Migraine

A 23-year-old woman presents with five episodes of headache during the past 2 months. Each episode began with yawning, sensitivity to light, and a depressed mood that was followed by the gradual onset of neck pain that spread to the occipital region and eventually to the retro-orbital region on the right side. The pain became incapacitating over a period of 1 to 2 hours and was associated with nausea and sensitivity to light and sound. With two of the episodes, she had jagged lines in her vision for 15 minutes as the neck pain was beginning; with all the episodes, she had severe fatigue and difficulty concentrating and finding words. The headache lasted approximately 24 hours, and, after resolution, she had several hours of residual neck soreness, fatigue, and depressed mood. How would you evaluate and treat this patient?