Differential Diagnosis
- Single most likely diagnosis
- Viral syndrome (e.g., influenza, viral meningitis): The combination of headache, body aches, photophobia, and dizziness with standing suggests a viral infection. The burning sensation in bilateral hands could be related to a viral neuropathy or a systemic viral infection.
- Other Likely diagnoses
- Migraine: The headache, photophobia, and dizziness could be indicative of a migraine episode. However, the presence of body aches and burning sensations in the hands makes this diagnosis less likely.
- Medication overuse headache: If the patient has been taking pain medications for an extended period, they may be experiencing a medication overuse headache, which could be exacerbated by the burning sensations in the hands.
- Fibromyalgia: The body aches and burning sensations in the hands could be indicative of fibromyalgia, but the acute onset and presence of photophobia make this diagnosis less likely.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid hemorrhage: Although the patient's symptoms do not strongly suggest a subarachnoid hemorrhage, the sudden onset of headache and photophobia warrants consideration of this diagnosis.
- Meningitis (bacterial or fungal): The combination of headache, photophobia, and dizziness could be indicative of meningitis, which requires prompt medical attention.
- Stroke or transient ischemic attack (TIA): The dizziness with standing and burning sensations in the hands could be indicative of a stroke or TIA, particularly if the patient has a history of cardiovascular disease.
- Rare diagnoses
- Guillain-Barré syndrome: The burning sensations in the hands and dizziness with standing could be indicative of Guillain-Barré syndrome, an autoimmune disorder that requires prompt medical attention.
- Complex regional pain syndrome: The burning sensations in the hands could be indicative of complex regional pain syndrome, a rare condition characterized by chronic pain and inflammation.
- Sjögren's syndrome: The burning sensations in the hands and dryness of the eyes (if present) could be indicative of Sjögren's syndrome, an autoimmune disorder that affects the exocrine glands.