[26F] Pregnant with severe headaches and vision disturbances

Patient Description

A 26-year-old female, currently 9 weeks pregnant, reports severe headaches occurring 3-6 times a week, predominantly on the right side and near the brain stem. The headaches are described as sharp and throbbing, with an intensity of 8 out of 10, lasting 2-5 hours, and are worst upon waking. They are alleviated by laying in complete darkness and quiet, or with acetaminophen or Excedrin. She also experiences blurred vision in the right eye, numbness in hands/shoulders and feet, and occasional slurred speech, coinciding with the headaches. The patient has a history of endometriosis and anemia, and is currently on prenatal Prozac, multivitamins, and fish oil. She has allergies to Vancomycin, Fentanyl, cinnamon, and grass. Sleep disturbances have been present for over 5 years, with insomnia treated previously, but she still cannot sleep through the night, leading to daytime naps.

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Arora's Assessment

What might be happening

Based on the information you've provided, possible explanations for your symptoms include:

  • Migraine: A type of headache characterized by severe, throbbing pain, usually on one side of the head. Migraines can cause blurred vision, nausea, and vomiting. They can also cause numbness or tingling in the face or extremities. Migraines are more common in women and can be triggered by hormonal changes, such as those that occur during pregnancy.

    • Treatment for migraines usually involves medications to relieve symptoms and prevent future attacks.
  • Tension Headache: This is a common type of headache characterized by a dull, aching sensation all over the head. It is often described as a feeling of a tight band or dull ache around the head or behind the eyes. These are common in people experiencing stress, anxiety, or poor sleep.

    • Treatment typically involves pain relievers, stress management, and improving sleep habits.
  • Insomnia: This is a sleep disorder that can make it hard to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. Insomnia can sap not only your energy level and mood but also your health, work performance and quality of life.

    • Treatment for insomnia can include lifestyle changes, cognitive behavioral therapy, and medication.
  • Preeclampsia: This is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. It usually begins after 20 weeks of pregnancy in women whose blood pressure had been normal. Left untreated, preeclampsia can lead to serious — even fatal — complications for both you and your baby.

    • Treatment often involves medications to lower blood pressure and prevent seizures. In some cases, early delivery of the baby may be necessary.

What you can do

  1. Consult a healthcare provider: Given the severity and frequency of your headaches, as well as your other symptoms, it's important to seek medical attention. Your healthcare provider can help determine the cause of your symptoms and develop a treatment plan.

  2. Monitor your symptoms: Keep track of when your headaches occur, how long they last, and any other symptoms you experience. This information can be helpful to your healthcare provider.

  3. Maintain a healthy lifestyle: Regular physical activity, a healthy diet, and adequate sleep can help manage symptoms of many conditions, including migraines and insomnia.

  4. Follow your treatment plan: If you have been prescribed medication for any condition, be sure to take it as directed by your healthcare provider.

What you should look out for

Seek immediate medical attention if you experience:

  • A sudden, severe headache that's different from past headaches
  • A headache accompanied by a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties
  • A chronic headache that's worse after coughing, exertion, straining, or a sudden movement
  • New headache pain if you're over 50

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 provider.

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11 mo ago

People Also Ask


What are the common symptoms of migraines during pregnancy?

Common symptoms of migraines during pregnancy include severe, throbbing pain on one side of the head, nausea, vomiting, sensitivity to light and sound, and sometimes visual disturbances or aura. Hormonal changes during pregnancy can trigger migraines.


How can insomnia affect pregnancy and what are some safe treatments?

Insomnia during pregnancy can lead to fatigue, mood disturbances, and can affect overall health. Safe treatments include practicing good sleep hygiene, cognitive behavioral therapy, and in some cases, medications prescribed by a healthcare provider. It's important to consult with a doctor before taking any medication.


What are the warning signs of preeclampsia that pregnant women should be aware of?

Warning signs of preeclampsia include high blood pressure, severe headaches, changes in vision (such as blurred vision or seeing spots), upper abdominal pain, nausea or vomiting, decreased urine output, and sudden weight gain or swelling. Immediate medical attention is necessary if these symptoms occur.


Are there any specific triggers for headaches during pregnancy that can be avoided?

Common triggers for headaches during pregnancy include stress, lack of sleep, dehydration, certain foods, and hormonal changes. Avoiding known triggers, maintaining a regular sleep schedule, staying hydrated, and managing stress can help reduce the frequency of headaches.


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