Diagnosis
Diagnostic criteria reviewed.
No red flags.
Frequency is less than for chronic migraines.
Differential diagnosis reviewed.
Labs to order or review: CBC, CMP, TSH, etc.
Cause is likely multi-factorial.
Treatment
-Stay Hydrated: Drink 2-3 liters of water per day (about eight 8 oz glasses of water).
-I advise quiet, dark room when episodes occur, avoid motion.
-Keep headache diary. Determine triggers & response to treatment. Will be reviewed at a follow-up visit.
-Avoid abortive medication overuse which can lead to medication overuse headache or analgesic rebound headaches.
-Education provided about the condition, alternative treatments, risks, and benefits of treatment.
-Control allergies if symptomatic.
-Perform stress-reducing techniques. Will consider CBT for migraines at a future visit. CBT may also benefit co-morbid stress and anxiety.
-See an optometrist for a vision check.
-Eat a balanced diet.
-F/U 1 month.
Pharmacologic Tx:
Tool Box: https://americanheadachesociety.org/headache-journal-toolboxes