General Headache Question

[montebello]

Hi all,

I have two GCA-related questions....

Question 1: If a GCA patient has a headache and they take extra prednisone (thinking it a flare) and the headache goes away, is that evidence that the headache was in fact inflammatory in nature?

Question 2: If a GCA patient has a headache and they take Tylenol (Acetaminophen) and the headache goes away, is that evidence that the headache was in fact non-inflammatory (and non-GCA-related? (and if so, why is this)?

I hope I'm not driving anyone crazy with these questions.....

Thanks.

[Grammy80]

Of course you're not driving us crazy, that is what we are all here for. However, it sounds like you are trying to diagnose yourself by process of elimination. We are not MediCal people and I wish you would see a professional. Can't your primary care physician order blood work to see if there is any inflammation? Please take care of yourself and let a doctor answer these questions for you💕

[SnazzyD]

It comes down to likelihood more than definite proof especially if it was a one off. Then I don’t think you can tell exactly if it was the Pred that did it and it would have gone anyway. If it comes back as soon as you reduce and you repeat the process and it works, it’s more likely to be GCA. worth looking at other symptoms, however strange or insignificant, as well to build up a picture.

Tylenol doesn’t have any significant anti inflammatory effect, it is good at working on the central nervous system to dull pain. GCA pain comes from inflammation in the blood vessels and really to get any relief, that inflammation needs to be reduced by a good anti inflammatory agent like Pred. So if it goes easily with Tylenol it is more likely to have been something else or the inflammation whatever that was, was slight enough for Tylenol to help in any big way.

[montebello in reply to SnazzyD]

Makes sense. Thanks so much

[PMRpro Ambassador]

To some extent - if it goes with pred, it is either inflammatory or it was coincidence, except that pred can be used for migraine-type headaches too. And there are some people who have found that ordinary pain-killers DID help their headache BUT they were later diagnosed with GCA. Tylenol - paracetamol/acetaminophen has relatively little anti-inflammatory effect so its value in GCA pain is a bit dubioous.

[montebello in reply to PMRpro]

Thanks

[AtopicGuy]

The answer depends on what you mean by "inflammation".

The term "inflammation" is frequently misused. The strict meaning of it is tissues becoming hot, red and swollen due the body's immune response. It is usually caused by millions of immune cells being deployed. Sometimes the word is used to mean any condition where the immune system becomes activated, even if tissues do not become hot, red and swollen. An example of this is diseases where very specific antibodies and receptors are involved, not huge numbers of immune cells. Steroids, such as prednisolone can be effective in both types of autoimmunity.

[montebello in reply to AtopicGuy]

Thank you