[38F] With severe migraine, body aches, and neurological symptoms

Patient Description

A 38-year-old female presents with a severe, constant migraine for the past three days, affecting both sides of her forehead. The migraine is painful to the point where it is difficult to lay down or move. It does not come with aura, nausea, or sensitivity to light and sound. Medication provides temporary relief, but the migraine returns. Additionally, she has been experiencing body aches that feel like cramping all over, rated as a 6 out of 10 in severity, also for the past three days. She has a history of arthritis in her spine, causing pain that feels like pins and needles in her lower back when she gets up. She reports feeling very tired and having no energy. She has experienced neck stiffness, fever, changes in vision, and weakness or numbness in her arms or legs. Her white blood count is very high, and her MPV is very low. Current medications include Tylenol 3, Gabapentin, and Duloxetine for bipolar disorder, as well as a medication in the 'zole' family for mood disorders.

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Arora's Assessment

What might be happening

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

  • Migraine: Migraines can cause severe, throbbing headaches that can last for days. They are often accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound. Although you mentioned not having sensitivity to light and sound, the severity and persistence of your headache suggest a migraine.

    • Treatment: Typical treatments include over-the-counter pain relievers, prescription medications, and lifestyle changes. It's important to stay hydrated, rest in a dark and quiet room, and avoid known migraine triggers.
  • Viral Infection: The combination of chills, body aches, and fever could indicate a viral infection such as the flu. Viral infections can also cause headaches and general malaise.

    • Treatment: Rest, hydration, and over-the-counter medications to relieve symptoms. Antiviral medications may be prescribed if a flu diagnosis is confirmed.
  • High White Blood Cell Count (Leukocytosis): This can indicate an infection, inflammation, or other medical conditions. Your high white blood cell count and low MPV (mean platelet volume) could be related to an underlying condition that needs further investigation.

    • Treatment: The treatment depends on the underlying cause. It's important to follow up with your healthcare provider for further evaluation and appropriate management.
  • Arthritis: Your history of arthritis in the spine could be contributing to your lower back pain and pins-and-needles sensation.

    • Treatment: Pain management, physical therapy, and medications to reduce inflammation and pain.

What you can do

  1. Consult a Healthcare Provider: Given the severity and persistence of your symptoms, it's important to consult a healthcare provider as soon as possible. They can perform a thorough evaluation, order necessary tests, and provide appropriate treatment.
  2. Stay Hydrated: Drink plenty of fluids to stay hydrated, especially if you are experiencing vomiting.
  3. Rest: Ensure you get plenty of rest to help your body recover.
  4. Monitor Symptoms: Keep track of your symptoms and any changes. This information will be helpful for your healthcare provider.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • Severe or Worsening Symptoms: If your headache, body aches, or other symptoms worsen or do not improve with treatment.
  • Neurological Symptoms: Any new or worsening weakness, numbness, difficulty speaking, or changes in vision.
  • High Fever: If you develop a high fever (over 100.4°F) that does not respond to over-the-counter medications.
  • Dehydration: Signs of dehydration such as dry mouth, decreased urination, or dizziness.

Remember, this information is not a substitute for professional medical advice. Please seek care from a healthcare provider to receive a formal diagnosis and appropriate treatment.

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6 mo ago


People Also Ask


What are the common symptoms of a migraine without aura?

A migraine without aura typically presents as a severe, throbbing headache that can last from hours to days. It often affects one or both sides of the head and may be accompanied by nausea, vomiting, and sensitivity to light and sound, although these additional symptoms are not always present.


How can a viral infection cause both headaches and body aches?

A viral infection, such as the flu, can cause systemic symptoms like headaches and body aches due to the body's immune response to the virus. The release of inflammatory mediators can lead to muscle pain and headaches as the body fights off the infection.


What does a high white blood cell count indicate?

A high white blood cell count, or leukocytosis, can indicate the presence of an infection, inflammation, stress, or other medical conditions. It is a sign that the body is responding to a perceived threat, and further investigation is often needed to determine the underlying cause.


How can arthritis in the spine lead to pins-and-needles sensations?

Arthritis in the spine can lead to nerve compression or irritation, which may cause sensations like pins and needles, numbness, or tingling in the affected areas. This is due to the inflammation or structural changes in the spine affecting nearby nerves.

1 Comments


Anonymous#28126

6 mo ago

Ask your PCP to check your labs for autoimmune markers alongside your next CBC labs. Best wishes on getting well.

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