Headache Flashcards
What are the red flags with HA?
new onset headache >55; knownprev malignancy; early morning headache; exacerbation by valsalva or coughing
What is the diagnostic criteria for migraine w/o aura?
2 of : mod/severe; unilateral; throbbing pain; worse on movement and 1 of autonomic features; photo/phonophobia
What is pathophysiology of migraine/
blood vessels constrict and dilate; chemical incl. substance P irritate nerves and blood vessels causing pain
What are the common triggers for migraine?
Chocolate Hangovers Orgasms Cheese/caffeine Oral contraceptives Lie-ins Alchohol Travel Exercise
What is the most common type of aura with migraine?
visual
Where is the migraine centre in the brain?
brainstem
What type of visual aura is most ocmmon?
monochromatic
If the aura is colourful what should be suspected?
an occipital lobe seizure
What is the first treatment fro migraine?
NSAIDs
what advice is given with analgesia and migraine?
take as early as possible
What are triptans?
5HT agonist
What is the problem with triptans in treating migraine?
can get triptan induced headache due to addiction so dont take more than 2x per week
When should migraine prophylaxis be considered?
more than 3 attacks/moth or very severe
How long does eachprophylactic drug for migraine need to be trialled for?
minimum of 4 months
What drugs are used as migraine prophylaxis?
beta-blockers; topiramate; amitriptyline; gabapentin; sodium valproate