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Asking for any ideas, again


Tony Only
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I am looking for any input or ideas for female patient who does not write in english so I am posting on her behalf. I don't know much about the brain injury involvements in particular.

Cluster headaches have begun and gone pretty severe in just few years. Here are some background details. Anything anyone can think of, to help or to try, it might help. Anything I can ask from her.

Brain injury in 2013 which left some symptoms; headaches, fatigue, memory problems and trouble with balance.
Cluster headache diagnosed in july 2017.
Medication prescribed for it: steroid course, verpamil, imitrex when needed and medical oxygen.
Only triptans and oxygen have worked.
Diagnosed further as chronic in 2018.
These have been tried:
Gabapentin - not effective
Topamax - too severe side effects
Baclofen - too severe side effects
Lioresen - not effective
Diazepam - only makes sleepy, not effective
Tramal (opioid) - increases amount of attacks

Tried during hospital stays:
Valproates
Indomethacin
Dexketoprofen
...these have only helped a little

They might help with oxygen but do not prevent attacks from happening. Verapamil dosage has been 360mgx3 times a day (total 1080mg/day) and now it is lowered to 120mgx3 (total 360mg/day). In addition to others there is melatonin daily at 9mg dosage. Oxygen and triptan when needed.

Occipital nerve block done last week, maybe it has only helped by decreasing a few attacks.

Her blood level for Vitamin D is 175 nmol/L. She is waiting for SPG stimulator but due to delivery problems it will take a while. Needless to say probably, she is exhausted.

Edited by Tony Only
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