Expert: Claes-Gustaf Nordquist, M.D. - 5/19/2009

Question
I am a 28yo female. I have had two healthy children, ages 10 and 6 and other than the following symptoms am in great physical condition . . . I am currently presenting with the following:

**tremors (which have been diagnosed as essential tremors, non responsive to Inderal, so I have just been dealing with them--this has been ongoing for the past couple of years, but has been progressively more noticable)
**night sweats--only at night. I do not have issues w/ hyperhidrosis during the day. Night sweats are intermittent and unpredictible, however, when they occur, they are incredibly disturbing--soaking thru sheets, duvet, bedclothes and mattress. I have had the night sweats for the past 6 months or so. They come off and on for days at a time.
**Pain at the base of my skull. This began 4 days ago. I have had no trauma or strain that would cause any type of muscle damage. In addition, I have taken Advil, Tylenol, Naproxen, Motrin and Soma, none of which have had any effect on the pain, which leads me to believe that it's not muscle related. If I move my head forward, backward, side to side or turn to the left or the right, it, for lack of a better way to describe it, creates a headache at the base of my skull that extends from the top of my neck almost to my ears. I have NEVER felt such pain. I liken it to waking up with a hangover and if you move your head, your headache gets so much worse . . . that's what it feels like, but even moreso. The pain is consistant all day, but is far more intense in the morning when I first get up. I feel as though I can barely lift my head. At first, I thought I'd just slept funny, but it's been 4 days . . .

I've had all the bloodwork you can imagine and it's all come back normal. Yesterday, I had an xray of my head/neck and again, normal. Friday, I'm scheduled to have a head ct, but I'm sort of freaking out at this point . . . Any insight would be greatly appreciated, in addition to any further guidance or research you believe I may benefit from reading.

Thank you,
Kami

Answer
First of all how are your thyroid hormones (T3 & T4)? Based on your symptoms I wonder about your neck condition. A neck x-ray examination is not enough to evaluate that. A clinical examination combined with an MRI examination would be essential to evaluate that, but with a medical history of just a few days for this problem you probably will have to wait and see some time. Since you probably are afraid of a brain tumor I have to tell you that an MRI brain scan is better than a CT scan for finding such tumors BUT if you should have a brain tumor with so much symptoms it most probably would be detected by a CT scan too.