[18F] Experiencing severe headaches with associated symptoms

Patient Description

An 18-year-old female presents with a history of severe, constant pressure headaches centered in the head, rated 9/10 in severity, with sudden onset lasting for approximately 3 hours. The headaches are exacerbated by sitting up or standing and are alleviated by lying down and closing her eyes. Accompanying symptoms include nausea, dizziness, difficulty walking described as clumsiness with feet placement, and sudden heat sensations similar to hot flashes, which have been occurring for several months. The patient has a history of OCD diagnosed 3 years ago and is currently taking Sertraline. She reports allergies to tree nuts, shellfish, and Penicillin but no other medications. There is no recent history of injury, fever, stiff neck, changes in vision, or weakness, numbness, or difficulty speaking. The walking difficulties are specifically noted to occur concurrently with the headaches and significantly impair her ability to perform daily activities.

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Arora's Assessment

What might be happening

Based on your symptoms, there are a few possible conditions that could be causing your symptoms:

  • Migraines: Migraines are a type of headache characterized by severe pain that can be preceded or accompanied by sensory warning signs such as flashes of light, blind spots, tingling in the arms and legs, nausea, vomiting, and increased sensitivity to light and sound. The excruciating pain that migraines bring can last for hours or even days.

    • Treatment for migraines can involve both preventative measures and medications to relieve symptoms. Over-the-counter pain relievers can sometimes help, but prescription medications are often needed.
  • Panic Disorder: Panic disorder is a type of anxiety disorder that consists of sudden attacks of fear and nervousness, as well as physical symptoms such as sweating and a racing heart. During a panic attack, the fear response is out of proportion for the situation, which often is not threatening.

    • Treatment for panic disorder often involves a combination of medication and cognitive-behavioral therapy.
  • Meniere's Disease: Meniere's disease is a disorder of the inner ear that can lead to dizzy spells (vertigo) and hearing loss. In most cases, Meniere's disease affects only one ear. It can cause severe dizziness, a roaring sound in your ears called tinnitus, hearing loss that comes and goes and the feeling of ear pressure or pain.

    • Treatment for Meniere's disease usually involves a combination of medications, therapy and lifestyle changes.

What you can do

  • Keep a headache diary: This can help you identify your headache triggers. When you get a headache, write down the date, time, and what you were doing and eating for the 24 hours prior to the onset of your headache.
  • Stay hydrated: Dehydration can cause headaches. Make sure you're drinking enough water each day.
  • Regular physical activity: Regular exercise can reduce the frequency and intensity of headaches and migraines. If your doctor agrees, choose any physical activity you enjoy doing.
  • Manage stress: Stress can trigger both migraines and panic attacks. Techniques such as meditation, deep breathing, yoga, and progressive muscle relaxation can help.

What you should look out for

  • Seek immediate medical attention if you have a headache that:
    • Is sudden and severe
    • Comes with a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or difficulty speaking
    • Gets worse over time
    • Happens after a head injury
    • Is different from what you usually experience

Remember, I'm an AI and this advice is based on the information you've given me. It's always a good idea to consult with a healthcare professional who can evaluate your symptoms and condition more accurately.

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11 mo ago

People Also Ask


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

Migraines often present with severe, throbbing headaches, nausea, vomiting, and sensitivity to light and sound. Management includes identifying and avoiding triggers, using over-the-counter or prescription medications, and sometimes preventative treatments.


How can panic disorder manifest physically and what are the treatment options?

Panic disorder can cause sudden attacks of intense fear, accompanied by physical symptoms like sweating, heart palpitations, dizziness, and shortness of breath. Treatment typically involves medication and cognitive-behavioral therapy to manage symptoms.


What is Meniere's disease and what symptoms should I be aware of?

Meniere's disease is an inner ear disorder that can cause vertigo, tinnitus, fluctuating hearing loss, and a feeling of fullness in the ear. Symptoms can be managed with medications, therapy, and lifestyle adjustments.


What lifestyle changes can help reduce the frequency and severity of headaches?

Lifestyle changes such as staying hydrated, maintaining regular physical activity, managing stress through techniques like meditation or yoga, and keeping a headache diary to identify triggers can help reduce headache frequency and severity.


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