B7-001 Headache Flashcards
4 characteristics of common migraines
- unilateral location
- pulsating quality
- moderate or severe pain
- aggravation by routine physical activity
must meet two of four
common migraines must cause what symptoms during the headache [2]
nausea/vomiting
OR
photophobia/phonophobia
migraine HA preceded/accompanied by visual, sensory, or other focal neurologic symptoms
migraine with aura
a migraine lasting longer than 72 hours
status migrainosus
4 characteristics of episodic tension-type headaches
- bilateral location
- pressing/tightening quality
- mild or moderate intensity
- not aggravated by physical activity
must meet 2 of 4 characteristics
chronic daily headache is defined as greater than […] days in a month
15
can be chronic tension type or chronic migraines
a headache must have [….] cause to be classified as a migraine
no identifiable cause
most common theory about cause of migraines
Trigeminal-vascular theory
(release of CGRP by 5HT1R causes sensitization)
5HT1 agonists used for headache [3]
ergotamines (dihydroergotamine)
triptans (sumatriptan)
Ditans (lasmiditan)
5HT1 agonist that does not cause vasoconstriction
ditans (lamiditan)
**safe in patients with CVD history
CGRP antagonists
-gepants (rimegepant)
most common cause of migraines transforming to chronic migraine is
overuse of symptomatic migraine drugs and/or analgesics
typically, if a patient has more than […] headaches a month you should offer prophylactic medications
4
botulinum toxin is helpful as prophylaxis for […]
chronic migraine
does not help unless they have progressed to chronic headaches as defined by >15 a month
medication classes used for migraine prophylaxis [7]
antiepileptics
beta blockers
antidepressants
NSAIDs
herbal therapies
botulinum toxin
CGRP receptor binding
most common primary headache syndromes [2]
migraine
tension-type
severe unilateral peri-orbital pain lasting 15-180 min
cluster headache (trigeminal autonomic cephalgia)