A 47 y.o. woman complains of having paroxysmal headaches for the last 5 years. The pain is one-sided, intense, localised in frontal region of head, accompanied by nausea and stomach discomfort, begins one of a sudden. Onset is usually preceded by vision reduction. Anamnesis gives evidence of periodical AP rise, but at the moment the woman doesn't take any medicines. Inbetween the onsets of headache her state is satisfactory. Objectively: high-calorie diet (body weight index - 29), AP- 170/95 mm Hg. Neurologic state has no pecularities. What is the most probable diagnosis?

Answer options

1. Epilepsy
2. Migraine
3. Hypertensive encephalopathy
4. Benign intracranial hypertension
5. Chronic subdural hematoma

Explanation

Although there is increased BP, neurologic symptoms are absent making hypertensive encephalopathy less likely. The absence of seizures also makes epilepsy, a doubt and hence migraine. A migraine is a primary headache disorder characterized by recurrent headaches that are moderate to severe. Typically, the headaches affect one-half of the head, are pulsating in nature, and last from a few hours to 3 days. Associated symptoms may include nausea, vomiting, and sensitivity to light, sound, or smell. The pain is generally made worse by physical activity. Up to one-third of people affected have an aura: typically, a short period of visual disturbance that signals that the headache will soon occur. Occasionally, an aura can occur with little or no headache following it. This patient, therefore, has migraines with aura.