[33F] Experiencing sharp headache and eye twitching

Patient Description

A 33-year-old female presents with a sharp headache on the right side, eye twitching every 5-10 minutes, and eye pain without redness or vision loss, persisting for over a week. The headache, rated 7 out of 10 in severity, lasts all day and is associated with the eyelid twitching. She experiences light sensitivity but no sound sensitivity, and reports mild neck stiffness without fever, speech changes, facial drooping, or limb weakness. The patient has a family history of migraines. Her medical history includes severe anxiety and depression diagnosed in 2013, gout in 2012, tendinitis in 2015, and a hernia surgery. Current medications include Hydrochlorothiazide 12.5 mg and Prozac 30 mg taken once in the morning, and Ibuprofen 800 mg and Trazodone 50 mg taken as needed. She has an allergy to an unspecified steroid.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Migraine: This is a type of headache that often causes severe throbbing pain or a pulsing sensation, usually on one side of the head. It's often accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraine attacks can cause significant pain for hours to days and can be so severe that the pain is disabling.

    • Treatment typically includes a combination of medications to relieve symptoms and prevent future attacks, as well as lifestyle changes like stress management and avoiding triggers.
  • Tension headache: This is the most common type of headache, and it causes a constant ache or pressure around the head, especially at the temples or back of the head and neck. Not as severe as migraines, tension headaches are not usually accompanied by nausea and vomiting, and they don't cause a halt to your daily activities.

    • Treatment typically involves over-the-counter or prescription medications to relieve symptoms, as well as lifestyle changes like stress management and regular physical activity.
  • Cluster headache: This is a rare type of headache that occurs in cyclical patterns or clusters, and it's one of the most painful types of headache. Cluster headache commonly awakens you in the middle of the night with intense pain in or around one eye on one side of your head.

    • Treatment typically involves medications to lessen the severity of cluster headache attacks when they occur, reduce the number of cluster headaches in a cycle, and prevent attacks altogether.
  • Blepharospasm: This is a condition where you have involuntary spasms of the muscles around your eye. It's often caused by fatigue, stress, or an irritant to the eye, but in many cases, the cause is unknown.

    • Treatment can include medications, botulinum toxin injections, and in some cases, surgery.
  • Dry eye syndrome: This is a condition where your eyes don't produce enough tears, which can cause discomfort and vision problems. It can be caused by a variety of factors, including age, certain medications, and medical conditions.

    • Treatment typically involves over-the-counter or prescription eye drops, as well as lifestyle changes like taking breaks from looking at screens and keeping your eyes clean.

Please note that these are potential explanations for your symptoms, but they may not be the actual cause. You should consult a healthcare professional for an accurate diagnosis.

What you can do

In the meantime, you can try the following to manage your symptoms:

  1. Rest and relax: Stress and fatigue can exacerbate headaches and eye twitching. Try to get plenty of sleep and engage in relaxation activities like yoga or meditation.

  2. Stay hydrated: Dehydration can also contribute to headaches. Make sure you're drinking enough water throughout the day.

  3. Avoid eye strain: Spending long periods of time looking at screens can cause eye strain, which can lead to headaches and eye discomfort. Try to take regular breaks from screens and make sure your glasses or contact lens prescription is up to date.

  4. Over-the-counter pain relievers: Non-prescription medications like ibuprofen can help relieve headache pain.

  5. Warm compress: Applying a warm compress to your eye can help relieve eye discomfort.

What you should look out for

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

  • A sudden, severe headache like a thunderclap
  • Headache with a fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties
  • Headache after a head injury, especially if the headache gets worse
  • A chronic headache that is worse after coughing, exertion, straining, or a sudden movement
  • New headache pain if you're over 50

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.

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10 mo ago

People Also Ask


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

Common symptoms of a migraine include severe throbbing pain or a pulsing sensation on one side of the head, nausea, vomiting, and sensitivity to light and sound. Management typically involves medications to relieve symptoms and prevent future attacks, as well as lifestyle changes like stress management and avoiding known triggers.


How can stress and anxiety contribute to headaches and eye twitching?

Stress and anxiety can lead to muscle tension and fatigue, which may contribute to headaches and eye twitching. Managing stress through relaxation techniques, regular exercise, and adequate sleep can help alleviate these symptoms.


What lifestyle changes can help prevent tension headaches?

Lifestyle changes that can help prevent tension headaches include maintaining a regular sleep schedule, staying hydrated, practicing good posture, managing stress through relaxation techniques, and engaging in regular physical activity.


When should I seek medical attention for a headache?

You should seek medical attention for a headache if it is sudden and severe, accompanied by fever, stiff neck, confusion, seizures, or other neurological symptoms, occurs after a head injury, or if it is a new type of headache pain and you are over 50.


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