Stabbing Pain Behind Eye Possible Causes
It can be quite frightening to suddenly feel stabbing pain behind your eye.
Causes of Stabbing Pain Behind Your Eye
“Pain behind the eye can be from a number of causes,” says Dr. Ravish Patwardhan, MD, nationally-renowned neurosurgeon and founder of Comprehensive Neurosurgery Network LLC.
“The most important things to rule out are a tumor or aneurysm, which can usually be done by using an MRI scan with MR angiogram.”
Dr. Patwardhan also notes: “Other intrinsic problems with the eye can be determined by an eye doctor.
“Some conditions will exist without any of these findings, such as Tolosa-Hunt syndrome, diagnosed with the help of a neurologist.
“In either case, the proper healthcare professional will guide diagnosis and therapy.”
Next time you suffer stabbing pain behind the eye, what should you do?
This is probably NOT a rupturing aneurysm or a tumor.
Nevertheless, ongoing occurrences mean you should get this checked out.
If this nuisance is your only symptom (i.e., no visual disturbances, slurred speech, numbness in a limb, unsteady gait or one-sided weakness, dizziness or nausea), you should not lose sleep over this.
According to Dr. Patwardhan, the stabbing pain behind the eye is most likely just a benign headache in a nasty location, creating the illusion that it means a serious condition.
Even a mere tension headache or ice cream headache can cause considerable discomfort in this location.
Take it easy, relax, and to put your mind at ease, you may want to consider recording your incidents of severe pain behind an eye, so that next time it happens, you could refer to your documents and possibly say, “Hey, I had this 14 months ago and nothing came of it! So there’s no need to worry!”
As for Tolosa-Hunt syndrome, this indeed can cause pain around the eye, rather than what would be described as behind the eye.
However, key features of this neurological disorder include difficulty moving the eye or the eyelid, as well as a bulging eye.
Though a brain tumor can cause pain behind the eye, the longer the time passage without any additional symptoms that would be suspicious for a brain tumor, the more reassured you can be that there isn’t a cancer causing the problem.
Symptoms of a brain tumor include (no particular order) seizures, cognitive changes, one-sided weakness, clumsiness, nausea, vomiting, morning headaches, loss of vision in one or both eyes, blurry or double vision, tingling or numbness in the face, trouble with swallowing food, and even a bulging eye.
Comprehensive Neurosurgery Network provides treatment for neurological disorders of the brain, spine and peripheral nerves.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
Lip Keeps Twitching: Causes, Solutions, when to Be Scared
Dang it, does your lip keep twitching?
What can it mean when a lip just won’t stop twitching?
This can be very unnerving (no pun intended) for some individuals.
Not only can a twitching lip be noticeable to someone you are interacting with, but it can cause a lot of worry and anxiety.
Lip twitching is actually quite common.
Lip Twitching Causes
“Repeated twitching of any muscle is often related to a problem of either the muscle itself or the nerve(s) leading to that muscle,” explains Dr. Ravish Patwardhan, MD, nationally-renowned neurosurgeon and founder of Comprehensive Neurosurgery Network LLC.
“Examples of muscle problems include spasms (from overuse or tiredness of the muscle itself) or a condition where the nerve leading to the muscle is sometimes pushed on by an artery near the brainstem.
“An example is hemifacial spasm, where half of the face twitches, including eye and lip muscles on that side.
“In rare cases, seizures can cause twitching on half of the face as well.”
Before you start thinking that your lip is twitching because of a hemifacial spasm, rest assured, the vast majority of cases are caused by, as Dr. Patwardhan initially says, muscle fatigue.
In fact, twitching in the lips has the same general cause as twitching (also known as fasciculations) in the calves, arches of the feet, eyelid and even the tongue.
Any muscle, that can be voluntarily moved, is capable of sustaining fasciculations every now and then, or repeatedly throughout the day (as in eyelids and calves, though other locations can be “hot spots” for relentless fasciculations).
But because lip twitching has a unique feel, and because it occurs on the face, this can create undue anxiety in hypochondriac-prone people.
Shutterstock/Aaron Amat
Anything having to do with the face can bring with it undue anxiety and fear.
Lip twitching can also be caused by general anxiety, or anxiety over something specific, such as a relationship, paying the bills, problems at work, etc.
Muscle fasciculations can also be aggravated by excessive worry about muscle fasciculations themselves.
This means that the more you worry and obsess about your lip, and the more you examine it in a mirror, the more likely it will twitch away.
Additionally, dehydration and a shortage of magnesium and potassium can cause fasciculations.
As for hemifacial spasm, Dr. Patwardhan says about the treatment: “An operation to put Teflon padding between the artery and nerve helps in the majority of cases.
