question: 12 year old boy. In November of 2012 he developed a painful right knee with mild swelling. There was no history of trauma. Radiographs and MRI of the knee were normal. Lyme and autoimmune profile were negative. Normal CBC and chemistry. It resolved late December without treatment. Sudden onset of chronic frontal headache on January 13, 2014. Pain is described as pressure with occasional ice pick spiking. There is chronic nasal congestion and hyperesthesia over the entire body. His joints crack often, causing pain. MRI, MRA and MRV normal with the exception of congenital sinus abnormalities which were thought to be incidental. No response to IV DHE, baclofen, hydroxyzine, tizanidine, ketorolac, indomethacin, acetominophen, ibuprofen, methylprednisolone. Currently on Bystolic and topamax with little response. Light and sound make headache worse. Minimal sleep apnea not thought to contribute (Pulse ox gets down to 97% during apnic episodes)