32 Y/o - 45 days nonstop headaches. Help find ideas

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Hello Everyone,

I've started with headaches since December 1st, they last the entire day since I wake up until I go to bed, usually pain is 5/10 but can go to 8/10 sometimes. It's a feeling of pressure in the entire head. I have no other symptoms (Covid, fever, etc etc)

Its very frustrating because I've been trying to get it diagnosed but still don't know what is causing this, It's very hard to live a normal life, I had to stop doing exercise, some days I stay half the day in bed because I just cannot work.

I'm looking for Ideas on what to check, any hint will be deeply appreciated.

I've made a log of every drug and doctor I visited, so far the only pending thing to do is a polysomnography and to visit the ENT, I'm attaching the log:

December 1st

Pain starts and I was treated with Ibuprofen / Acetaminophen without satisfactory results

December 10

I take azithromycin for 3 days and it doesn't go away either, having a history of sinusitis was an idea.

December 15

I visit the doctor, he prescribes me to take Ibuprofen / acetaminophen / Tramadol together and it doesn't go away. I do blood tests and my cholesterol is a bit high (250). I start taking atorvavastine 40mg to lower my cholesterol, the pain persists

December 20

I have a strong episode and I go to the emergency room. I have a brain CT scan and it goes well, despite telling the doctor that I have no stress, he gives me the same day with neurexan and tizanidine which are for stress / muscle relaxants, I take them and I do not notice any improvement.

December 24

I do an acupuncture session, everything the same.

As my eyes bother me a little, I go to the ophthalmologist for a general check-up, my eyesight is perfect and they rule out any related problems.

I go to the neurologist and he asks for a very detailed blood test and a brain MRI with contrast

December 27

The results go well, the neurologist sends me to give me injections of diclofenac / dexamethasone for 2 days and take valproic acid 250mg, diagnosing a de novo migraine.

January 3

Everything remains the same, the neurologist sends me to the emergency room to do a lumbar puncture. I come and I am hospitalized for 4.5 days.

In the emergency department, I had a cerebri venography with contrast and a lumbar puncture, which went well.

In all the days that I was on Voltaren / diclofenac / acetaminophen and intravenous valproic acid the pain never went down.

During the hospitalization I consult a rheumatologist to consider the possible association of my arthritis or the treatment I am taking, and he totally discards it.

They release me on my own request with outpatient treatment of pregabalin / amitriptyline. After 5 days of treatment I stop taking it since the pain remains the same but it leaves me "zombie" all day.

January 15

Maxillofacial visit with X-ray and dental CT, the theory is that a residual root in the extraction of wisdom teeth could be causing the pain.

The maxilli discarded it and sent me to do a baseline polysomnography to check for apneas during sleep.

January 16

Physiotherapy session, I do not notice improvement

January 17 baseline polysomnography, results at 10-20 days.

Pending visit to the ENT

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Thanks for your help!

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