[28F] Experiencing severe, recurring headaches with a history of seizures

Patient Description

A 28-year-old female has been experiencing severe headaches for approximately one month, with a pain severity of 8 out of 10. The headaches are described as pounding and occur behind the eyes, shifting from one side to the other. She has been using BC powder multiple times for relief. The patient has a history of seizures, first diagnosed in October 2022, and is currently on Keppra 500mg twice daily. She also has a family history of migraines or cluster headaches. Additionally, the patient has reported episodes of double vision and seizures, but no recent head injury. She has a known allergy to Penicillin and is not on any other medications.

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Arora's Assessment

What might be happening

Based on your symptoms, here are a few possibilities:

  • Migraines: These are severe headaches that can cause throbbing pain, usually on one side of the head. They can last for hours or even days. Migraines are often accompanied by other symptoms, such as nausea, vomiting, and sensitivity to light and sound. However, you didn't mention these symptoms. Migraines can sometimes cause visual disturbances, like double vision. Your family history of migraines or cluster headaches also increases your likelihood of having migraines.

    • Treatment typically involves medications to relieve symptoms and prevent future attacks. Lifestyle modifications, such as stress management and avoidance of triggers, can also be beneficial.
  • Cluster headaches: These are extremely painful headaches that occur in clusters or cyclical patterns. They are characterized by severe burning and piercing pain. They typically occur on one side of the head and are often associated with other symptoms on the same side of the body, such as teary eye, runny nose, or drooping eyelid. However, you didn't mention these symptoms.

    • Treatment typically involves medications to shorten the duration of the headache, reduce the severity of the pain, and prevent future attacks.
  • Medication overuse headaches: These are chronic headaches caused by the overuse of medication, especially pain medication. You mentioned using BC powder multiple times a week for your headaches, which could potentially lead to medication overuse headaches.

    • Treatment typically involves reducing or stopping the overused medications under the supervision of a doctor.
  • Seizure disorder: You mentioned having a history of seizures and experiencing double vision, which can sometimes be associated with seizures. However, it's important to note that headaches and double vision can also be symptoms of many other conditions.

    • Treatment typically involves anti-seizure medications, like the Keppra you're currently taking.

What you can do

  1. Consult a healthcare professional: Given the severity and frequency of your headaches, as well as your history of seizures, it's important to consult a healthcare professional for a proper diagnosis and treatment plan.

  2. Monitor your symptoms: Keep track of your headaches, noting when they occur, their severity, duration, and any potential triggers. This information can be helpful for your healthcare provider.

  3. Lifestyle modifications: Regular exercise, a healthy diet, adequate hydration, and good sleep hygiene can help manage headaches. Try to identify and avoid potential headache triggers, such as certain foods, stress, or lack of sleep.

  4. Medication management: If you're using BC powder or any other pain relief medications frequently, discuss this with your healthcare provider. They can provide guidance on safe use and explore other treatment options if necessary.

What you should look out for

Seek immediate medical attention if you experience:

  • A sudden, 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
  • A chronic headache that is 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 an AI and not a substitute for professional medical advice. Always consult a healthcare professional for a formal diagnosis and treatment.

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1 yr ago

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People Also Ask


What are the common symptoms of migraines and how can they be managed?

Migraines often cause throbbing pain on one side of the head and can be accompanied by nausea, vomiting, and sensitivity to light and sound. Management includes medications to relieve symptoms and prevent future attacks, as well as lifestyle modifications like stress management and avoiding triggers.


Can medication overuse lead to chronic headaches, and how can this be addressed?

Yes, overusing pain medications can lead to medication overuse headaches, which are chronic. Addressing this involves reducing or stopping the overused medications under a doctor's supervision and exploring alternative treatments.


What are the potential side effects of Keppra, and how should they be managed?

Common side effects of Keppra include dizziness, drowsiness, and irritability. It's important to discuss any side effects with a healthcare provider, who may adjust the dosage or suggest ways to manage them.


How can lifestyle changes help in managing severe headaches?

Lifestyle changes such as regular exercise, a healthy diet, adequate hydration, and good sleep hygiene can help manage headaches. Identifying and avoiding triggers like certain foods, stress, or lack of sleep can also be beneficial.


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