Author Topic: Drug-induced aseptic meningitis  (Read 5537 times)

mtadrian99

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Drug-induced aseptic meningitis
« on: October 06, 2014, 04:50:06 pm »
I am a little less than 5 months post-op (middle fossa craniotomy).  I started taking ibuprofen as soon as I got home from the hospital and continued to take ibuprofen up until now (so almost 5 months straight).  I was taking 1800mg of ibuprofen each day with 1000mg of acetaminophen between doses.  After 4 months, I started worrying about the effect the meds would have on my stomach, kidneys and liver so I tried to stop taking them.  My pain level escalated to a 10 and my neck got stiff.  I thought I was having my first migraine.  I emailed my surgeon and he had me drive to Los Angeles to meet with him (I live in Orange County, so about an hour away).  He prescribed me Nortriptyline and told me to try to skip a dose of ibuprofen here and there, and make an appointment with a headache specialist (neurologist).  The Nortrip worked, I was taking less ibuprofen (down from 1800mg to 800mg per day) so I did that for a couple weeks then tried to go "cold turkey" again.  On day 1, my pain was at a level 5, day 2 at a level 7, then day 3 back up to a 10 with a stiff neck.  It felt like a caffeine withdrawal headache, just a lot of pressure on my brain.  So I treated it like a withdrawal headache and just gave myself one 200mg tablet of ibuprofen and voila, my headache was gone for 8 hours.  Then it came back at a level 10.  So today, I met with the neurologist and it just so happened that he was currently researching ibuprofen and its dangerous side affects and publicly speaking on the topic.  He said that ibuprofen, when taken frequently, can cause aseptic meningitis which is the inflammation of the lining between the brain and skull.  Pretty much, an allergic reaction to the medication.  The lining swells and when it gets to a point that is unbearable we take ibuprofen and it feels better, but as soon as the ibuprofen wears off, the lining swells again and it becomes a vicious cycle.  So what is the treatment?  Take the Nortriptyline or Amitriptyline and try to ween myself off the ibuprofen.  So try not to take any until the pain gets to a level 8,9, or 10, then just take 1 ibuprofen (200mg) and try again.  The goal is to continue taking the Nortrip or Amitrip until no ibuprofen is needed, then once I am headache free for 2-3 months, start weening myself off the Nortrip or Amitrip.  He said those drugs have a low incidence of addiction.  Although they are commonly used for depression, research has shown that they interrupt pain signals that travel through the nerves.  But hey, if they can make me happy as well, all the better.  So now that I know that my problem is not with the muscles (since my doctor originally thought I had tension headaches), I know the muscle relaxers are unnecessary and the acupuncture is unnecessary.  Wish me luck.  If any of you had the same problem, please share your recovery story.

Lesliegc

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Re: Drug-induced aseptic meningitis
« Reply #1 on: October 11, 2014, 05:18:13 pm »
Wow that sounds...awful. And familiar. I also had middle fossa (3 years ago) and started developing headaches, though not until a few months later. Got into a bad cycle with over the counter meds, ibuprofen among them, and was advised that part of the ongoing headache cycling might be rebound headache. I don't have the neck stiffness, but I hope that this information about aseptic meningitis gets out into the wider audience of brain surgery patients, because it sounds like it is pretty easy to develop if you use the meds daily. Will you keep us posted here on your progress? I hope the process of weaning brings you out of headache cycles. Best luck. Leslie
4mmx9mm  right side
diagnosed 6/11/11
middle fossa  7/25/11 at HEI
developed chronic headaches at 5 months post op

keithmac

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Re: Drug-induced aseptic meningitis
« Reply #2 on: October 12, 2014, 01:58:21 am »
Wow that's a rough one and lookks like it will take some time to regularize your situation. 

The following story is unrelated and far less serious a situation than yours, but my wife came down with a problem that we eventually realized was shingles. We're Brits and as full-timing RVers we had only emergency travel insurance but no local care centre. Her pain was intense for quite some time and she had only isobuprofen and acetaminophen. 

She also had bad headaches which persisted even after the severe shingles pain began to diminish and she continued using the two painkillers.  Eventually I suspected that her pain was worse after taking acetaminophen and we began to wean her off it, aspirin being substituted if necessary.  It worked and the headaches began to ease but it took many weeks to get there.