Suggest Treatment For Headaches And Vision Problems

Posted on Sat, 27 Sep 2014

Question: 15 year old daughter who is a volleyball player had an issue last night where she had head ache, some blanks in her field of vision, had difficulty writing numbers when keeping score (ex. would write a 6 when she meant to write a 9), had some limited difficulty finding words to express what was going on. My husband brought her home and she threw up and went to sleep. Seems perfectly fine now. She had stayed up very late the night before studying. Wants to go to school. She's never had migraines but both I and her brother get them. Could it be that or do we need to be more concerned?

Answered by Dr. Saumya Mittal (11 minutes later)

Brief Answer:
need more information

Detailed Answer:
Hi
I am Dr Mittal
I will like to help you
However I need more details
Can she describe her headache?
How long did she have the headache?
Any prior history of headache?

Please let me know
So i can help u better
DR Mittal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Saumya Mittal (6 minutes later)

She said her headache was dull and achy and started around 6pm. She went to sleep around 7:30 and still had it when my husband went to check on her , around 10:30. No prior history of headaches.

Answered by Dr. Saumya Mittal (8 minutes later)

Brief Answer:
Need more information

Detailed Answer:
Is there a possibility that she is anxious about something??
Was it a pulsatile pain?
were her eyes red?
was there any eyes pain?
has she been sleeping sufficiently?
Any neck pain/discomfort?
Fever?
diet pattern? normal?

I think it may fit into the syndrome of migraine
But I will need to be sure further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Saumya Mittal (17 minutes later)

Anxious about grades she is A student but not more anxious than normal for that type of student

Not pulsating, no red eyes or eye pain, no neck stiffness

Was up until 1:00 am the night before last night studying because volleyball game ended late

Her diet is normal for her. Has been eating 2000-2500 calories per day to gain weight. She is 5'4" and weighs about 102. She has not had her period since Feb( had really just started to have periods a few months prior to that). Her doctor is aware of period loss and that's why she is eating the higher calories.

Neither me nor my son has ever experienced number confusion or visual issues with our migraines

Answered by Dr. Saumya Mittal (9 minutes later)

Brief Answer:
Migraine vs Tension headache

Detailed Answer:
the idea about visual issues was to rule out other differentials of migraine.
And migraine does have photophobia- a condition where the light feels brighter and hurts more than usual while the headache is there.

I think there is a strong possibility that this is one of the 2 possible diagnosis
1. migraine- being a first episode, we do need to watch for the further episodes. lack of sleep can always trigger a migraine. stress (of grades) can be a trigger for a migraine. Plus she has family history of migraine. I would consider this as a strong possibility. If this is a migraine, I think right now we just need to give her painkillers as and when needed. The medicine has to be give as soon as possible after the onset of headache. She could use a general painkiller like paracetamol, or a more migraine specific painkiller like sumatriptan or ergotamine (with an antacid of course.

2. this second is not the top diagnosis, but one needs to be sure that this is not there- tension headache. The idea is simply this that if it is a tension headache, all she has to do is learn relaxation techniques like yoga and meditation. she really wont need medications as of now.

I hope that information helps
Please feel free to ask a follow up query if you need any more info
Best of luck
Dr Mittal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Saumya Mittal (33 minutes later)

One last question- is the number confusion when she was writing a 6 when she meant to write a 9 and she knew it was right also consistent with a migraine?

Answered by Dr. Saumya Mittal (14 minutes later)

Brief Answer:
Not really

Detailed Answer:
Ideally the number confusion is not a feature of migraine.
However I will say that the pain may have caused her to do this in a hurry or confusion.
But if it was a caused by some neurological problem, it wont go away by sleep.
Therefore it is a migraine

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar