Nausea and Vomiting

Both nausea and vomiting are very common symptoms and can be caused by a wide range of factors. They occur in both children and adults, although they are probably most common in pregnant women and people undergoing cancer treatments. Vomiting is an uncontrollable reflex that expels the contents of the stomach through the mouth. It is also called “being sick,” or “throwing up.” Nausea is a term that describes the feeling that you might vomit, but are not actually vomiting.

The most common causes of nausea are intense pain — usually from an injury or illness — and the first trimester of pregnancy. There are also a number of other relatively common causes, including: motion sickness / emotional sickness / indigestion / food poisoning / viruses / exposure to chemicals or toxins.  According to Dr Winnie Lim Khoo, Neurologist; The most common causes of vomiting in children are viral infections and food poisoning.  However, vomiting can also be caused by: severe sickness / coughing / high fever / overeating.

Chronic (long-term) stomach conditions can often cause nausea and vomiting, along with other symptoms, such as diarrhea, constipation, and stomach pain. These chronic conditions include food intolerances, such as gluten intolerance (celiac disease), and dairy protein and lactose intolerance.

Irritable bowel syndrome (IBS) is a common stomach condition that causes bloating, nausea, vomiting, heartburn, fatigue, and cramping. It occurs when parts of the gut becoming overactive. Doctors usually diagnose IBS by identifying symptoms and ruling out other stomach and bowel conditions.

Though rare, vomiting can sometimes occur as a symptom of a more serious condition, including:

• meningitis
• appendicitis
• concussion
• a brain tumor
• migraine headaches

Before prescribing medication, you doctor will ask questions about when the nausea and vomiting began and when it’s at its worst. They may also ask you about your eating habits and whether anything makes the vomiting and nausea better or worse. A number of prescription medications can control nausea and vomiting, including medications you can use during pregnancy.

Ménière’s Disease

Meniere’s disease symptoms tend to come on as “episodes” or “attacks.” Most people with Meniere’s disease don’t experience symptoms between episodes. Symptoms of Meniere’s disease include: vertigo (attacks can last anywhere from a few minutes to 24 hours)

 

• loss of hearing in the affected ear
• tinnitus (a sensation of ringing) in the affected ear
• a feeling of fullness in the affected ear
• loss of balance
• headaches
• nausea, vomiting, and sweating caused by severe vertigo

 

Meniere’s disease is a disorder that affects the inner ear. The inner ear is responsible for your balance, as well as hearing. This disorder causes vertigo (a sensation of spinning), hearing problems, and a ringing sound in the ear. Meniere’s disease usually affects only one ear.

Meniere’s disease is a chronic (long-term) disease, but treatments and lifestyle changes can help to ease the symptoms. Many people diagnosed with Meniere’s disease will go into remission within a few years after their diagnosis.

Neurologist may prescribe medication to help with the symptoms of Meniere’s disease. Motion sickness medicines can be used to ease symptoms of vertigo, nausea, and vomiting. If nausea and vomiting is a problem for you, your doctor may prescribe an antiemetic (anti-nausea medication).

Ménière’s Disease

Vertigo & Dizziness

Vertigo is when a person feels like they are moving when they are not. Often it feels like a spinning or swaying movement.

There may be associated nausea, vomiting, sweating, or difficulties walking. It is typically worsened when the head is moved. Vertigo is the most common type of dizziness

The most common diseases that result in vertigo are benign paroxysmal positional vertigo, menieres disease and labyrinthitis. Physiologic vertigo may occur following being exposed to motion for a prolonged period such as when on a ship or simply following spinning with the eyes closed. Other causes may include toxin exposures such as to carbon monoxide, alcohol or aspirin. Vertigo is a problem in a part of the vestibular system. Other causes of dizziness include presyncope, disequilibrium and non-specific dizziness. Vertigo is classified into either peripheral or central depending on the location of the dysfunction of the vestibular pathway, although it can also be caused by psychological factors.

Dizziness affects approximately 20%-40% of people at some point in time while about 7.5%-10% have vertigo. About 5% have vertigo in a given year. It becomes more common with age and affects women two to three times more often than men.

 

Rebound Headache

While over-the-counter medicines are helpful in improving headache pain, they must be taken with caution because they could actually make your headaches worse if they aren’t taken correctly. The overuse or misuse of analgesic medications — exceeding labeling instructions (such as taking the medications three or more days per week) or not following your physician’s advice — can cause you to “rebound” into another headache. When the pain medication wears off, you may experience a withdrawal reaction, prompting you to take more medication, which only leads to another headache and the desire to take more medication. And so the cycle continues until you start to suffer from chronic daily headaches with more severe headache pain and more frequent headaches.

Analgesic overuse appears to interfere with the brain centers that regulate the flow of pain messages to the nervous system, worsening headache pain.

According to Adult Neurologist, Dr Winnie Khoo; This rebound syndrome is especially dangerous if your medication contains caffeine, which is often included in many medications to speed up the reaction of the other ingredients. While it can be beneficial, caffeine in medications, combined with consuming caffeine (coffee, tea, soft drinks, or chocolate) from other sources, makes you more vulnerable to a rebound headache.

In addition to the rebound headache, overuse of analgesics can lead to addiction, more intense pain when the medication wears off, and possible serious side effects.

