[36F] Experiencing headache, eye twitching, and neck pain

Patient Description

A 36-year-old female reports a week-long headache, described as sharp and achy, located on one side near the temple and behind the eye, which worsens in the evening and is less painful when moving around. The headache intensity is rated 5 out of 10. Eye twitching, rated 2 out of 10 in severity, occurs on the same side as the headache. Neck pain is described as sore and achy, with a severity of 4 or 5 out of 10. The patient also experiences pressure and tenderness in the sinuses around the eyes, nausea, and sensitivity to light, sound, and physical activity. The patient has a medical history of Postural Orthostatic Tachycardia, PCOS, and Fibromyalgia, diagnosed around 2010, and has allergies to Sulfa and Sudafed. No medications are currently being taken.

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Arora's Assessment

What might be happening

Based on the information you have provided, possible diagnoses include:

  • Migraine: A type of headache characterized by moderate to severe pain that is throbbing or pulsing, and often on one side of the head. It is often accompanied by nausea, and sensitivity to light and sound. Migraines can be triggered by various factors including stress and anxiety, which you mentioned.

    • Treatment typically involves pain relieving and preventive medications.
  • Tension Headache: This type of headache is often described as a constant ache or pressure around the head, especially at the temples or back of the head and neck. They are often associated with muscle tightness in these areas and can be related to stress or anxiety.

    • Treatment typically involves pain relievers, stress management, and physical therapy.
  • Sinusitis: Inflammation or swelling of the tissue lining the sinuses can result in discomfort or pressure around your eyes, cheeks, nose or forehead. Although you mentioned your nose is clear, sinusitis can sometimes occur without a blocked nose.

    • Treatment typically involves use of decongestants, pain relievers, and sometimes antibiotics if a bacterial infection is suspected.
  • Cluster Headache: These are severe headaches that occur on one side of the head (often around or behind the eye) and come in clusters, meaning you experience cycles of headache attacks followed by headache-free periods.

    • Treatment typically involves medications to decrease the severity of the cluster headache, as well as preventive medications.

Please note that these are potential explanations for your symptoms based on the information you provided, and not a definitive diagnosis.

What you can do

You should consult a healthcare professional who can evaluate your symptoms and medical history in order to provide a formal diagnosis. In the meantime, you can try the following:

  1. Over-the-counter pain relievers: Non-prescription medications such as ibuprofen or aspirin can be effective for relieving headache pain.
  2. Rest and relaxation: Try to rest in a quiet, dark room. This can often help with migraine and tension headaches.
  3. Stay hydrated: Dehydration can sometimes trigger headaches. Make sure you are drinking enough fluids.
  4. Avoid known triggers: If certain foods or situations trigger your headaches, try to avoid them.

What you should look out for

You should seek immediate medical attention if:

  • Your headache is severe and sudden, and unlike any you've had before.
  • You have a headache accompanied by confusion, fainting, high fever, stiff neck, or double vision.
  • Your headache gets worse over days and changes with position or during routine physical activity.
  • You have a history of headaches but they have changed in pattern or intensity.
  • You have a headache following a head injury.

Remember, I am an AI and this advice is based on the information you provided. It's always important to consult with a healthcare professional for an accurate diagnosis.

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11 mo ago

People Also Ask


What are the common symptoms of a migraine?

Common symptoms of a migraine include moderate to severe throbbing or pulsing pain on one side of the head, nausea, and sensitivity to light and sound. Some people also experience visual disturbances known as auras.


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

A tension headache is usually described as a constant ache or pressure around the head, especially at the temples or back of the head and neck, and is often associated with muscle tightness. In contrast, a migraine is typically more severe, throbbing, and may be accompanied by nausea and sensitivity to light and sound.


What are some effective treatments for sinusitis?

Effective treatments for sinusitis include decongestants, pain relievers, and sometimes antibiotics if a bacterial infection is suspected. It's also helpful to stay hydrated and use saline nasal sprays to keep the nasal passages moist.


When should I seek medical attention for a headache?

You should seek medical attention for a headache if it is severe and sudden, unlike any you've had before, or if it is accompanied by symptoms such as confusion, fainting, high fever, stiff neck, or double vision. Also, if your headache changes in pattern or intensity, or follows a head injury, medical evaluation is advised.


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