Kazakh neurologist Altyn Kamalovna shared an unusual clinical case on the social network Threads: she asked colleagues to identify a patient's diagnosis based on symptoms, sparking keen interest among medical professionals, reports infohub.kz.
"So, the patient is 50 years old. For many years, every month for five to seven days she gets severely 'rocked': she can't walk properly, grabs onto walls. At the same time, a pulsating pain appears in one half of her head, 10/10, nausea, vomiting, light and sounds irritate her," the doctor described the symptoms.
She also clarified that every month the patient receives 'vascular' IV drips and then takes piracetam. After a week, everything passes. Brain MRI is normal, osteopaths didn't help.
"What do you think is wrong with her?" Altyn Kamalovna wondered, promising to post the answer later.
Doctors who joined the "game" offered quite a few diagnoses. Among them were positional vertigo, vascular compression, hernias, aseptic lesions and swelling of the vertebrae. They suggested cluster headache, hormonal imbalance, menstrual migraine, and even low ferritin.
However, the author of the post noted in a comment that low ferritin (iron) doesn't cause headaches.
It's worth noting that five doctors managed to make the correct diagnosis based on the description of symptoms. After that, the neurologist published the correct diagnosis.
"The patient has vestibular migraine. Unilateral pulsating headache, nausea, vomiting, photophobia and phonophobia plus pronounced dizziness," the doctor reported.
She also emphasized that 'vascular' IV drips are not needed for this diagnosis. And the fact that she felt better after a week of drips didn't mean they were what helped. The migraine episode was simply ending.
"What's needed? Properly abort the attack. And if the attacks are frequent or significantly disrupt life, select preventive treatment," she concluded.
Earlier, neurologist Aliya Sagindykova explained how to distinguish migraine from tension headache using an ordinary self-monitoring diary.