Right-Sided Throbbing Pain During Fever: Is It Migraine?

Severe pain in the right side of the head during a fever?

Hello, Doctor.
The first time I experienced sharp pain in my right brain was after giving birth to my first child.
At that time, the pain persisted for several days, with sharp episodes lasting a few seconds.
I consulted a doctor and had an EEG, but nothing was found.
About four years later, I had a fever and cold, and the same sharp pain in my right brain occurred again, with continuous episodes.
A year later, which is now, I caught a viral infection from my son and had a fever, with the same continuous sharp pain in my right brain.
I took medication for two days, which alleviated the pain, but without medication, the sharp pain continues.
I would like to know if this could be classified as a migraine.
Is there a specific medical term for the type of pain I am experiencing? Additionally, I have seen "thunderclap headache" mentioned; does that refer to my symptoms? I have been wondering if something is pressing on my nerves, but two different doctors have said there is no issue.
I still want to know if this pain is truly "idiopathic" pain.
What further examinations would you recommend?

Waiwai, 20~29 year old female. Ask Date: 2015/04/02

Dr. Jiang Junyi reply Neurology

Generally, severe headaches that meet the following characteristics: 1.
Sudden onset, reaching maximum intensity in less than 1 minute; 2.
Lasting from 1 hour to 10 days, with no regular pattern of recurrence in the following weeks or months.
It is recommended to visit a neurology clinic for examination and follow-up.
Wishing you good health and happiness.
Dr.
Jiang Junyi, Taoyuan Medical Center.

Reply Date: 2015/04/02

More Info

Your symptoms of right-sided throbbing pain during fever, particularly after childbirth and during episodes of viral infections, raise several important considerations. Based on your description, it seems that you may be experiencing a type of headache that could be classified as a migraine, especially since you have noted a pattern of throbbing pain that is unilateral (affecting one side of the head).
Migraines are often characterized by intense, throbbing pain that can last from a few hours to several days. They can be accompanied by other symptoms such as nausea, vomiting, and sensitivity to light and sound. The fact that your headaches have recurred during periods of illness, such as when you had a fever or viral infection, suggests that they may be triggered by these systemic conditions.
The term "thunderclap headache" or "lightning bolt headache" typically refers to a sudden, severe headache that reaches maximum intensity within seconds. This type of headache is often associated with serious conditions such as subarachnoid hemorrhage or other vascular issues. However, your description of the pain being intermittent and throbbing rather than a sudden, severe onset may not fit this category.
Given that you have undergone neurological evaluations, including EEGs, and have been told that there is no significant issue, it is possible that your headaches are indeed primary headaches, such as migraines or tension-type headaches, rather than secondary headaches caused by an underlying condition.
However, it is essential to consider other potential causes of your symptoms, especially since you have a history of headaches following childbirth and during viral infections. Hormonal changes, stress, dehydration, and changes in sleep patterns can all contribute to headache frequency and intensity. Additionally, the presence of fever can exacerbate headache symptoms, as the body is under stress from the infection.

To further investigate your condition, I recommend the following steps:
1. Keep a Headache Diary: Document the frequency, duration, intensity, and triggers of your headaches. Note any accompanying symptoms, such as nausea or sensitivity to light. This information can be valuable for your healthcare provider in diagnosing your condition.

2. Consult a Neurologist: If you have not already done so, consider seeing a neurologist who specializes in headaches. They may recommend further imaging studies, such as an MRI or CT scan, to rule out any structural issues that could be contributing to your symptoms.

3. Consider a Comprehensive Evaluation: Since you have experienced these headaches in conjunction with viral infections, it may be worth exploring your overall health, including any potential underlying conditions such as hormonal imbalances or nutritional deficiencies that could be contributing to your symptoms.

4. Lifestyle Modifications: Implementing lifestyle changes such as maintaining hydration, managing stress, ensuring adequate sleep, and avoiding known headache triggers (such as certain foods or environmental factors) may help reduce the frequency and severity of your headaches.

5. Medication Review: Discuss with your doctor the medications you are currently taking for pain relief. Sometimes, overuse of pain medications can lead to rebound headaches, which can complicate the clinical picture.

In summary, while your symptoms may suggest a migraine or another type of primary headache, it is crucial to continue working with your healthcare providers to explore all potential causes and to develop an effective management plan tailored to your specific needs.

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