A 53-year-old woman presented with a history of migraine without aura (MwoA) since the age of 16. She described experiencing unilateral, pulsating, severe headache attacks associated with photophobia, phonophobia, osmophobia, nausea, and occasional vomiting. Her family history included MwoA in her mother and sister. Her past medical history was otherwise unremarkable, with no record of childhood periodic syndromes. In November 2015, coinciding with premenopausal menstrual dysregulation, she began experiencing episodes of nausea and frequent vomiting associated with photophobia, phonophobia, and osmophobia but without headache. These episodes, lasting one to three days when untreated, did not respond to common antiemetic agents such as metoclopramide and domperidone. The frequency and triggers of these episodes were similar to her previous migraine attacks, occurring two to three times per month. She also reported some residual but infrequent "typical" migraine attacks with headaches. At her first visit, extensive neurological and general examinations were conducted, which were completely normal. Based on her long-standing history of MwoA, the episodic nature of her symptoms, and normal examination findings, the diagnosis of migraine was confirmed. Her presentation includes both typical migraine attacks and migraine-related episodes without headache, likely exacerbated by premenopausal changes.