[35F] With frequent throbbing headaches and associated symptoms

Patient Description

A 35-year-old female has been experiencing frequent throbbing headaches for almost two weeks. The headaches occur several times a day, last for a few hours, and are rated at an intensity of 8 out of 10. The pain location varies with each episode. The patient also reports dizziness, nausea, changes in vision (seeing white spots and blurry vision), and sensitivity to light and sound during the headaches. There is no associated weakness, numbness, difficulty speaking, or recent head trauma. The patient has a history of high blood pressure, which is stabilized with Losartan (100mg at night) and Amlodipine (7.5mg at night). She also takes Buspirone (7.5mg once in the morning) and Wellbutrin. Her recent blood pressure reading was 133/94. The patient uses tobacco (half a pack a day) and consumes one energy drink daily. Her menstrual periods have been heavier recently. There is a family history of heart disease (grandmother).

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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 throbbing pain, often on one side of the head. They can be accompanied by nausea, dizziness, sensitivity to light and sound, and visual disturbances like seeing spots or blurry vision.

    • Treatment: Migraines can be managed with medications such as triptans, anti-nausea drugs, and over-the-counter pain relievers. Preventive medications may also be prescribed. Lifestyle changes, such as stress management and avoiding known triggers, can help reduce the frequency of migraines.
  • Tension Headaches: These are the most common type of headache and can cause a dull, aching pain across the forehead or the back of the head and neck. They can be triggered by stress, poor posture, or muscle tension.

    • Treatment: Over-the-counter pain relievers, relaxation techniques, and improving posture can help manage tension headaches.
  • Hypertension-Related Headaches: High blood pressure can sometimes cause headaches, especially if it is not well-controlled. Your blood pressure reading of 133/94 is slightly elevated, which could contribute to your symptoms.

    • Treatment: Ensuring that your blood pressure is well-managed with medications and lifestyle changes is important. Regular monitoring and consultation with your healthcare provider are essential.
  • Medication Overuse Headache: Frequent use of pain relievers can sometimes lead to rebound headaches. If you have been taking medications frequently to manage your headaches, this could be a contributing factor.

    • Treatment: Gradually reducing the use of pain medications under the guidance of a healthcare provider can help alleviate medication overuse headaches.
  • Caffeine Withdrawal: If you consume energy drinks regularly, you might experience headaches if you suddenly reduce or stop your intake. Caffeine withdrawal can cause throbbing headaches, nausea, and irritability.

    • Treatment: Gradually reducing caffeine intake can help minimize withdrawal symptoms.

What you can do

While it's important to consult a healthcare provider for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Keep a Headache Diary: Use MDandMe to journal your symptoms, track the frequency and intensity of your headaches, and note any potential triggers. This information can be valuable for your healthcare provider.
  2. Stay Hydrated: Drink plenty of water throughout the day to stay hydrated, as dehydration can contribute to headaches.
  3. Limit Caffeine: Gradually reduce your intake of energy drinks and other sources of caffeine to see if it helps alleviate your headaches.
  4. Practice Relaxation Techniques: Stress management techniques such as deep breathing, meditation, and yoga can help reduce the frequency and intensity of headaches.
  5. Maintain a Healthy Lifestyle: Ensure you are getting enough sleep, eating a balanced diet, and engaging in regular physical activity.
  6. Monitor Blood Pressure: Keep track of your blood pressure readings and ensure that your hypertension is well-managed with medications and lifestyle changes.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or Sudden Headache: If your headache is the worst you've ever experienced or comes on very suddenly, seek immediate medical attention.
  • Neurological Symptoms: If you develop weakness, numbness, difficulty speaking, or changes in consciousness, seek urgent medical care.
  • Persistent or Worsening Symptoms: If your headaches persist or worsen despite trying the above measures, consult your healthcare provider.
  • Changes in Vision: If you experience significant changes in your vision, such as loss of vision or double vision, seek medical attention.

Remember, while I can provide information and suggestions, it's important to consult a healthcare provider for a formal diagnosis and treatment plan. If you have any further questions or need additional support, feel free to reach out.

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4 mo ago


People Also Ask


What are the common symptoms of a migraine?

Common symptoms of a migraine include throbbing pain on one side of the head, nausea, dizziness, sensitivity to light and sound, and visual disturbances such as seeing spots or experiencing blurry vision.


Can high blood pressure cause headaches?

Yes, high blood pressure can sometimes cause headaches, especially if it is not well-controlled. These headaches are often described as a dull, throbbing pain and can be accompanied by other symptoms like dizziness.


How can caffeine withdrawal lead to headaches?

Caffeine withdrawal can lead to headaches because caffeine narrows the blood vessels in the brain. When caffeine intake is reduced or stopped, these blood vessels expand, which can cause a headache. Other withdrawal symptoms may include nausea and irritability.


What lifestyle changes can help manage frequent headaches?

Lifestyle changes that can help manage frequent headaches include staying hydrated, reducing caffeine intake, practicing relaxation techniques like meditation or yoga, maintaining a healthy diet, getting regular exercise, and ensuring adequate sleep.


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