An 8-Year-Old Boy Is Brought to the Office Due to Intermittent

An 8-year-old boy is brought to the office due to intermittent headaches for the past 6 months.  The headaches occur once or twice a month and can last 2-10 hours.  The patient describes them as "pounding like loud music" located over the entire frontal area.  The headaches are often associated with nausea and either nasal congestion or rhinorrhea.  The pain does not wake him from sleep.  Each episode, the patient's mother gives him ibuprofen, which improves the pain.  He sometimes worries about developing an episode while in school.  He has missed 2 days of school due to headache and has spent this time with his mother, refusing to watch television or play video games due to the brightness of the screen.  Vital signs are normal, and neurologic examination, including funduscopy, is unremarkable.  Which of the following is the most likely cause of this patient's clinical presentation?

A) Chronic sinusitis
B) Cluster headaches
C) Generalized anxiety disorder
D) Idiopathic intracranial hypertension
E) Medication overuse headaches
F) Migraine headaches

Correct Answer:

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