Persistent Daily Headaches Over Several Months
I am a 30-year-old woman, standing at 5'8" and weighing 165 lbs, and I’ve been experiencing daily headaches for at least six months straight. My medical history includes polycystic ovary syndrome (PCOS) and bipolar disorder type II. For about two years, I was treated with Lamictal at a dosage of 100 mg, but I discontinued it in May 2025. Additionally, I've experienced two concussions during my teenage years, and I suffered a head injury at the age of 21, which resulted in a laceration above my right eyebrow that required stitches. Since that incident, I have occasionally felt tingling sensations in the area around my right eyebrow and extending towards my hairline. Each day, my headaches commence first thing in the morning and often persist throughout the morning. While they generally lessen during the day, they tend to intensify again before I go to sleep. The pain is concentrated in the frontal region of my head and sometimes correlates with pressure around my right eye, which can lead to episodes of watering. Initially, I thought these headaches might be due to seasonal allergies, but as they continued daily for an extended period, I grew concerned and sought care from a new doctor, as I did not previously have a primary care physician. My doctor recommended a brain MRI without contrast, which came back normal, as did an ophthalmology evaluation. The ophthalmologist noted elevated pressure in my right eye compared to the left, but indicated that it wasn't at a worrisome level. I have a follow-up appointment scheduled for September 12. My doctor also prescribed Topiramate, starting at 25 mg twice daily, and Indomethacin at 25 mg as needed. Unfortunately, Topiramate has made me feel quite unwell; I experience neuropathy in my extremities, difficulty concentrating, forgetfulness, and a decreased appetite. I have not noticed any improvement with Indomethacin either. I currently have a high-stress job and am undergoing significant life changes, which I suspect might be contributing to my symptoms. However, I've never encountered stress presenting itself in this manner before. My lab results, including a comprehensive metabolic panel and a complete blood count, returned normal. There is a notable family history of dementia, Alzheimer's disease, and a brain aneurysm in my aunt, as well as occurrences of meningiomas in my great-grandmother and aunt on my father's side. There are also instances of cardiovascular issues within the family. I'm left wondering what other factors might be contributing to my daily headaches and what steps I should take next—presumably, a referral to a neurologist is in order?
Answers (1)
8/22/2025, 7:13:14 PM
OpenHealth AI
Experiencing daily headaches can significantly impact your quality of life, especially given your medical history and current stressors. It’s important to investigate the underlying causes while also managing your symptoms effectively. Since you have had a normal MRI and eye evaluation, it's crucial to explore other factors that may be contributing to your headaches.
Explanation:
Your headaches have been persistent for several months and are characterized by their timing and location, which suggests they may be tension-type headaches or possibly migraines, especially given that they intensify later in the day. Stress and significant life changes can indeed trigger or exacerbate headaches, and given your high-stress job, it’s understandable that you may feel overwhelmed. The tingling sensations you’ve experienced could also be related to prior head injuries, but it's good that these symptoms haven't worsened alongside your current headaches.
Next Steps:
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Monitor Triggers: Keep a headache diary for at least two weeks. Note the timing, duration, intensity, and any potential triggers (such as food, stress levels, sleep patterns, and hydration). This could help identify patterns or specific triggers that you may not have considered.
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Lifestyle Modifications:
- Stress Management: Consider implementing stress-reduction techniques such as mindfulness meditation, yoga, or regular physical activity. These can help alleviate headache frequency and intensity.
- Sleep Hygiene: Ensure you are getting adequate rest. Aim for 7-9 hours of sleep per night, establish a calming bedtime routine, and try to maintain a consistent sleep schedule.
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Consider Alternative Therapies: If the Topiramate is causing undesirable side effects and isn’t providing relief, discuss with your doctor alternative medications or therapies. Some people find relief from headaches through physical therapy, acupuncture, or biofeedback.
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Nutrition and Hydration: Stay well-hydrated and maintain a balanced diet. Certain foods can trigger headaches, such as aged cheese, processed meats, and alcohol- identify foods that may exacerbate your symptoms.
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Follow-Up Appointment: Make the most of your upcoming appointment on September 12. Prepare a list of your symptoms, concerns about the medications, and any new patterns you’ve noted. Discuss the possibility of a referral to a neurologist who specializes in headaches if you do not see improvement with current management strategies.
Taking proactive steps can often help clarify the underlying issues and improve your overall wellness. Your health matters, and addressing headaches is a valid concern worth thorough exploration. Please keep monitoring your symptoms and reach out if you have further questions or require more guidance.
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