ADOLESCENT WITH NEW DAILY PERSISTENT HEADACHE
do not cause any symptoms but are visualized when someone undergoes brain MRI for various reasons. When extremely large and compressing other parts of the brain, Rathke’ s cysts may be treated surgically, generally by removing part of the membrane that surrounds the fluid-filled cavity. Possible symptoms do include headache, but this generally occurs in the context of other findings as well – visual impairment, mood swings, weight changes, frequent urination, breast discharge, and fatigue. If your husband has only had headaches for 6 years( vs. most of his life), lacks these other issues, and is worsening despite a stable appearance in the cyst, then most likely there is another explanation for the headaches. A visit to a comprehensive headache program would then seem in order.
– Robert Kaniecki, MD Director, The Headache Center Chief, Headache Division Assistant Professor of Neurology University of Pittsburgh Pittsburgh, PA
ADOLESCENT WITH NEW DAILY PERSISTENT HEADACHE
My 14-year-old daughter has been diagnosed with New Daily Persistent Headache after having a headache 24 / 7 for the past 7 months. We have been to her doctor, eye doctor, allergist, physical therapist, orthodontist, two neurologists, and had blood work and an MRI, which all came back normal. She is currently trying medicine # 8. She is becoming very discouraged and depressed. She went from being a very active and fit cheerleader, outgoing and social, to spending the majority of her time in bed. She is behind in her schoolwork and we just recently decided to home school her for the rest of the school year. We don’ t know what else to do. We are just watching her agonize in pain with no relief in sight.
The meds she has tried: Muscle relaxant Treximet Maxalt Migranal Prednisone Morphine( given in E. R.) Propranolol Topamax Cymbalta( currently taking for the past 5 weeks, has not helped at all)
– Alisha B.
This is the most difficult headache to treat. At this point, you need to be managed by a pediatric headache specialist. There are a few main principles of management to follow:
• get adequate sleep
• eat properly
• deal with depression, if present, with counseling, medication, and exercise as tolerated
Your medications need to be optimized. Each prevention drug should be given a fair trial of 3 months; starting with a low dose, increasing in increments until it works or she has side effects. This is very difficult to manage and requires an expert calling the shots.
– Jack Gladstein, MD University of Maryland Director of the Pediatric Headache Clinic Baltimore, MD
CONTINUED ON PAGE 8
www. headaches. org | National Headache Foundation 7