[34F] Experiencing migraine with sinus pressure and other symptoms

Patient Description

A 34-year-old female is experiencing a migraine for the past four days, with pain primarily at the top of her head, rated 7/10 in severity. The migraine worsens with noise and light and is relieved by Ketorolac. This is her first experience with migraines. She also reports sinus pressure for seven days, rated 5/10, along with nausea, diarrhea, fatigue, dizziness, earache, and nasal congestion. There are no visual disturbances, vomiting, recent travel, or new medications aside from Ketorolac. Current medications include 10 mg of Fluoxetine and 80 mg of Strattera daily, taken for over a year without side effects. No pre-existing conditions or chronic illnesses reported.

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Arora's Assessment

What might be happening

Your symptoms could be related to a few different issues:

  1. Migraine: Your severe headache, worsened by noise and light, suggests a migraine. Migraines can also cause nausea and fatigue. Treatment often includes medications like triptans or NSAIDs, and sometimes anti-nausea drugs.

  2. Sinusitis: The sinus pressure and earache might indicate a sinus infection, which can also cause dizziness and fatigue. This can be viral or bacterial, and treatment may involve decongestants, nasal sprays, or antibiotics if bacterial.

  3. Medication Side Effects: While you haven't experienced side effects before, sometimes medications like Strattera can cause dizziness or gastrointestinal symptoms.

What you can do

Migraine:

  • Continue using Ketorolac as prescribed.
  • Rest in a dark, quiet room.
  • Stay hydrated and maintain a regular sleep schedule.

Sinus Pressure:

  • Use a saline nasal spray or rinse.
  • Apply a warm compress to your face.
  • Consider over-the-counter decongestants.

General Tips:

  • Track your symptoms using MDandMe to identify triggers and patterns.
  • Avoid known migraine triggers like certain foods or stress.

What you should look out for

Seek medical attention if you experience:

  • Worsening headache or new symptoms like visual changes.
  • High fever or persistent vomiting.
  • Severe dizziness or fainting.

Remember, it's important to consult a healthcare professional for a formal diagnosis and treatment plan.

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5 mo ago

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People Also Ask


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

Common migraine triggers include stress, certain foods (like aged cheese and processed meats), caffeine, alcohol, changes in sleep patterns, and hormonal changes. Avoiding these triggers involves maintaining a regular sleep schedule, managing stress, and keeping a food diary to identify and avoid specific foods that may cause migraines.


How can I differentiate between a migraine and a sinus headache?

Migraines often present with throbbing pain, sensitivity to light and sound, and nausea, while sinus headaches are usually associated with a deep, constant pain in the cheekbones, forehead, or bridge of the nose, and may be accompanied by nasal congestion and facial pressure. A healthcare provider can help differentiate between the two based on symptoms and possibly imaging tests.


What are the potential side effects of Strattera and how common are they?

Strattera can cause side effects such as dizziness, gastrointestinal symptoms (like nausea and diarrhea), dry mouth, and decreased appetite. These side effects are generally not very common, but if they occur, they should be discussed with a healthcare provider to determine if the medication should be adjusted or changed.


When should I seek medical attention for sinus pressure or a headache?

You should seek medical attention if you experience a headache that is severe and sudden, accompanied by visual changes, high fever, persistent vomiting, or severe dizziness. For sinus pressure, if symptoms persist for more than 10 days, worsen, or are accompanied by a high fever, it may indicate a bacterial infection that requires medical evaluation.


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