darkhorse
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A 24-year old nurse calls your office. She has had four episodes of an excruciating right-sided headache in the last six months. Twice there was an associated tingling of the left side of the face and left hand. The pain, which is throbbing, builds up over an hour or two until she is forced to lie down in a dark room. She experiences nausea and vomiting, and blurred vision. The headache usually subsides once she is able to sleep. She also gets less severe headaches, also on the right, relieved by 2-4 aspirin per day. She denies family history of headache. Her sister works on a neurology ward and insisted she call for an appointment.
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| mjl1717
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Except for family history sounds migraine like to me..
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| neuroblastoma
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MIgraine
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| drdg
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| Kamsi
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Migraine
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| darkhorse
Forum Elite
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Migraine with aura is likely. The side-locked location is a little worrisome for possible referred pain due to intracranial pathology. Remember that according to International Headache Criteria for migraine headache the patient has to have at least five headaches which are similar in nature. She is also overusing analgesics to a small extent, which could lead to medication-induced chronic headache. She needs an exam to rule out focal neurologic signs and more specific migraine therapy.
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| Vietnamese
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Hi mates,
Migraine, typically. However, a non-pharmaceutical therapy is caffeine only (tea, coffee, coke...) effective for some; it worked for me as a freshmen of medical school. Beside -tryptan and NSAIDs, propanolol also works for Migraine. The question is:
1- Why do caffeine, propanolol work for Migraine?
Vietnamese
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