Lecture 7.2 - Migraine 1

Question 1

Episodic Migraine (EM)

Answer 1

< 15 monthly migraine days (MMDs) or monthly headache days

Question 2

Chronic Migraine (CM)

Answer 2

> 15 MHDs for > 3 months (> 8 days are MMDs)

Question 3

Aura

Answer 3

complex of positive and negative focal neurologic symptoms that precedes or accompanies an attack

Question 4

Positive Symptoms

Answer 4

Scintillations
Photopsia
Teichopsia
Fortifiction spectrum

Question 5

Negative Symptoms

Answer 5

Scotoma

Hemianopsia

Question 6

Medication-overuse Headache

Answer 6

self-sustaining cycle of headaches in which the headache returns when the medication wares off, leading to use of more medication utilization which perpetuates the cycle.

Characterized by increased headache frequency and medication consumption

Question 7

Primary headache

Answer 7

Sinus
Cluster
Tension
Migraine

Question 8

Secondary Headaches

Answer 8

Head trauma
Stroke
Infections
substance abuse/withdrawal
Craniofacial structure disorders

not good for selfcare

Question 9

Sinus Headache

Answer 9

pain is usually behind the forehead and/or cheekbones

Question 10

Cluster Headache

Answer 10

pain is in and around one eye

Question 11

Tension Headache

Answer 11

pain is like a band squeezing the head

Question 12

Migraine Headache

Answer 12

pain, nausea, and visual changes are typical of classic form

Question 13

Tension Headache onset & duration

Answer 13

gradual & Min to days

Question 14

Migraine Headache onset & duration

Answer 14

sudden & hours to 2 days

Question 15

Sinus Headache onset & duration

Answer 15

Simultaneous w/ sinus symptoms & Days (resolves w/ sinus symptoms)

Question 16

Migraine Risk factors

Answer 16

Gender ( Women > men)
Age
Socioeconomic status
Family History
Diet
Co-morbidities (Neurologic, psychiatric, CV disorders)

Question 17

Acute Migraine Pathophysiology

Answer 17

External trigger -> Neuronal dysfunction -> Vasodilation -> Activation of trigeminal nerves -> Neuroeptide release -> inflammation

Question 18

4 phases of acute migraines

Answer 18

Prodrome/Premonitory Symptoms
Aura
Headache
Postdrome/Resolution

Question 19

Prodrome/Premonitory Symptoms

Answer 19

1. few hours to days prior to onset of migraine

Question 20

Aura

Answer 20

Duration: 20-60min, headache usually begins within 60mins of aura

occurs in ~ 25% of patients

Question 21

Headache Duration

Answer 21

4-72hrs

Question 22

Postdrome/Resolution

Answer 22

Duration: few hours to few days

Question 23

POUND

Answer 23

P: pulsatile quality 
O: one day duration (4-72h)
U: unilateral
N: nausea/vomiting
D: Disabling

Question 24

Non-pharm therapy for migraines

Answer 24

Cold compress
Rest or sleep
Quiet, dark environment
Devies
ID and avoidance of triggers
Behavior intervention = relaxation tech, acupuncture, wellness programs