[38F] Experiencing severe headaches and vertigo

Patient Description

A 38-year-old female reports experiencing severe headaches at least three times a week, rated as a 10 out of 10 in intensity, with a sharp pain affecting the whole head, neck, and shoulders. These headaches are exacerbated by light and noise, lasting more than six hours if untreated with medication. The patient also experiences vertigo, described as a quick spinning sensation, particularly when turning over in bed or looking up or down for an extended period. This vertigo has been ongoing for a few months and is rated as a 7 out of 10 in severity. The patient has been taking Dimenhydrinate daily for vertigo or motion sickness and Extra Strength Tylenol as needed for pain. There is a history of unconfirmed migraines, with no recent head or neck injuries reported. Additionally, the patient has experienced a sudden onset of severe headache, neck stiffness, and some vision issues.

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Arora's Assessment

What might be happening

Based on the information you've provided, the following conditions could be causing your symptoms:

  • Migraines: Your symptoms of severe, sharp headaches that last for several hours, are worsened by light and noise, and are accompanied by nausea are consistent with migraines. Migraines can also cause neck and shoulder pain.

    • Treatment typically involves medications to relieve symptoms and prevent future attacks.
  • Benign paroxysmal positional vertigo (BPPV): This condition could explain your vertigo symptoms. BPPV is a disorder arising in the inner ear, which is the body's balance center. It causes brief episodes of mild to intense dizziness that usually occur with changes in position or movement of the head.

    • Treatment often involves maneuvers performed by a healthcare provider to move the tiny loose particles causing the problem into a part of the inner ear where they won't cause dizziness.
  • Tension headaches: These are often associated with a feeling of pressure or tightness around the head and can cause pain in the neck and shoulders. They can be triggered by stress, anxiety, lack of sleep, or skipping meals.

    • Treatment usually involves pain relievers and lifestyle changes to manage stress.

Please remember that while these conditions could explain your symptoms, only a healthcare provider can provide a definitive diagnosis.

What you can do

  1. Make an appointment with your healthcare provider to discuss your symptoms. They may refer you to a neurologist or an ear, nose, and throat specialist for further evaluation.
  2. Keep a headache diary. Note when your headaches start, what you were doing at the time, how long they last and what, if anything, provides relief.
  3. Try to identify any triggers for your headaches and vertigo, such as certain foods, activities, or situations, and avoid them if possible.
  4. Practice good sleep hygiene. Regular, restful sleep can help reduce the frequency and severity of migraines.
  5. Stay hydrated and eat regular, balanced meals. Dehydration and skipping meals can trigger headaches.
  6. Try relaxation techniques, such as yoga, meditation, or deep breathing, to help manage stress and reduce tension.

What you should look out for

Seek immediate medical attention if:

  • Your headache or vertigo suddenly becomes severe or changes in nature
  • You have a high fever along with a headache
  • You experience a sudden, severe headache that is different from past headaches
  • You have difficulty speaking, seeing, walking, or balancing
  • You have a headache after a head injury, especially if the headache gets worse
  • You have a chronic disease, such as HIV or cancer, and develop a new headache

Remember, I'm an AI and this advice is based on the information you've provided. It's always a good idea to consult with a healthcare provider for an accurate diagnosis and treatment.

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9 mo ago

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People Also Ask


What are the common symptoms of migraines and how can they be managed?

Common symptoms of migraines include severe, throbbing headaches often on one side of the head, sensitivity to light and noise, nausea, and sometimes visual disturbances. Management typically involves medications to relieve symptoms and prevent future attacks, as well as identifying and avoiding triggers.


What is benign paroxysmal positional vertigo (BPPV) and how is it treated?

Benign paroxysmal positional vertigo (BPPV) is a disorder of the inner ear that causes brief episodes of dizziness, often triggered by changes in head position. Treatment usually involves specific head maneuvers performed by a healthcare provider to reposition the particles in the inner ear.


How can tension headaches be distinguished from migraines?

Tension headaches are usually characterized by a feeling of pressure or tightness around the head, often accompanied by neck and shoulder pain. They are generally less severe than migraines and are not typically associated with nausea or visual disturbances. Stress management and pain relievers are common treatments.


What lifestyle changes can help reduce the frequency of headaches and vertigo?

Lifestyle changes that can help reduce headaches and vertigo include maintaining regular sleep patterns, staying hydrated, eating balanced meals, managing stress through relaxation techniques, and keeping a diary to identify and avoid triggers.


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2 Comments


Brian#4030

9 mo ago

Did your doctor ever recommend Epley maneuver for your vertigo. It's super uncomfortable but works really well as my physical therapist said. Not all physical therapists know how to do it but some are specifically trained. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/home-epley-maneuver

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Brian#4030

9 mo ago

the headaches seem like standard migraines but they do happen a lot so maybe ask about a prophylactic maintenance medication rather than just an abortive migraine medication if that's all you're taking. Also, if these headaches have come on just recently or are increasing, no harm in trying to get an MRI to make sure there's no physical explanation

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