Last updated on:September 28th, 2021
You’re looking at an interactive case study from Prognosis: Your Diagnosis (one of four distinct learning formats available in Clinical Odyssey). Try it out, and have fun improving your clinical skills.
A 22 year old woman presents with multiple episodes of right sided periorbital and temporal headache, in association with lacrimation, rhinorrhea, nausea, and vomiting. The episodes occurred up to 5 times a day, and lasted around an hour each.
These attacks first started 2 years ago. All investigations, including a MRI brain, were normal. She was unresponsive to treatments for cluster headache and migraine.
She is a frequent visitor to the outpatient department. Her records reveal suspicions of her using artificial tears to simulate tearing, and the fact that actual vomiting was not witnessed by any medical personnel.