Nursing

Migraine is described as a recurring headache accompanied by various symptoms leading to moderate to severe pains characterized by throbbing. The pain caused by the subject disease usually occurs on one side of the head, leading to weakness and high sensitivity to light and sound. Some migraine patients get the disorder from their family lineage. Those patients who experience migraines in early childhood can end up sharing the disease in their adulthood.

In the context of the case study, the migraine disorder is most likely caused by hormonal changes. Those suffering from migraines are likely to undergo four stages; prodrome, aura, attack, and post-drome. Not all migraine patients experience all these stages/ Prodrome symptoms include constipation, mood changes, neck stiffness, frequent yawning, neck stiffness, and food cravings. Auras are described as reversible symptoms of the nervous system, usually visual. The symptoms are generally gradual and build up in minutes lasting twenty to sixty minutes. Aura symptoms are characterized by vision loss, speaking difficulty, uncontrollable jerking, and numbness in the face. Attack migraine usually lasts between four to 72 hours if not attended to. It is characterized by pain on one side of the head or both, pulsating pain, nausea, vomiting, and light/sound sensitivity (Godley et al., 2019). Post-drome migraine is characterized by a feeling of being drained confusion and washed out. Some patients feel elated; head movement might result to slight pains.

The patient in this context can be concluded to be suffering from an attack migraine. Common migraine triggers include hormonal changes in women, drinks, stress, sense of stimuli, sleep changes, sensory stimuli, medications, weather changes, and foods. The patient in this context must have had her migraine triggered from her drugs leading to hormonal changes. The first piece of advice for the patient is to seek attention from a neurologist (Olla et al., 2010). The patient can also carry out MRI tests that apply a strong magnetic field and radio waves to generate detailed brain and blood vessel images. MRI test will enable the doctor to diagnose any tumors, bleeding in the brain, strokes, and any other infection in the brain and the nervous system. A CT scan that applies X-rays to generate detailed cross-sectional images of the brain will enable the doctor to diagnose any tumors, brain damage, infections, and brain bleeding.

The core logic of migraine treatment is to eradicate the symptoms and stop future attacks. Migraine medications are primarily categorized into pain-relieving and preventive medications. Pain-relieving medications are typically taken during migraine attacks to prevent the symptom; preventive medications are handled consistently daily to minimize the severity or rate of migraine attacks. Some of the recommended medicines for pain-relieving include ibuprofen, triptans like sumatriptan and rizatriptan. Dihydroergotamines, Lasmiditan, ubrogepant, opioid medications and anti-nausea drugs are other pain relievers for migraines. Preventive medications include propranolol, metoprolol, antidepressants, anti-seizure drugs (valproate and topiramate), and Botox injections every two weeks (Osipova et al., 2017). The subject patient should stop taking the pills since they might be the reason for hormonal changes, thereby contributing to migraines. The patient should seek neurologist attention and opt for preventive medications to live everyday life. Other potential questions include why she takes the pills? Why doesn’t she want to have kids?

Other differential diagnoses include subarachnoid hemorrhage, which usually occurs abruptly and is characterized by severe headache, double vision, nausea and vomiting, and sudden decrease of consciousness level. Meningitis is the second differential diagnosis; the headache is associated with fever and neck stiffness. The subject diagnosis is usually characterized by altered mental status, phonophobia, and photophobia. Other related differential diagnoses include acute glaucoma and cluster headaches.

In conclusion, migraine is a severe disorder that must be treated with the care and utmost attention that it deserves. Neglecting the condition might lead to severe pains and suffering from the patient. Therefore, performing the above-recommended tests is significant in helping them determine the kind of treatment to be taken by the patient.

References

Godley, F. A., Casiano, R. R., Mehle, M., McGeeney, B., & Gottschalk, C. (2019). Update on the diagnostic considerations for neurogenic nasal and sinus symptoms: A current review suggests adding a possible diagnosis of migraine. American journal of otolaryngology, 40(2), 306-311.

Olla, D., Sawyer, J., Sommer, N., & Moore, J. B. (2020). Migraine treatment. Clinics in plastic surgery, 47(2), 295-303.

Osipova, V. V., Filatova, E. G., Artemenko, A. R., Lebedeva, E. R., Azimova, Y. Y., Latysheva, N. V., … & Yahno, N. N. (2017). Diagnosis and treatment of migraine: Recommendations of the Russian experts. Zhurnal nevrologii i psikhiatrii imeni SS Korsakova, 117(1. Vyp. 2), 28-42.