Central Nervous System - Migraines Flashcards
1
Q
what is a migraine?
A
- unilateral
- pulsating
- severe enough to affect daily activities
2
Q
what symptoms are frequently accompained with migraine?
A
- N+V
- phtophobia
- phonophobia
3
Q
when does aura come with migraines?
A
precede most at onset of headache
4
Q
what are the symptoms of migraines with aura?
A
- visual symptoms -> zigzag, flickering lights, spots, lines
- sensory symp -> pins + needles, numbness
- dsyphagsia
5
Q
what are the lifestyle advice of migraines with aura?
A
- maintain hydration
- sleep
- exercise
- avoid chocolate + wine
- relax after stress
- headaches diary = useful triggers
6
Q
what is acute tx of migraines with aura
A
- aspirin
- ibuprofen
- 5HTI-receptor agonist - sumatriptan
- soluble paracetamol if x favourable
7
Q
when is acute tx of migraines with aura given?
A
- ASAP when symptoms start
- triptan given at start of headache not aura
8
Q
when is triptans repeated?
A
- repeated 2hr
- 4hr-naratriptin - only if response to 1st dose x adequate
9
Q
which antiemetics is given for migraine with aura?
A
- metoclopramide
- prochlorperazine
10
Q
what is 1st line migraine prophylaxis?
A
- propranolol
- if CI then metoprolol/nadolol
11
Q
what are other migraine prphylaxis tx?
A
- amitriptyline
- if sedating use less sedating TCA
- sodium valproate
- pizotifen
- botox = specialist
12
Q
what is cluster headache?
A
intense unilateral pain or around one eye
13
Q
what is acute tx of cluster headaches?
A
- SC sumatriptan
- nasal sumatriptan/zolmitriptan if unavailable
14
Q
what is prophylaxis tx cluster headaches?
A
- verapamil
- lithium
- prednisolone
- ergotamine tartate
15
Q
what is trigeminal neuralgia?
A
severe facial pain = electrical shock in jaw, teeth or gums
