Should I Get Further Tests for Possible Neurological Issues?

Q: Should I Get Further Tests for Possible Neurological Issues?

Hello： The causes of discomfort in the forehead may initially be attributed to cervical myofascial pain. <br>Prolonged periods of looking down can lead to overuse of the trapezius muscle in the neck, resulting in neck and shoulder pain that may extend to the forehead. <br>In the

Should I undergo additional tests to rule out the possibility of any lesions? Thank you?

Hello Doctor: I have developed elevated intraocular pressure due to poor posture from frequently looking down while taking naps.
I have seen an ophthalmologist, and my eye pressure is now under control.
However, I experience intermittent dizziness when my head is tilted down, which resolves immediately when I tilt my head back.
Sometimes, I feel a strange sensation above my eyebrows, as if there is some swelling, and massaging that area can be somewhat tender.
Initially, I thought this was related to the elevated eye pressure, but the ophthalmologist indicated that high eye pressure does not cause these symptoms.
I have also had an X-ray of my neck, which showed some abnormalities.
However, I still have some questions.
My first question is whether I should undergo further imaging, such as an ultrasound of the neck and head, to rule out any potential lesions.
My second question is whether I should consult a neurologist or a neurosurgeon.
Thank you for your guidance, Doctor.

Su Xiansheng, 30~39 year old female. Ask Date: 2018/02/18

Dr. Jiang Junyi reply Neurology

Hello: The causes of discomfort in the forehead may initially be attributed to cervical myofascial pain.
Prolonged periods of looking down can lead to overuse of the trapezius muscle in the neck, resulting in neck and shoulder pain that may extend to the forehead.
In the early stages, resting may alleviate the pain, but it can progressively worsen, affecting daily activities.
Some patients experience severe neck pain upon waking, characterized by stiffness, tightness, and intolerable pain.
Additionally, elevated intraocular pressure can lead to visual disturbances and discomfort in the eye socket, as well as nausea.
To address neck discomfort, it is advisable to consult a neurologist or a rehabilitation specialist to discuss examination and treatment options, including learning techniques for cervical muscle relaxation to avoid overuse.
Wishing you good health, safety, and happiness.
Dr.
Tao cares about you.

Reply Date: 2018/02/18

More Info

Based on your description, it seems that you are experiencing a range of symptoms that could be related to your posture during sleep, particularly with your head being in a low position. This has led to elevated eye pressure, which you have managed to control with the help of an ophthalmologist. However, the persistent dizziness, sensations of pressure above your eyebrows, and discomfort when massaging the area are concerning and warrant further investigation.

Should You Get Further Tests?
Given your symptoms, it would be prudent to consider further evaluations. The dizziness you experience when tilting your head could be indicative of several issues, including cervical spine problems, vestibular dysfunction, or even neurological conditions. Since you mentioned that X-rays of your neck showed abnormalities, this could suggest that there may be underlying issues related to your cervical spine that could be contributing to your symptoms.

1. Cervical and Head Ultrasound: An ultrasound of the neck could help assess blood flow in the carotid arteries and check for any vascular issues that might be contributing to your symptoms. Additionally, a head ultrasound (if appropriate) could help visualize any structural abnormalities.

2. MRI or CT Scan: If your symptoms persist or worsen, an MRI or CT scan of the brain may be necessary to rule out any intracranial issues, such as lesions, tumors, or other abnormalities that could be causing your dizziness and discomfort.

Which Specialist to Consult?
As for which specialist to see, both neurology and neurosurgery have their roles, but they focus on different aspects:
- Neurologist: This specialist would be more appropriate for evaluating your symptoms, particularly if they are related to neurological function. They can perform a thorough neurological examination, assess your symptoms in the context of your medical history, and determine if further imaging or tests are necessary. Neurologists are trained to manage conditions like dizziness, headaches, and other neurological symptoms.

- Neurosurgeon: This specialist is typically consulted if there is a need for surgical intervention or if there are findings that suggest a structural issue that may require surgery. If your neurologist finds that there is a significant structural problem that could benefit from surgical intervention, they may refer you to a neurosurgeon.

Conclusion
In summary, it would be advisable to consult a neurologist first. They can evaluate your symptoms in detail, recommend appropriate imaging studies, and determine if there are any neurological issues that need to be addressed. If necessary, they can then refer you to a neurosurgeon if surgical evaluation becomes relevant.
It's essential to address these symptoms promptly, as they can significantly impact your quality of life. Maintaining good communication with your healthcare providers and ensuring that all your concerns are addressed will help you get the best care possible.

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