Migraine Without Aura

Abstract

A 39-year-old female was admitted to our headache outpatient center with a 1-month history of three headache attacks with nausea. She was very anxious about that because her mother died with a history of stroke a few months ago. She reported that the first attack of her headache was exploding, with a relatively sudden onset. This first attack lasted 6 h. She was not able to move because while walking, her headache got worse. Therefore, she stayed at home, had bed rest, and she had to put up the blackout curtains. After a short sleep, she felt a little better but was even more anxious, so she went to her GP the same day. After a general examination, the GP advised her to undergo a CT scan of the brain. She was admitted to the emergency hospital the next day. After examination of blood pressure and routine blood tests, all of them were normal and due to persisting moderate headache, she was given an infusion with 500 mg aspirin and 1 g metamizole. Headache suspended within the next 1–2 h, leaving her completely ran out. At home, she felt sleepy and slept for 12 h. The day after, the headache returned. Besides nausea, she was extremely hypersensitive to sound and light, anxious, and somewhat dizzy. Her husband, who is a lawyer, brought her to the next emergency hospital. Again, an MRI scan was performed—without any pathology. Thereafter, she was admitted to the neurological department where she underwent complete neurological status examination, electro encephalo graphy (EEG), and visual evoked potentials (VEP), all of them without any abnormality. After 2 days of hospitalization, she was dismissed with the diagnosis of migraine without aura. One week after, the third attack started with a severe pulsating headache, vertigo, nausea, and sensitivity to light and sound aggravated by walking or moving the head. Aspirin 330 mg did not relieve the pain. This attack nearly lasted 15 h.