1.5 Probable migraine

A 52-year-old patient counts at least her ninth episode of this kind over the years, still grinding on after three days and a few hours, despite paracetamol at home. She mentions a fleeting, indistinct sensation beforehand that arrived all at once rather than creeping in slowly, and it was over and gone before any head pain started, roughly ninety minutes later by her reckoning, so the two clearly did not overlap. It was, she said, just the one odd feeling, nothing following on from it, and not obviously worse on either side of her head. Once established, the pain became a forceful, throbbing pressure that she scored as severe, and she vomited three times overnight. The strange preceding sensation itself lasted about sixty-five minutes.