instruction: hello doctor my dad has been on dialysis for years and has only recently been getting pounding headaches hour into dialysis he says they are pretty painful and it only occurs in his forehead and just to the right of the forehead it does not make him sensitive to light sound or any vision changes he was in the hospital a month ago for a left leg amputation and while in the rehab unit he had a seizure that we witnessed and it took him days to wake up from it the mri showed posterior reversible encepholopothy caused by very high blood pressure luckily he is almost 100 neurologically and memory regained I bring that up because only after the seizure and pers mri result is when the headaches started on dialysis he never had headaches before on dialysis prior to the seizure headache the doctors did not put him on any new medications after this and tylenol helps the headache greatly but it still bothers him and I do not like him taking tylenol almost every day he is on metoprolol 50mg extended release ex per day usually in the morning and his blood pressure is fairly controlled usually in the 130 70 however sometimes it gets high during dialysis I have an appointment with a neurologist in january as that was the first available any answers
output: hi having headache one hour into dialysis suggest either it could be related to transient increase in blood pressure or changes in electrolytes during this interval is his be monitored during dialysis and where do they stand one way to get around is by slowing the dialysis speed which will help in slower change in electrolytes and body fluid thus preventing fluctuation in be see if has be fluctuation during dialysis and his nephrologist should be able to help you metaprolol is also a migraine prophylactic medicine thus it should help with headaches there are other medications also but will discuss once we are sure its not related to be taking tynelol daily is not good it can cause rebound headache the day you dont take it limit its use to day or max 3 week and or max 10 month how is his mri brain now he had pres but has it completely resolved not just clinically but also radiologically is he on any anti seizure medication post seizure how was his eg is it normalized