Throbbing bifrontal headaches and nausea
Author and Disclosure Information [Show]

Angeliki Vgontzas, MD, Instructor, Department of Neurology, Harvard Medical School; Associate Neurologist, Department of Neurology, Brigham and Women's Hospital/Brigham and Women's Faulkner Hospital, Boston, Massachusetts.

Angeliki Vgontzas, MD, has disclosed no relevant financial relationships.

Question 1 of 3

A 7-year-old boy presents for evaluation of throbbing bifrontal headaches accompanied by abdominal cramping, nausea, and diarrhea. According to the patient's mother, the patient's headaches begin in the early morning and often awaken him from sleep. During his most recent episode, the patient complained of pain radiating to his neck. He also states that light hurts his eyes during these episodes. The patient's headaches began approximately 6 months earlier and occur two to three times per month. He normally falls asleep within an hour after headache onset and wakes up 2-3 hours later with no headache, although on occasion, the patient's headache has persisted for at least 48 hours. The patient's birth and development history are normal, and his medical history is unremarkable with the exception of motion sickness. Vital signs, physical examination, and neurologic examination are normal.

On the basis of what you know about this patient, what diagnosis do you suspect?

Muscle contraction tension headache

Intracranial hypertension

Migraine without aura

Chronic paroxysmal hemicrania

This quiz is not accredited for CME.

More from Case in Point: Migraine

QUIZ

Nausea and abdominal pain
Transient monocular visual loss
Debilitating headaches every several weeks
Headaches and severe nausea
Face paralysis on right side
Extreme lethargy and mood swings
Chronic migraine headache
Woman with blurred vision
Headache in the occipital area
Woman presents with vertigo
Headache accompanied by photophobia