A 36-year-old woman has migraine without aura 8 days per month despite appropriate acute therapy. She is not pregnant and has no asthma, depression,

Question

A 36-year-old woman has migraine without aura 8 days per month despite appropriate acute therapy. She is not pregnant and has no asthma, depression, or kidney stones. Neurologic examination is normal. Which of the following is the most appropriate next step in management?

Accepted Answer

Start preventive migraine therapy such as propranolol or topiramate after shared decision-making

Answer

Avoid acute treatment and follow symptoms for 5 years

Answer

Order brain MRI before any treatment despite normal examination

Answer

Start daily antibiotics

Answer

Use opioids for every migraine attack

Migraine prophylaxis — USMLE Step 3 MCQ

A 36-year-old woman has migraine without aura 8 days per month despite appropriate acute therapy. She is not pregnant and has no asthma, depression, or kidney stones. Neurologic examination is normal. Which of the following is the most appropriate next step in management?