A 32-year-old woman is evaluated for a gradual increase in migraine frequency and severity over the past 6 months. Migraine attacks, which formerly oc

Subject
Medicine
System
Nervous System

Kathryn

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Jul 29, 2020
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A 32-year-old woman is evaluated for a gradual increase in migraine frequency and severity over the past 6 months. Migraine attacks, which formerly occurred two or three times each month, are now occurring approximately three times each week, with each attack lasting at least 12 hours. She has no other medial problems and takes only almotriptan as needed for acute migraine. On physical examination, vital signs and results of a general physical examination, including a neurologic examination, are normal. An MRI of the brain shows no abnormalities. Which of the following is the most appropriate treatment for this patient?
(A) Botulinum toxin
(B) Propranolol
(C) Nortriptyline
(D) Sertraline
 
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