[19F] Experiencing repeated headaches and additional symptoms

Patient Description

A 19-year-old female has been experiencing repeated headaches for several months, with pain that is sometimes one-sided and other times affects the entire head. The headaches, described as throbbing or sharp, occur multiple times a day and last a few minutes before returning. No specific triggers or relief methods have been identified. Additional symptoms include a sensation of floating and an increased heart rate of 110+ bpm upon standing, as well as transient vision changes such as floaters and brief blurriness when looking up. The patient also reports a feeling of weakness in the arms. There is no past medical history of chronic illnesses or known allergies, and the patient is not currently on any medications.

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Arora's Assessment

What might be happening

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

  • Migraines: These are a type of headache characterized by severe, throbbing pain that can be on one side of the head. They can last for hours to days, and can be so severe that the pain is disabling. Warning symptoms known as aura can occur before or with the headache. These can include flashes of light, blind spots, or tingling on one side of the face or in your arm or leg.

    • Treatment typically involves medications to help reduce the frequency and severity of migraines. Your doctor might also recommend lifestyle changes, such as stress management and dietary changes.
  • Tension headaches: These are the most common type of headache, and they cause a constant ache or pressure around the head, temples, or back of the head and neck. They're often described as a tight band around the head or a weight on top of it. They're not usually associated with other symptoms.

    • Treatment typically involves pain relievers, stress management, and physical therapy.
  • Orthostatic hypotension: This is a form of low blood pressure that happens when you stand up from sitting or lying down. It can make you feel dizzy or lightheaded, and you might even faint. Orthostatic hypotension can occur for various reasons, including dehydration, prolonged bed rest, pregnancy, diabetes, heart problems, burns, excessive heat, large varicose veins and certain neurological disorders.

    • Treatment of orthostatic hypotension depends on the underlying cause. Your doctor might suggest lifestyle changes, such as drinking plenty of fluids and avoiding alcohol.
  • Postural orthostatic tachycardia syndrome (POTS): This is a condition in which a change from lying to standing causes an abnormally large increase in heart rate. This can cause symptoms such as lightheadedness, fainting, and rapid heartbeat.

    • Treatment of POTS typically involves a few different approaches, including lifestyle changes and medications.

What you can do

It would be best to consult a doctor about your symptoms so that they can provide a formal assessment and order relevant tests if necessary. In the meantime, you can try the following to relieve your symptoms or figure out what's going on:

  1. Try to identify any triggers for your headaches, such as certain foods, smells, stress, or lack of sleep. Avoiding these triggers can help prevent headaches.
  2. Stay hydrated and eat regular, balanced meals. Skipping meals or becoming dehydrated can trigger headaches.
  3. Try to maintain a regular sleep schedule. Both too much and too little sleep can trigger headaches.
  4. When you feel a headache coming on, try to relax and rest in a quiet, dark room.
  5. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help relieve headache pain.

What you should look out for

Reasons to see a doctor more urgently:

  • If your headaches become more frequent or severe
  • If your headaches are accompanied by fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or speaking difficulties
  • If your headaches are accompanied by shortness of breath, chest pain, or fainting
  • If your headaches are preventing you from participating in your usual daily activities

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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10 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. Some people experience aura, which includes visual disturbances. Management includes medications to reduce frequency and severity, and lifestyle changes like stress management and dietary adjustments.


What is orthostatic hypotension and what causes it?

Orthostatic hypotension is a form of low blood pressure that occurs when standing up from sitting or lying down, causing dizziness or lightheadedness. It can be caused by dehydration, prolonged bed rest, heart problems, or certain medications. Treatment involves addressing the underlying cause and may include lifestyle changes like increasing fluid intake.


How can postural orthostatic tachycardia syndrome (POTS) be treated?

Treatment for POTS typically involves lifestyle changes such as increasing salt and fluid intake, wearing compression garments, and gradually increasing physical activity. Medications may also be prescribed to help manage symptoms.


What lifestyle changes can help prevent tension headaches?

To prevent tension headaches, it is helpful to manage stress through relaxation techniques, maintain good posture, ensure adequate hydration, and get regular exercise. Regular sleep patterns and avoiding eye strain can also be beneficial.


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