“Treatment for spasms may require Botox. And, under severe circumstances, surgery may offer relief.”
Don’t fret if you have a twitching lip. Chances are very high that it will run its course and settle down before you know it.
This oddball symptom is not a sign of degenerative neurological disease.
Talking will most likely bring some remission to the fasciculations.
Comprehensive Neurosurgery Network provides treatment for neurological disorders of the brain, spine and peripheral nerves.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
I Hit My Head Hard: When Should I Go to the ER ?
Have You Banged or Hit Your Head Really Hard Lately and Are Wondering If You Should Visit the ER?
Getting hit hard in the head isn’t pretty, and sometimes an ER visit is warranted.
Sometimes it’s a no-brainer that a visit to the emergency room is in order after one hits or bangs their head, if the ensuing symptoms are beckoning for medical attention.
But what if the symptoms are more subtle and the hit on the head doesn’t seem that bad?
When to Go to the ER
“Head injuries are very common and the vast majority are not serious,” begins Dr. David Beatty, MD, a retired general practitioner with 30+ years of experience and an instructor of general medicine for 20+ years.
“In the majority of people the skull is tough and prevents most trauma from causing brain injury.
“Young children, those on anticoagulants, the elderly and those with osteoporosis are exceptions to this rule.
“Having said that, head injuries are one of the major causes of death in young people. About 0.2% of people attending ER with a head injury die.”
Dr. Beatty provides 12 symptoms to look out for if you get hit in the head.
1) Severe or worsening headache
2) Vomiting
3) Confusion or drowsiness
4) Loss of consciousness
5) Convulsions
6) Visual disturbance such as double vision or loss of some of your visual field
7) Weakness or loss of power in a limb or a drooping on one side of the mouth
8) Clear fluid or bloody discharge from the nose or ears
9) If you take anticoagulants (blood thinners)
10) If there has clearly been a dangerous impact such as a high speed RTA or a fall from a great height
11) Memory loss
12) Any suspicion of non-accident injury
Hard Impact but No Symptoms
What if the impact to the head was really, really hard, but there weren’t notable physical symptoms immediately after?
Some trauma centers have used the criterion of whether or not there was an alteration of consciousness such as asking the same question over and over.
Nevertheless, a person with only one of the aforementioned symptoms may indeed have an intracranial bleed or subdural hematoma.
An ER physician may order a CT scan if the patient has only a headache, especially if it’s getting worse.
What if there’s a big bump or bruise — but no symptoms?
“After any significant bump on the head it’s good practice for the person to stay with a relative or friend for 24 hours after the injury — then if there’s a deterioration, further help can be called,” says Dr. Beatty.
“They should rest, avoid alcohol, avoid sedative drugs, avoid contact sports and avoid driving.
“The size of the bruise gives some measure of the severity of the impact and is certainly taken into account in infants.
“In adults it’s probably less useful as an indicator than the other factors listed above.”
CT Scan of the Head
“Most hospitals will have guidelines/protocols for which patient warrants a CT scan and which doesn’t,” says Dr. Beatty.
“If they are seeing the subdural patient on a good day they may not tick the right boxes to get the test done.
“The guidelines as to when a CT scan is needed will vary from region to region, but most of the above will warrant a CT scan.
“There may be specific guidelines such as more than one vomit or more than five minutes of memory loss.
“The assessment of confusion or drowsiness may involve assessment using a scale such as the Glasgow Coma Scale (GCS).
“This gives scores for eye opening, verbal response and motor response.
“A normal person would score 15 and a totally comatose person would score 0.
“The lower the GCS score the more appropriate it is to do a CT scan.”
Bleeding in the Brain
“After serious head trauma a rapid deterioration in the first few hours is usually caused by a bleed into the substance of the brain: an intra-cerebral hemorrhage,” explains Dr. Beatty.
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“These can bleed profusely, causing pressure and damage within the brain, usually leading to obvious symptoms. It’s easy to spot that things aren’t right.
“Relatively minor trauma can lead to a subdural hematoma when blood collects between the bones of the skull and the substance of the brain.
“The amount of blood may vary from very little to a great deal.
“Small subdurals may not cause many (or any) symptoms. They may cause obvious neurological symptoms with limb weakness.
“They can, however, cause more subtle symptoms which are less likely to be picked up by the doctor or the patient.
“The onset is often more gradual [a “chronic” subdural hematoma] — and the symptoms may fluctuate.”
For example the person may be normal one day but have confusion or memory loss the next.
A chronic subdural hematoma may also present with personality change, speech issues or drowsiness.
