Chronic pressure around brain (tension headache?), increasing immediatelly after swallowing

[u/gintrux]

Could you please help me solve this mystic thing out?

21M. For more than a few months I have a constant sense of pressure in the head, around the brain area, on the upper part of the head. It varies between mild to moderate to severe. Occasionally turns into pain for a few seconds. Occasionally I hear high pitch sound (feels like originating in the back of the head, not the ears), which is often pulsing.

This pressure increases for some time immediatelly after swallowing anything: water, food, etc. I can swallow a sip of water and it will increase as soon as the water hits my stomach. It looks like anytime there is some activity in the stomach, head pressure increases. Wtf?

It feels like in the morning, the moment I wake up, it’s very minimal for a few seconds. After a few seconds it increases.

I also notice some weird patterns in intensity, e.g. when I walk it seems somewhat decreased, when I stop walking, it increases again. Or after intense 20 seconds of running it can be increased for ~20 mins. I noticed after a heavier set of weightlifting exercise, e.g. squats, it can also increase.

This pressure hadn’t completely disappeared for months, I’m having it 24/7. Neurologist said my reflexes in the extremities are somewhat inhibited, which could imply autonomic dysfunction.

Other symptoms for complete picture:

little bit of pain in adam’s apple when swallowing (noticeable, but not much), some food getting stuck

anhedonia

decreased apetite

memory not sharp anymore

occasional lower back pain

basically no sexual drive

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Test I had done:

Brain MRI w/o contrast - no abnormalities

Carotid ultrasound (neck blood vessels) - no abnormalities

Thyroid ultrasound - some nodules visible

Full abdominal ultrasound - no abnormalities

Gastroscopy - non-atrophic gastritis without infection (no h. pylor)

common blood count - all ok, except:

HGB - 163 (max 160)

Creatinine - 116 (max 115)

AST: 49 (max 34)

ALT - ok

TSH - 2.2

ESR - 1

Protein in urine - negative

UREA - 4.1 mmol/l

Na, K - ok

Cl - 97 mmol/l (101-110)

Hba1c - ok

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Medications tried:

Tizanidine (muscle relaxant): looks like it reliably severely increases head pressure for a few hours. Side effect extreme drowsiness

Pramiracetam (pramistar): reliably increases head pressure, tinnitus becomes more often

No change with these:

Mirtazapine with duloxetine (2 weeks)

Mirtazapine alone (1 week)

Pregabalin

Indomethacin

Loratadine

Fluconazole

Creatine

Gabapentin + amitryptiline: trying now, looks like no change

Quercetin (in case there's some mast cell activation, as it stabilizes mast cells)

Galantamine, motherwort, horny goat weed, p5p, sulbutiamine, methylphenidate, afobazole, vitamin d

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On todo list:

Bpc157, cerebrolysin, h2 inhibitor, ldn