Differential Diagnosis for Seeing Lights Brighter for 5 min when Fatigued in a 22-year-old Man
- Single most likely diagnosis:
- Migraine aura: This condition can cause visual disturbances, including seeing lights or auras, which can be triggered by fatigue. The transient nature (5 minutes) and the specific trigger (fatigue) align with migraine characteristics.
- Other Likely diagnoses:
- Ocular migraine: Similar to migraine aura but typically involves one eye and can cause seeing brighter lights or other visual disturbances.
- Fatigue-induced visual disturbance: Prolonged fatigue can lead to various visual disturbances due to the brain's decreased ability to properly process visual information.
- Dry eyes: Can cause visual disturbances, including sensitivity to light, which might be exacerbated by fatigue.
- Do Not Miss diagnoses:
- Hypoglycemia: Low blood sugar can cause visual disturbances, including blurred vision or seeing lights, and is critical to diagnose due to the risk of severe hypoglycemia.
- Hypertension crisis: Although less common in a 22-year-old, a sudden increase in blood pressure can cause visual disturbances, including seeing lights or flashes, and is a medical emergency.
- Retinal detachment: Symptoms can include sudden flashes of light and are a medical emergency requiring immediate attention.
- Rare diagnoses:
- Occipital lobe seizure: Rarely, seizures can present with visual disturbances, including seeing lights or colors, without other typical seizure symptoms.
- Vitamin deficiencies (e.g., Vitamin B12): Certain deficiencies can cause neurological symptoms, including visual disturbances, though these would typically be part of a broader spectrum of symptoms.
- Multiple sclerosis: An autoimmune disease that can cause a wide range of neurological symptoms, including visual disturbances, though it would be unusual for this to be the only symptom.