[24F] Experiencing episodes of head numbness and shooting pain

Patient Description

A 24-year-old female presents with episodes of deep numbness and tingling in the skull, described as a lack of blood flow or oxygen to the brain. These episodes are constant for days and can disappear for a month, with a two-year history of progressively worsening symptoms. The patient also experiences sharp, shooting pains radiating into the skull, brain fog, and new-onset sinus pressure rated at a severity of 5 out of 10. Headaches associated with these episodes are described as causing numbness and tingling, rated at a severity of 3-5 out of 10, and may be stress-related. The patient's family history includes migraines in her father and a history of epilepsy in her aunt. Currently, the patient is on Venlafaxine 75 mg daily and Hydroxyzine up to 100 mg daily. No known allergies or chronic illnesses have been reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, the following possibilities could be considered:

  • Migraines: These are severe headaches that can cause throbbing pain, usually on one side of the head. They can also cause numbness and tingling, and can be triggered by stress. Your family history of migraines increases your likelihood of experiencing them.

    • Treatment typically involves medication to relieve symptoms and prevent future attacks. Lifestyle changes, such as stress management and regular sleep, can also help.
  • Tension Headaches: These are often described as a constant ache or pressure around the head, especially at the temples or back of the head and neck. They can be associated with stress and can cause a sensation of pressure or tightness, which could potentially be described as numbness.

    • Treatment usually involves pain relievers, stress management, and sometimes antidepressants for chronic cases.
  • Trigeminal Neuralgia: This condition affects the trigeminal nerve, which carries sensation from your face to your brain. It can cause episodes of severe, shooting or jabbing pain, and can sometimes cause a sensation of numbness or tingling.

    • Treatment usually involves medication to lessen or block the pain signals sent to your brain.
  • Medication Side Effects: Both Venlafaxine and Hydroxyzine can cause unusual sensations, including tingling or numbness, as side effects.

    • If this is the cause, your doctor may adjust your dosage or switch you to a different medication.
  • Sinusitis: This is inflammation of the sinuses, often due to an infection. It can cause pain and pressure in the face, and if severe, could potentially cause referred pain or sensations in the head.

    • Treatment usually involves managing symptoms and treating the underlying cause, often with antibiotics.

Please note that these are potential explanations based on the symptoms you've described, but only a healthcare professional can provide a definitive diagnosis.

What you can do

  1. Consult a healthcare professional: Given the severity and duration of your symptoms, it's important to seek medical attention. They can provide a formal assessment and order relevant tests if necessary.

  2. Monitor your symptoms: Keep a record of when your symptoms occur, their severity, and any potential triggers. This can be helpful information for your healthcare provider.

  3. Manage stress: Since you've noticed a correlation between stress and your symptoms, techniques such as yoga, meditation, deep breathing, or other stress management strategies may be beneficial.

  4. Stay hydrated and maintain a healthy diet: This can help to ensure your body is functioning optimally.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Sudden, severe headache or change in the pattern of headaches
  • Headache accompanied by confusion, seizures, double vision, weakness, numbness, or difficulty speaking
  • Headache after a head injury, especially if it worsens
  • Chronic, progressive headache that's accompanied by other symptoms, such as loss of appetite or weight loss
  • New headache if you're over 50

Remember, I'm an AI and this advice is based on the information you've provided. It's always important to consult with a healthcare professional for an accurate diagnosis.

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1 yr ago

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People Also Ask


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

Migraines often present as severe, throbbing headaches on one side of the head, accompanied by nausea, vomiting, and sensitivity to light and sound. They can also cause numbness and tingling. Management includes medications to relieve symptoms and prevent attacks, as well as lifestyle changes like stress management and regular sleep.


Can stress cause headaches and what are some effective stress management techniques?

Yes, stress can lead to tension headaches, which are characterized by a constant ache or pressure around the head. Effective stress management techniques include yoga, meditation, deep breathing exercises, and maintaining a regular sleep schedule.


What are the potential side effects of Venlafaxine and Hydroxyzine?

Venlafaxine can cause side effects such as dizziness, dry mouth, and unusual sensations like tingling or numbness. Hydroxyzine may cause drowsiness, dry mouth, and similar unusual sensations. If side effects are concerning, a doctor may adjust the dosage or switch medications.


How can sinusitis cause head pain and what are the treatment options?

Sinusitis, an inflammation of the sinuses, can cause pain and pressure in the face and head. This can sometimes lead to referred pain or sensations in the head. Treatment typically involves managing symptoms with decongestants, pain relievers, and sometimes antibiotics if an infection is present.


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