A 14-year-old girl is brought to the office due to headache, nausea, and visual disturbances. She experienced a pulsatile bilateral headache that associated with an episode of vomiting. She has had 4 episodes of same pain on the right side of her head over the last 2 months. Medical history is unremarkable, and the patient recently began menses. Ibuprofen and acetaminophen have not improved her symptoms. Neurologic examination is unremarkable. Which of the following is most likely involved in the pathogenesis of this patient's current condition?

Question

Quizplus · Accepted Answer

Eductional Objective: Migraines are episodic, unilateral, throbbing headaches associated with nausea, vomiting, and sensitivity to light.  The pathogenesis of migraines involves a genetic predisposition to increased cerebral excitability (eg, cortical spreading depression), which leads to abnormal neuronal activation of trigeminal afferents and the release of calcitonin gene-related peptide, a vasoactive neuropeptide involved in the transmission of pain signals.

A 14-Year-Old Girl Is Brought to the Office Due to Headache