What could cause headaches despite medications?

Question

Hello doctor,

This is regarding the health of my 50-year-old mother, who is not keeping well for the past six months. She has been complaining of headaches for the past five to six months, which have been constant with heaviness around her forehead and the area between the eyes and the nose. We got all the recommended tests done including a CT scan of her brain, which showed some age-related cerebral atrophy and bilateral basal ganglia calcification. The doctors said that it may be a chronic tension headache, for which they gave her medicines for three months. Now, it is almost two and a half months but, there is no improvement in her condition.

For the past few days, her headache has increased and it is mostly on the forehead, eyes, and nose area. At night, her nose is severely blocked, and the heaviness of her head bothers her a lot. It is affecting her day-to-day life. And lastly, her condition deteriorated the day she had acidity, indigestion, and nausea. The medicines which she has been taking are Escitalopram 10 mg, Clonazepam 0.5 mg once daily, Nortriptyline 10 mg, Gabapentin 400 mg, Domperidone, Naproxen sodium for pain, and Rablet L in the morning. Apart from these, she has been under medication for hypertension for the past 10 years. They are Cilnidipine, Telmisartan and Rosuvastatin 5 mg. All her blood tests including electrolyte test, CBC, thyroid, etc., have been normal. Only her EEG had shown some changes in the theta waves after which the CT scan of her brain was done. Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I just went through your query regarding your mother's health.

The complaints could be due to sinusitis (inflammation of sinus). She will need further testing to confirm it. Until then, I suggest the following:

Please start Furamist nasal spray (Fluticasone topical) once a day for 15 days. If the symptoms persist after 15 days, she will need a CT (computerized tomography) scan of the paranasal sinuses done.
Please ask your mother to take steam inhalation thrice a day. She could add one drop of Karvol plus capsule (camphor, eucalyptol, menthol, and others) in it. This will give her some relief from the heaviness in her head and the stuffiness in her nose.
I also recommend drinking plenty of warm water.
All the meals should be eaten on time. Have small, frequent meals. Avoid oily, spicy and cold food.
Do not sleep or lie down immediately after having food.
Please meet an ENT (ear, nose and throat) specialist for examination and a diagnostic nasal endoscopy for optimum treatment.

I hope this helps.

Please revert so I can assist you further.

Thank you.