Persistent One-Sided Head and Neck Pain: A Neurology Perspective - Neurology

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Understanding persistent one-sided head and neck pain can be quite complex, especially when considering the various underlying causes that may contribute to such symptoms. Based on your description, it seems that you have been experiencing a range of symptoms, including persistent pain, tension, and potentially neurological issues. Let’s break down some of the key aspects of your situation.

Firstly, it is important to consider the possibility of vascular issues, such as narrowing of blood vessels or embolism, as you mentioned. These conditions can indeed lead to headaches and neck pain, particularly if there is reduced blood flow to certain areas of the brain. However, these vascular issues are typically accompanied by other symptoms, such as visual disturbances, weakness, or changes in consciousness. If you have not experienced these additional symptoms, it may be less likely that vascular problems are the primary cause of your pain.

Regarding the need for advanced imaging, if you have already undergone a CT scan without contrast and no significant findings were reported, it may be worthwhile to discuss with your physician the possibility of an MRI or a CT angiogram. These tests can provide more detailed images of the blood vessels and brain structures, which may help identify any abnormalities that could be contributing to your symptoms. If your health insurance does not cover these tests, you may need to weigh the potential benefits against the costs involved.

As for the possibility of myofascial pain syndrome or fasciitis, it is indeed possible that muscle tension and inflammation could be contributing to your symptoms. In cases of myofascial pain, blood tests may not always show elevated inflammatory markers, as the pain is often due to localized muscle issues rather than systemic inflammation. Therefore, normal inflammatory markers do not necessarily rule out myofascial pain. Physical therapy, massage, and other modalities may be beneficial in managing this type of pain.

Regarding the medications you have been taking, it is important to note that different types of headaches respond to different treatments. For instance, medications like ibuprofen (found in products like "易克痛") are non-steroidal anti-inflammatory drugs (NSAIDs) that can be effective for tension-type headaches and mild migraines. However, if your headaches are not responding to these medications, it may indicate that they are not the right choice for your specific type of headache.

You mentioned that you have tried various medications, including "舒腦" and "維他命B12," which are often used for migraine prevention and nerve health. If these medications have not provided significant relief, it may be worth discussing alternative treatments with your healthcare provider. They may consider prescribing other classes of medications, such as tricyclic antidepressants or anticonvulsants, which have been shown to be effective in preventing chronic headaches.

In summary, persistent one-sided head and neck pain can arise from various causes, including vascular issues, myofascial pain, and neurological factors. It is essential to work closely with your healthcare provider to explore further diagnostic options and tailor a treatment plan that addresses your specific symptoms. If you have not already done so, consider seeking a referral to a neurologist or pain specialist who can provide a more comprehensive evaluation and management plan. Your health and well-being are paramount, and finding the right approach to your symptoms is crucial for improving your quality of life.