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Migraine without aura — SCE Neurology MCQ

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HardHeadacheMigraine without auraSCE Neurology

A 34-year-old woman has recurrent unilateral throbbing headaches lasting 12–24 hours with nausea and photophobia. Neurological examination is normal between attacks. Attacks worsen with movement and improve after sleep. There is no thunderclap onset, papilloedema or systemic illness. What is the most likely diagnosis?

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Correct answer: D — Migraine without aura

The best answer is “Migraine without aura”. Parkinsonian syndromes are distinguished by tempo, symmetry, eye movements, falls, autonomic and cognitive features; treatment is individualised to motor and neuropsychiatric burden. The alternatives “Idiopathic intracranial hypertension”, “Cluster headache”, “Subarachnoid haemorrhage”, “Tension-type headache” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: NICE NG71 Parkinson disease recommendations: https://www.nice.org.uk/guidance/ng71/chapter/Recommendations