Miss A Case Summary

Gilbert suffers from Graves Disease, an immune system disorder with an overproduction of thyroid hormones. Gilbert also suffers from severe migraines but cannot afford the prescription medication that alleviates them. She gave

Patient is a 19-year-old right-handed white female who is a fair historian. She states that she started having headaches as a child. Her father told her that he also had headaches and that they would eventually go away. She describes having a severe headache, which she calls her first migraine, after softball practice at age 12. Menarche was at age 13 with no change in her headaches. Her headaches have not been menstrually related. There was no clear change in her headaches during pregnancy or in the postpartum period. She states that she gets a dull headache two to three days out of a week. This is in variable locations on her head, but can also be a nuchal. The pain is of variable quality, but it does worsen with exertion. She also gets more

On admission, Ms. Pilkey subjectively described her pain as being rather excruciating. There were times when she had to curl up into a ball due to pain during the week prior to admission. Her headaches felt like a “stabbing pick which penetrates her head” that is not localized to a particular region. The initiation of topiramate on July 31st 2015 has helped. The frequency, duration and degree of pain from chronic daily headaches had reduced considerably, allowing Heather to have a better quality of life. However, the degree of cognitive impairment, manifested in difficulty understanding commands and word finding have been more pronounced. In addition, she often forgot to take her morning dose of topiramate due to the cognitive deficits

Sulmatriptan is a selective 5-HT1D agonist but also has actions act 5-HT1B receptors. Sulmatriptan does not cross the blood-brain barrier. The mechanism of action of drugs use in migraine are very little understood as they include such a wide variety in actions sunatirptuan and it congnars are currently 1st-pherorapy for a kid acute migraine in most patient they should not be use for patient at risk for pulmonary artery sunatriptan an order triptans are selective agonist for 5-HT1D and 5-HT1B receptors. These receptors types are found cerebral and meningeal vessels and moderate vasoconstrictron they are found on neurons and probably function as brbs inhibitior receptors the efficacies of all the triptan 5-HT agonist in migraine are equal to

Discuss weight loss since her BMI is 27.8. Per Hopkins School Medicine study, Wednesday is five times more likely to have chronic migraines due to her obesity

Because severe pain is more difficult to control, Mrs R may become anxious and fatigued, and may also withdraw again from the regimen if there is no success in achieving pain relief; therefore, the preventive approach needs to be considered. (Wells, 2014). For an effective pain control pain, Mrs R should also keep a daily record of her pain. Writing a diary can help empower the patient in her own care, give her confidence and increase self-efficacy (Bastable, 2014). Also, a strategy of pain management is to combine opiods with non-narcotics, such as Tylenol, in order to enhance pain relief and to slowly decrease the use of narcotics overtime (Lewis, 2014). Mrs R was explained to always follow the right dosage of medication to optimize the narcotic results. A complete assessment of pain should be performed: PQRST. Pain is a subjective concept and the patient must describe the pain in order to provide an effective care plan (Jarvis, 2013). Responses to pain medication should be documented to facilitate communication between health care providers, therefore to maximise effective pain management strategies (Lewis, 2014). The use of non-pharmacological therapy for pain is also recommended to Mrs R because it helps reduce the dose of an analgesic/opiod required to control pain and helps to minimize analgesic side effects, and also promote the release of endorphins which inhibit pain signals (NCBI, 2010). Mrs R is encouraged to use distraction such as watching TV, listening to the radio/music, which redirect the attention on something and away of the pain. Imagery can also be proposed to divert the focus away from the pain by stimulating the client’s imagination to develop sensory images. Relaxation strategies can also be used to help Mrs R to be free of her anxiety and stress, and to reduce muscle tension (Lewis,

Then she started noticing headaches at her menses. They start five days before her period and go through her period. Sometimes it can last beyond her period. She has otherwise, one to two headaches a week outside of her menses. These headaches again are pan cephalic. Sometimes it feels like she is wearing a helmet. They are knifelike and retrobulbar. They are worsened with exertion. She gets nausea, photophobia, and phonophobia with them. Last month, she had an episode of graying out of her vision and then zigzag lines, followed by dizziness and then after several minutes was followed by a headache. Last month, she had an episode of vertigo upon arising in the morning for 10 minutes, after that she had a headache. Otherwise, she has no neurological aura. There is no clear precipitant, except for stress. She has been on amitriptyline 10 mg for two months with no significant change in her headaches. Imitrex 100 mg sometimes helps. She recently took an over-the-counter medication with Tylenol and caffeine and

□ Probability of migraine is 92% in patients who report at least four of the POUND symptoms in the primary care setting 11

Migraine headaches are the third most prevalent illness in the world, and ranked as the sixth most disabling illness. Statistics show that only about fifty percent of people who suffer from chronic headaches know that they’re suffering from a migraine. 76% of people who suffer from migraines worry that they will suffer for the rest of their lives, and 37% of sufferers worried about their migraines between attacks. Studies found that approximately 12% of Americans suffer from migraines, and 40% of Americans could benefit from preventative therapies. Even though studies show that at least 40% of sufferers could benefit from preventative therapies, only one in five sufferers are currently using preventative therapies. Studies also show that over 25% of people who suffer from migraine attacks miss at least one working day over the past three months, and nine out of ten sufferers say that they cannot “function normally” during those days. At least 98 percent of migraine attack sufferers take medications for temporary headache relief, whether it be over the counter or prescription. Only 12% of sufferers take preventative medications as opposed to the 98% of sufferers taking medications for relief. Severe migraines are ranked in the highest of seven disability classes, along with psychosis, dementia, and quadriplegia, published by the World Health Organization. People who participated in a survey who admitted to a

The significant results shown in the above mentioned studies, provide extra support to the theory that a cranial-suture-dysfunction, materialized and felt as a headache, can be easily relieved by way of cranial manipulation. Namely, the CV-4 technique. Applying direct pressure to the fourth ventricle cause a slight separation of the parietal bones which relieves sutural compression and increases brain volume. This increase in brain volume causes the ventricles to enlarge and thereby triggering a state of relaxation. It is for this reason that the CV-4 technique is considered by many therapists as a vital element for the treatment of tension-type headaches.

According to the World Health Organization (WHO), migraine is recognized and its impact categorized as causing the same level of disability as dementia, quadriplegia and acute psychosis. Additionally, the WHO characterized chronic migraine as equal to or more disabling than blindness, rheumatoid arthritis or paraplegia angina. (19)

Throughout the entirety of my life, I have suffered from migraines. I have gone days, even weeks at a time in constant excruciating pain. My migraines have not only affected my social life but my academics as well. Even as I write this now my head is in searing pain.

Transition: Now that you know what a migraine is, the causes and symptoms and the burden on a person.

Additionally, there is no specific cure for migraine headaches. In addition, the goal in treating migraines is to treat migraines symptoms. Also, migraines can be treated with amitriptyline or venlafaxine. Furthermore, a migraine can be treated with blood pressure medicines such as propanolol. Researchers have also proven that migraines can be treated with seizure medicines such as valproic acid. (http://www.sciencedaily.com/news). In addition, when I read that you can treat a migraine with seizure medications, I thought that research finding was interesting to be aware of. Also, researchers stated that you could treat a

Acute treatment aims to reverse, or at least stop, the progression of a headache that has started. Preventive treatment, which is given even in the absence of a headache, aims to reduce the frequency and severity of the migraine attack, make acute attacks more responsive to abortive therapy, and perhaps also improve the patient's quality of life. An overview of migraine treatment is shown in the image