[27F] With chronic headaches, memory loss, and fatigue

Patient Description

A 27-year-old female has been experiencing throbbing and aching headaches primarily on the sides of her head and behind her right eye for the past 8 months. These headaches occur intermittently, ranging from a few days a week to once or twice a month, and last for several days. The pain is rated as 8 out of 10. The headaches are exacerbated by stress, bright lights, and loud sounds. Relief is occasionally found with prescribed medication and sleep. Accompanying symptoms include nausea, sensitivity to light and sound, and occasional blurry vision. The patient also reports memory loss over the past year, worsening recently, affecting her ability to remember conversations and important events, leading to missed appointments. There is occasional limb weakness or numbness, but no recent head injuries or diagnosed neurological conditions. Medical history includes ADHD diagnosed this year and hypothyroidism diagnosed five years ago. The patient is currently taking methylphenidate daily and a combination of vital/acetaminophen/caffeine as needed. There is a family history of multiple sclerosis in her mother. No known allergies to medications.

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Arora's Assessment

What might be happening

Your symptoms could be related to a few different conditions:

  1. Migraines: The throbbing headache, sensitivity to light and sound, nausea, and pain behind the eye are common migraine symptoms. Migraines can be triggered by stress, bright lights, and loud sounds.

  2. Tension Headaches: These can cause pressure-like pain on the sides of the head and may be related to stress.

  3. Hypothyroidism: This condition can contribute to fatigue and memory issues. It's important to ensure your thyroid levels are well-managed.

  4. Medication Side Effects: Methylphenidate can sometimes cause headaches and affect sleep, which might contribute to fatigue and memory problems.

What you can do

For Headaches:

  • Keep a headache diary using MDandMe to track triggers and patterns.
  • Practice stress-reduction techniques like meditation or yoga.
  • Ensure you're staying hydrated and maintaining a regular sleep schedule.
  • Discuss with your doctor about adjusting medications or trying migraine-specific treatments.

For Memory Loss:

  • Use reminders and organizational tools to help manage appointments and tasks.
  • Ensure your thyroid levels are regularly checked and managed.
  • Consider cognitive exercises to help improve memory.

For Fatigue:

  • Prioritize good sleep hygiene, such as a consistent bedtime routine.
  • Balance activity with rest, and avoid overexertion.

What you should look out for

Seek medical attention if you experience:

  • Sudden, severe headaches or changes in headache patterns.
  • Persistent or worsening memory issues.
  • New or worsening neurological symptoms, like limb weakness or numbness.

Remember, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan. You can use MDandMe to journal your symptoms, track progress, and share insights with your provider.

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3 mo ago

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People Also Ask


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

Common triggers for migraines include stress, bright lights, loud sounds, certain foods, and hormonal changes. Managing these triggers involves identifying them through a headache diary, practicing stress-reduction techniques, and avoiding known triggers when possible.


How can hypothyroidism affect memory and what steps can be taken to address this?

Hypothyroidism can lead to fatigue and cognitive issues, including memory problems. Ensuring that thyroid hormone levels are well-managed through regular check-ups and medication adjustments can help mitigate these effects. Cognitive exercises and organizational tools can also support memory.


What are the potential side effects of methylphenidate, and how might they relate to headaches and memory issues?

Methylphenidate can cause side effects such as headaches, insomnia, and anxiety, which might contribute to fatigue and memory problems. If these side effects are significant, discussing medication adjustments with a healthcare provider is advisable.


How can one differentiate between migraine and tension headaches based on symptoms?

Migraine headaches are often characterized by throbbing pain, sensitivity to light and sound, and nausea, while tension headaches typically involve a pressure-like pain around the head. Keeping a symptom diary can help in distinguishing between the two based on patterns and triggers.


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