Migraine Flashcards
def
severe episodic headache that may have a prodrome of focal neurological symptoms (aura)
how can migraine be classified
1 classical migraine
-headache + aura
2 common migraine
-headache + NO aura
aetiology
unknown
epi
females>males
adolescence/early adulthood
history
1 headache -pulsating -unilateral (mostly) -lasts 4-72h 2 associated symptoms -may be preceded by an aura which may include visual disturbances (flashing lights, spots, blurring) or sensory disturbances (tingling or numbness in limbs) -N+V -photophobia -phonophobia
what might chronic daily headaches suggest
analgesia overuse headaches
what is the classical presentation of a classic migraine
1 aura preceding;
2 headache
-unilateral
-throbbing
what is the classical presentation of a common migraine
1 NO aura preceding; 2 headache -often premenstrual -unilateral -photophobia -phonophobia
examination
none
investigations
none investigations (bloods, CT head, LP) for exclusion
what is prodrome
precedes headache by hours/days
- fatigue
- mood/sleep changes
what is an aura
precedes headache by minutes
- visual disturbances
- sensory disturbances
- motor disturbances in basilar migraine
what are the triggers of migraine
CHOCOLATE
chocolate hangovers orgasms cheese oral contraceptives lie-ins alcohol tumult exercise
management
Conservative Treatment:
-warm/cold packs to the head
-rebreathing into paper bag
Medical Treatment:
-NSAIDs are first line (good as less risk of medication misuse headaches)
-5HT agonists (triptans and ergot alkoloids)
-12 weekly botulinum toxin type A as last resort for chronic migraine
what NSAIDs may be used in treatment of migraine
ketoprofen
aspirin
