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Clinical case review

When migraine becomes more than a pain in the head

ESTHER TANTSIS

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Abstract

A 14-year-old boy presents with a history of migraine and a constant dull headache. A multimodal approach is required to ensure there is no sinister cause for his pain and that he is managed appropriately.

Article Extract

Case scenario

Lachlan, a 14-year-old boy, began having occasional migraines, generally during school hours, when he was 12 years of age. He is now averaging one severe migraine every two to four weeks and has a dull headache on most days. He has a family history of migraine and background stress. Lachlan is attending counselling and being treated for depression with the selective serotonin reuptake inhibitor (SSRI) fluoxetine. What investigations should be considered in a patient such as Lachlan? Does medication for an adolescent patient differ from that for an adult with recurrent migraines?

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© SOLSTOCK/ISTOCKPHOTO.COM MODEL USED FOR ILLUSTRATIVE PURPOSES ONLY