Patient: I’ve been having some migraines, three in two weeks, this all started when I started invisalign for my bite, well, now I am having pressure in my head, pain around my eyes and above my eyebrows, I woke up this morning with a lot of head congestion that drained when I got out of bed. My PCM did a cat scan that came back normal and she did blood work about a week ago checking for infection and she said it came back normal. However, this morning, I feel nauseous, and when I breath in through my nose it sounds plugged, but there is no snot there.
Doctor: Hi.If the cat scan is negative, your headaches might be migraines or tension headache. In migraine, the headache is usually grinning and one sided. It may also be associated with flashes of light and intolerance to light.However, in case of tension headache, there is a pressure band like sensation over the forehead and the back. Tension type headache is more common than migraine. In your case, it appears to me that you have tension type headache. The most common treatment for this is to identify the stress factor and take care of it.Usually low dose anti depressants also help.Hope this helps
Comments / Follow Ups
Patient: What would explain the head congestion? Also, I had loss of vision in one eye with the three migraines, which are typical for me. Vision loss only last about 30 minutes and then returns. I have had migraines in years past.
Doctor: Head congestion is a feature of tension headache. Vision loss is not exactly a feature of migraine, visual sura in the form of flashes is. Triptans are the first line of treatment for migraine. I would suggest to start with a low dose Triptan during headache episode. If the headaches font go way, low dose antidepressants should be added