14 Dec 2016 Answered on

Wed, 4 Jan 2017 Last reviewed on

Question : I have a 13 year old daughter. For the last two years she has had headaches almost daily (some days are worse than others), nausea, feels like her neck is swollen and closed up, shaking. She feels like she is shaking but I can't see it or feel it when I touch her. She also has - randomly - blurry vision and coughing. Headache is on both sides of the head, intense. At the moment she has been home from school for three days with a very intense headache, the worst one to date. She coughs a lot and recently had an episode where she could not stop coughing for weeks. Her pediatrician tried all kinds of medication that didn't work and finally admitted to us that she didn't know what to do for our daughter. It slowly subsided.
She has had bloodwork (normal), an MRI (normal), allergy tests (has some allergies but is on medication for them and it has not helped her symptoms). She has been to the eye doctor to see if there is any pressure - eyesight was great, no pressure that would cause the headaches. She is currently seeing a neurologist who has prescribed:
Topiramate 25 mg
Cetirizine HCL 10 mg
It does not help the headaches. No over the counter pain medication helps.
No one can tell us what is wrong.
I am not sure what type of doctor we need to take her to? Could it have something to do with her spinal fluid?
We have a 19 year old son and a 16 year old daughter - neither one has this problem.
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Answered by Dr. Diptanshu Das (2 hours later)

Brief Answer:
A step by step approach needs to be taken. It might be hard to treat.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone through your problem very carefully. Although a neurologist is the right doctor to treat headaches, other non-neurological causes need to be ruled out. Try giving your child steam inhalation. Water in form of vapor will reach deep inside and would help in diluting any thickened mucus which could be blocking the opening of the air sinuses. This could thereby provide relief as sinusitis could be an undetected cause of headaches.

It might be worthwhile to get a lumbar puncture done. Testing the spinal fluid will help in ruling out an infection of the nervous system as a possible cause. I would also insist getting an EEG and MRI brain done.

I need to ask if the headache is diffuse and affecting the entire head, or whether it involves just half the head in particular. In that case, migraine needs to be considered as a possibility.

I would insist you to get an ophthalmological checkup done. Examination of the eyes will help in ruling out an ocular cause.

Feel free to write back.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar