Differential Diagnosis for "Comes and Goes. Switches Sides"
- Single Most Likely Diagnosis
- Migraine: This condition is characterized by episodic headaches that can switch sides and vary in intensity, often accompanied by other symptoms like nausea, vomiting, and sensitivity to light and sound.
- Other Likely Diagnoses
- Cluster Headaches: These are severe headaches that occur in cycles or clusters, can switch sides, and are often accompanied by nasal congestion or eye watering on the same side as the headache.
- Tension Headaches: While typically bilateral, tension headaches can occasionally switch sides and are known for their fluctuating intensity.
- Sinus Headaches: These can switch sides depending on which sinus is affected and can come and go with changes in sinus pressure or infection.
- Do Not Miss Diagnoses
- Temporal Arteritis: Although less common, this condition can cause headaches that switch sides and is a medical emergency due to the risk of vision loss if not promptly treated.
- Subarachnoid Hemorrhage: A severe headache that can change sides due to the spread of blood in the subarachnoid space, often described as "the worst headache" of the patient's life.
- Meningitis: Inflammation of the protective membranes covering the brain and spinal cord, which can cause severe, fluctuating headaches that may switch sides, along with fever, neck stiffness, and other symptoms.
- Rare Diagnoses
- Hemicrania Continua: A rare form of headache that can switch sides and is characterized by a continuous, fluctuating headache with periods of exacerbation.
- Trigeminal Neuralgia: While typically unilateral, in rare cases, it can switch sides and is known for causing intense, shock-like or stabbing pain in parts of the face.
- Occipital Neuralgia: Involves the nerves that run from the base of the skull to the scalp and can cause pain that switches sides, though this is less common.