“A chronic subdural can grumble on for days or weeks before being diagnosed.
“Those on blood thinners and the elderly are more susceptible.
“If the elderly person doesn’t have normal cognitive function to begin with, it may be very difficult to pick up subtle changes in memory or mental ability caused by a subdural.”
Dr. Beatty has worked in primary medicine, surgery, accident and emergency, OBGYN, pediatrics and chronic disease management. He is the Doctor of Medicine for Strong Home Gym.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: Shutterstock/Phovoir
How Do I Prevent Migraine Headaches at Night?
Migraine headaches can really mess up your sleep, but there’s good news:
Specific things you can do to finally get a good night’s sleep.
“Migraine headaches can happen at any time of the day or night,” says Daniel Kantor, MD, director of the Neurology Residency Program, Florida Atlantic University.
“We are often so busy during the day that some people are ‘too busy’ for the headache during the day (they have it but just don’t notice it), and only really feel the pain at night.”
And that’s when the problems begin, when the migraine headache sufferer tries to fall asleep.
First Tip for Falling Asleep Despite Migraine Headaches
“Sleep hygiene means doing things right to make the bedroom an environment conducive to sleep,” says Dr. Kantor.
“The bedroom is for two things: sleep and sex. It is not a place for TV watching, eating, etc. — these things are stimulating and will keep you awake and make it harder to fall asleep.”
You don’t want the bedroom to be a conditioned stimulus for staying awake.
Second Tip for Migraine Relief
The next thing is to make sure your doctor is doing all that’s possible to lower the intensity of your migraine headaches, since a good night’s sleep will be impossible if the pain is bad enough.
Dr. Kantor advises: “Try to relax before falling asleep — breathing exercises work great, as does mindful meditation.”
Wind down as bedtime approaches; avoid stressful or stimulating activities like heavy computer work.
Additional Sleeping Tips for Migraine Headache Sufferers
“Take a warm bath 45 minutes before your bedtime — as your body cools down, you get sleepier and sleepier,” says Dr. Kantor.
He also suggests taking a medication prior to bedtime that’s designed to subdue migraine pain, as these can induce a sleepy feeling.
“Go to bed at the same time every night, so that your body gets used to a full night’s rest.” This will help reset your body’s circadian rhythm.
“Make sure to talk to your doctor about your sleeping problems — they may be related to other problems, like anxiety, stress, depression and even sleep apnea and narcolepsy.
“Sleep apnea is important, not only because it makes you feel less rested, but also because it causes chronic migraines and can lead to an increased risk of heart attack and stroke.”
Being overweight, with a short thick neck, are risk factors for sleep apnea, though thinner people, including children (a tiny percentage) can have this treatable disorder.
If you suffer from migraines, it is absolutely crucial that you persistently try to remedy any sleeping problems. Dr. Kantor says, “We know that lack of sleep can trigger migraines.
Dr. Kantor is also President Emeritus, Florida Society of Neurology.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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Top image: ©Lorra Garrick
Brain Tumor Headache vs. Normal Headaches
Is there a difference between brain tumor headaches and normal headaches?
Answers to brain tumor headache questions you could never find are now right here.
I asked an expert questions about brain tumor headaches that you’ve wondered about.
Headaches are so common.
Is there a way to tell the difference between brain tumor headaches and regular headaches?
I asked Virginia Stark-Vance, MD, who specializes in the field of neuro-oncology (treatment of brain and spinal cord malignancies), about BT headaches vs. regular headaches.
She is coauthor of the book, “100 Questions and Answers about Brain Tumors.”
Do BT headaches necessarily feel like a “brain tumor headache”? Or can it feel normal?
Dr. Stark-Vance: “A tension headache, often felt as tightening in the back of the head or neck, is a common symptom in brain tumor patients who have a tumor in the back of the head, or causing pressure on the lateral ventricles, the spinal fluid spaces in the middle of the brain.
“The pressure from the tumor seems to transmit to the back of the head and downwards.
“It is not unusual for such patients to see a chiropractor, thinking they have a neck problem.”
Credit: James Heilman, MD
What are unique characteristics of BT headaches that differ from regular (tension, dehydration) headaches?
“There are no truly unique characteristics, although some patients will have an increase in pain with changes in barometric pressure, during a flight, or with changes in altitude.
“Some have a headache when bending forward or coughing. However, absence of these signs isn’t unusual either. Some brain tumor patients never have a headache.”
How do BT headaches differ from migraines and cluster headaches?
“Patients who have a history of migraines who develop a tumor often say their ‘tumor headache’ is different from their ‘migraine’ headache. They are not relieved with the same medication.
