She is otherwise healthy. She experiences about 5-6 episodes per month, each lasting 2-3 days. There is some initial prodrome and aura followed by sensitivity to light, sound, and smell and severe headaches associated with nausea. She has been able to manage her pain better with prophylactic medications but would like to try and reduce her reliance on these if possible.

She has considered botox injections but is concerned by cost and the need for repeated injections. She has tried inhaled street cannabis with benefit but does not want to continue using illicit drugs.

Lifestyle modifications, relaxation therapy and diet modification have all proven unhelpful. She is regularly taking several days off three times a month due to her headaches.