Response to Kathy

Please respond to this post, you can add more information about migraines or other treatments.

 

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Case Study 2

            A 30-year-old Asian female presents to the clinic with headaches. The patient has a history of headaches since her teen years. Headaches have become more debilitating recently. Describes the pain as sharp, worsens with light and accompanied by nausea and at times vomiting. She rates the pain as 7/10. Typically takes 2 tabs of OTC Motrin with “some help”. “Sleeping it off in a darkened room’ helps alleviate the headache. VS WNL, physical exam unremarkable.

            In addition to the history given by the patient more information from the patient is necessary such as symptom onset, location and radiation of the pain, any other medical conditions or medications taken routinely, any recent trauma or other procedures this will help to rule out different headache disorders (Buttaro et al., 2017).  Determination of whether the headache is primary or secondary is identified during the focused history (Buttaro et al., 2017).  If it is a primary condition than the type of headache should be diagnosed, however if determined to be secondary then a careful physical exam will help determine the cause as well as whether further neurological testing and imaging is needed.  The primary diagnosis for this patient would be Migraine headache.   Migraine headaches are common, multifactorial, disabling, and recurrent; many times they are hereditary and often start a few times a year in childhood and then progress to a few times a week as an adult; they primarily affect females (Burstein, Noseda, & Borsook, 2015).  Migraines tend to start with no warning sign and end with sleep, in some cases they are preceded by a prodromal phase such as fatigue, depression, food, and irritability to name a few (Burstein, Noseda, & Borsook, 2015).  Many times the start of menses in women play a role as well, so including this information in the patient’s history will aid in diagnosis. 

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            Treatment is based on these three broad approaches which are lifestyle and trigger management, acute episode treatment, and preventive treatment (Weatherall, 2015). Teaching the patient to be regular in regards to meals, sleeping, hydration and stress is generally very helpful in reducing migraines (Weatherall, 2015).

 

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