skip to main content

Migraine with aura — MCCQE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

EasyHeadacheMigraine with auraMCCQE Part 1

24-year-old woman presents with recurrent unilateral pulsating headaches. Episodes last 8 hours with photophobia, nausea and visual zigzags, with normal neurological examination. Which of the following is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Treat acute migraine and discuss trigger management and preventive therapy if frequent

Treat acute migraine and discuss trigger management and preventive therapy if frequent is best because recurrent stereotyped headache with aura and normal examination is migraine. Discharge with reassurance and routine follow-up only is suboptimal because it underestimates acute or progressive risk; Treat symptomatically and defer definitive assessment is suboptimal because symptom control alone does not address the likely underlying diagnosis; Arrange non-urgent outpatient imaging in several months is suboptimal because delayed imaging is unsafe when the presentation has red flags; Start long-term corticosteroids without confirming the diagnosis is suboptimal because empiric steroids can obscure infection, malignancy or other diagnoses. New neurological deficit, papilloedema or thunderclap onset would require urgent imaging.

Reference: Canadian Headache Society guideline