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K. M. A. Welch, MD

JAMA. 1997;278(4):322-328.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Dr Daley:

Mrs D is a 27-year-old married elementary school teacher with migraine headaches. She recently moved to Boston from the Midwest and works as a substitute teacher. Her health care insurance is through a commercial managed care plan. Her doctor, Dr N, practices in the primary care unit at Beth Israel Deaconess Medical Center.

Mrs D has been in good health aside from migraine headaches since the age of 10 years. Her mother, brother, and a maternal aunt also have migraines. She has had "normal" computed tomographic scans and electroencephalograms. Her headaches begin with a prodrome she describes as a "weird feeling," then a headache follows over her right eye with nausea and vomiting. She has these headaches as frequently as 4 to 5 times a month, but recently she only gets them once a month prior to her menstrual period. In the summer of 1996, she began taking . . . [Full Text PDF of this Article]

Author Affiliations
Dr Welch is Director, Headache and NMR Research Centers, Department of Neurology, Henry Ford Hospital and Health Sciences Center. Detroit, Mich; Professor of Neurology. Case Western Reserve University, Cleveland, Ohio; Clinical Professor of Neurology, University of Michigan, Ann Arbor; and Adjunct Professor of Physics, Oakland University, Rochester, Mich.

Dr Welch is a consultant for Glaxo/Wellcome and has received honoraria from Zeneca Corp.

Footnotes
This conference took place at the Medicine Grand Rounds of the Beth Israel Deaconess Medical Center, West Campus, Boston, Mass, on April 15, 1997.

Reprints: Erin E. Hartman, MS, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, East Campus, 330 Brookline Ave, LY318, Boston, MA 02215.

Clinical Crossroads at Beth Israel Deaconess Medical Center is produced and edited by Thomas L. Delbanco, MD, and Jennifer Daley, MD; Erin E. Hartman, MS, is managing editor. Clinical Crossroads section editor: Margaret A. Winker, MD, Senior Editor, JAMA.

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