Altitude Headache

This headache is especially common in individuals who climb mountains and ski at high altitudes. It may be seen in acute mountain sickness along with other primary symptoms of pulmonary edema and cerebral edema. The headache is seen at high altitudes (above 8,000 feet and with increasing frequency as elevation increases) and is usually associated with low oxygen levels.

The headache is described as generalized and throbbing and is aggravated by exertion, coughing, and lying down. The headache usually appears from 6 to 96 hours after arriving at high altitudes.

On examination, patients may have retinal hemorrhages, papilledema, and confusion. Relief of headache is obtained by descending to lower altitudes. Ergotamine may be effective, but oxygen inhalation is especially effective according to neurologist – Dr Winnie Sharon Lim Khoo

Cough Headache

Cough headache is considered by some to be a form of exertional headache and is sometimes grouped together with other headaches described as “sneezing headache” and “laughing headache.” The International Headache Society defines cough headache as a headache that is felt in both sides if the head, which is of sudden onset, that lasts less than 1 minute, is brought on by coughing, and can be prevented by avoiding coughing. The most common triggers of cough in children are chronic bronchitis, asthma, and cystic fibrosis.

Exercise Headache

Exertional headaches are brought on by strenuous activities, such as running, swimming, or weight lifting, as well as sexual activity.  It  occur during or after sustained, strenuous exercise. Doctors divide exercise headaches into two categories. Primary exercise headaches are usually harmless, aren’t connected to any underlying problems and can often be prevented with medication.

Secondary exercise headaches are caused by an underlying, often serious problem within the brain — such as bleeding or a tumor — or outside the brain — such as coronary artery disease. Secondary exercise headaches may require emergency medical attention.

Treatment of these headaches should be conservative according to Dr Winnie Lim Khoo, An adult neurologist in Manila. In many patients, headaches disappear spontaneously. Long-acting nonsteroidal anti-inflammatory drugs, such as indomethacin, can be used chronically and/or prior to specific activities. If indomethacin is taken chronically, monitoring for side effects is mandatory.

If headaches occur only with exertion and are not associated with neurologic signs or symptoms, imaging studies may not be necessary. If neurologic signs and symptoms are present, medical evaluation is needed.

Sinusitis & Headache

Many people think their headaches are due to sinusitis, but this isn’t usually the case. Although headaches can be a symptom of sinusitis, sinusitis is a distinct medical condition. Sinusitis is an inflammation and/or infection of the sinuses. Some of the causes include allergies, smoke, respiratory infections and immune deficiency. Sinusitis may have a sudden onset and be of short duration or can be a chronic condition, characterized by at least four recurrences of sinusitis or infection that last 12 weeks or longer.

Common symptoms of sinusitis include facial pain/pressure, nasal blockage and pus discharge, and frontal headache. Other symptoms include fever, bad breath, and fatigue.

The clinical diagnosis of sinusitis can be based on symptoms or, even better, confirmed by nasal endoscopy or a CT scan of the sinuses. Treatments include decongestants and antibiotics.

Cluster Headache

A cluster headache may cause sharp, severe pain on one side of the head at the temple. The pain may also occur around the eye. The eye and nostril on the affected side of the head may water, and the sufferer may become restless as well. The pain usually lasts between 30 and 60 minutes. The headaches occur frequently for 1 to 3 months, then do not occur again for months or even years, according to Winnie Lim Khoo MD a Neurologist from Manila Philippines.

In contrast to people with migraine headache, perhaps 5-8 times as many men as women have cluster headache. Most people get their first cluster headache at age 25 years, although they may experience their first attacks in their teens to early 50s.

2 types of cluster headache:

Episodic: This type is more common. You may have 2 or 3 headaches a day for about 2 months and not experience another headache for a year. The pattern then will repeat itself.

Chronic: The chronic type behaves similarly but, unfortunately, you get no period of untreated sustained relief

Health Conditions Linked to Migraine

If you get migraine headaches, you may be at risk for heart attack, stroke, and other health conditions. Find out more to protect your health.

If you are one of the people with migraines, you already know that these headaches can cause pain, misery, and missed days from work, but you may not know that a growing body of research suggests they may also increase your risk for other conditions including :

Depression and Anxiety. When it comes to the relationship between migraine and psychological illnesses such as depression and anxiety, the migraine is both the chicken and the egg, says Dr Winnie Sharon Lim Khoo, a neurologist.

Cardiovascular Disease. Up to one-third of people with migraineexperience an aura preceding their headache — some type of visual disturbance such as flashing lights or a temporary loss of vision. Some research shows that migraine with aura may put you at greater risk for cardiovascular disease, including heart attack and stroke. One study, also presented at the 2013 American Academy of Neurology meeting, looked at data on more than 27,000 women participating in The Women’s Health Study and found that it was one of the top risk factors for heart disease and stroke among women, second only to high blood pressure.

Epilepsy. Both migraine and the seizure disorder epilepsy are characterized by brain excitability, says Dr Winnie Lim Khoo “Whichever you have first, whether epilepsy or migraine, you are twice as likely to get the other,”.

Allergies. If you have nasal allergies, you may be more likely to also get migraines, Dr Lim Khoo explains. The reason is that the trigeminal nerve, which is involved in causing migraine also supplies the nasal mucosa. “Nasal allergies occur when there is irritation or inflammation of the nerve by allergens which leads to itchy, runny nose,”