A 12-year-old boy complains of severe weekly headaches that last 2 to 3 hours. The pain involves both sides of
the head and the frontal and occipital areas. Occasionally during a headache, the patient complains of some abdominal
discomfort and pain. He becomes passive and irritable during the headache; he does not want to be around
people, play, or even watch TV. The patient’s parents note that a few hours before a headache, he becomes somewhat
restless and agitated. The headaches started about 1 year earlier, and the headache pattern (frequency, duration,
location of pain, and associated symptoms) has not changed since that time. The patient’s mother and maternal
grandmother suffer from migraine.