Headaches, dizziness, olfactory hallucinations, fatigue, insomnia, swollen lymph nodes , nose bleeds. Have no idea what is wrong. Need help asap please.

Headaches, dizziness, olfactory hallucinations, fatigue, insomnia, swollen lymph nodes ,unexplained nose bleeds.

I'm an 18 year old female.I've been experiencing the above symptoms for a quite a while, with the occasional "feeling of bugs crawling all over me" and smelling non-existent food. I'm having trouble concentrating. I have sharp pains at certain points on my head and everythings goes bright and I feel like I'm going to fall. Or when I get up I feel shaky and dizzy. I take paracetamol ( in very small doses, like half a tablet) for the headaches, but then I get nosebleeds (only form my left nostril) . I'm tired all the time and I still can't go to sleep. My lymph nodes under my neck are swollen and I have urticaria. I need an answer. My mum thinks I'm imagining it. I thought so too, but now I'm not too sure. It's getting worse everyday. Thank you for your time.

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

You mention multiple symptoms, some of which are difficult to tie together, and others which are unlikely to have a direct neurologic cause.

Swollen lymph nodes suggest a systemic infectious process, such as a virus, or certain bacterial infections. The same infection could potentially explain the headaches and dizziness as well. Other potential causes of fatigue in someone your age include anemia (low blood counts), hypothyroidism (thyroid is not functioning well), other endocrine disorders, and vitamin deficiencies (such as vitamin B12).

Regarding your headaches there are several causes of headaches. Headaches can be divided into primary and secondary. Primary headache disorders are headaches without a direct cause. These are diagnosed after secondary causes have been excluded. Secondary headache disorders are due to an underlying problem, there are many many causes but some include medication side effects, systemic illness, nervous system infection, tumors, bleeds in the brain or clots in the veins of the brain, and others. Primary headache disorders are much more common than secondary ones. There are several primary headache disorders, over 50 different types.  For example migraines, which usually a pulsating throbbing one-sided pain with nausea and discomfort in bright lights that lasts several hours. Another type is tension type headache, which is common in young adults such as your self.

In general, when headaches are occuring, seeing a neurologist is a good idea, just to make sure there is nothing serious causing this pain. Imaging of the brain and sometimes then neck may be indicated depending on your exact symptoms, your physical examination, and other factors, particularly if you are having consistent olfactory hallucinations. Olfactory hallucinations can be due to seizures, though they also may be of psychiatric cause.

Sometimes, when there are so many symptoms that do not tie together or seem to have a specific cause, depression should be considered. Sometimes, when people are depressed, instead of feeling depressed, they have physical symptoms. However, this should of course be considered in the context of all your other symptoms and signs. Evaluation by an internist (general practioner, family physician) is recommended with referral to a specialist as indicated.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.