Chronic Migraine Sufferer Finds Relief Through Targeted Treatment
At 38 years old, this patient had struggled with persistent headaches for much of her life. Environmental triggers such as cold exposure, poor sleep, and common colds often led to severe, unbearable pain. With a family history of headaches—specifically her mother—and increased work-related stress as she aged, the frequency and intensity of her headaches worsened. Eventually, she sought professional medical care. Based on her symptoms, medical history, and diagnostic results, chronic migraine was strongly suspected. With appropriate treatment, she experienced significant symptom relief.
Patient Profile
- Age/Gender: Female, 38 years old
- Diagnosis: Chronic Migraine
- Hospital: Shandong Third Provincial Hospital
- Visit Date: January 2022
- Treatment: Pharmacological therapy (Propranolol Hydrochloride Tablets + Paracetamol and Dihydrocodeine Tablets)
- Follow-Up: Outpatient care with a one-month follow-up
- Outcome: Stable condition with reduced headache severity
Initial Consultation
The patient had experienced recurring headaches since childhood, often triggered by wind exposure, lack of sleep, or extended work and study hours. The pain was typically localized to one side of the head and often accompanied by nausea and vomiting. Symptoms intensified during menstruation. Given her family history and the pattern of her symptoms, an initial outpatient diagnosis of chronic migraine was made. To rule out other neurological conditions, further diagnostic tests were recommended, including brain MRI, EEG, and blood tests. The patient consented and cooperated fully with the testing process.
Treatment Process
Blood tests assessing liver and kidney function, electrolytes, lipids, glucose, and cardiac enzymes showed no abnormalities. Brain MRI and vascular imaging, along with EEG, revealed no significant neurological issues. However, a cervical spine MRI indicated mild cervical spondylosis. Taking into account her family history, frequency of attacks, and clinical presentation, chronic migraine was confirmed. Treatment included the use of non-steroidal anti-inflammatory drugs such as Paracetamol and Dihydrocodeine Tablets for acute pain relief. Given the frequency of her headaches, she was also advised to adopt a regular sleep schedule, avoid mental overexertion, and take Propranolol Hydrochloride Tablets as a preventive measure. Notably, her headache symptoms improved significantly within 24 hours of starting treatment.
Clinical Outcome
Chronic migraine is a commonly diagnosed condition, but it must be differentiated from other types such as cluster headaches and tension-type headaches. After pharmacological intervention, the patient's symptoms improved significantly. Follow-up phone calls three days post-treatment confirmed complete symptom resolution. She was advised to continue using Paracetamol and Dihydrocodeine Tablets as needed and to take Propranolol regularly for prevention. At her one-month outpatient follow-up, she reported fewer and less severe headaches, indicating a positive treatment response.
Post-Treatment Recommendations
We are encouraged by the patient's improvement following targeted therapy. While chronic migraine typically has a favorable prognosis with proper treatment, lifestyle adjustments remain crucial. Patients should avoid alcohol and tobacco, prioritize 8–10 hours of quality sleep, and engage in moderate physical activity based on their health status. It's also important to avoid exposure to cold environments and to stay well-hydrated. Dietary considerations include limiting spicy, fatty, or overly processed foods that may act as migraine triggers.
Medical Insights
This case underscores the importance of patient education and lifestyle modification in managing chronic migraine. Establishing healthy routines and promoting awareness of preventive strategies can significantly reduce both the frequency and intensity of migraine attacks. In addition to pharmacological treatment, comprehensive neurological evaluation is essential to rule out secondary causes such as brain lesions or structural abnormalities. Early diagnosis and a multidisciplinary approach can prevent treatment delays and improve long-term outcomes.