Migraine Disparities in Women
“Undertreated and Overlooked: Addressing Migraine Disparities in Black Women of Childbearing Age”
topic pertinent to the role of the Family Nurse Practitioner in primary care for women’s health. prepare a case study with at least four related discussion questions for the class members to respond to virtually at the end of the powerpoint. The completed presentation (with documentation and rationale for answers to the questions) must include per answer 7th edition apa references and at least 10 references for the entire powerpoint within 10 years.
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Migraine Disparities in Women
Case Study (Slide 1–4)
Patient: Shanice, a 32-year-old African American woman, presents to a primary care clinic complaining of recurring headaches for the past 2 years. She describes them as throbbing, unilateral, lasting for hours to days, often accompanied by nausea and sensitivity to light and sound. Hence, was told by previous providers that it’s “just stress.”
She works full-time, has two children, and notes that her headaches worsen around menstruation. She’s tries over-the-counter pain medications and they are minimally effective. No formal diagnosis has made. Blood pressure is 130/84 mmHg, BMI is 29. Family history is positive for migraines (mother).
Slide 5: Discussion Question 1
Q1: What diagnostic criteria must be met to clinically diagnose migraine without aura in primary care?
Answer Rationale: The International Classification of Headache Disorders (ICHD-3) outlines specific diagnostic criteria for migraine without aura. To begin with, the patient must experience at least five headache attacks. Moreover, these attacks should display certain features, such as being unilateral, pulsating in nature, and of moderate to severe intensity. In addition, the headaches must be aggravated by routine physical activity. Furthermore, they must be associated with either nausea or photophobia/phonophobia to meet the diagnostic threshold (ICHD-3, 2018).
Slide 6: Discussion Question 2
Q2: What factors contribute to the underdiagnosis and undertreatment of migraines in Black women?
Answer Rationale: Studies cite provider bias, misattribution to stress, poor access to specialty care, and lack of culturally responsive assessment tools as contributing factors (Burch et al., 2021; Young et al., 2020).
Slide 7: Discussion Question 3
Q3: Clinicians should consider pharmacologic and nonpharmacologic strategies for Shanice, keeping her reproductive age in mind.
Answer Rationale: Consider pregnancy-safe abortive (e.g., acetaminophen, sumatriptan) and preventive therapies (e.g., magnesium, beta-blockers), as well as lifestyle modifications. Avoid NSAIDs during third trimester and certain antiepileptics (MacGregor, 2019).
