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