28/female H/o migarine.. Almost 5-6 attacks per month Frequency decreased substantially after f

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Diagnosis requires detailed history about pain characteristics, type of pain, laterality, duration of episodes, triggering and relieving factor to rule out whether it's migraine or tension headache or somatoform pain disorder or headache related with other Psychiatric disorders like mood disorder / anxiety disorders. Investigations can include Hb level, PNS x-ray, CT brain to rule out medical causes. If final diagnosis is migraine then management of acute attack by analgesics like naproxen, ibuprofen on sos basis, triptans like sumatriptan, and prophylaxis to prevent attacks with sod valproate, Flunarizine, Beta- blockers like propranolol, TCAs like Amitriptyline.

Needs further investigation and evaluation to conclude and treatment plan. Tab vasograin + PCM TDS till reports complied. Multivitamin and antioxidant orally.

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NEED'S CLINICOPATHOLOGICAL EVALUATION WITH.. * X-RAY STUDY.. PNS & HEAD.. * CTCE STUDY.. HEAD , BRAIN..

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NEEDS ... FURTHER. EVALUATION... ALL. ROUTINE. INVESTIGATIONS RULE. OUT ANEMIA

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If clinically migraine, can consider flunarizine prophylaxis. Naproxen sos.

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Do complete evaluation

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Adv. Ct scan Head

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Hi Doc Client need to stopping taking migraine aggravating foods, sleep pattern need to be established. Neurology referral needed. As my colleagues Suggested, try TCA and other analgesics. If it is psychological (somatoform) psych referral and address the underlying stressors. Regards, Dr. Sudhakar

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