Persistent Right Forehead Pain: Seeking Answers After Medication

I have a migraine near the right forehead area. I have seen a doctor, and after taking medication, I still feel some discomfort?

Hello, Doctor.
I started experiencing headaches about three weeks ago on a Monday.
At that time, the symptoms felt like there was a pulsating pressure inside my right forehead, which made it difficult to sleep for long periods.
When it was severe, my right eye would tear up, and the area where I had the headache felt warm to the touch, while the left side was completely fine.
I visited a Western medicine doctor on the Thursday three weeks ago.
I was prescribed three types of medications: a non-steroidal anti-inflammatory drug, a muscle relaxant, and a medication for vascular circulation disorders.
By Sunday night, I felt some improvement.
However, last week I noticed a strange sensation in my right forehead again.
It no longer pulsated with my heartbeat, but there is a heavy feeling, as if someone is pushing down from inside.
I can fall asleep at night, but during times when I feel worse, my head has a sensation that is between dizziness and heaviness.
Lying down seems to help.
I would like to ask if it would be advisable to undergo an EEG to determine the cause.
Thank you, Doctor.

xuesheng, 20~29 year old female. Ask Date: 2010/07/06

Dr. Gao Chunde reply Neurology

Initially, the symptoms were consistent with migraines.
After treatment, the headache should improve, but it may evolve into a tension-type headache.
If discomfort persists, it is advisable to return for a follow-up appointment for reevaluation by a physician.
Any necessary examinations should be determined based on the physician's professional judgment.

Reply Date: 2010/07/06

More Info

Dear Patient,
Thank you for reaching out with your concerns regarding the persistent pain in your right forehead. Based on your description, it seems you have been experiencing a complex set of symptoms that have persisted for several weeks. The pain you describe, particularly the pulsating sensation and the associated tearing of the right eye, could suggest a few potential underlying issues.

Firstly, it’s important to consider that headaches can arise from various causes, including tension-type headaches, migraines, or even secondary headaches due to other medical conditions. Given that you have already been prescribed non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and medications for vascular circulation, it seems your healthcare provider is attempting to address a multifaceted issue.

The fact that your symptoms improved initially but then returned, albeit in a different form, is noteworthy. The sensation of heaviness and the feeling of pressure in your forehead could indicate that the original cause of your headache has not been fully resolved. It’s also concerning that you mentioned a sensation of something pressing down inside your forehead, which could suggest increased intracranial pressure or other neurological concerns.

Regarding your question about whether to undergo an EEG (electroencephalogram) to check for brain activity, it’s essential to understand that EEGs are typically used to diagnose conditions like epilepsy or other seizure disorders. They may not be the most appropriate test for your symptoms. Instead, imaging studies such as a CT scan or MRI of the brain might be more beneficial in ruling out structural issues, such as tumors, vascular malformations, or other abnormalities that could be contributing to your symptoms.

Additionally, if you have not already done so, I would recommend keeping a headache diary. Documenting the frequency, duration, intensity, and any associated symptoms (like nausea, sensitivity to light, or changes in vision) can provide valuable information for your healthcare provider. This information can help them determine the best course of action and whether further testing is necessary.

It’s also crucial to consider lifestyle factors that might be contributing to your headaches. Stress, lack of sleep, dehydration, and poor posture can all exacerbate headache symptoms. Implementing relaxation techniques, ensuring adequate hydration, and maintaining a regular sleep schedule may help alleviate some of your discomfort.

In summary, while your symptoms warrant further investigation, an EEG may not be the most appropriate first step. Instead, I recommend discussing the possibility of imaging studies with your healthcare provider to rule out any serious underlying conditions. If your symptoms persist or worsen, do not hesitate to seek further medical attention. Your health and well-being are paramount, and it’s essential to address these symptoms comprehensively.

Wishing you a swift recovery and relief from your symptoms.

Best regards.

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