[21F] Experiencing persistent migraine with associated symptoms

Patient Description

A 21-year-old female has been experiencing a persistent migraine for 3 days, with pain localized on the left side of the head, affecting the eye, and described as a stabbing pain that worsens with rapid movement. Applying pressure seems to alleviate the discomfort slightly. Accompanying symptoms include dizziness, nausea, chills, and an earache, also primarily on the left side. The patient's vision is slightly affected. There is no history of trauma, discharge from the ear, nasal congestion, fever, stiff neck, confusion, seizures, double vision, weakness, or trouble speaking. The patient has no known allergies, is not on any medications, and has no pre-existing conditions or chronic illnesses.

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Arora's Assessment

What might be happening

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

  • Migraine: A neurological condition that can cause severe, throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can last for hours to days, and the pain can be so severe that it interferes with your daily activities.

    • Treatment typically involves pain-relieving medications and preventive medications.
  • Sinusitis: An inflammation or swelling of the tissue lining the sinuses. This can cause headaches, fever, and chills. However, you didn't report any nasal congestion or discharge, which are common symptoms of sinusitis.

    • Treatment typically involves antibiotics, pain relievers, and sometimes nasal corticosteroids.
  • Ear Infection: This could explain your earache and dizziness. However, ear infections often cause more severe symptoms like hearing loss, drainage of fluid from the ear, and fever.

    • Treatment typically involves antibiotics and pain relievers.
  • Anemia: This condition, characterized by a lack of healthy red blood cells to carry adequate oxygen to your body's tissues, can cause dizziness and chills. However, it's less likely given that you didn't report any fatigue, weakness, or pale skin.

    • Treatment typically involves dietary changes and supplements.

What you can do

  1. Rest and hydrate: Make sure to get plenty of sleep and drink lots of fluids.
  2. Over-the-counter pain relievers: Non-prescription medicines like ibuprofen can help with the pain.
  3. Avoid triggers: If you notice certain foods or activities trigger your migraines, try to avoid them.
  4. Consult a doctor: If your symptoms persist or worsen, you should seek medical attention.

What you should look out for

Seek immediate medical attention if you experience:

  • A sudden, severe headache or a headache accompanied by a stiff neck, fever, confusion, seizures, double vision, weakness, numbness, or trouble speaking.
  • A headache after a head injury, especially if the headache gets worse.
  • A chronic headache that is worse after coughing, exertion, straining, or a sudden movement.
  • New headache pain if you're over 50.

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a consultation with a healthcare professional.

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11 mo ago

People Also Ask


What are the common symptoms of a migraine?

Common symptoms of a migraine include severe, throbbing pain or a pulsing sensation on one side of the head, nausea, vomiting, and sensitivity to light and sound. Some people also experience visual disturbances known as auras.


How can I differentiate between a migraine and sinusitis?

Migraines typically present with throbbing pain on one side of the head, nausea, and sensitivity to light and sound, while sinusitis often includes nasal congestion, facial pressure, and a dull, constant headache. Sinusitis may also cause fever and nasal discharge, which are not typical of migraines.


What are some effective treatments for migraines?

Effective treatments for migraines include over-the-counter pain relievers like ibuprofen or acetaminophen, prescription medications such as triptans, and preventive medications for frequent migraines. Lifestyle changes, such as avoiding known triggers and managing stress, can also help.


When should I seek medical attention for a headache?

You should seek medical attention for a headache if it is sudden and severe, accompanied by symptoms like a stiff neck, fever, confusion, seizures, double vision, weakness, or trouble speaking. Also, seek help if the headache follows a head injury or if it worsens with coughing, exertion, or sudden movements.


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