1.3 Chronic migraine

The patient reports a pounding pain confined to one side of the head, brought on or clearly worsened by climbing stairs or bending to pick things up, severe enough on occasion to make her vomit. Each of these full attacks lasts well over a full day, occasionally edging into a second night, before finally clearing. She says that from the very first twinge she can usually tell it is going to be 'one of the bad ones', and that these particular days settle reliably within an hour or so of taking the tablet her GP has previously prescribed for this purpose. She recalls at least eight such full attacks over her lifetime that fit this description closely, and for roughly the last four months has been getting a milder version of the same one-sided, pounding pain on about eleven days most months. There is no visual aura, diplopia or eye pain accompanying any of this.