[25F] Experiencing dizziness, nausea, and visual disturbances

Patient Description

A 25-year-old female has been experiencing dizziness, nausea, pressure in the head behind the eyes, and visual disturbances for 6 days. The dizziness is characterized as both spinning and a 'drunk' sensation, rated at a severity of 5/10, and is relieved by lying down. The patient reports blurry vision and a reduced ability to see far away, which started concurrently with the other symptoms. The patient has a history of idiopathic intracranial hypertension and has undergone a hysterectomy due to HPV-related precancerous changes in 2021, cholecystectomy in 2019, and hernia repair in 2020. The patient is currently taking the lowest dose of Qulipta once nightly and Zofran 4mg as needed every 8 hours. She reports no new medications or substance use and is allergic to tramadol and morphine. Additionally, there is a family history of brain tumors and increased cerebral spinal fluid requiring shunt placement.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, there are several possibilities:

  • Idiopathic Intracranial Hypertension (IIH): Given your history of IIH, your symptoms of headache, dizziness, and visual disturbances could be related to a flare-up of this condition. IIH is a condition where the pressure inside your skull (intracranial pressure) increases for no obvious reason. It can cause symptoms similar to those of a brain tumor, such as headache and vision problems.

    • Treatment usually involves medications to reduce the production of cerebrospinal fluid, and in some cases, surgical procedures to relieve the pressure.
  • Migraine: Migraines 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. Some people may experience visual disturbances, such as flashes of light or blind spots, before the headache (aura).

    • Treatment typically includes pain relievers, anti-nausea drugs, and preventive medications or therapies.
  • Medication side effects: Some of the symptoms you're experiencing could be side effects of the medications you're taking. Qulipta, which you're taking for migraines, can cause dizziness and visual disturbances. Zofran, which you're taking for nausea, can also cause headaches and dizziness.

    • If you suspect your symptoms are related to your medications, you should consult your doctor. They may be able to adjust your dosage or switch you to a different medication.

What you can do

  1. Consult your doctor: Given your symptoms and medical history, it's important to consult your doctor as soon as possible. They can assess your condition, order necessary tests, and adjust your treatment plan if necessary.

  2. Monitor your symptoms: Keep track of your symptoms, including when they occur, how long they last, and any potential triggers. This information can help your doctor determine the cause of your symptoms.

  3. Stay hydrated and rest: Dehydration and fatigue can worsen symptoms like dizziness and headaches. Make sure you're drinking enough fluids and getting plenty of rest.

  4. Avoid triggers: If you notice that certain factors trigger your symptoms, try to avoid them. This could include certain foods, stress, lack of sleep, or certain physical activities.

What you should look out for

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

  • A sudden, severe headache, especially if it's accompanied by a stiff neck, fever, nausea, vomiting, or altered consciousness
  • Sudden, severe visual disturbances, such as loss of vision in one or both eyes, double vision, or blind spots
  • Difficulty speaking, understanding speech, or recognizing familiar things
  • Sudden weakness or numbness on one side of your body
  • Loss of balance or coordination, or difficulty walking

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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9 mo ago


People Also Ask


What is idiopathic intracranial hypertension and how is it treated?

Idiopathic intracranial hypertension (IIH) is a condition where the pressure inside the skull increases without an obvious reason, leading to symptoms like headaches and vision problems. Treatment often involves medications to reduce cerebrospinal fluid production and, in some cases, surgical procedures to relieve pressure.


Can migraines cause visual disturbances and dizziness?

Yes, migraines can cause visual disturbances such as flashes of light or blind spots, known as aura, and can also lead to dizziness. These symptoms often accompany the severe headache and nausea typical of migraines.


What are the potential side effects of Qulipta and Zofran?

Qulipta, used for migraines, can cause side effects like dizziness and visual disturbances. Zofran, used for nausea, may cause headaches and dizziness. If you suspect these medications are causing your symptoms, consult your doctor for possible adjustments.


When should I seek immediate medical attention for my symptoms?

You should seek immediate medical attention if you experience a sudden, severe headache with a stiff neck, fever, or altered consciousness, sudden severe visual disturbances, difficulty speaking or understanding speech, sudden weakness or numbness on one side of your body, or loss of balance or coordination.


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