Occasional Forehead Pain: Symptoms and When to Seek Help

Intermittent frontal headaches, occasional chest tightness, nausea, excessive sleepiness, and weakness in the limbs?

Hello, Dr.
Yeh.
I work in marketing and have mild allergic rhinitis.
Occasionally, I experience dry heaving upon waking up.
Since November of last year, I have also had occasional headaches, chest tightness, nausea, dizziness, and weakness in my limbs, occurring about every 2 to 3 weeks.
This year, the frequency has increased, with frequent frontal headaches that feel like someone is pulling the muscles towards my brow, occurring several times a day or sometimes just once for a long duration.
Occasionally, I also feel nauseous or excessively sleepy (the longest I slept in one day was over 12 hours without waking up).
My memory has worsened, and I often forget many things related to work and daily life.
I also experience weakness in my limbs, shortness of breath, and fatigue.
When my condition is better, my complexion tends to be pale yellow, and when it's worse, I appear very pale with no color.
Which department should I consult?

maggie, 30~39 year old female. Ask Date: 2016/05/08

Dr. Ye Qianyu reply Family Medicine

Thank you for your question! If there are significant changes in the type or intensity of your headache, you should consult a neurologist.
Additionally, the other symptoms you mentioned may suggest anemia, so please seek evaluation from a hematologist or gynecologist as soon as possible.

Reply Date: 2016/05/08

More Info

It sounds like you're experiencing a complex set of symptoms that could be related to several underlying issues. Based on your description, you have occasional forehead pain, nausea, dizziness, fatigue, and memory issues, which can be quite concerning. Given the variety of symptoms, it's essential to approach this systematically.

Understanding Your Symptoms
1. Forehead Pain: The pain you're experiencing in your forehead could be tension-type headaches or migraines, especially since you mentioned that it feels like muscle tension pulling towards your brow. Tension headaches are often associated with stress, poor posture, or prolonged screen time, while migraines can be triggered by various factors, including hormonal changes, certain foods, or environmental factors.

2. Nausea and Dizziness: These symptoms can be linked to several conditions, including vestibular disorders, migraines, or even anxiety. The fact that you experience nausea alongside headaches suggests that migraines could be a possibility, especially if the headache is unilateral (one-sided) and accompanied by other symptoms like sensitivity to light or sound.

3. Fatigue and Memory Issues: Chronic fatigue and cognitive difficulties can stem from various causes, including sleep disorders, depression, anxiety, or even chronic fatigue syndrome. Given that you mentioned sleeping excessively at times, it might be worth exploring whether you have a sleep disorder, such as sleep apnea, which can significantly affect your overall health and cognitive function.

4. Physical Symptoms: The feelings of weakness in your limbs and shortness of breath could indicate a more systemic issue, such as anemia or other metabolic disorders. The pale complexion you described could also suggest a potential deficiency in essential nutrients, such as iron or vitamin B12.

When to Seek Help
Given the complexity and variety of your symptoms, it is advisable to seek medical attention. Here are some steps you can take:
1. Primary Care Physician (PCP): Start by visiting your primary care physician. They can conduct a thorough evaluation, including a physical examination and necessary lab tests, to rule out any underlying medical conditions. They can also assess your blood pressure, blood counts, and other vital signs.

2. Neurologist: If your primary care physician suspects that your symptoms are related to neurological issues (like migraines or other headache disorders), they may refer you to a neurologist. A neurologist specializes in disorders of the nervous system and can provide further evaluation and treatment options.

3. Psychiatrist or Psychologist: If anxiety or depression is suspected to be contributing to your symptoms, a mental health professional can help. They can provide therapy and medication if necessary, which can be particularly beneficial if your symptoms are exacerbated by stress or emotional factors.

4. Allergist: Since you mentioned having allergic rhinitis, it might also be worth consulting an allergist. They can help determine if your headaches and other symptoms are related to allergies and provide appropriate management strategies.

Conclusion
In summary, your symptoms warrant a comprehensive evaluation by a healthcare professional. Start with your primary care physician, who can guide you through the process of diagnosis and treatment. It’s essential to keep a detailed record of your symptoms, including their frequency, duration, and any potential triggers, as this information can be invaluable in diagnosing your condition. Remember, early intervention can lead to better outcomes, so don’t hesitate to seek help.

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