RSD Puzzle #133

H. Hooshmand, M. D.

DIPLOMATE AMERICAN BOARD OF PSYCHIATRY AND NEUROLOGY

BOARD CERTIFIED IN ELECTROENCEPHOLOGRAPHY

BOARD CERTIFIED IN ELECTROMYOGRAPHY

BOARD CERTIFIED IN AMERICAN BOARD OF ELECTODIAGNOSTIC MEDICINE

INTRACTABLE NEUROLOGY

EPILEPSY, PAIN, MS

An International Referral Center dedicated to Treatment, Education and Research

RSD PUZZLE #133

CRPS and Headaches

Dear Dr. Hooshmand,

I have increasingly worse headaches. They are totally disabling and have been diagnosed as migraines since the new migraine medicines Maxalt and Imitrex (not Zomig) help. I also occasionally get some relief when I eat, but I eat VERY often (small portions--like the 4-Fs diet) and don't know what else to do to steady my blood sugar. The Maxalt only HELPS some and only sometimes. I have a headache 24 hours / 7 days a week. I also have developed a couple of lumps on my head. The neurologist here said everybody has lumps on their heads and I know that but these are new and hurt when I press on them. He did a skull X-ray that came out negative. Could it have to do w/the RSD. I feel like I'm going to go crazy if I have to deal with this pain anymore. Do you have any suggestions?

Thank you.

First of all, Imitrex and Maxalt do not help this type of headache. It is not a true migraine. The two migraine medications constrict your blood vessels and aggravate your CRPS.

The headache you have is called occipital neuralgia which can mimic migraine but does not respond to migraine medications.

You need occipital nerve blocks. If you can convince a doctor to do them, I will be glad to give them the information.

The lumps on your head are a sign of neuroinflammation due to CRPS and secondary occipital neuralgia.

Sincerely,

H. Hooshmand, M.D.

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