NR603 Week 1 PBL Case Discussion: Neurologic Disorders - Part One

Patient: Christopher

Further Questions for Christopher:

1. Duration of Headaches:
   • How long do your headaches typically last?
   • Do you wake up with headaches?
   • Are they of sudden onset or do they gradually build up?
2. Activity During Headache Onset:
   • What are you usually doing when your headaches start?
   • Do you notice if they are triggered by stress or anxiety?
   • Do your headaches occur during or after activities such as reading or using the computer?
3. Relief Measures:
   • What do you usually do to relieve the pain?
   • Does resting in a dark room or sleeping help reduce the pain?
4. Medication Usage:
   • Do you take any over-the-counter (OTC) medications for your headaches?
   • If so, do they provide relief?
5. Pain Assessment:
   • How would you rate the pain of your headaches on a scale of 0 to 10?
6. Additional Symptoms:
   • Is there a family history of migraines?
   • Do you experience any sensitivity to light or sound when you have a headache?
   • Do you see flashes of light or have any visual changes before your headache starts?
   • Do you experience blurred vision or other vision changes?
7. Frequency of Headaches:
   • How many headaches do you get in a day, week, or month?
8. Mental Health and Stress:
   • Do you feel depressed, anxious, or stressed?
   • How often do you use the computer, cellphone, or engage in activities like reading?

Differential Diagnosis List:

1. Migraine Headache:
   • Rationale: Migraines are often accompanied by visual disturbances (flashes of light), sensitivity to light and sound, and are typically relieved by resting in a dark room or sleeping. Christopher’s headaches might fall into this category if these symptoms are present, especially if there is a family history of migraines.
2. Tension Headache:
   • Rationale: Tension headaches are usually associated with stress, anxiety, and muscle tension, and they might be relieved by OTC medications. If Christopher reports that his headaches are related to stress or anxiety, this could be a likely diagnosis.
3. Eye Strain (Asthenopia):
   • Rationale: Eye strain-related headaches can occur after prolonged use of digital screens or reading. If Christopher experiences headaches during or after such activities, this diagnosis should be considered.
4. Cluster Headache:
   • Rationale: Cluster headaches are characterized by severe, unilateral pain, often around the eye, and can occur in cycles. If Christopher reports that his headaches are localized and follow a pattern, this diagnosis might be relevant.
5. Sinus Headache:
   • Rationale: If Christopher reports symptoms such as facial pain or pressure, nasal congestion, or headaches that worsen with bending forward, sinusitis could be a potential cause.