instruction: hello doctor three weeks ago I had headache in late night I managed to sleep but it was still there in the morning it was unilateral headache on the left side of my head pain is in my temporal area which sometimes radiates across my cheek and even down my jaw as well as on the top left of my head I have occasionally felt discomfort on my chin too almost like a bruised bone feeling when pressed the pain subsided with paracetamol and ibuprofen but returned the following evening medication no longer had any effect on it after a week of non stop pain I went to my doctor he could not work out why I was having the pain when I have absolutely no other symptoms I feel fine other than the pain he sent me to other hospital for further evaluation my bloods were taken and came back normal and I passed all of the doctor strength reflex and cognitive tests it was a mystery to him too he referred me to a specialist who said it was likely a benign tension headache and I was discharged while the pain is not generally as bad as it was it is still there every day I get a few moments of pain every now and then as well as head pressure but some days the pain lasts all day a dull ache that does not seem to shift the most annoying part of is that within a minute of my head hitting the pillow at night severe pain suddenly kicks in my left temporal region and back of the head I could not sleep without taking medication at home I have tried three different pillows yet I still get pain the only medication I take for it is a combination of paracetamol and aspirin I am currently taking it each night about 30 minutes before bed to ensure the pain will not kick in if I do not do this I simply cannot sleep I do not want to be reliant on these pills or take too many so I am trying to limit myself to just two of each before bed I still have no other symptoms other than the unilateral pain and pressure I do not suffer with migraines and do not feel anxious or stressed at the moment the only anxiety I have recently felt was during hospital visits as my pulse rate went a little high but returned to normal later is it really a tension headache or something else I must stress that despite days where the pain has subsided the discomfort has been constant throughout I am always conscious of it please help me out of this thank you
output: hello my main concern here would be trigeminal cephalgia the most common being trigeminal neuralgia trigeminal neuralgia is a sharp shooting unilateral headache that becomes extremely worse with nerve irritation that could be caused by shaving brushing hair or teeth or any one touching the scalp or wearing cap the other important fact could be medication induced headache extremely common it happens if you are using painkillers for 15 to 30 days a week mri of the temporomandibular joint taj to rule out taj arthritis mri of the brain nos nerve conduction studies and egg electromyogram trigeminal neuralgia gabapentin 300 my three times a day start from 300 my at bedtime and increase it to three times a day for one or two weeks as tolerated avoid any irritation to the scalp revert back after a month with the reports to an internal medicine physician online