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Neurology - Headache Medicine
A 21-year-old woman presents with headaches that have been recurring since she was 13 years old, corresponding with the onset of her menstrual periods. The headaches occur approximately 1 to 2 times monthly and can last up to 8 hours without treatment. Prior to her typical headaches, she experiences scintillating scotoma in her right visual field, lasting about 30 minutes. This is followed by a hemicranial throbbing headache. During these visual disturbances, she is unable to drive. The intensity of the headaches can be so debilitating that she often has to leave work and go home, where she prefers to lie down and sleep. She expresses significant concern about these headache episodes, particularly about the associated vision loss, fearing that she might have a brain tumour or stroke. However, a CT scan of her brain and a physical examination yielded normal results.1
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