Persistent Headaches and Dizziness: When to Seek Neurological Help

Headache and dizziness for several days?

Doctor, I started experiencing a fever and weakness in my limbs around 11 PM on November 4th.
Since I didn't have a thermometer at home, I assumed I had a fever.
The next day, the fever subsided, but I continued to experience mild dizziness and headaches for several days.
On November 7th, I suddenly developed severe pain in the left back of my head, which also extended to my neck.
The pain felt very tight and intense, unlike anything I had experienced before.
I went to a small clinic where they treated me symptomatically, including prescribing painkillers, but after taking them, my pain worsened instead of improving.
Therefore, I went to a larger hospital to see a neurologist.
During the three-hour wait, the pain in the back of my head persisted and even shifted to my forehead.
Eventually, the headache improved, but I still felt a slight numbness in my head.
The doctor suggested it might be meningitis, so they conducted detailed examinations, but the results ruled out meningitis and showed no other issues.
The doctor prescribed me Periactin, but since my head still felt uncomfortable and my back hurt from a recent bone marrow aspiration, I took the medication immediately.
However, I quickly became dizzy and felt extremely nauseous, to the point where I could barely walk.
The next day, I felt much better upon waking, but I still experienced dizziness and headaches, which have persisted until today.
I just took some painkillers (prescribed by the small clinic), which provided some relief, but after a few hours, the dizziness and discomfort returned.
My current condition includes: 1.
Mild headaches and dizziness for several days now.
2.
Fatigue; I can't seem to get enough sleep no matter how long I sleep.
3.
Severe headache on November 7th, which was unbearable.
4.
Aside from mild cold symptoms and fever on November 4th, I have not experienced any other cold symptoms such as cough, runny nose, or sore throat.
5.
On November 7th, I underwent tests including blood tests, X-rays, CT scans, and a bone marrow aspiration.
I would like to ask the doctor if it is safe to take Periactin given that I already had symptoms of dizziness and headaches, especially since I noticed its side effects include dizziness and nausea.
Additionally, with this persistent dizziness and headache not improving, should I see a doctor again? What could these symptoms indicate? Thank you, doctor.

Lao Wang, 20~29 year old female. Ask Date: 2012/11/09

Dr. Gao Chunde reply Neurology

Acetaminophen is a standard medication for pain relief and fever reduction, and it is one of the least likely medications to cause allergic reactions and side effects.
It is indeed the first-line treatment for dizziness and headaches.
Side effects, such as dizziness and headaches, can occur with almost any medication, but not everyone will experience them, and the incidence of side effects varies among different drugs.
However, they are always listed for reference.
If symptoms persist without improvement, it is important to consult a physician, as there may be other underlying issues causing the lack of progress.
Some conditions may not be clearly identifiable at first, but after some time, a physician may be able to determine the specific problem more definitively.
In the case of a viral infection, it is common to experience dizziness and headaches, but as long as there are no complications such as meningitis or other forms of neuritis, one can focus on resting and recovering.
The body will produce antibodies, which is essential for the restoration of other affected functions.

Reply Date: 2012/11/09

More Info

Based on your detailed description of persistent headaches, dizziness, and other associated symptoms, it is crucial to approach this situation with a comprehensive understanding of potential underlying conditions. Your symptoms, including the sudden onset of severe headaches, neck pain, and feelings of dizziness, warrant careful evaluation by a healthcare professional, particularly a neurologist.

Understanding Your Symptoms
1. Headaches: The nature of your headaches, especially the sudden onset of severe pain on the left side of your head, could indicate several possibilities. While tension-type headaches and migraines are common, the intensity and sudden nature of your pain may suggest a more serious condition, such as a vascular headache or even a secondary headache due to an underlying issue.

2. Dizziness: The dizziness you are experiencing, particularly if it is accompanied by nausea and a feeling of imbalance, can be indicative of several conditions. It could be related to vestibular issues, migraines, or even neurological conditions that affect balance.

3. Neck Pain: The pain radiating to your neck could suggest tension or irritation of the cervical spine or surrounding muscles, which can often accompany headaches. However, it can also be a sign of more serious conditions, such as meningitis or other central nervous system issues.

4. Fatigue and Sleep Issues: Feeling excessively tired and not refreshed after sleep can be linked to various factors, including chronic pain, anxiety, or even sleep disorders. This can exacerbate your headache and dizziness symptoms.

When to Seek Further Help
Given that your symptoms have persisted and evolved, it is advisable to seek further medical evaluation. Here are some considerations:
- Neurological Evaluation: Since you have already undergone some tests, including blood work and imaging studies, it may be beneficial to follow up with a neurologist who can interpret these results in the context of your symptoms. They may recommend additional tests, such as an MRI or EEG, to rule out any serious conditions.

- Medication Review: You mentioned taking medications like "百利寧" (likely referring to a pain reliever). It’s essential to discuss with your doctor whether this medication is appropriate for your symptoms, especially since you are experiencing side effects like dizziness and nausea. Some medications can indeed exacerbate these symptoms, and a review of your current medication regimen may be necessary.

- Symptom Management: In the meantime, managing your symptoms with non-pharmacological approaches may help. Techniques such as relaxation exercises, physical therapy for neck pain, and cognitive behavioral strategies for managing headaches can be beneficial.

Potential Conditions to Consider
While it is impossible to diagnose without a thorough examination, some conditions that could be considered include:
- Migraine: Given the nature of your headaches, migraines could be a possibility, especially if they are unilateral and associated with nausea.

- Tension-Type Headache: This is the most common type of headache and can be exacerbated by stress and muscle tension.

- Cervicogenic Headache: This type of headache originates from the cervical spine and can cause referred pain to the head.

- Intracranial Issues: Although less common, conditions such as intracranial hypertension or other vascular issues could be a concern, especially given the severity of your symptoms.

- Vestibular Disorders: If dizziness is a significant component, vestibular disorders should be considered.

Conclusion
In summary, your symptoms of persistent headaches, dizziness, and fatigue are concerning and merit further investigation. It is advisable to return to a healthcare provider, preferably a neurologist, for a comprehensive evaluation. They can provide a tailored treatment plan based on a thorough assessment of your symptoms and medical history. Remember, timely intervention is key in managing neurological symptoms effectively.

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