iCliniq Logo
HomeAnswersNeurologymigraine

I have pain and pressure in head with weakness and dizziness in legs. Why?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I am a 51-year-old female. My symptoms are triggered by any physical exertion even just walking to the bathroom. I have pain and pressure in the head, weakness in the legs, dizziness, and pain in the center of the chest. It lasts for thirty minutes to three hours. I have done an MRI of the head, a CT scan of the chest, EKG, ECHO, blood work, nuclear stress test, and heart catheterization. I am taking Prozac currently. All the results were negative. Please suggest.

Answered by Dr. Hitesh Kumar

Hi,

Welcome to icliniq.com.

I would like to know some further details about your symptoms. Please mention about the duration of headache, kind of headache whether it is heavy or stretching or squeezing or throbbing, part of the head where you feel headache, do you have nausea or vomiting during headache, do you have a headache with redness in eyes or watering from eyes or nasal blockage, any kind of physical activity that triggers your symptoms, how frequent you have a headache, the intensity of headache whether it is mild, moderate or severe.

Please mention about the chest pain. Please mention whether you have chest pain with heaviness or pricking or tightness, do these pain present with fast heartbeats, do these chest pain occur along with headache and dizziness episodes, mention the reason for taking Prozac (Fluoxetine) and its dose, do you take medicine for headache, how is your vision at this condition. Please mention about your sleep whether it is routine, or do you take a long time to sleep, do you have frequent awakening during sleep, or do you feel fresh on awakening from sleep in the morning. Please mention about the usual mood in the day to day activities and appetite.

Investigations to be done

You need to do T3 (triiodothyronine), T4 (thyroxine), TSH (thyroid-stimulating hormone), serum Vitamin B12, and serum Vitamin D3.

Treatment plan

As you mentioned, many of the tests pertaining to the heart and brain are normal. There may be a possibility that headache can be a primary headache and chest pain symptoms can be due to non-organic or psychological factors associated. Please revert with detailed information about your symptoms.

Regarding follow up

Please revert with above mentioned information for better understanding and further judgement.

Patient's Query

Thank you doctor,

I have it after detoxing Hydrocodone before six months. I am attaching the picture. My headache is present in combination with squeezing or throwing or bursting. My headache is episodic and lasts for thirty minutes to three hours. I have nausea with episodes. I do not have headaches associated with watery eyes. My symptoms are triggered by physical exertion like walking upstairs or even walking to the bathroom. Sometimes, I have severe pain in the head along with weakness in the legs, dizziness, blurry vision, and chest pain. These symptoms get triggered at least one time a day. My intensity is severe.

Chest pain is present with episodes and it started before six months and it is getting progressively worse. I have heaviness and tightness during chest pain. All these symptoms happen at the same time with each episode. I am taking Prozac for 20 years for anxiety. I am taking Valium PRN along with it. My vision is good and during episodes, it is blurry. It takes a long time to fall asleep and I wake for two to three times for urination. The mood is good during day time and I have a good appetite.

Answered by Dr. Hitesh Kumar

Hi,

Welcome back to icliniq.com.

Along with symptoms and MRI (magnetic resonance imaging) brain, you might be having migraine headache or tension-type headache or a mixture of both. Along with this, you can have depression and anxiety issues and it may trigger your headache.

You can take some regular medications for prophylaxis of these headaches. You can get migraine prescription online which includes Propranolol sustained release 20 mg twice daily. For anxiety issues, you can take Etizolam 0.25 mg twice daily. For the depression issue, you are already taking Prozac 40 mg once a day, but it is not sufficient and you can try adding Amitriptyline 25 mg once at bedtime and Prozac (Fluoxetine) 40mg once daily. For getting relief from pain, you can take a simple NSAID (instead of Tramadol), you can take a tablet Naproxen 500 mg once in the morning and one in the evening when you have severe intensity headache. You can discuss these with your treating neurologist or psychiatrist.

Investigations to be done

You need to do T3, T4, TSH, Serum Vitamin B12, Serum Vitamin D3, ANA (antinuclear antibody) IFA (indirect fluorescent antibody) Method, ds-DNA (double-stranded DNA), and ENA (extractable nuclear antigen antibodies) profile.

Differential diagnosis

You can have a tension-type headache or migraine Headache or mixed anxiety and depression

Probable diagnosis

You need to do T3, T4, TSH, Serum Vitamin B12, and Serum Vitamin D3.

Treatment plan

You can take some regular medications for prophylaxis of these headaches. You can get migraine prescription online which includes Propranolol sustained release 20 mg twice daily. For anxiety issues, you can take Etizolam 0.25 mg twice daily. For the depression issue, you are already taking Prozac 40 mg once a day, but it is not sufficient and you can try adding Amitriptyline 25 mg once at bedtime and Prozac (Fluoxetine) 40mg once daily. For getting relief from pain, you can take a simple NSAID (instead of Tramadol), you can take a tablet Naproxen 500 mg once in the morning and one in the evening when you have severe intensity headache. You can discuss these with your treating neurologist or psychiatrist.

Preventive measures

Along with this, you can meet a psychologist for counseling sessions for your mental health. Also, start doing some physical exercise like simple jogging in the morning daily for 20 to 30 minutes. Exercise is very helpful in all these issues (anxiety, depression, tension headaches, and migraine headache. It helps in sleep.

Regarding follow up

You can try the above-mentioned medicines (after discussing with your treating neurologist & psychiatrist), meet a psychologist for counseling sessions and start jogging exercises and update me after two weeks of it. We will discuss further based on the response to the above measures.

Answered byDr. Hitesh Kumar

Medically reviewed byDr. K. Shobana

Published At January 13, 2021
Reviewed AtJanuary 2, 2024

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hitesh Kumar
Dr. Hitesh Kumar

Neurology

Consult this doctor
Listen to related tracks in our music library

Related Questions

Anxiety is every day of my life. Rarely I do get a small break without anxiety. It has been 10 years.

I feel a tight band like pressure on my head while wearing specs. Why?

My sister has a headache that does not subside with pain medications. Please help.

Generalized Anxiety Disorder(GAD)

Which specialist should I consult for one side headache?

I have sweaty palms and feet with nausea and headache every morning. Please help

Read answers about:

migrainetension type headacheanxiety

Ask your health query to a doctor online

Neurology

*guaranteed answer within 4 hours

Trustpilot

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.