What is the treatment for twitching, congestion, and migraine?

Question

Hi doctor,

I am a 64-year-old male. I have been experiencing the following symptoms:

Recently, a little muscle on the side of my chin started twitching several times a day.

Seasonal allergies at the moment.
Feeling my head is heavy.
Brain fog.
Feeling congestion high in the nose (breathing not impaired).
Sore throat.
Tinnitus (since 26 years old) has increased slightly, mainly in the left ear and feels a little painful once in a while.
Started having migraine with auras.
Sometimes, an odor of something burning in the nose (I feel this each year during allergies season).
Laundry detergents begin to smell unusual on clothes after a few hours.
If I remove the clothes, the smell disappears, so the detergent (I tried various brands) seems to be the trigger).
Recently, a little muscle on the side of my chin started twitching several times a day.
I thought that I had a sinus infection, but the total of these symptoms worried me.
I also have some nausea (but not in the stomach, more on the side of the neck (glandular nods, or something like this).

Kindly help.

Answer 1

Hi,

Welcome to icliniq.com

I am glad you chose icliniq for your medical-related queries.

I understand your concern and will try to help you with it.

I am sorry to hear about your troubles, and certainly, this seems to be multi-factorial.

Most of your symptoms can be attributed to chronic rhinosinusitis (nasal congestion, odor changes, headache). There are also some symptoms attributable to vascular headache or migraine (headache, nausea, aura). The muscle twitching can be secondary to dehydration, electrolyte depletion, or fatigue.

However, headache, nausea, and phantosmia (olfactory hallucination) may also be rarely associated with an intracranial tumor or space-occupying lesion (brain tumor), especially of the anterior lobe or increased pressure of the brain fluids CSF (cerebral spinal fluid).

Please follow these:-

-Oral rehydration solution to replenish the electrolytes and correct dehydration.
- To start on Mometasone furoate nasal spray(steroid mediation) 50 mcg two puffs both nostrils once a day.
-MRI(magnetic resonance imaging) of the brain and the sinuses with contrast- to rule out any intracranial or sinus pathology.
It is not clear whether you are on any treatment for the migraine as such; if not, this may be considered after ruling out any intracranial tumors with an MRI (magnetic resonance imaging) scan.

Thank you for consulting me.

You can always come back and reach me at icliniq.com.