headache 2

Question 1

what are the criteria for a migriane

Answer 1

At least 2 of the following:
1. unilateral
2. throbbing
3. worsened by movement
4. moderate to severe
PLUS 1 of the following:
nausea
vomiting
photophobia and phonophobia

Question 2

what are the aura characteristics

Answer 2

1. positive aura - flickering lights
2. negative aura - loss of vision
3. speech disorders (like news broadcaster)

Question 3

what is specifically not characteristic of aura migraines

Answer 3

weakness

Question 4

what are the key signs for need to refer a headache to a physician

Answer 4

1. systemic symptoms (fever, weightloss, HIV
2. neurologic signs (double vision, hemisensory loss, hemiparesis)
3. onset - worse headache of life or thunderclap (aneurism)
4. old age - new onset after age of 50
5. progression of existing headache disorder/ change in location or frequency

Question 5

what are some environmental triggers of migraines

Answer 5

tobacco
weather changes
strong smells
loud noises
flickering lights

Question 6

what are some foods that can cause migraines

Answer 6

alcohol
caffeine
chocolate
fermented food (aged cheeses)
nitrate foods (processed foods)
sweeteners

Question 7

what are some physiologic triggers of migraines

Answer 7

sleep 
fatige
menstruation
missed meals
prolonged exercise
stress

Question 8

why are menstrual migraines common

Answer 8

the low estrogen levels in first few days of cycle triggers a migraine

Question 9

what oral contraceptive puts estrogen in placebo week to alleviate menstrual migraines

Answer 9

Mircette

Question 10

what medications are associated with headaches

Answer 10

1. vasodilator therapy
2. SSRI’s
3. niacin

Question 11

what are some common vasodilators that often cause headaches

Answer 11

1. nitroglycerin
2. hydralazine
3. dihydropyridine calcium channel blockers