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Rebound Headache

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Classic Headache Cases – by Dr. Dennis Brown at Memorial City Neurology in Houston, Texas

Our final patient is sue she was diagnosed with rebound headaches so why don’t you tell us about your headaches how did they begin about three and a half years ago i came down with bell’s palsy and about three months later i had my first headache you’d never had a headache before no did you know what headaches were like never i had rarely ever even felt a pain

In my head i never even really took aspirin what side of the face was the bell’s palsy on the left side where was the headaches on the left side what part about the middle on this side kind of back okay did you have any other symptoms with these headaches like nausea or vomiting no not at all how often were you getting these headaches well when i first started

Having headaches i may have one maybe two a day and to help the pain i would take two to three advil then i noticed over time and we’re talking over a few months at first that the headaches were getting harder and they were afraid coming more frequent to the point that i was having maybe three or four headaches a day and they were harder and it was taking five to

Six advil a time to relieve the pain now did you come back to see me in that timeframe yes i did and you did an mri and basically the mri from what i understand was clear you wanted to make sure there wasn’t anything wrong i’m you know because i had never had headaches before and then what happened and then basically i felt like i would just be getting okay and

So i just was taking advil on my own did you go to the doctor yes i was seeing my family physician just for different things and when i would go in he would ask me you know well as are there any problems and i told him that i had headaches and he said okay what are you doing for them and i said well i’m up to taking 18 to 20 advil a day he at that time said well

That’s okay that won’t hurt you and then last spring i went to my gynecologist for my yearly checkup and i mentioned to her that i was having these headaches and that i was taking a lot of advil and at that time she said you need to get back to your neurologist and that’s when i came to see you again when you came to see me how many advils were you taking a day

Well it depends sometimes i take 18 to 20 if i had more headaches than that i may take it up to 24 you know advil a day how many advils were you taking after every headache usually five to six okay so you would take five to six advils with a headache mm-hmm what would happen to the pain the pain would go away then what would happen the headache would come back

Usually about four or five hours later then what would you do i would take advil again okay and the cycle just would repeat itself every day that’s what i went through okay so you were taking large amounts of advil for these recurrent headaches that’s right then you came back to me again and what did i do at that time and that’s when you said i believe you have

Rebound headaches and i’ve never heard the term before and you put me on steroids prednisone and you started me with a higher dose and then you decreased it over about two and a half weeks and after that time i felt great my headaches were totally gone i didn’t have a headache for about five days what happened then headaches came back and i started taking advil

Again on my own i didn’t call you and so i just thought well i guess that’s taking advil again okay then you called us then i called you back after i started doing that and i realized you know this isn’t working and so i came back and that’s when you put me on vioxx and he started me on about 12 and a half milligrams twice a day and that did help but it just wasn’t

Totally getting rid of the headache and it was taking a long time to get rid of them and so you changed me first of all to 25 milligrams of biotics twice a day and then i wasn’t having a headache for two or three days and now i’ve gotten to the point to where i’m only taking one vioxx a day how often are you taking about i said once a day i’m not taking them once

A day when i take it i take it once a day and i only take it maybe every three to four days depending on when i have a headache so in general your headaches have gone down tremendously tremendously the the pain is nothing like they were so you’re taking one vioxx have a headache relieves a headache then you go for days may need another and this is 25 milligrams

About and how do you overall how do you feel about the way the treatment of your headaches has taken place i am very happy i’m very happy i’m very glad i i tried something else you know i guess because you know i’d never even heard the term rebound i didn’t know what i was dealing with i thought i was just well i’ll just take advil and so i’m very very happy sue

Has classic rebound headaches the headache can be stopped with minor analgesics but soon returns and she has to use the analgesic again this pattern may be repeated several times during the day the only treatment for rebound headaches is to remove the offending medication in this case tylenol after the medication is removed one can use an anti-inflammatory agent

Or steroids while the offending medication is tapered usually the headache resolves most primary care providers are unaware of this common type of headache

Transcribed from video
Rebound Headache By adamhealthcommunitie