A 29-year-old woman comes to the office due to frequent episod | Surgery collections Videos and quizez 2021

A 29-year-old woman comes to the office due to frequent episodes of headache. She has moderate to severe, left-sided, throbbing pain associated with nausea and occasional vomiting. Her headache is often preceded by a tingling sensation in the right hand that gradually involves the right arm and face and is followed by numbness lasting <1 hour. She feels irritable while experiencing the headaches. The pain typically improves following several hours of rest in a dark and quiet room. The patient has had these episodes every 1-2 months for the past 5 years. She has taken as-needed sumatriptan with some relief, but the symptoms have caused her to miss several days of work. She has no other medical history and does not use tobacco, alcohol, or recreational drugs. There is a family history of depression. Vital signs are within normal limits and physical examination is normal.