Sparkly

A 23 year old man developed a severe generalized headache, which was sudden in onset, pulsating in nature, exacerbated by bright light, and which made him feel nauseous.

The headache was preceded by worsening scintillating zigzags in both visual fields, which lasted for around 20 minutes.

He presents 2 hours later, with no sign of resolution.

Three months ago, he experienced a similar, but milder episode. His medical history is otherwise unremarkable, while he does not smoke, drink, or use recreational drugs.

Select Relevant Investigations
CSF Full Report & Culture

Performed

Appearance: clear
Polymorphs: nil (< 5)
Gram stain: negative
Glucose: 70 mg/dL (50 - 80)
Protein: 50 mg/dL (15 - 60)
CT Brain

Performed

The CT scan appears completely normal, with no evidence of hemorrhages, or mass lesions.
Carotid Duplex Scan

Performed

No abnormalities were detected.
Slit Lamp Examination

Performed

No abnormalities noted.

Select Relevant Management
Oxygen via Face Mask
Sumatriptan
Propranolol
Antiemetics