[35F] Experiencing headache with nausea and sensitivity to light and sound

Patient Description

A 35-year-old female presented with a sudden onset of headache in the right temple area and extreme nausea that began yesterday afternoon. The nausea is exacerbated when standing up but lessens upon lying down. The headache persisted through the night despite taking Tylenol and was accompanied by weakness upon waking up this morning. The patient also reports sensitivity to light and sound, with the nausea occurring in association with the headache and worsening with head movements. There is no fever, vision change, or stiff neck reported. The patient has a history of chronic colitis diagnosed in 2011 but is not currently on any medications and has no known drug allergies. There is no recent history of caffeine, alcohol, or recreational drug use. The patient's spouse has a history of similar headaches, suggesting a potential migraine pattern, though the patient does not have a blood relative with such a history.

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Arora's Assessment

What might be happening

Based on your symptoms, the most likely causes could be:

  • Migraines: These are a type of headache characterized by severe pain on one side of the head, often accompanied by nausea and sensitivity to light and sound. Migraines can last for hours to days, and the pain can be so severe that it interferes with your daily activities.

    • Treatment typically involves pain relievers and other medications to manage the symptoms. Preventive medications can also be used if the migraines are frequent or severe.
  • Tension headaches: These are the most common type of headache, often described as a constant ache or pressure around the head, especially at the temples or back of the head and neck. They can be triggered by stress, lack of sleep, missed meals or dehydration.

    • Treatment typically involves over-the-counter pain relievers and rest. Regular physical activity and managing stress can also help prevent tension headaches.
  • Orthostatic hypotension: This is a form of low blood pressure that happens when you stand up from sitting or lying down. It can cause dizziness and fainting.

    • Treatment typically involves lifestyle changes, such as drinking plenty of fluids and standing up slowly.

Please note that these are possible causes and not a definitive diagnosis. You should consult a healthcare professional for a formal diagnosis.

What you can do

  1. Rest in a quiet, dark room.
  2. Stay hydrated.
  3. Try not to skip meals.
  4. Try to manage stress through activities such as yoga, meditation, or deep breathing exercises.
  5. Over-the-counter pain relievers can help with the headache.

What you should look out for

You should seek immediate medical attention if:

  • Your headache is severe and sudden.
  • You have a headache accompanied by a high fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or speaking difficulties.
  • You have a headache after a head injury, especially if the headache gets worse.
  • You have chronic headaches and they're getting worse or they're accompanied by other symptoms, such as vision changes or neck stiffness.

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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8 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, vomiting, and sensitivity to light and sound. Some people also experience visual disturbances known as aura.


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

Migraines typically involve severe, throbbing pain on one side of the head, often with nausea and sensitivity to light and sound. Tension headaches, on the other hand, usually cause a constant, dull ache or pressure around the head, especially at the temples or back of the head and neck, and are not usually accompanied by nausea.


What lifestyle changes can help manage or prevent migraines?

Lifestyle changes that can help manage or prevent migraines include maintaining a regular sleep schedule, staying hydrated, eating regular meals, managing stress through relaxation techniques, and avoiding known migraine triggers such as certain foods or environmental factors.


When should I seek medical attention for a headache?

You should seek medical attention for a headache if it is severe and sudden, accompanied by a high fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties, or if it occurs after a head injury and worsens. Additionally, if you have chronic headaches that are getting worse or are accompanied by other symptoms, it's important to consult a healthcare provider.

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