# Co-occurrence of Primary Headache and Tremor in a Young Woman: A Case Report

## TL;DR

A young woman experienced a rare combination of headache and tremor, which was diagnosed as a functional disorder and quickly treated with clonazepam.

## Contribution

This case highlights the atypical co-occurrence of primary headache and tremor, emphasizing the need to consider functional disorders in differential diagnosis.

## Key findings

- The patient exhibited a 5-Hz resting and postural tremor in the right upper limb.
- Symptoms resolved rapidly after clonazepam treatment, suggesting a functional disorder.
- MRI and blood tests did not reveal organic causes, supporting a diagnosis of tremor associated with primary headache.

## Abstract

This case report describes a 28-year-old woman presenting with right temporal headache and tremor of the right hand. She had a history of menstrual-related, nonthrobbing headaches but no prior tremors or visual symptoms. Neurological examination revealed a 5-Hz resting and postural tremor in the right upper limb, hyperreflexia, and normal cognitive function, with unremarkable magnetic resonance imaging findings. Blood tests showed euthyroidism and elevated inflammatory and lipid markers. Surface electromyography confirmed the tremor. The patient was diagnosed with tremor associated with primary headache and responded rapidly to clonazepam, with symptom resolution the next day. This case underscores the diagnostic difficulties presented by the atypical co-occurrence of primary headache and tremor. It highlights the importance of considering functional disorders in the differential diagnosis when encountering such presentations, alongside a thorough exclusion of organic causes.