[34F] With pulsing headache, dizziness, and fatigue

Patient Description

A 34-year-old female has been experiencing a pulsing headache on the sides of her head for the past three days. The headache developed gradually and is rated as a 7 out of 10 in severity. Accompanying symptoms include dizziness, fatigue, nausea, sensitivity to sound, and visual disturbances, but no sensitivity to light. This is the first occurrence of such a headache, with no known family history of migraines or other headaches. The patient has taken Aleve for relief and uses methamphetamine daily. There are no pre-existing conditions, chronic illnesses, or other medications reported. The patient has not experienced chest pain, shortness of breath, or palpitations and has not traveled recently or been exposed to new environments. The patient inquired if the symptoms could be related to pregnancy.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Migraine: Migraines are a common type of headache that can cause severe, throbbing pain, usually on one side of the head. They are often accompanied by nausea, sensitivity to sound (phonophobia), and visual disturbances (such as seeing flashing lights or blind spots). Migraines can be triggered by various factors, including stress, certain foods, and changes in sleep patterns.

    • Treatment: Over-the-counter pain relievers like ibuprofen or acetaminophen can help, but stronger prescription medications may be needed. Preventive medications and lifestyle changes can also be effective.
  • Tension Headache: These are the most common type of headache and can cause a dull, aching pain on both sides of the head. They are often associated with stress, anxiety, or muscle tension.

    • Treatment: Over-the-counter pain relievers, relaxation techniques, and stress management can help alleviate symptoms.
  • Substance Use: Daily use of methamphetamine can lead to various health issues, including headaches, dizziness, and fatigue. Methamphetamine use can also cause dehydration and electrolyte imbalances, which can contribute to your symptoms.

    • Treatment: Reducing or stopping methamphetamine use is crucial. Seeking help from a healthcare provider or addiction specialist is highly recommended.
  • Dehydration: Methamphetamine use can lead to dehydration, which can cause headaches, dizziness, and fatigue.

    • Treatment: Ensure you are drinking plenty of water and staying hydrated.
  • Pregnancy: While less likely, pregnancy can cause headaches, dizziness, and fatigue due to hormonal changes.

    • Testing: A home pregnancy test or a visit to your healthcare provider can confirm or rule out pregnancy.

What you can do

  1. Consult a Healthcare Provider: It's important to consult a healthcare provider to get a formal diagnosis and appropriate treatment. They can also help you address any substance use issues.
  2. Stay Hydrated: Drink plenty of water to stay hydrated, especially if you are using substances that can cause dehydration.
  3. Rest: Ensure you are getting enough sleep and rest to help your body recover.
  4. Avoid Triggers: Try to identify and avoid any potential headache triggers, such as certain foods, stress, or lack of sleep.
  5. Use MDandMe: You can use MDandMe to journal your symptoms, track your progress, get insights, and share longitudinal medical notes with your provider.

What you should look out for

Seek medical attention more urgently if you experience any of the following:

  • Severe or sudden onset of headache
  • Headache accompanied by fever, stiff neck, or confusion
  • Persistent vomiting
  • Weakness or numbness in any part of your body
  • Changes in vision or speech
  • If you suspect you might be pregnant, take a home pregnancy test or consult your healthcare provider

Remember, while I can provide information and suggestions, I am not a substitute for a real healthcare professional. Please seek care from a qualified healthcare provider for a formal diagnosis and treatment.

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5 mo ago

People Also Ask


What are the common symptoms of a migraine?

Common symptoms of a migraine include severe, throbbing pain usually on one side of the head, nausea, sensitivity to sound, and visual disturbances such as seeing flashing lights or blind spots.


Can methamphetamine use cause headaches and other symptoms?

Yes, methamphetamine use can cause headaches, dizziness, fatigue, and other health issues. It can also lead to dehydration and electrolyte imbalances, which may contribute to these symptoms.


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

Migraines typically cause severe, throbbing pain on one side of the head and are accompanied by nausea and sensitivity to sound or visual disturbances. Tension headaches usually cause a dull, aching pain on both sides of the head and are often related to stress or muscle tension.


Could my symptoms be related to pregnancy?

While less likely, pregnancy can cause headaches, dizziness, and fatigue due to hormonal changes. A home pregnancy test or consultation with a healthcare provider can confirm or rule out pregnancy.


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