Base on the table, Mrs. Y’s presented symptoms more likely falls under migraine headache. More distinctive characteristics of migraine headache to note for are unilateral throbbing pain associated with moderate to severe disability, nausea, vomiting, phonophobia, photophobia, and increased pain with physical exertion (Mueller, 2007).Physical assessment for vertigo and diplopia include eye check for presence, direction, and duration of spontaneous nystagmus; the ear canal is inspected for discharge and foreign body; and the tympanic membrane is checked for signs of infection or perforation. Note for head or neck pain, ataxia, loss of consciousness, and focal neurologic deficit (Tucci, 2009).Assessment tools: (1) Vital signs kit (thermometer, timer, sphygmomanometer). (2) A pen light to check the eyes and ears. (3) Snellen chart to check visual acuity. (4) Patellar hammer use for assessing reflexes. (5) MIDAS or Migraine Disability Assessment Test assessment tool.Headache disorders are associated with migraine, brain tumor, stroke, substance exposure/withdrawal, head injury, increased intracranial pressure, seizure, trigeminal neuralgia, meningitis and other infection 2009). Y’s case is more likely indicative of migraine with aura. The falling sensation (vertigo) and diplopia of Mrs. Y can be considered as aura if it occurs 10-30 minutes prior to the onset of an initially dull headache that develops into a constant, throbbing and pulsating pain felt at the temples. Thorough assessment of Mrs. Y could have suggested factors that trigger. Mrs. Y and Her lllness.
Aggarwal, S.K. & Swierzewski, S.J. (2008). Migraine Headaches. Healthcommunities.com, Inc. Internet article retrieved on November 30, 2009 from <http://www.neurologychannel.com/migraine/symptoms.shtml>.
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Bickley, L.S., & Szilagyi, P.G. (2009). The Nervous System. Bates’ Guide to Physical Examination and History Taking. (10th Ed.) (pp. 549-550). Philadelphia: Lippincott Williams & Wilkins.
Mueller, L.L. (2007). Diagnosing and Managing Migraine Headache. The Journal of the American Osteopathic Association. Volume 107; November, pp. 10-16. Internet copy retrieved on November 30, 2009 from <http://www.jaoa.org/cgi/content/full/107/suppl_6/ES10>.
National Institute of Neurological Disorders and Stroke (2009). Headache: Hope Through Research. Internet article retrieved on November 30, 2009 from <http://www.ninds.nih.gov/disorders/headache/detail_headache.htm>.
Sandhaus, S. (2002). Stop the spinning: Diagnosing and managing vertigo. CBS Interactive Inc. Article retrieved on November 28, 2009 from <http://findarticles.com/p/articles/mi_qa3958/is_200208/ai_n9103886/>.
Tucci, D.L. (2009). Dizziness and Vertigo. The Merck Manuals Online Medical Library. Internet copy retrieved on November 30, 2009 from <http://www.merck.com/mmpe/sec08/ch084/ch084e.html>.
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