Differential Diagnosis
- Single most likely diagnosis
- Migraine: The patient has a history of migraines, and her symptoms of headaches, nausea/vomiting, and body aches are consistent with a migraine episode. The fact that darkness helps alleviate her symptoms also supports this diagnosis, as many migraine sufferers find relief in a quiet, dark environment.
- Other Likely diagnoses
- Viral illness (e.g., influenza, viral gastroenteritis): The patient's symptoms of headaches, body aches, and nausea/vomiting could be indicative of a viral illness. The lack of response to Tylenol and the presence of body aches suggest that this could be a possible diagnosis.
- Tension headache: Although the patient has a history of migraines, her symptoms could also be consistent with a tension headache, especially if she is experiencing stress or anxiety.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Subarachnoid hemorrhage: Although unlikely, a sudden and severe headache (often described as "the worst headache of my life") could be indicative of a subarachnoid hemorrhage, which is a life-threatening condition that requires immediate medical attention.
- Meningitis: The patient's symptoms of headaches, nausea/vomiting, and body aches could be indicative of meningitis, especially if she is experiencing fever, stiff neck, or photophobia.
- Temporal arteritis: This condition can cause headaches, nausea/vomiting, and body aches, especially in older adults. If left untreated, temporal arteritis can lead to blindness and other serious complications.
- Rare diagnoses
- Cluster headache: Although rare, cluster headaches can cause severe, one-sided headaches that are accompanied by nausea/vomiting and body aches.
- Trigeminal neuralgia: This condition can cause sudden, severe facial pain that may be accompanied by headaches and nausea/vomiting.
- Idiopathic intracranial hypertension: This condition can cause headaches, nausea/vomiting, and body aches, especially in young, obese women.