[25F] Experiencing severe migraine with associated symptoms

Patient Description

A 25-year-old female is experiencing a severe migraine, rated 9 out of 10 in intensity, with the pain originating around the right eye and moving down the back of the head. The patient has a 12-year history of migraines and currently reports accompanying symptoms of nausea, sensitivity to light, smell, and sound, as well as tense shoulder muscles. Triggers for the migraines include salt, loud noises, and strong smells. The patient finds some relief from taking 1000mg of Tylenol and using a cold compress. Additionally, the patient is experiencing a sore throat, fatigue, and pain in the right eye.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

  • Migraine: Your symptoms of one-sided headache, nausea, sensitivity to light, sound, and smell, and relief from Tylenol and cold compresses are classic for migraines. Migraines are a type of headache characterized by severe pain on one side of the head, and can last for hours to days.

    • Treatment typically involves a combination of lifestyle changes (like avoiding triggers), over-the-counter pain relievers, and prescription medications.
  • Tension headache: These are often associated with stress, anxiety, or muscle strain. They can cause a constant ache or pressure around the head, tenderness around the scalp, forehead, or back of the neck. However, your sensitivity to light and sound is more typical of a migraine.

    • Treatment usually involves stress management, physical therapy, and pain relievers.
  • Cluster headache: These are extremely painful headaches that occur in clusters or cyclical patterns. They are characterized by severe burning and piercing pain. They occur around or behind one eye or on one side of the face at a time. However, these are rare and usually don't cause nausea or sensitivity to light and sound.

    • Treatment involves a combination of medications to reduce the severity of the cluster headache attacks and to help prevent future attacks.

What you can do

  1. Continue taking Tylenol as needed for pain, but be sure not to exceed the recommended daily dose.
  2. Try to identify and avoid potential migraine triggers, such as certain foods, smells, or stress.
  3. Practice good sleep hygiene, as poor sleep can trigger migraines.
  4. Stay hydrated and eat regular, balanced meals.
  5. Consider seeking advice from a healthcare professional. They may be able to prescribe medications to help prevent migraines or to take when they start.

What you should look out for

Seek immediate medical attention if you experience:

  • An abrupt, severe headache like a thunderclap
  • Headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
  • 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

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

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10 mo ago

People Also Ask


What are common triggers for migraines and how can they be avoided?

Common migraine triggers include certain foods (like those high in salt), strong smells, loud noises, stress, and changes in sleep patterns. To avoid them, try to identify your specific triggers by keeping a headache diary and then minimize exposure to these triggers.


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

Migraines often present with severe, throbbing pain on one side of the head, accompanied by nausea and sensitivity to light and sound. Tension headaches typically cause a constant, dull ache or pressure around the head, without the nausea or sensitivity to light and sound. Identifying these symptoms can help differentiate between the two.


What are some effective home remedies for managing migraine symptoms?

Effective home remedies for migraines include using a cold compress on the forehead, resting in a dark, quiet room, staying hydrated, and taking over-the-counter pain relievers like Tylenol. Relaxation techniques such as deep breathing or meditation can also help.


When should I seek medical attention for a headache?

Seek medical attention if you experience a sudden, severe headache, a headache with fever or neurological symptoms (like confusion or weakness), a headache after a head injury, or if you have a new headache pain and are over 50. These could be signs of a more serious condition.


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