Headaches: When to See a Neurologist and What Tests to Consider

Frequent headaches

Doctor: Hello! I apologize for bothering you again.
Regarding my previous inquiry, I didn't quite understand your response, so I'm asking again.
1.
"For headaches, see a headache specialist!" This means that if I have a headache, I should see a neurologist, and other specialties may not be able to help.
2.
Muscle tension can lead to headaches, and tumors in the brain can also cause headaches, but headaches caused by structural changes should be persistent.
If my headache is pulsating, it might be a vascular headache.
Does this mean that if my headache is continuous, it could be due to something pressing on my brain? However, since my headaches are not continuous, could they be caused by other factors? I previously had an EEG, which showed nothing abnormal, and the doctor said it was normal.
If the doctor mentioned that tension could lead to a tumor, would a tumor be detectable through an EEG? 3.
Last time, I went to Boai Hospital in Yilan to see a neurologist, who performed an EEG and found no abnormalities.
He didn't prescribe any medication, but I later experienced similar headache symptoms intermittently.
What tests should I undergo to identify the cause? I already consulted a neurologist! 4.
Can staying up late cause headaches, or does it only cause dizziness? Thank you! Lastly, could you please suggest what tests I should consider or which specialty I should consult? This has been troubling me for a long time, but the previous doctor couldn't find the cause!

Xiao Zhi, 20~29 year old female. Ask Date: 2005/08/10

Dr. Ye Boshou reply Neurology

1.
Headaches should be considered a specialty of neurology.

2.
Normal brain waves indicate normal brain function.

3.
Stress does not cause tumors to grow.

4.
Staying up late can also trigger headaches.

5.
Headaches may be caused by muscle tension, emotional factors, and other reasons, and may not always be identifiable.

Reply Date: 2005/08/10

More Info

Understanding headaches can be quite complex, as they can arise from a multitude of causes, ranging from benign to serious conditions. It’s essential to recognize when to seek help from a neurologist and what tests might be appropriate to determine the underlying cause of your headaches.

Firstly, headaches can be classified into primary and secondary types. Primary headaches, such as migraines and tension-type headaches, are not caused by another medical condition. Secondary headaches, on the other hand, are symptoms of an underlying issue, such as a brain tumor, infection, or vascular disorder. Given your concerns about the nature of your headaches and their persistence, it is indeed wise to consult a neurologist, who specializes in disorders of the nervous system, including headaches.

1. When to See a Neurologist: If you experience headaches that are new, persistent, or have changed in pattern, it is advisable to seek a neurologist's opinion. Additionally, if your headaches are accompanied by neurological symptoms such as visual disturbances, weakness, or changes in consciousness, immediate medical attention is warranted. You mentioned that your headaches are not continuous, which can still be indicative of underlying issues, especially if they are severe or associated with other symptoms like nausea or vomiting.

2. Understanding Headache Characteristics: The nature of your headaches can provide clues to their cause. For instance, pulsating headaches may suggest migraines, while tension-type headaches often feel like a tight band around the head. You mentioned that your headaches are not continuous, which might suggest they are not due to a structural issue like a tumor. However, episodic headaches can still be caused by various factors, including stress, sleep disturbances, or even dietary triggers.

3. Diagnostic Tests: You have undergone an EEG (electroencephalogram), which primarily assesses electrical activity in the brain. While an EEG can help identify seizure disorders, it is not typically used to diagnose headaches. For structural issues, imaging studies such as a CT scan or MRI of the brain are more appropriate. These tests can help identify tumors, bleeding, or other abnormalities that might be causing headaches. If you have not had these imaging studies, it may be worth discussing with your neurologist.

4. Lifestyle Factors: You asked about the impact of lifestyle on headaches. Indeed, factors such as sleep deprivation, stress, and poor posture can contribute significantly to headache frequency and intensity. Chronic sleep deprivation can lead to both headaches and dizziness. Therefore, maintaining a regular sleep schedule, managing stress through relaxation techniques, and ensuring proper ergonomics while working can be beneficial.

5. Further Evaluation: If your headaches persist despite previous evaluations, consider asking your neurologist about other potential causes, including hormonal changes, dietary factors, or even medication overuse headaches if you have been using pain relievers frequently. Keeping a headache diary can also be helpful in identifying triggers and patterns, which can assist your healthcare provider in tailoring a treatment plan.

In summary, while your previous tests have not indicated serious issues, it is essential to continue seeking answers, especially if your symptoms persist or worsen. A comprehensive approach that includes lifestyle modifications, further diagnostic testing, and possibly a referral to a headache specialist may be necessary. Don't hesitate to advocate for your health and seek a second opinion if you feel your concerns are not being adequately addressed.

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