Eyelid oedema and headache

A 42-year-old woman developed painless swelling of the upper eyelids (figure, A, arrows). She was seen by doctors who applied topical mydriatic drops, and examined her eyes thoroughly, but found nothing unusual, and made a working diagnosis of an allergic reaction. 3 days later, the patient developed a headache and consulted an orthopaedic specialist and a practitioner of alternative medicine, neither of whom made a specific diagnosis. On day 6, she presented to our hospital. Her medical history was unremarkable and she was not prone to headaches. Blood pressure, body temperature, and routine blood tests were in the normal range. The patient had a body mass index of 32.2.