[23F] Experiencing recurrent migraines without aura

Patient Description

A 23-year-old female has been experiencing migraine headaches on and off for several days. These headaches are sudden, without aura, and are most intense in the temples and forehead, with a pain intensity rated at 7 out of 10. The headaches are exacerbated by light, strong smells, and loud noises, and are alleviated by using ice packs. Each headache lasts about 8 hours and has been occurring daily this week. Associated symptoms include nausea, poor appetite, and fatigue. The patient has a history of an autoimmune disease and migraines with aura, diagnosed 5 years ago. Current medications include Sumatriptan (10 mg as needed), Tylenol (400 mg as needed), and Benadryl (200 mg as needed). No fever, neck stiffness, changes in vision, confusion, weakness, difficulty speaking, or scalp tenderness reported.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Migraine without Aura: Migraines can occur with or without aura. Since you have a history of migraines with aura, it's possible that these current headaches are migraines without aura. Common symptoms include intense headache, nausea, and sensitivity to light, sound, or smells.

    • Treatment: Sumatriptan, which you are already taking, is commonly used to treat migraines. Other treatments include over-the-counter pain relievers like Tylenol, anti-nausea medications, and preventive medications if migraines are frequent.
  • Chronic Migraine: If you have been experiencing headaches for 15 or more days per month for at least three months, it might be classified as chronic migraine.

    • Treatment: Preventive medications, lifestyle changes, and avoiding known triggers can help manage chronic migraines.
  • Tension-Type Headache: These headaches can also cause pain in the temples and forehead and are often triggered by stress, poor posture, or eye strain.

    • Treatment: Over-the-counter pain relievers, stress management techniques, and proper posture can help alleviate symptoms.

What you can do

Here are some steps you can take to manage your symptoms:

  1. Avoid Triggers: Since light, strong smells, and loud noises worsen your headaches, try to avoid these triggers as much as possible.
  2. Stay Hydrated: Dehydration can trigger headaches, so make sure you are drinking enough water throughout the day.
  3. Maintain a Regular Sleep Schedule: Irregular sleep patterns can contribute to migraines. Aim for consistent sleep and wake times.
  4. Use Ice Packs: Continue using ice packs, as they provide relief for you.
  5. Over-the-Counter Medications: Use Tylenol as needed, but be cautious about overuse, as it can lead to medication-overuse headaches.
  6. Consult Your Doctor: Since your headaches are frequent and severe, it would be best to consult your doctor for a formal assessment and to discuss preventive treatment options.

What you should look out for

Seek medical attention if you experience any of the following:

  • A sudden, severe headache that feels like a "thunderclap"
  • Headache following a head injury
  • Fever, neck stiffness, or changes in vision
  • Confusion, weakness, or difficulty speaking
  • Scalp tenderness or sensitivity to touch

Remember, while I can provide information based on your symptoms, it's important to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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6 mo ago


People Also Ask


What are the common triggers for migraines without aura?

Common triggers for migraines without aura include stress, hormonal changes, certain foods and drinks, sensory stimuli like bright lights or strong smells, changes in sleep patterns, and physical exertion.


How can I differentiate between a migraine and a tension-type headache?

Migraines typically present with moderate to severe throbbing pain, often on one side of the head, and are accompanied by nausea and sensitivity to light and sound. Tension-type headaches usually cause a dull, aching pain on both sides of the head and are not associated with nausea or sensitivity to light and sound.


What are the potential side effects of taking Sumatriptan for migraines?

Potential side effects of Sumatriptan include dizziness, drowsiness, muscle pain, nausea, and a feeling of warmth or tingling. Serious side effects can include chest pain, irregular heartbeat, and severe stomach pain, and should be reported to a doctor immediately.


When should I seek medical attention for a headache?

You should seek medical attention for a headache if it is sudden and severe, follows a head injury, is accompanied by fever, neck stiffness, changes in vision, confusion, weakness, difficulty speaking, or if you experience scalp tenderness.

1 Comments


Billy#7

6 mo ago

Is the sumatriptan prescribed for your headaches and is it giving you any relief?

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