[21F] Experiencing dizziness, intense facial and head pain, and first-time nosebleed

Patient Description

A 21-year-old female reports a first-time nosebleed two days ago, followed by intense stuffiness causing a suction sensation when swallowing, alongside severe facial and head pain, and persistent dizziness. The dizziness, described as a swaying motion exacerbated by rapid movements, rates a 5 in severity and improves with rest or sleep. The patient also experiences an intense, pulsating headache and aching jaw pain, primarily in the front chin and upper jaw area, which was severe enough to cause crying. These symptoms have been present for the past two days, with the headache and jaw pain being intermittent today. The patient has been managing symptoms with Dayquil and Mucinex, also for two days. No previous history of similar symptoms, chronic illnesses, or recent injuries was reported.

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Arora's Assessment

What might be happening

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

  • Sinusitis: This is an inflammation or swelling of the tissue lining the sinuses. It can cause headaches, facial pain, and sometimes dizziness. It's usually caused by a viral infection and often improves within a week or two.

    • Treatment typically involves rest, hydration, and over-the-counter remedies. If symptoms persist for more than a week, or are severe, you should see a healthcare provider as you may need antibiotics.
  • Migraine: This is a type of headache characterized by severe, throbbing pain, usually on one side of the head. It can be accompanied by other symptoms like dizziness, sensitivity to light and sound, and nausea.

    • Treatment usually involves medications to relieve symptoms and prevent future attacks. Lifestyle changes, such as stress management and avoiding certain foods, can also help.
  • Vertigo: This is a sensation of feeling off balance and can be associated with feeling as though you're spinning or the world around you is spinning. It can be caused by issues in the inner ear or brain.

    • Treatment depends on the cause and severity of the symptoms. It may include medications, physical therapy maneuvers, or other treatments.

What you can do

  1. Rest and stay hydrated. Avoid sudden movements or changes in position if they make your dizziness worse.
  2. Over-the-counter pain relievers can help with the headache and facial pain.
  3. If your symptoms persist or worsen, seek medical attention.

What you should look out for

Seek immediate medical attention if:

  • Your headache is severe and sudden
  • You have a fever
  • You have sudden vision changes
  • You have difficulty speaking or understanding speech
  • You have numbness or weakness in your face, arm or leg, especially on one side of your body
  • You have trouble walking or lose balance

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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7 mo ago


People Also Ask


What are common causes of nosebleeds and should I be concerned if I experience one?

Nosebleeds can be caused by dry air, allergies, nasal irritation, or trauma. Occasional nosebleeds are usually not a cause for concern, but if they are frequent or severe, you should consult a healthcare provider.


How can I differentiate between a sinus headache and a migraine?

Sinus headaches are often accompanied by facial pain, pressure, and nasal congestion, while migraines typically involve throbbing pain on one side of the head, sensitivity to light and sound, and sometimes nausea. A healthcare provider can help diagnose the type of headache.


What are some effective home remedies for managing sinusitis symptoms?

Home remedies for sinusitis include staying hydrated, using a humidifier, applying warm compresses to the face, and using saline nasal sprays. Over-the-counter medications like decongestants and pain relievers can also help.


When should I seek medical attention for dizziness and headaches?

Seek medical attention if dizziness and headaches are severe, sudden, or accompanied by symptoms like fever, vision changes, difficulty speaking, numbness, or loss of balance. Persistent symptoms that do not improve with rest should also be evaluated by a healthcare provider.


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2 Comments


Leo#3962

7 mo ago

The way this all started sounds a little concerning. Did you injure your head when you got a nosebleed? What was the chronology of your symptoms? The severe facial pain sounds similar to trigeminal neuralgia which is irritation of one of your facial nerves, but it's unclear why it's all happening all of a sudden

https://www.mayoclinic.org/diseases-conditions/trigeminal-neuralgia/symptoms-causes/syc-20353344

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Anonymous#15532

7 mo ago

I did not injure my head at all that I remember, the symptoms were pretty extreme the day after the nosebleed happened. But these past few days have been flu-like symptoms.

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