[18F] Experiencing constant, severe headaches with associated symptoms

Patient Description

An 18-year-old female has been experiencing constant, severe throbbing headaches for a few weeks, with a pain intensity of 8 out of 10. The headaches are present from waking until sleep and are exacerbated by movement and loud noises. Accompanying symptoms include nausea and occasional fevers, as well as ear and jaw pain. The patient has a history of infectious mononucleosis (mono) from a year ago and reports allergies to many antibiotics. Currently, the patient is on birth control and no other medications. There is no past medical history of chronic illnesses, no recent visual disturbances, sensitivity to light, or neck stiffness reported.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible diagnoses include:

  • Migraine: Migraines are a type of headache characterized by throbbing pain, usually on one side of the head, that can last for hours to days. They can be accompanied by nausea, and can be triggered or worsened by physical activity and loud noises.

    • Treatment typically involves medication to relieve symptoms and prevent future attacks.
  • Tension Headache: This is a common type of headache characterized by a constant ache or pressure around the head, particularly at the temples or back of the head. It can be associated with muscle tightness in these areas and can last for several hours.

    • Treatment usually involves over-the-counter pain relievers, stress management, and physical therapy.
  • Sinusitis: Inflammation or swelling of the tissue lining the sinuses can lead to persistent headaches, often accompanied by facial pain or pressure, and sometimes fever. Ear and jaw pain could be related to this condition.

    • Treatment typically involves antibiotics, nasal decongestants, and pain relievers.
  • Temporomandibular Joint Disorder (TMJ): This is a condition affecting the joint that connects the jaw to the skull. It can cause pain in the jaw, ear, and often results in headaches.

    • Treatment usually involves pain relievers, muscle relaxants, and physical therapy.
  • Infections: Certain infections, such as meningitis or encephalitis, can cause severe headaches, fever, and nausea. These are serious conditions that require immediate medical attention.

    • Treatment typically involves antibiotics or antiviral medications.

Please note that this is not an exhaustive list and other conditions could also explain your symptoms. It's also possible that more than one condition could be contributing to your symptoms.

What you can do

Given the severity and persistence of your headaches, it's important to seek medical attention. Here are some steps you can take:

  1. Schedule an appointment with your primary care provider. They can perform a physical examination, ask more detailed questions about your symptoms, and potentially order tests to help determine the cause of your headaches.

  2. Keep a headache diary. Note when your headaches start and stop, any potential triggers, the severity of the pain, and any accompanying symptoms. This can help your healthcare provider diagnose your condition.

  3. Try over-the-counter pain relievers, such as acetaminophen or ibuprofen, if you haven't already. However, be sure to follow the instructions on the package and do not exceed the recommended dose.

  4. Practice good sleep hygiene, eat a balanced diet, stay hydrated, and engage in regular physical activity. These lifestyle factors can sometimes help reduce the frequency and severity of headaches.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • A sudden, severe headache that's different from any you've had before
  • A headache accompanied by a high fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties
  • A headache after a head injury, especially if it worsens
  • A chronic headache that's worse in the morning

Remember, while I strive to provide accurate information, I'm not a doctor. You should consult with a healthcare provider for a formal diagnosis and treatment.

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11 mo ago

People Also Ask


What are the common symptoms of migraines and how can they be managed?

Migraines are characterized by severe, throbbing pain, often on one side of the head, and can be accompanied by nausea, vomiting, and sensitivity to light and sound. Management includes medications to relieve symptoms, lifestyle changes, and sometimes preventive medications.


How can tension headaches be distinguished from other types of headaches?

Tension headaches typically present as a constant ache or pressure around the head, especially at the temples or back of the head, and are often associated with muscle tightness. They differ from migraines, which are usually more severe and throbbing, and from cluster headaches, which are intense and occur in cycles.


What are the signs and treatment options for sinusitis?

Sinusitis involves inflammation of the sinuses, leading to symptoms like persistent headaches, facial pain or pressure, nasal congestion, and sometimes fever. Treatment may include antibiotics, nasal decongestants, and pain relievers.


What is Temporomandibular Joint Disorder (TMJ) and how is it treated?

Temporomandibular Joint Disorder (TMJ) affects the joint connecting the jaw to the skull, causing jaw pain, ear pain, and headaches. Treatment can involve pain relievers, muscle relaxants, physical therapy, and sometimes dental splints or surgery.


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