[24F] With severe headache, nausea, and light sensitivity

Patient Description

A 24-year-old female has been experiencing a severe, sharp headache for five days, primarily in the forehead and temples. The headache worsens when leaning over and is somewhat relieved by laying down. This is her first occurrence of such a headache. Accompanying symptoms include nausea, sensitivity to light, and lightheadedness with exertion, along with a high-pitched noise in the ears. Diarrhea began today, and she reports random joint pain and jaw pain near the lymph nodes. There is no history of similar headaches, weakness, numbness, tingling, sinus congestion, neck stiffness, or recent head injuries. Tylenol provides partial relief. She denies alcohol, tobacco, or recreational drug use and has no family history of migraines or headaches. She was diagnosed with severe vitamin D deficiency two weeks ago and is on 50,000 units of vitamin D. She takes 50 mg of amitriptyline and sertraline daily before bed. No known drug allergies.

Arora's Assessment

What might be happening

Your symptoms could be related to several potential issues:

Migraine or Tension Headache: The sharp headache, sensitivity to light, and nausea are common in migraines. Tension headaches can also cause similar symptoms but are usually less severe.
Sinusitis: Although you haven't had congestion, the location of your headache and pain near your lymph nodes could suggest sinus involvement.
Infection or Inflammatory Condition: The sudden onset of symptoms, including diarrhea and joint pain, might indicate an infection or inflammatory condition affecting multiple systems.
Medication Side Effects: Sometimes, medications like amitriptyline and sertraline can cause headaches or gastrointestinal symptoms.

Typical treatments might include pain relief medications, hydration, and rest. Your doctor may also consider imaging or blood tests to rule out other causes.

What you can do

Headache and Light Sensitivity:

Rest in a dark, quiet room.
Use a cold compress on your forehead.
Continue taking Tylenol as needed, but follow dosage guidelines.

Nausea and Diarrhea:

Stay hydrated with clear fluids like water or electrolyte solutions.
Eat bland foods like toast or rice if you can tolerate them.

Joint and Jaw Pain:

Apply a warm compress to the affected areas.
Consider over-the-counter anti-inflammatory medications if approved by your doctor.

General Tips:

Keep a symptom journal using MDandMe to track your symptoms and any triggers.
Share this information with your healthcare provider for a more accurate diagnosis.

What you should look out for

Seek medical attention if you experience:

Worsening headache or new neurological symptoms like vision changes or confusion.
Persistent vomiting or inability to keep fluids down.
Severe joint pain or swelling.
High fever or signs of infection.

Remember, it's important to consult a healthcare professional for a formal diagnosis and treatment plan.

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7 mo ago

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