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what is the differential diagnosis for the following info: 26-year-old female patient who came to the clinic for worsening in intensity and frequency of non-radiating, intense, throbbing-type headaches specifically at left behind the patient’s eye that can last the whole day (15 hours) for the past few months. At present the headache happens more often, every 1 to 2 weeks, increasing in the intensity of pain. It usually starts with 2-3 out of 10 pain scale and would progress to 8/10 and at times it could go up till 10/10 accompanied by nausea and vomiting. Prior to the onset of the headaches, patient’s vision, in both eyes, although still intact, gets spotty (a bunch of zig-zaggy flashing lights. Nonetheless, her eyes were swollen or watery. The headache is usually aggravated by light, noise and stress(due to graduate studies and being a parttime waitress).It is often relieved by lying down in a dark quiet room sleep it off. In the past patient would take Acetaminophen or Ibuprofen for pain, but lately since there is an accompanying nausea and vomiting(typical, no blood or dark appearing particles seen) every time she’s experiencing headaches, she’s unable to swallow the pill. PMH include occasional headaches one to two per month for 10 years. Childhood illnesses include – coughs, colds, tummy aches. Family history reveals mother having the same course of headaches; father and grandparents on both side – unknown ; no child or siblings. Patient has NKDA.
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