Which of the following best describes a patient with a classical migraine?
Correct Answer: Pulsating unilateral headache worsened with the movements of head
Description: Choice A describes GIANT CELL AERITIS - Typical presenting symptoms include headache,Polymyalgia Rheumatica, jaw claudication,fever,Weight loss. Choice B describes CLUSTRE HEADACHE- The frequency is approximately 0.1%.The pain is deep, usually retroorbital,excruciating in intensity, nonfluctuating, explosive in quality. special features Periodicity -A core feature of cluster headache is periodicity. At least one of the daily attacks of pain recurs same hour each day for the duration of a cluster bout Parasympathetic autonomic activation -Cluster headache is associated with ipsilateral symptomsof cranial parasympathetic autonomic activation leading to conjunctival injection or lacrimation, rhinorrhea or nasal congestion, or cranial sympathetic dysfunction,such as ptosis. Choice C describes Ophthalmoplegic migraine choice D describes classical migraine DIAGNOSTIC CRITERIA FOR MIGRAINE Repeated attacks of headache lasting 4-72 hr in patients with a normal physical examination, no other reasonable cause for the headache, At least 2 of the following features: Plus at least 1 of following features: Unilateral pain Nausea/ vomiting Throbbing pain -Photophobia -Phonophobia Aggravation by movement Moderate or severe intensity
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