Mysterious sharp head pain is mysterious.

April 6, 2008 2:57 PM

Head-pain-filter: 50 year-old woman suffers from pain both internal and external, in the right side of her head above her ear.

The pain feels as a sudden prick that goes from the small circle to the big one.

Externally, the skin in the area feels painful to touch, similar to the oversensitivity after a burn. This dissapears and appears along with the internal pain.

The pain is not permanent. When it happens she can get dizzy if she opens her eyes. There are days when it happens more frequently than others.

She will go to the doctor in the near future, but before she would like to have an idea about what it could be.

posted by Memo to health & fitness (14 answers total)

Sound similar to the issue discussed in this thread.
posted by kimdog at 3:13 PM on April 6, 2008

See you doctor. Now. While you're there, ask about a referral to a neurologist.

Sharp, unusual pains in the head (especially if they're in a specific spot) are not to be messed with. Chance are it's nothing that can't be easily dealt with, but why take the chance?
posted by cgg at 3:31 PM on April 6, 2008

See YOUR doctor...
posted by cgg at 3:32 PM on April 6, 2008

Make sure she talks to a neurologist. The only thing I can think of, as a neuroscience student who knows her neuroanatomy, is that she's got a problem with the cranial nerve in that location - either one of the nerves having to do with the eyes or the vestibulocochlear nerve, since you said she feels dizzy.
posted by kldickson at 3:44 PM on April 6, 2008

Of course, I am not a physician, so I will reiterate: Get the hell to a doctor as soon as possible. Don't wait until the near future.
posted by kldickson at 3:45 PM on April 6, 2008

before she would like to have an idea about what it could be

Why does it take a neurologist 60 minutes to figure it out in his office, after taking a detailed history and doing a physical exam - but the internet can somehow magically figure it out at a distance?

Consider the answer to that question carefully when evaluating other answers in this thread.

And if you solve the problem, let me know - I'd love to be able to diagnose my patients without having to bother with annoying things like speaking with them or touching them or being in the same room with them.
posted by ikkyu2 at 3:47 PM on April 6, 2008 [7 favorites]

She will go to the doctor in the near future, but before she would like to have an idea about what it could be.

Guys, the OP has said she is going to see her doctor soon. Sometimes people are very apprehensive about the visit itself, and want to know that out of the many, many things something scary can turn out to be, an number of them are, let us say, reasonably distant from fatal.

I mean, while I'd like to be prepared for the fact that it could be, say, brain cancer, it's also nice to know that it could be something simple like a pinched nerve.

She didn't ask for a diagnosis. She asked what it could be, ahead of seeing her doctor. I think that's pretty standard human behaviour, no?
posted by DarlingBri at 4:12 PM on April 6, 2008 [1 favorite]

I was going to try to explain further but, on preview, DarlingBri has done a magnificent job. Really, it's not like she'll decide to not go because of something that has been said here.

If anything, I hope this thread will make her want to go as quick as possible, as she's somewhat convinced (wishful thinking?) that it's just an stress thing.
posted by Memo at 4:19 PM on April 6, 2008

Of course people want to know what they might have ahead of hearing a diagnosis, in order to have some time to prepare themselves. Totally normal. But I think ikkyu2's point was that it's impossible for anyone reading this post to answer the question, and that speculation is a waste of time. Could it be inoperable, incurable brain cancer? Sure! Could it be multiple sclerosis? Sure! Could it be glaucoma? A ruptured eardrum? A chronic subdural hematoma? A Greek goddess ready to spring fully-formed from this person's forehead?

Seriously, it could be anything; without a detailed medical history and a complete physical and neurological examination performed by a competent physician, any suggestions are pure conjecture. Even with a detailed medical history and examination, it can take many months to diagnose neurological diseases/issues. It took six months of doctors' visits and tests to get my MS diagnosis, and that's actually on the faster end of the scale as these things go.

No one reading this question has the information or tools necessary to make useful suggestions to this person. The best we can do is say that we know it's scary, it sucks to be scared, and we hope everything is OK.
posted by jesourie at 5:23 PM on April 6, 2008

Well, the two things that spring to mind given this description are paroxysmal hemicrania and temporal arteritis, but there certainly isn't enough information given to be sure. If I had to put money on it, I'd put the money down on common migraine, because common migraines are so common that every other kind of head pain looks extremely rare next to them. The duration and frequency of the attacks aren't specified; if they're brief, it could be trigeminal neuralgia. Brain tumor and aneurysmal rupture would be unusual given these descriptions, but not impossible. MS doesn't generally cause headaches, and I've never seen a case of parthenocephalogenesis. The cranial nerves "having to do with the eyes" and the vestibulocochlear nerve lack pain afferentation, so it's not them either. Let's not rule out cluster headache, psychogenic headache, medication-induced headache, an allergic reaction, zoster ophthalmicus, mononeuritis multiplex, a tumor metastasis impinging on V1 or the ansa cervicalis (or one of its branches such as great auricular nerve), a pterygopalatine ganglioma, occipital neuralgia, and Munchausen by proxy.

The above is pure conjecture based on insufficient information and is all probably wrong. See your doctor.
posted by ikkyu2 at 10:28 PM on April 6, 2008 [1 favorite]

Oh, I forgot caffeine withdrawal. Let's not forget caffeine withdrawal, responsible in some series for 50% of all headaches - let's not forget it, while we are about the business of drawing up useless, tendentious, laborious lists of possible diagnoses.
posted by ikkyu2 at 10:30 PM on April 6, 2008

Sounds like trigeminal neuralgia/myalgia. Though I'm a nurse, I coincidentally suffer from the same thing. Have your friend see a neurologist to find out for sure.
posted by magnoliasouth at 10:35 PM on April 6, 2008

Trigeminal myalgia. There's a new one. Will it be in ICD-11?
posted by ikkyu2 at 12:04 AM on April 7, 2008 [1 favorite]

While agreeing with the statements above that, yes, do see a doctor, I can add my anecdote that shows the possibility that it could be something less than horrrifying. I had similar pain that ran alongside my head over my ear and I freaked a little internally wondering what it could be. Luckily, my doctor knew I was a cartoonist and asked me to mime how I drew. I admitted I had been drawing on a flat table and I was hanging my head down and at an angle. Turned out the whole thing was muscular in that I was stressing the muscles and tendons running up from the neck and alongside my head. A little adjustment in how I sat made the whole thing go away. Does your friend do any physical action that may cause a similar reaction?
posted by lpsguy at 6:30 AM on April 7, 2008