[40F] Experiencing severe migraine, swollen glands, and mild sore throat

Patient Description

A 40-year-old female presents with a severe migraine located at the top, back of the head, and neck, with onset 12 hours ago, rated 6-7/10 in severity, and exacerbated by movement. Accompanying symptoms include nausea, swollen glands, a mild sore throat, stiffness in the neck, and sensitivity to light. The patient has been self-medicating with ibuprofen and hydrocodone-acetaminophen for pain relief. No significant weight changes, fever, or rash were reported. The patient has a history of mild arthritis and seasonal allergies, with an adverse reaction to morphine. No regular medications are taken, but the patient recently discontinued a vitamin B12 and multivitamin supplement due to concerns about an ingredient.

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Arora's Assessment

What might be happening

Based on the information you provided, possible diagnoses include:

  • Migraine: A type of headache characterized by severe pain, often on one side of the head, and other symptoms such as nausea, vomiting, and sensitivity to light and sound. Your description of a sudden, severe headache that worsens with movement and is accompanied by light sensitivity is consistent with a migraine.

    • Treatment typically involves rest, hydration, and over-the-counter or prescription medications to relieve pain and other symptoms.
  • Tension Headache: This is a common type of headache characterized by a dull, aching sensation all over the head. It is often described as a feeling of a tight band or dull ache around the head or behind the eyes. These are often related to stress, depression, or anxiety. Overworking, not getting enough sleep, missing meals, and using alcohol or street drugs can make you more susceptible to them.

    • Treatment typically involves rest, stress management, and over-the-counter pain relievers.
  • Viral Pharyngitis: This is an inflammation of the pharynx, which is in the back of the throat. It's most commonly caused by viral infections, such as the common cold or flu. Symptoms include a sore throat, swollen glands, and sometimes a fever.

    • Treatment typically involves rest, hydration, and over-the-counter medications to relieve pain and fever.
  • Sinusitis: This is an inflammation or swelling of the tissue lining the sinuses. It can cause headaches, a sore throat, and a cough.

    • Treatment typically involves rest, hydration, and over-the-counter or prescription medications to relieve pain and other symptoms.

Please note that these are potential diagnoses based on the symptoms you've described. It's important to consult with a healthcare provider for an accurate diagnosis and treatment.

What you can do

  1. Rest and hydrate: Make sure you are getting plenty of sleep and drinking enough fluids. This can help your body recover from any potential infections and can also help manage headache symptoms.

  2. Over-the-counter medications: Over-the-counter pain relievers can help manage headache and sore throat symptoms. Over-the-counter decongestants can also help if sinusitis is causing some of your symptoms.

  3. Avoid triggers: If you notice that certain things make your headache worse, try to avoid them. This could include things like bright lights or loud noises.

  4. Seek medical attention: If your symptoms persist or worsen, it's important to seek medical attention. Your healthcare provider can provide an accurate diagnosis and appropriate treatment.

What you should look out for

Reasons to seek urgent medical attention include:

  • A sudden, severe headache that is different from past headaches.
  • A headache accompanied by a high fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness, or speaking difficulties.
  • A headache after a head injury, especially if the headache gets worse.
  • A chronic headache that is worse after coughing, exertion, straining, or a sudden movement.
  • New headache pain if you're over 50.

Remember, I'm an AI and this advice is based on the symptoms you told me. It's always important to consult with a healthcare provider for an accurate diagnosis and treatment.

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9 mo ago


People Also Ask


What are the common symptoms of a migraine?

Common symptoms of a migraine include severe headache often on one side of the head, nausea, vomiting, and sensitivity to light and sound. The pain can be throbbing and may worsen with physical activity.


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

A migraine typically presents with severe, throbbing pain on one side of the head, along with nausea and sensitivity to light and sound. A tension headache usually causes a dull, aching sensation all over the head, often described as a tight band around the head, and is not typically associated with nausea or light sensitivity.


What are the typical treatments for viral pharyngitis?

Treatment for viral pharyngitis generally involves rest, staying hydrated, and using over-the-counter medications to relieve pain and fever. Since it's usually caused by a virus, antibiotics are not effective.


When should I seek urgent medical attention for a headache?

You should seek urgent medical attention for a headache if it is sudden and severe, different from past headaches, 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.


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