Differential Diagnosis for a Teen Waking Up Nauseated with Blurry Vision
Single Most Likely Diagnosis
- Migraine: This condition is common in teenagers and can cause nausea, vomiting, and visual disturbances such as blurry vision or auras. The symptoms often worsen upon waking due to changes in sleep patterns and hormonal fluctuations.
Other Likely Diagnoses
- Viral Gastroenteritis: Although more commonly associated with diarrhea, viral gastroenteritis can cause nausea and vomiting that may lead to dehydration, potentially causing blurry vision due to electrolyte imbalances.
- Sleep Disorders: Conditions like sleep apnea or insomnia can lead to morning nausea and visual disturbances due to poor sleep quality and potential hypoxia.
- Hypoglycemia: Overnight hypoglycemia, especially in diabetic patients, can cause nausea, sweating, and visual disturbances, including blurry vision, upon waking.
- Medication Side Effects: Certain medications, such as those used for depression, ADHD, or birth control, can have side effects that include nausea and visual disturbances.
Do Not Miss Diagnoses
- Diabetic Ketoacidosis (DKA): A serious complication of diabetes that can present with nausea, vomiting, and visual disturbances due to severe hyperglycemia and metabolic acidosis.
- Meningitis: Although less common, meningitis can present with nausea, vomiting, and visual disturbances, along with severe headache and fever. It is a medical emergency.
- Increased Intracranial Pressure: Conditions such as a brain tumor or idiopathic intracranial hypertension can cause morning nausea and visual disturbances, including blurry vision or double vision.
- Carbon Monoxide Poisoning: Exposure to carbon monoxide, especially in poorly ventilated areas, can cause nausea, headache, and visual disturbances, and is potentially life-threatening.
Rare Diagnoses
- Wilson's Disease: A genetic disorder that leads to copper accumulation in the body, potentially causing liver disease, neurological symptoms, and visual disturbances.
- Porphyrias: A group of rare genetic disorders that can cause a variety of symptoms, including nausea, vomiting, and neurological symptoms, sometimes triggered by certain medications or hormonal changes.
- Mitochondrial Myopathies: Rare genetic disorders affecting the mitochondria, which can cause a range of symptoms including muscle weakness, nausea, and visual disturbances due to impaired energy production.