“Often the migraine headache is accompanied by nausea and sensitivity to light. Most brain tumor headaches are not accompanied by nausea.”
Are BT headaches necessarily confined to one area (pinpointed), or can they be in the entire head?
“Some patients describe their headache as poorly localized, at the top of the head, or the whole head. Some never describe it as a headache, just as ‘pressure.’
“They usually do not throb, but can radiate to the top of the head, behind the eye, or the back of the head.”
Is it typical or possible for the first incidence of BT headaches to be unbearable pain?
Or is the first headache almost always a mild pain?
“Sometimes patients have ‘the worst headache of their life’ when they present with a brain tumor, almost like an intracranial hemorrhage.
“More commonly, a patient will describe a more subtle headache; it can come and go, sometimes worse in the morning.
“Many patients have not even taken Tylenol for a headache.”
What percentage of patients experience only headaches as a symptom?
“Some patients have headache as the only symptom, or as the first symptom. Obviously not every patient with a headache gets a CT or MRI.
“Often a physician will look for some other problem (weakness, visual problems, dizziness) before ordering a scan on a patient with a headache.
“Some physicians have been successfully sued because they didn’t order a scan after the patient complained repeatedly of headache, but the physician didn’t order the scan because no other signs or symptoms were present.”
What about the tumor causes headaches?
“A ‘brain tumor headache’ in the classical sense, is a headache caused by the pressure of a tumor against the meninges, skull, or another structure that has pain receptors.
“The brain has no pain receptors, per se, but that doesn’t mean all patients are free of headache.”
How big does a BT need to be before it starts causing headaches?
“Some large brain tumors never cause headache; some small brain tumors can cause very severe headaches.
“The latter occurs with tumors in the ventricles that block the flow of spinal fluid.”
Can a person have a BT and NEVER have headaches?
“About 50% of brain tumor patients have headache at the time of diagnosis.
“It has been estimated that 10 million people in the U.S. have a headache on any given day.
“Therefore, the vast majority of people having a headache do not have a brain tumor, since even counting patients with metastatic brain tumors, less than 100,000 people are walking around with a brain tumor of some type.”
Do brain tumor headaches respond to aspirin or ibuprofen?
“Brain tumor headaches may respond to Tylenol, ibuprofen, Darvocet, Vicodin, Fioricet, and many other medications.
“Sometimes the swelling or edema around a brain tumor may be contributing to the headache, and reducing the edema with steroids, mannitol, or other drugs relieves the headache.
“Brain tumor headaches usually do not respond to Imitrex, Amerge, or other migraine drugs.”
What should a person ask himself if he’s afraid he might have a brain tumor?
Shutterstock/B-D-S Piotr Marcinski
The patient should be careful to note any other characteristics of the headache that seem unusual:
- Is the patient prone to headaches, or is this something completely different?
- Is the headache present at certain times every day, such as early in the morning?
- Can the headache be explained by other problems, such as sinus infection or a herniated disk in the neck?
- Are there other symptoms, such as memory loss, dizziness, loss of balance, visual loss, or word-finding difficulty?
- Is there a family history of brain tumors? (only about 5% of BT patients have a family history of brain tumors)
- Is the pain unusual in its location?
- Has the headache persisted over days or weeks? Some brain tumors are so slow-growing that a patient could have a headache for years and still have a brain tumor.
What kind of test should a person insist upon that can rule out a BT?
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“The physician may tell the patient that insurance will not cover a CT or MRI, but if a patient is very concerned, he or she can ask for a referral to a neurologist or headache specialist.
“If the headache becomes very severe, one can always go to an emergency room.
“However, the majority of ER scans are CT scans done without contrast, and some tumors are not detected without contrast.
“A scan done to rule out a brain tumor should be an MRI, which is more sensitive, and should be done with contrast, which will ‘light up’ when there is breakdown of the blood-brain barrier caused by a tumor.”
Dr. Stark-Vance is a medical oncologist in private practice in Dallas and Fort Worth, providing medical neuro-oncology services to patients of neurosurgical consultants. She received her training in medical oncology at the National Cancer Institute in Bethesda, Maryland. Following her Fellowship, Dr. Stark-Vance served as a clinical investigator at the Cancer Treatment Evaluation Program of NCI. Since her return to Texas in 1996, she has continued developing clinical trials for malignant glioma plus lecture widely on treatment options for primary and metastatic brain tumors. Her work has been published in Journal of Clinical Oncology and Neuro-Oncology.
Lorra Garrick has been covering medical, health and personal security topics for many years, having written thousands of feature articles for a variety of print magazines and websites. She is also a former ACE-certified personal trainer.
