[27F] Experiencing sudden headache with pressure and neurological symptoms

Patient Description

A 27-year-old female reported a severe headache followed by a sensation of pressure building up in the head, which then 'burst' leading to temporary relief. This episode was succeeded by a 20-minute period of anxiety, an urge to defecate, and a return of pressure sensation in the head accompanied by tachycardia, tinnitus, dizziness, nausea, and shaking, resembling a panic attack. The patient also experienced jerky movements in her arms, predominantly in the right arm. After resting, the patient's heart rate and breathing normalized, but residual nervousness and shaking persisted. The patient described the post-episode state as feeling abnormal, akin to an incomplete recovery of the parasympathetic nervous system after a stress response.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Panic Attack: This is a type of anxiety disorder characterized by sudden episodes of intense fear that trigger severe physical reactions when there is no real danger or apparent cause. The symptoms you described such as rapid heart rate, shaking, feeling of impending doom, and a feeling of being out of control are common during a panic attack.

    • Treatment typically involves psychotherapy and medication.
  • Migraine: This is a type of headache characterized by intense pain and sometimes accompanied by nausea, vomiting, and sensitivity to light. Some people may experience auras, which are sensory disturbances that occur before the headache.

    • Treatment usually involves pain-relieving medications and preventive medications.
  • Hypertensive Crisis: This is a severe increase in blood pressure that can lead to a stroke. Symptoms can include a severe headache, nausea, and anxiety.

    • Treatment involves medications to lower blood pressure.

Please note that these are only possibilities and not a definitive diagnosis. It's important to consult with a healthcare professional who can evaluate your symptoms and medical history to provide an accurate diagnosis.

What you can do

  1. Consult a healthcare professional: Given the severity and sudden onset of your symptoms, it's important to seek medical attention as soon as possible. They can provide a definitive diagnosis and appropriate treatment.

  2. Monitor your symptoms: Keep track of when your symptoms occur, how long they last, and any potential triggers. This information can be helpful for your healthcare provider.

  3. Practice stress management techniques: If your symptoms are related to anxiety or panic attacks, techniques such as deep breathing, meditation, and yoga may help.

What you should look out for

Seek immediate medical attention if you experience:

  • Severe headache or headache that comes on suddenly
  • Difficulty speaking or understanding speech
  • Loss of vision or double vision
  • Loss of balance or coordination
  • Shortness of breath or chest pain
  • Confusion or altered consciousness

Remember, it's important to consult with a healthcare professional who can evaluate your symptoms and provide appropriate treatment.

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11 mo ago

People Also Ask


What are the common symptoms of a panic attack?

Common symptoms of a panic attack include a rapid heart rate, sweating, shaking, shortness of breath, a feeling of impending doom, and a sense of losing control. These episodes can occur suddenly and without warning.


How can migraines be distinguished from other types of headaches?

Migraines are often characterized by intense, throbbing pain on one side of the head, and may be accompanied by nausea, vomiting, and sensitivity to light and sound. Some people experience auras, which are visual or sensory disturbances that occur before the headache.


What are the signs of a hypertensive crisis and why is it dangerous?

A hypertensive crisis is marked by a severe increase in blood pressure, which can lead to serious health complications like a stroke. Symptoms include a severe headache, anxiety, shortness of breath, and chest pain. It requires immediate medical attention to prevent damage to organs.


What are some effective stress management techniques for anxiety?

Effective stress management techniques for anxiety include deep breathing exercises, meditation, yoga, regular physical activity, and maintaining a healthy lifestyle. These practices can help reduce stress and improve overall well-being.


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