Aloha! You're speaking with Dr. Michael SalkinI'm sorry to hear of this with Molly. Please confirm that the original diagnosis of keratoconjunctivitis sicca ("dry eye") was incorrect and Optimmune was unnecessary. That seems to be the case because the opthalmologist didn't find anything wrong with her eyes.If that's the case, her behavior is, indeed, indicative of head pain and a congenital (present at birth) brain disorder should be suspected if only because normal blood tests have ruled out disorders in the rest of her body. Referral to a specialist veterinary neurologist* should be considered. I would expect a cerebrospinal fluid tap and MRI to be recommended looking for increased pressure and anatomical malformations in Molly's brain (hydrocephalus, e.g.).*Please see here: www.acvim.org and please respond with further questions or concerns if you wish. I regret that your question wasn't answered in a timely manner.