From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.
At Medicine Grand Rounds in April 1997, Dr K. M. A. Welch discussed
the options for a 27-year-old woman with migraine headaches that had occurred
up to 5 times per month.1 At that time, use
of β-blockers had decreased the frequency of her migraines to 1 per month
just prior to her menses.
Dr Welch described the common triggers of migraine attacks as well as
their diagnosis, epidemiology, and pathogenesis. He provided a detailed approach
to the management of migraines, including both abortive and preventive use
of different medications. Dr Welch suggested that Mrs D, the patient, might
get better relief of her migraines by following her sumatriptan succinate
injection with an oral form of the drug, and that she might also benefit from
prophylactic use of a nonsteroidal anti-inflammatory agent prior to the onset
of her menses. We asked the patient and her primary physician to comment on
the year that has passed.
Daley J, Delbanco TL, Hartman EE. A 27-Year-Old Woman With Migraine Headaches, 1 Year Later. JAMA. 1998;279(12):954. doi:10.1001/jama.279.12.954