A 31-year-old woman at 12 weeks gestation comes to the office for recurrent headaches. The patient has a history of episodic migraines that typically resolve with nonsteroidal anti-inflammatory drugs; but since becoming pregnant, the headaches have become more severe and frequent. Over the past month, the patient has had 5 migraine headaches with associated nausea and vomiting that required treatment in the emergency department. In addition, she has had to go to a dark room and rest for a few hours before recovering. The patient has no other chronic medical conditions and her only other medication is a daily prenatal vitamin. Temperature is 36.7 C (98 F), blood pressure is 120/80 mm Hg, and pulse is 76/min. Fetal heart rate is 160/min. Cranial nerves are intact. Deep tendon reflexes are 2+. Strength and sensation are normal in all extremities. Which of the following is the most appropriate preventive therapy for this patient?

Question

A 31-year-old woman at 12 weeks gestation comes to the office for recurrent headaches.  The patient has a history of episodic migraines that typically resolve with nonsteroidal anti-inflammatory drugs; but since becoming pregnant, the headaches have become more severe and frequent.  Over the past month, the patient has had 5 migraine headaches with associated nausea and vomiting that required treatment in the emergency department.  In addition, she has had to go to a dark room and rest for a few hours before recovering.  The patient has no other chronic medical conditions and her only other medication is a daily prenatal vitamin.  Temperature is 36.7 C (98 F), blood pressure is 120/80 mm Hg, and pulse is 76/min.  Fetal heart rate is 160/min.  Cranial nerves are intact.  Deep tendon reflexes are 2+.  Strength and sensation are normal in all extremities.  Which of the following is the most appropriate preventive therapy for this patient?

Quizplus · Accepted Answer

The Answer is C

A 31-Year-Old Woman at 12 Weeks Gestation Comes to the Office