Good Evening! A 27 year old male working in the IT sector for many years in a metro city experiences headache while going home from work only during the time he is sitting in the cab. It has been increasing in intensity. Not associated with nausea. No refractive errors. No intake of junk/spicy food. Not relieved with OTC painkillers. Please suggest the line of management. Thank You

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May be a case of tension headache, probably scared to see his wife. Reassurance. Psychological counseling. Counsel wife first. Kindly bear with my sense of humour. Thanks again dear Shaina.

Dr Krishna, excellent way of putting up an answer on this query :)After all little humour is required
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Tension headache increasing in intensity and only on going home in cab?what happens when he changes way of going or place where he's going?Is this a real type of headache or a psychiatric symptom-meant without adding the stigma of "psychiatric"

Thank You,ma'am!
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It is migrane as whole day working in centralized Air conditioning office and then cab,traffic,noise,pollution,humidity, the environment changes,can act as a trigger for migrane,still evaluate further from neurological &psychological point,or as Dr.Krishna mohan sir adviced though in humour but many a times true. you can start with flunarazine+Analgesic till you confirm the diagnosis

Thank you,sir!
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it's TTH line of management ,, amitryptilline 10 mg od at 7 pm

wat TTH?
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To the best of my knowledge it is neither migraine nor tension type but it seems a non specific situation type headache where symptoms occur in certain situations but not in others. the best management is avoiding the situation or changing it.

migraine

Thank you,ma'am!
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Other things that may help are Relaxation exercises like deep breathing or JPMR Counselling and psycho education about cause, relieving and aggravating factors.

Thank you,sir!
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and flunarizine 5 mg bid

Thanks a lot, sir!
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it is migraine best option is homoeopathic medicine

Thank you!
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dr. goyal u can try topiramate

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