[20F] Experiencing headache with dizziness and nausea

Patient Description

A 20-year-old female reports waking up with a headache on the right side of her head, which has persisted for approximately 14 hours. The pain, described as sharp when moving the neck and head, is rated a 6 out of 10 in severity. Accompanying symptoms include dizziness, particularly when standing, and some nausea. The patient has a history of occasional headaches but notes this instance as not being frequent. No fever, neck stiffness, sudden severe headache, or changes in speech, vision, or movement were reported. The patient has a medical history of Addison's disease, diagnosed 8 years ago, and allergies to penicillin and omnicef. Current medications include Lexapro (20mg daily), Cortef (5mg daily), Breo (one puff once a day), and Singulair (10mg daily).

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Arora's Assessment

What might be happening

Based on the information you've provided, here are a few possibilities:

  • Tension Headache: This is a common type of headache characterized by a dull, aching sensation all over the head. It is often described as a feeling of a tight band or dull ache around the head or behind the eyes. These headaches are often related to stress, depression, or anxiety. Over-the-counter pain relievers such as ibuprofen or aspirin can be effective. Relaxation techniques may also help.
  • Migraine: This is a type of headache characterized by severe pain on one side of the head. Associated symptoms can include nausea and dizziness. Treatment typically includes rest, hydration, and over-the-counter or prescription medications.
  • Dehydration: Dehydration can cause both headaches and dizziness. It's important to drink plenty of fluids and eat foods high in water such as fruits and vegetables.
  • Addison's Disease: This is a disorder that occurs when your body produces insufficient amounts of certain hormones produced by your adrenal glands. In Addison's disease, your adrenal glands produce too little cortisol and, often, too little aldosterone. Dizziness and fatigue are common symptoms of Addison's disease. It's important to manage this condition under the care of a healthcare provider.

What you can do

  1. Rest and hydrate: Make sure you're getting enough sleep and drinking plenty of fluids. Dehydration can cause both headaches and dizziness.
  2. Over-the-counter pain relievers: Try taking over-the-counter pain relievers such as ibuprofen or aspirin to help with your headache.
  3. Monitor your symptoms: Keep track of when your symptoms occur, how long they last, and any potential triggers. This information can be helpful for your healthcare provider.
  4. Consult with a healthcare provider: If your symptoms persist or worsen, seek medical attention. Your healthcare provider can perform a physical examination and order tests to determine the cause of your symptoms.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe headache or headache that worsens
  • Fever
  • Stiff neck
  • Mental confusion
  • Seizures
  • Double vision
  • Weakness, numbness or difficulty speaking
  • Uncontrolled vomiting

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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8 mo ago


People Also Ask


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

Migraines often present with severe, throbbing pain on one side of the head, accompanied by nausea, vomiting, and sensitivity to light and sound. Management includes resting in a dark, quiet room, staying hydrated, and taking medications such as NSAIDs or triptans as prescribed by a healthcare provider.


How does dehydration contribute to headaches and dizziness?

Dehydration can lead to headaches and dizziness because it reduces blood volume, leading to decreased blood flow to the brain and causing the brain to temporarily contract from fluid loss. Drinking plenty of water and consuming foods high in water content can help alleviate these symptoms.


What are the potential effects of Addison's disease on headaches and dizziness?

Addison's disease can cause dizziness and fatigue due to insufficient production of cortisol and aldosterone, which are crucial for maintaining blood pressure and electrolyte balance. Proper management of Addison's disease with medication and regular monitoring by a healthcare provider is essential to minimize these symptoms.


What should I do if over-the-counter pain relievers do not alleviate my headache?

If over-the-counter pain relievers do not alleviate your headache, it is important to consult with a healthcare provider. They can assess your symptoms, rule out more serious conditions, and potentially prescribe stronger medications or recommend other treatments.


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