[30F] Experiencing severe fatigue, dizziness, and migraines

Patient Description

A 30-year-old female presents with severe fatigue, significant enough to cause near syncope, especially when standing, for the past 5 days. The patient also reports severe dizziness described as a sensation of the surroundings spinning, which has been ongoing for 3 days. Accompanying symptoms include migraines at night with shooting pain behind one eye and down the neck, ear pain with pressure and a sensation of being underwater, and occasional stabbing flank pain on the side of the back near the kidney area, which has been present for a few months. The patient has confirmed fluid in the inner ear, diagnosed by a doctor today. The patient has a history of migraines since puberty and high stress for the past year. No fever has been reported, but the patient experiences chills. The last bowel movement was described as dark and pebbly. Current medications include a Z pack of antibiotics and a thyroid pill. No known drug allergies. No recent changes in weight, and no pregnancy.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possibilities:

  • Vestibular Neuritis or Labyrinthitis: These are inner ear problems usually caused by viral infections that result in inflammation in the inner ear around nerves that are key to the body's sense of balance. Symptoms can include dizziness, loss of balance, and vertigo (a spinning sensation), as well as ear pain and hearing loss.

    • Treatment often involves medications to control nausea and dizziness, along with physical therapy to help improve balance.
  • Migraines: Migraines are a type of headache characterized by intense, throbbing pain, often accompanied by nausea and sensitivity to light and sound. They can last for hours to days, and the pain can be so severe that it interferes with daily activities.

    • Treatment often involves medications to relieve symptoms and prevent future attacks.
  • Sinusitis: This is an infection or inflammation of the sinuses, often caused by a viral or bacterial infection. Symptoms can include headache, fatigue, and ear pressure or pain.

    • Treatment often involves antibiotics if the cause is bacterial, as well as decongestants and pain relievers.
  • Kidney Stones: These are hard deposits made of minerals and salts that form inside your kidneys. They can cause severe pain in your side or back below your ribs, as well as other symptoms.

    • Treatment often involves pain relievers and drinking lots of water to help the stone pass. In some cases, medical procedures may be needed to remove or break up the stones.

What you can do

  1. Rest and hydrate: Make sure you're getting plenty of sleep and staying hydrated, especially if you're experiencing dizziness and fatigue.
  2. Over-the-counter pain relievers: These can help with your headache and ear pain. However, they should not replace a visit to the doctor.
  3. Avoid triggers: If you notice certain things trigger your migraines or dizziness, try to avoid them if possible.
  4. Seek medical attention: Given the severity and duration of your symptoms, it's important to seek medical attention as soon as possible.

What you should look out for

Please seek immediate medical attention if you experience any of the following:

  • Severe headache or migraine that doesn't improve with rest or medication
  • Increased severity or frequency of dizziness
  • Blood in your urine, which could be a sign of kidney stones
  • Fever, which could indicate an infection

Please remember that while I strive to provide accurate information, I'm not a doctor and this advice should not replace a visit to a healthcare professional.

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11 mo ago

People Also Ask


What causes vestibular neuritis or labyrinthitis, and how is it treated?

Vestibular neuritis or labyrinthitis is often caused by viral infections that lead to inflammation in the inner ear, affecting balance. Treatment typically includes medications to control nausea and dizziness, and physical therapy to improve balance.


How can migraines be managed or prevented?

Migraines can be managed with medications to relieve symptoms and prevent future attacks. Lifestyle changes, such as avoiding known triggers, maintaining a regular sleep schedule, and managing stress, can also help prevent migraines.


What are the symptoms and treatments for sinusitis?

Sinusitis symptoms include headache, fatigue, and ear pressure or pain. Treatment may involve antibiotics if bacterial, along with decongestants and pain relievers to alleviate symptoms.


What are the signs of kidney stones and how are they treated?

Kidney stones can cause severe pain in the side or back below the ribs. Treatment often involves pain relievers and increased water intake to help pass the stone. In some cases, medical procedures may be necessary to remove or break up the stones.


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