Sudden, Sharp Pain on Upper Left Side of Head? Seeking Advice

Posted by abba @abba, Aug 11 9:52pm

71-year-old male . Looking for insight into a sudden and puzzling issue I've been having.
About two weeks ago, I started experiencing sharp shooting, electric-shock feeling pain on the upper left side of my head, roughly 5 inches above the ear. The pain is isolated to this exact spot and doesn’t start at the base of the head. Along with the pain, the scalp in this area becomes sore to the touch and feels warm. The sensation extends to the body, but temperature returns to normal after the pain subsides.
This is the first time I've had pain like this, and it started suddenly on July 31, 2024. Now it occurs multiple times a day. During these episodes, the pain is excruciating (10/10), and I’ve had head jerking and body jolts due to the shock-like sensation.
I went to the ER almost daily from July 31 until August 5, when they admitted me due to the frequent visits. They treated me with various medications, including:
- Gabapentin 300 mg
- Tramadol (37.5 mg) + Paracetamol (325 mg)
- Codeine Phosphate 10 mg + Paracetamol 500 mg
- Ibuprofen (400 mg) + Paracetamol (325 mg)
- Indomethacin
A Neurologist did a physical exam and ordered MRI and MRV scans of my head, which came back clear. The neurologist suggested it might be a migraine and prescribed Gabapentin 300 mg (twice a day) and Indomethacin 25 mg (three times a day) for the next 7 days. The pain is intermittent, occurring every 8 to 24 hours or so, and continues until the painkillers take effect.
I’m baffled by how this issue appeared suddenly and continues for the past two weeks. Has anyone experienced something similar, or do you have any suggestions on what might be causing this and what I should do next?

Interested in more discussions like this? Go to the Brain & Nervous System Support Group.

I was diagnosed with trigeminal and occipital neuralgia. Not exactly the same because your pain is so focal. Pain in the scalp would be occipital according to my neuro. They did a lidocaine injection to block the nerve which helps some people but made mine worse. I cannot take gabapentin and they prescribed baclofen. I used to take flurbiprofen, stronger than Advil and by prescription but had to stop due to kidneys. It helped.

Do you have any idea of what is triggering this? Or what helps? Cold, heat, massage? Has anyone mentioned steroids (just curious, I have no idea if that is a good idea)?

I recently saw an integrative medicine doctor who prescribed curcumin, alpha lipoic acid and PEA/luteolin as well as CBD. None of this is helping!

I hope you get a good diagnosis and treatment. This sounds like a crisis so you can't afford a medical wild goose chase. You need relief asap! Hope some of the meds are helping!

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My first thought is occipital neuralgia. I had those incredible shooting pains several times a day for about 2 years. I honestly thought I must have a brain tumor it was so bad. A neurologist diagnosed it as occipital neuralgia and told me it originates in the neck even though the shooting pains were not in my neck. I did have a lot of neck issues though. He gave me neck stretching exercises to do (I don’t recall the details). I did them and it stopped. I have only had a few random pains there in the past 15 years.

I do have problems with scalp tenderness across the top of my head and crown. That comes and goes. I figure that is part of a hereditary neuropathy I have. My mother complained of scalp tenderness too. I did not have the heat sensation with any of it.

Do a search for occipital neuralgia on this site and read thru posts from others to see if it seems to fit. While mine was very painful, it seems it was harmless. Prayers that you find the cause and solution.

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And the location of my lightning bolt shooting pains were the same location as you describe. A lightning bolt of pain across the top left side of my head. If I part my hair in the middle, it would be a couple inches left of the part.

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@abba, I would like to add my welcome along with @windyshores, @zebra and others. I thought I would share a link to discussions and comments by other members on "brain zaps" that sound similar to what you are experiencing. Here's a link that shows the discussions and comments - https://connect.mayoclinic.org/search/discussions/?search=brain%20zaps.

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Hello @abba,

I would like to add my welcome to you as so many others have done. I am so sorry to hear of this terrible pain. I see that it was mentioned by a neurologist that it could be migraines. I have a similar problem with vertigo (no pain) and I was told that it could be migraines. It was suggested that I eliminate certain foods that are triggers for migraines. These include caffeinated foods/drinks, chocolate, aged cheese, wine, etc.

It might be wise to keep a food/activity diary to see if any particular foods/drinks or activities might be a trigger for the pain you are experiencing. The book that was suggested to me was, "Heal Your Headache". It was written by David Buchholz, M.D. Among other information, the book lays out foods, drinks and activities that can be triggers for migraines.

As you are looking for possible answers, this might be interesting for you to take a look at the book.

I look forward to hearing what progress you are making dealing with this pain. Will you continue to post?

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Hi - i had that a few months ago. It’s so painful! Mine also felt like it shot down through my ear and into my jar. ER diagnosed it as trigeminal neuralgia, on the left. Prescribed gabapentin, i’ve weaned down to one 100 mg at might.

Then a month ago, a few days after a facial (where she did a strong face/head massage, I got the same thing on the right side of my head, but starting to the right of center on my right side. It was horrible. I ended up taking tylenol, advil and a muscle relaxant, and that helped. I didn’t bring enough gabapentin on my trip to the midwest (hence the tylenol, etc.) and I found out gabapentin is treated as a Class V drug in Wisconsin, so getting extra was a problem.

Basically cleared up but last few days a bit of pain in top of head and right ear.
I slept funny a week ago, neck is still a little stiff, so maybe my massage tomorrow will help?

The PA neurologist wants me to get a brain MRI to see if there’s compression of nerve or something. I have to do open MRI, and even that is so stressful, but since it’s acting up again guess I should schedule it.

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I have had occipital and trigeminal neuralgia with pain and numbness these last two days. I wish I could tolerate gabapentin! I feel fortunate that I am retired. I took some Klonopin (1/4) to be able to sleep. I don't sleep on the affected side if I can help it. Lying on a pillow on the affected side is a trigger so I would imagine a facial massage would be too.

I was evaluated for acoustic neuroma but cannot do contrast and MRI exacerbates tinnitus, so CT w/out contrast may not have been sufficient. If things get worse I will have an MRI.

Good luck everyone!

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Like some of you, at different times I’ve also had pain from my right temple into my teeth and believe it was trigeminal neuralgia. That lasts no more than a couple weeks. I’ve also had pain with tenderness in and around my left ear and down my jaw that was not TMJ. I had an MRI looking for an acoustic neuroma but don’t have that. That pain comes and goes and has for years and years. It’s amazing how much pain neuro problems can generate without causing any real deficit. The occipital neuralgia pain was only across the top left side of my head not on the side or face. I have a rare hereditary neuropathy that causes a multitude of issues and nerves are easily damaged so I’m just prone to painful issues. Best of luck to all in resolving your neuro issues.

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Thanks everyone. I am scheduled for a MRA to rule out. Btw did anyone talk with your Dr. about Temporal Arteritis ( Giant cell arteritis)?

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@abba

Thanks everyone. I am scheduled for a MRA to rule out. Btw did anyone talk with your Dr. about Temporal Arteritis ( Giant cell arteritis)?

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Hello @abba,

As we wait for others in this group to answer your question, I thought that you might find some of these posts on Connect from members who have Temporal Arteritis to be helpful. Here is a link to those posts.
--Temporal Arteritis
https://connect.mayoclinic.org/search/?search=Temporal+Arteritis
As you read these posts, it will provide you with information about the symptoms that others have with this disorder and how it has been treated.

Is there a reason why you are thinking about this particular diagnosis? Is there anyone in your family who was diagnosed with this?

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