Frequent Migraines with Nausea: When to Seek Medical Help?

Chronic headaches accompanied by vomiting?

Hello, I would like to ask about my condition.
I have a history of migraines, but in recent years, they have become more frequent, occurring at least once a week, and sometimes the pain is severe enough to cause vomiting.
The headache is usually on the left side, and at times, I also feel a tight sensation in my left eye.
Which specialist should I consult? I recently underwent surgery for a malignant thyroid tumor, but the symptoms mentioned above were present before the surgery.

Ru, 20~29 year old female. Ask Date: 2022/01/29

Dr. Ye Qianyu reply Family Medicine

Hello! Based on your description, I recommend that you visit a neurologist for a comprehensive evaluation and to understand how to manage your headache issues through diet, lifestyle, and medication.

Reply Date: 2022/01/29

More Info

Frequent migraines accompanied by nausea can be distressing and may indicate a need for medical evaluation, especially given your history of thyroid malignancy. Migraines are a common neurological condition characterized by recurrent headaches, often accompanied by nausea, vomiting, and sensitivity to light and sound. However, when migraines become more frequent or severe, it is essential to assess whether there are underlying issues that need to be addressed.

Given your situation, it is advisable to consult a neurologist. Neurologists specialize in disorders of the nervous system, including headaches and migraines. They can conduct a thorough evaluation, which may include a detailed medical history, a physical examination, and possibly imaging studies such as an MRI or CT scan to rule out any serious underlying conditions, especially considering your recent surgery for thyroid cancer.

The frequency of your migraines—at least once a week—and the associated symptoms of nausea and tightness in your left eye warrant attention. While migraines can cause nausea, the presence of these symptoms could also suggest other conditions, such as increased intracranial pressure or other neurological issues. It is crucial to differentiate between typical migraine symptoms and those that may indicate a more serious problem.

In addition to seeking a neurologist's opinion, you should also inform your healthcare provider about your history of thyroid cancer and any recent treatments you have undergone. This information is vital as it may influence the diagnostic process and treatment options. For instance, certain treatments or medications you are on for your thyroid condition could potentially contribute to your migraine frequency or severity.

If you experience any of the following symptoms, you should seek immediate medical attention:
1. Sudden onset of a severe headache: Often described as a "thunderclap" headache, this could indicate a serious condition such as a hemorrhage.

2. Neurological symptoms: Such as weakness, numbness, difficulty speaking, or changes in vision, which could suggest a stroke or other neurological disorder.

3. Persistent vomiting: That does not improve with typical migraine treatments.

4. Changes in headache pattern: Such as an increase in frequency or intensity, or a change in the nature of the headache.

5. Confusion or altered consciousness: This could indicate a more serious underlying condition.

In terms of managing your migraines, there are various treatment options available, including lifestyle modifications, preventive medications, and acute treatments for migraine attacks. Keeping a headache diary can also be beneficial in identifying triggers and patterns, which can help your healthcare provider tailor a treatment plan specific to your needs.

In summary, given the increase in the frequency of your migraines and the associated symptoms, it is essential to seek a consultation with a neurologist. They will be able to provide a comprehensive evaluation and determine the best course of action to manage your migraines effectively while considering your medical history.

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