Central Nervous System - Migraines Flashcards
what is a migraine?
- unilateral
- pulsating
- severe enough to affect daily activities
what symptoms are frequently accompained with migraine?
- N+V
- phtophobia
- phonophobia
when does aura come with migraines?
precede most at onset of headache
what are the symptoms of migraines with aura?
- visual symptoms -> zigzag, flickering lights, spots, lines
- sensory symp -> pins + needles, numbness
- dsyphagsia
what are the lifestyle advice of migraines with aura?
- maintain hydration
- sleep
- exercise
- avoid chocolate + wine
- relax after stress
- headaches diary = useful triggers
what is acute tx of migraines with aura
- aspirin
- ibuprofen
- 5HTI-receptor agonist - sumatriptan
- soluble paracetamol if x favourable
when is acute tx of migraines with aura given?
- ASAP when symptoms start
- triptan given at start of headache not aura
when is triptans repeated?
- repeated 2hr
- 4hr-naratriptin - only if response to 1st dose x adequate
which antiemetics is given for migraine with aura?
- metoclopramide
- prochlorperazine
what is 1st line migraine prophylaxis?
- propranolol
- if CI then metoprolol/nadolol
what are other migraine prphylaxis tx?
- amitriptyline
- if sedating use less sedating TCA
- sodium valproate
- pizotifen
- botox = specialist
what is cluster headache?
intense unilateral pain or around one eye
what is acute tx of cluster headaches?
- SC sumatriptan
- nasal sumatriptan/zolmitriptan if unavailable
what is prophylaxis tx cluster headaches?
- verapamil
- lithium
- prednisolone
- ergotamine tartate
what is trigeminal neuralgia?
severe facial pain = electrical shock in jaw, teeth or gums
what is tx of trigeminal neuralgia?
carbamazepine
what is tension headache?
bilateral throbbing pain like tight band around head
what is tx of tension headache?
- paracetamol
- ibuprofen
