Hello doctor, My daughter is 9 years old and has a typical headache at right temple. The headache, she says, is more or less constant and not severe in the day but is intense at night. She sleeps at around 10:00 PM and wakes up around 12:15 AM to 12:30 AM. This is when she cries as she is not able to bear the pain. She gets up from the pain itself. We have already done head X-ray and sinuses is ruled out. Even though the medicine is for antibiotics and I am not sure that it is working, as there is no improvement for last four nights (saving the first night when there was no pain and she could sleep the entire night). During her night pains when we give her Crocin, she is better after 10 to 15 minutes and then typically sleeps the rest of the night. We are trying to get appointment for silent MRI and have our fingers crossed. However, as you are very experienced and could identify a pattern or known case or cause, please do share. Again, the pain is only at right temple and nowhere else
Hello. I understand your concern and would explain that this type of headache could be related to hipnic headache. Anyway, a brain MRI or CT scan is necessary in order to exclude a possible brain lesion, as the headache is always located in the right temple. I would also recommend performing PCR and ESR for inflammation. Temporal arteritis is another possible disorder, which could lead to pain in this region. In such case steroids would be needed. A Doppler ultrasound of the temporal artery is needed too. In case the brain MRI, inflammation tests and transcranial doppler of the temporal artery is normal, I would recommend considering hipnic headache as a possible cause. In such case Flunarizine or Topiramate would help improve her situation.