Migraine Flashcards
Describe the characteristics of a migraine
idiopathic
paraoxysmal
unilateral pain
Are migraines a primary or secondary headache disorder?
primary
What are the types of migraines?
classical migraine
common migraine
silent migraine
What is the difference between a classical and a common migtaine?
common migraines are more common, no aura
What is a silent migraine?
aura present but no headache
features of an aura
visual and sensory distubrances
aphasia
fainting
what characterises stage 1 of a migraine?
prodromal head discomfort
irritability
sensitivity to smells and noises
what stage does the aura occur?
2
describe phase 3 of a migraine?
pain
4-72 hours
what stage does the pain disapear?
4
describe phase 5 of a migraine?
postdromal phase lingering non-pain symptoms similiar to that seen in prodromal phase
does vasoconstriction or vasodilation occur first?
vasoconstriction
pathophysiological theories
inflammatory substances
genetic
environmental
familial
vascular
hormone
what is though to cause auras?
vasoconstriction of cerebral blood vessels
what is thought to cause headache pain and throbbing?
vasodilation
which neuromodulators are invovled in the development and the symptoms of a migraine?
nitric oxide and substance P
How would an increase in serotonin affect migraine?
enhance migraines due to increased NO activity
how does NO increase afferent firing?
sensitiation of nerve endings
vascular dilation
what neuropeptides contribute to neuroinflammation?
SP
CGRP
how do SP and CGRP lead to NO release?
cause release of mediators which act on vascular endothelium
effect of sensory nerve discharge
CGRP and SP production
aura
why are 5HT2 antagonits used to treat migrains?
limits NO
what are the effects of 5HT1D agonists?
inhibit vasodilation
reducing sensoty nerve discharge
limiting aura
preventing neuropeptide release
effect of CGRP antagonists
limiting neuroinflammation effectd of CGRP
purpose of CGRP monoclonal antibodies
deactive CGRP
NSAIDS mechanism of action
inhibit COX enzymes and therefore release of inflammatory mediators
risatriptan better than sumatriptan as
higher oral bioavailability and rate of absorption
Triptan mechanism of action
5-HT1B and 5-HT1D receptor agonists
newer Triptans
longer half life, bioavailability, faster onset, longer duration and less cardio effects
Migraine Treamtments
Triptans
Ergotamines
Nauesea Treatment
DA receptor antagonists
Magnesium
