Migraine in a Patient with Essential Hypertension
The patient, a married woman 47 years of age, came to the Clinic on October 15, 1937, complaining of right-sided headaches which had been present for eight years and of irregular menses for one year. An interesting observation was that she always had hemicrania on the right side affecting the right temple. These headaches occurred at any time, but usually began when the patient rose in the morning and lasted all day if measures were not taken to obtain relief. No aura preceded the ache, nor was it accompanied by visual disturbance. The headaches were quite severe and had become increasingly more frequent, recurring at intervals of two or three weeks at the time of admission. They were always accompanied by nausea and vomiting. On one occasion the patient had vomited sixteen times in one day and on another occasion ten times. Following the headache, the stools tended to be lighter in color. The patient suspected that several foods such as cheese and beer would provoke a headache.
Other probable manifestations of allergy included a chronic, mucoid postnasal drip and short periods of diarrhea not accompanied by crampy pain. A brother of the patient had migraine and her son had hay fever.
For one year the menses had been irregular and had been characterized by menorrhagia and periods of amenorrhea. She had an occasional “warm feeling” but no other symptom of the menopause. Dyspnea had been noted on exertion, with occasional slight edema of the ankles and mild nocturia.
Physical. . .