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Top image: ©Lorra Garrick
Lump in Throat: Causes and Solutions
Does a lump in your throat, or feeling that something is stuck in your throat, have you frightened it could be ALS or laryngeal cancer?
When a person develops an obsessive fear of ALS, sometimes they fixate on the bulbar-onset version of ALS.
If you clicked on this article, you probably know all about bulbar-onset ALS.
People with the bulbar-onset fear often detect a lump in their throat, or the sensation that something is stuck in their throat, and worry this may be bulbar-onset ALS. In fact, any throat or mouth peculiarity sets them into a panic.
Major Cause for the Throat Lump…
And for the sensation that something is stuck there, is ANXIETY — including anxiety over bulbar-onset ALS.
Anxiety begets the lumpy feeling in the throat.
This is why, in many novels, for example, a character who’s nervous is described as feeling “a lump in her throat.”
Ever notice that nervous people put their hand to their throat? It’s an automatic reaction to that lumpy feeling.
I asked an ear, nose and throat (ENT) doctor just exactly what creates the lump or stuck feeling, that can scare people into thinking they have bulbar-onset ALS or laryngeal cancer.
Other Benign Causes Besides Anxiety
There are others, according to Steven Y. Park, MD, author of the book, “Sleep, Interrupted: A Physician Reveals The #1 Reason Why So Many of Us Are Sick And Tired,” Dr. Park is Clinical Assistant Professor of Otolaryngology at the New York Medical College.
Some people fear laryngeal cancer due to throaty lump sensations or feeling something is stuck there.
But fear of bulbar-onset ALS may be more common, as evidenced by the hundreds of postings on various neurology help sites.
Many of the forum participants express fear of bulbar-onset ALS due to feeling the lump or something stuck in the throat.
Ironically, these forum participants don’t fear laryngeal cancer, even though these sensations are more likely to be laryngeal cancer than bulbar-onset ALS!
But the bigger picture is, these sensations almost always are neither laryngeal cancer nor bulbar-onset ALS, but rather, just plain anxiety and stress.
What causes the lump-in-the-throat feeling?
Dr. Park explains, “This a very common problem that I see almost every day.
“The most common reason for this is due to laryngopharyngeal reflux disease (LPRD), but there can be other reasons such as a foreign body, neurologic conditions and rarely, laryngeal cancer.
“The most common symptoms of LPRD include chronic throat clearing, hoarseness, post-nasal drip, a lump sensation, pain, cough, mucous, burning, tightening or phlegm. You can have one or all of the above.
“The ‘lump’ sensation is called a globus sensation, or a ball-like feeling.
“In our field, we treat LPRD with aggressive PPI therapy (such as Prilosec or Nexium) for 1-3 months, but it only works sometimes.
“One of the main reasons for this high rate of failure is that there’s something else that’s suctioning up your stomach contents into your throat.
“So the acid reflux medications don’t really prevent reflux. They only lower the acidity of the stomach juices.
“You also have bile, digestive enzymes and bacteria that come up and irritate the delicate voice box tissues.”
“A stressed person swallows differently than does a relaxed person.”
The altered swallowing mechanics somehow cause the lumpy feeling in the throat or the sensation that something is stuck in the throat.
How does this happen?
“If you change your swallowing mechanics due to any reason, whether from allergies, post-nasal drip, a scratch from a bone or acid reflux, you will feel pain, discomfort or a foreign body sensation,” says Dr. Park.
“Vigorous rubbing of opposing mucous membranes and cartilages can definitely irritate your throat temporarily.
“This can cause a raw surface on the mucous membranes that takes a few days to heal.
“The cricopharyngeus muscle (the upper esophageal sphincter) can go into spasm and cause a tightening sensation when under stress.
“It’s also been shown that under stress, due to dysfunction of the upper esophageal sphincter, stomach contents can leak up and cause irritation of the throat structure, aggravating the condition.
“If you have microscopic stomach contents in the throat, the mucous secreting glands in this area try to dilute and clear out this area, so you’ll feel mucous, hoarseness and post-nasal drip.
“There will be generalized inflammation in the throat, which can also go up into the nose.”
And there you have it: Why, when you worry about bulbar-onset ALS or laryngeal cancer, you suddenly start feeling scary things going on with your throat!
So relax … and realize that the mind is a very powerful force.
Finally, a very uncommon cause of a lump feeling in the throat is Eagle’s syndrome.
In this condition, a small bone below the skull becomes too long or its ligament hardens.
The resulting nerve irritation can cause a variety of symptoms.
Eagle’s syndrome usually starts later in adulthood due to aging.
Dr. Park practices integrative medicine and surgery, and has helped thousands of people breathe better and sleep better.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
