Headaches / Dizziness Post Virus

by Andrew
(Phoenix, AZ)

Mary Kay,

My name is Andrew, I am a 23 year old Male (6'0 , 150lbs). I have always had migraines, when they are bad maybe 3 times a week. Medication(OTC) doesn’t help much, normally the best cure is just to sleep them off. I had an MRI about 3 years ago, it came back normal.

About a month ago I started getting dizzy at work and that developed into a fever, loss of appetite, light sensitivity, and a feeling of being in a "dream state". I got general blood/urine tests done as well as thyroid and mono tests. They all came back normal (the mono test came back that I have had it before but not currently). My Doctor and the urgent care physician both believe it was just a virus. I had these symptoms for 2 weeks, and then felt pretty normal for a week.

After that week I decided it was ok to get some exercise and played kickball for about 2 hours. I felt fine afterwards but the next day I started getting the feeling of not being present (feeling like I was in a dream). It seemed like my eyes just took an extra millisecond to focus on objects. During this time I also began to experience a new kind of headache or sensation, it feels like a brain freeze but at the back of my head/neck. This wasn’t brought on by an cold drinks/foods. This dream state went for about 5 days, it would start about an hour after I woke up and would last for about 8 hours.

That feeling went away and I felt normal again for another week and then 4 days ago I drank alcohol for the first time since the start of all this and got very hungover the next day (something that never happened to me normally) from about 4 beers. Since then I have been feeling light headed and getting dizzy spells where my eyes seem to have trouble focusing again. I also have daily headaches including those 'brain freeze' ones I described on the back of my neck/head.

I am not really sure what to do from here, do I need another MRI? I have undiagnosed anxiety issues (I get nervous for things like work for no reason, I avoid weekend trips as I am afraid I might get sick and be in unfamiliar area, etc). I am sure the anxiety doesn’t help this either. Any help or suggestions would be greatly appreciated!



Hi Andrew,

Post viral syndrome in a migraineur can result in a sense of disequilibrium that can last for several weeks. In the world of neurology, there is no 'dizziness' rather lightheaded which is feeling faint, vertigo where the room spins, of disequilibrium ..a sense of feeling off balance or even mildly drunk.

Feeling like you are in a dream like state that lasted 8 hours is most probably mild anxiety. Seizures can also have a prodrome of feeling outside yourself or being in a dream but that lasts for only a few minutes, not 8 hours.

About 85-90% of migraineurs have anxiety to some degree so I would suggest that you see a neurologist and discuss treatments that may effectively get both under control.

Having 3 migraines a week is way too frequent. Control of migraine is considered one a month or so. More than 12 uncontrolled migraines per year increases the risk of stroke. The neurologist will probably suggest you be on some medication for a short amount of time to get these under better control. Once you are down to one a month then the medication is usually stopped.

Keep exercising as that will not only help the migraines but also the anxiety!

Good luck,
Mary Kay Betz MS RPA-C

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