Summary
The patient presented with a right-sided headache; the chief complaint was nausea, vomiting, and pain 10/10. This symptom cluster is commonly associated with migraine in adults, especially if they have a history of migraines. The neurological and musculoskeletal pathophysiologic processes for patients presenting these symptoms are migraines (Puntillo et al., 2021). A migraine is a chronic disorder characterized by recurrent attacks of intense pain on one side of the head. Migraine headaches are frequently preceded by nausea, vomiting, and visual changes. The pain is usually described as a throbbing or pounding sensation, and some patients experience a feeling of pressure in the head. They can last anywhere from two hours to three days; however, they can sometimes last longer.
Migraine headaches are generally caused by increased blood flow to the brain, which results in increased neuronal activity. This increased activity leads to an increase in the neurotransmitter serotonin, also known as 5-HT (Puntillo et al., 2021). Serotonin is thought to play a role in regulating mood and appetite control. Migraine headaches are often preceded by gastrointestinal symptoms such as nausea, vomiting, abdominal pain, or diarrhea. These symptoms may be directly related to activating the trigeminal nerve pathways that project from the brainstem to the stomach. The presence of nausea in combination with vomiting and pain suggests that the patient has an aura, which may indicate an increase in intracranial pressure or cerebral venous sinus thrombosis.
Racial/Ethnic Variables Impacting Physiological Functioning
The patient’s race/ethnicity is not explicitly discussed in the Case Study Analysis, but it does impact their physiological functioning. The patient in this case study is a 24-year-old with migraine headaches (Woo et al., 2019). The patient has been prescribed medications for them; the body may be more sensitive to pain than a person who does not have these conditions. This sensitivity could exacerbate symptoms if the patient does not take medication regularly or if they take too little or too much medication.
One can determine that this is a migraine by considering the patient’s chief complaint and other symptoms: nausea, vomiting, and pain 10/10. Migraines are classified as primary headaches if they occur without an identifiable cause of pain (Woo et al., 2019). However, an identifiable cause of the headache, such as an infection, may be considered secondary to another condition, such as sinusitis or meningitis. It is important to remember that it may be possible to diagnose a migraine based on physiological data such as temperature readings or blood pressure measurements. Sometimes, confirming one’s diagnosis with additional testing, such as imaging studies or laboratory tests, may be necessary.
Interactions of the Processes
The patient’s neurological symptoms are likely caused by a brainstem lesion, including nausea, vomiting, and decreased vision. This symptom is consistent with a lesion in the brainstem affecting the cranial nerves that control these functions. A brainstem lesion likely causes the patient’s musculoskeletal symptoms, including pain 10/10 (Riuzzi et al., 2018). Lesions in the brainstem can cause pain 10/10 due to their proximity to the spinal cord. However, it is essential to note that this symptom should be assessed with other symptoms, such as movement or touch sensitivity.
Nausea and vomiting likely resulted from stimulation of the trigeminal nerve, which is responsible for facial pain and causes nausea in some patients. The pain likely resulted from activating the muscular system since the contracted muscles will cause discomfort (Riuzzi et al., 2018). The patient’s medications were ibuprofen and acetaminophen, anti-inflammatory agents used to treat headaches and other pain conditions. Some neurological or musculoskeletal issues may have triggered their use because they had no effect alone or made the pain worse by causing inflammation in the brain or muscles.
References
Puntillo, F., Giglio, M., Paladini, A., Perchiazzi, G., Viswanath, O., Urits, I.,… & Brienza, N. (2021). Pathophysiology of musculoskeletal pain: a narrative review. Therapeutic Advances in Musculoskeletal Disease, 13, 1759720X21995067. Web.
Riuzzi, F., Sorci, G., Sagheddu, R., Chiappalupi, S., Salvadori, L., & Donato, R. (2018). RAGE in the pathophysiology of skeletal muscle. Journal of cachexia, sarcopenia and muscle, 9(7), 1213-1234. Web.
Woo, B., Fan, W., Tran, T. V., & Takeuchi, D. T. (2019). The role of racial/ethnic identity in the association between racial discrimination and psychiatric disorders: A buffer or exacerbator?SSM-population health, 7, 100378. Web.