Unusual Headache Case Studies
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Unusual headache.
History
Patient is 63-year-old right-handed white female who presents with her husband for evaluation of an unusual headache followed by hallucinations. She does have a history of migraine headaches with aura. These started over 20 years ago. At that time, she had a negative workup, including a negative CAT scan. Her headaches usually start with biperipheral scintillating scotoma, which in itself can be debilitating because it significantly disrupts her vision and makes it difficult for her to remain at work. This is followed often by numbness and tingling in her arms and word finding problems, especially when her headache is severe. The headache itself is mild to moderate. She sometimes takes Advil for it. She has tried using triptans in the past without any relief. She usually has to go to bed at night and sleep and then the next morning she is fine. She did have a severe headache at work, less than 10 years ago with a prolonged speech problem. She had a CAT scan at that time, which was negative. This summer, she has been up from Florida visiting family in Maine, New Hampshire, and Vermont. Since she has been up here, her sleep-wake cycle has been disrupted. She is going to bed later at night and waking up earlier in the morning. She noted that two months ago, she had her typical migraine with a brief visual numbness, tingling and aphasia auras. However, one month ago, at Bridge, she will realize she was having some …show more content…
I do not think there is any need for a follow up CAT scan at this time, but I did tell her that if she has another one of these events, if she wants to come into the emergency room, she certainly can get a CAT scan and possibly dose of steroid to try to break that particular event. Otherwise, I will recommend that she continue with magnesium citrate and she can follow up with me as
Unusual headache.
History
Patient is 63-year-old right-handed white female who presents with her husband for evaluation of an unusual headache followed by hallucinations. She does have a history of migraine headaches with aura. These started over 20 years ago. At that time, she had a negative workup, including a negative CAT scan. Her headaches usually start with biperipheral scintillating scotoma, which in itself can be debilitating because it significantly disrupts her vision and makes it difficult for her to remain at work. This is followed often by numbness and tingling in her arms and word finding problems, especially when her headache is severe. The headache itself is mild to moderate. She sometimes takes Advil for it. She has tried using triptans in the past without any relief. She usually has to go to bed at night and sleep and then the next morning she is fine. She did have a severe headache at work, less than 10 years ago with a prolonged speech problem. She had a CAT scan at that time, which was negative. This summer, she has been up from Florida visiting family in Maine, New Hampshire, and Vermont. Since she has been up here, her sleep-wake cycle has been disrupted. She is going to bed later at night and waking up earlier in the morning. She noted that two months ago, she had her typical migraine with a brief visual numbness, tingling and aphasia auras. However, one month ago, at Bridge, she will realize she was having some …show more content…
I do not think there is any need for a follow up CAT scan at this time, but I did tell her that if she has another one of these events, if she wants to come into the emergency room, she certainly can get a CAT scan and possibly dose of steroid to try to break that particular event. Otherwise, I will recommend that she continue with magnesium citrate and she can follow up with me as