Posted: July 17th, 2022

Assignment Scenario: Patient is a 24-year-old female administrative Helpant

Scenario: Patient is a 24-year-old female administrative Helpant who comes to the emergency department with a chief complaint of severe right-sided headache. She states that this is the sixth time in the last 2 months she has had this headache. She says the headaches last 2–3 days and have impacted her ability to concentrate at work. She complains of nausea and has vomited three times in the last 3 hours. She states, “the light hurts my eyes.” She rates her pain as a 10/10 at this time. Ibuprofen and acetaminophen ease her symptoms somewhat but do not totally relieve them. No other current complaints.

In your Case Study Analysis related to the scenario provided, in 1-2page (MAX) explain the following:

Both the neurological and musculoskeletal pathophysiologic processes that would account for the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient.

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Neurological and Musculoskeletal Pathophysiologic Processes

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Neurological and Musculoskeletal Pathophysiologic Processes
The symptoms suggest the patient is suffering from migraine attacks. Migraine attacks trigger symptoms such as pain on one side of the eye, sensitivity to light, nausea, vomiting, and throbbing pain (Onderwater et al., 2020). Headache is caused by distention and excessive pulsation of the branches of the external carotid artery. Ultrasonography shows the dilation of the superior temporal artery on the side of the migraine (Viana et al., 2016). During the aura, there is a significant reduction in blood flow. It begins in the occipital lobe and extends like a wave of oligemia. Research attributes the aura and spreading wave of oligemia to cortical depression (Gross et al., 2019). Neurological and musculoskeletal mechanisms involving circulatory change and diminished neural activity are the primary reason for the headache.
Racial variables affect physiological functioning, thus affecting specific ethnic groups more than others. Statistics indicate that migraine attacks affect 20 percent of whites, 16 percent of African Americans, and 9 percent of Asian Americans (Luedtke et al., 2018). The statistics suggest that according to the International Classification of Headache Disorders (ICHD) criteria, whites are more at risk of migraine attacks while Asian Americans are least likely to suffer from migraine attacks (Luedtke et al., 2018). The high-risk group should take precautions and regular assessments to avoid deterioration of the condition.
The factors interact in causing genetic predisposition. Heritable nature is apparent among specific families and ethnic groups. Statistics indicate that 60-80 percent of cases occur in successive generations (Onderwater et al., 2020). The role of genes that affect the code for ion channels is a common predictor in migraine attacks. Thus, genetic factors play a significant role in causing migraine attacks (Viana et al., 2016). Genetic predisposition leads to neurological and musculoskeletal changes that trigger migraine symptoms.
References
Gross, E. C., Lisicki, M., Fischer, D., Sándor, P. S., & Schoenen, J. (2019). The metabolic face of migraine—from pathophysiology to treatment. Nature Reviews Neurology, 15(11), 627-643.
Luedtke, K., Starke, W., & May, A. (2018). Musculoskeletal dysfunction in migraine patients. Cephalalgia, 38(5), 865-875.
Onderwater, G. L., Dool, J., Ferrari, M. D., & Terwindt, G. M. (2020). Premonitory symptoms in glyceryl trinitrate triggered migraine attacks research paper writing help : a case-control study. Pain, 161(9), 2058.
Viana, M., Linde, M., Sances, G., Ghiotto, N., Guaschino, E., Allena, M., … & Tassorelli, C. (2016). Migraine aura symptoms: duration, succession and temporal relationship to headache. Cephalalgia, 36(5), 413-421.

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