Strange 1-second jolts of pain on top of head when coughing or jumping

April 6, 2019 6:59 PM

YANAD, etc. I'm seeking ideas about what may be going on while waiting on a neuro appointment. I've already seen my GP and been to the ER. For 3 months I've experienced strange jolts on top of my head (always exact same spot) on impact (running down stairs, jumping) or coughing. Past month has blossomed into tinnitus, facial numbness (which prompted ER visit, CT came back clear), and now constant pins & needles all over body, which makes it hard to focus on much else. Any ideas I can read more about while I anxiously wait another week+?

I do have a history of migraine with aura, which is a very different set of sensations. I've read a lot about MS and other autoimmune conditions, which don't exactly fit due to the very localized head jolts that occur upon certain movements... almost seems like it must be something directly irritating a certain area. The pins & needles are just driving me through the roof though, it's almost like they are occurring on the inside of my body, not just the skin. Organs feel like they are burning.

My GP initially prescribed antibiotics thinking a bacterial sinus infection, possibly the sphenoids. ENT was fruitless, and I believe the ER was just trying to rule out a stroke or tumor with the CT (they didn't see anything except mild sinus inflammation). It's scary though, and feeling scarier, but going to the ER again doesn't seem like it would be productive ($$$, another CT scan?).

This seems like a weird grab bag of symptoms that's been difficult to Google, particularly the brief head jolts. I'm just trying to wait it out hoping an MRI with the neuro provides some answers. Any thoughts in the meantime? Thanks!

posted by allisonrae to Health & Fitness (9 answers total)

Best answer: I had sphenoid sinusitis and I think your GP was smart and on the right track. The jolting top of the head pain when your foot hits the ground is exactly what I had, except I also had pain in the base of my skull. And blurred vision and swelling around my eyes. then the neuro symptoms started, I had numbness and weird burning rashes. Mine wasn't bacterial, probably fungal, and did eventually clear up after they threw everything and the kitchen sink at it but now it seems to be coming back. Yay. My understanding is that it often barely shows up on imaging and a scope will be in order this time.

It took me forever to get diagnosed, your GP is a good doc to even think of it.
posted by fshgrl at 8:19 PM on April 6, 2019

Is it possible it's another form of migraine? I know there are other forms like vestibular migraine that can cause skin sensations.
posted by oneear at 8:22 PM on April 6, 2019

Are you on any prescription medications ?
posted by hobo gitano de queretaro at 12:08 AM on April 7, 2019

How is your jaw bone? Do you side sleep or lean your chin on your hand / watch tv on your side propped up on your hand? I’ve had similar pain jolts (without tingling) and it was a jaw thing.
posted by St. Peepsburg at 1:23 AM on April 7, 2019

If you recently stopped taking or started tapering off an antidepressant, e.g. venlafaxine, it could be a side effect of withdrawal.
posted by Morpeth at 3:19 AM on April 7, 2019

Best answer: There is a syndrome called jabs and jolts which is associated with migraine (at least, seems to be more common in migraineurs).

One prophylactic word of caution: if you have migraine with aura, your MRI will almost certainly have unidentified bright objects. These are not MS lesions! But are frequently mistaken for them, even by well-trained neuroradiologists. Certainly, a person could have migraine with aura AND MS, but there are specific criteria involved in that diagnosis, not just the number and appearance of "spots on brain."
posted by basalganglia at 5:28 AM on April 7, 2019 [2 favorites]

Cough headache is a thing.
posted by ellenaim at 6:05 AM on April 7, 2019 [1 favorite]

Response by poster: Thanks, everyone!

No prescriptions currently.

Fshgrl, you are the first person I’ve come across in my web travels who described the exact phenomenon with the head jolts upon impact-based movement, and then the bizarre neurological pains and vision issues on top of it! I’ll press this line of thought back at the GP and see if I can get back into the ENT again before the neurologist appointment. Out of curiosity, how were they able to distinguish between bacterial and fungal?

Atypical migraines are another good idea to keep in mind. Thanks again, all!
posted by allisonrae at 1:23 PM on April 7, 2019

They weren't really. Antibiotics did nothing though and I took some anti-fungals and it got a lot better. But the snotty nose never really 100% cleared up. I think my care was really sub standard tbh. If it is coming back I'm going to push for a top ENT referral.
posted by fshgrl at 9:18 PM on April 7, 2019