Migraine Flashcards
1
Q
What percentage of men and women get migraine
A
18% women
6% men
2
Q
What causes migraine
A
1o brain disorder resulting from altered modulation of normal sensory stimuli + trigeminal nerve dysfunction
3
Q
What are the risk factors
A
- obesity
- Patent foramen ovale
- Stress (bright lights, long-distance travel, extreme weather)
- Trauma
CHOCOLATE - Chocolate, Hangovers, Orgasms, Cheese, Oral contraceptives, Lie-ins, Alcohol, Tumult, Exercise
4
Q
What are the criteria of migraine without aura
A
- Typically 4-72hrs
Need at least 2 of following features
- unilateral
- pulsating
- mod –> sev intensity of pain
- aggravated by or resulting in avoidance of routine physical activity
In addition at least 1 of
- Nausea + vom (affect 60%)
- Photophobia + phonophobia
5
Q
What are the details of migraine with an aura
A
- Gradual onset over mins –> last 5mins to 1hr
- Visual disturbances start in 1 eye - can spread (may be homonymous)
- SCINTILLATING SCOTOMA (shape jagged crescent) common
May be SENSORY (usually follows visual) - paraesthesia
- Usually starts in hand + moves to face/lips/tongue
6
Q
What are the details of menstrual migraines
A
- Without aura
- Occur regularly w.in 1/2 days of onset of menstruation
- Due to falling oestrogen
7
Q
What are the symptoms of migraine
A
- Episodic severe headache (often premenstrual) UNILATERAL
- May be associated with nausea + vom, photophobia, phonophobia
- ALLODYNIA - all stimuli produce pain
- PREMONITORY PHASE - hrs/days beforehand - depression, tiredness, difficulty concentrating, irritability, stiff neck, food craving
8
Q
What investigations do you perform
A
CRITERIA NO AURA
- 5 headaches + N/V (photo/phono)
- Plus any 2 from –> unilateral, pulsating, impairs routine activity
9
Q
How do you treat migraine
A
- NSAIDs + soluble aspiring
- AVOID OPIATE CONTAINING MEDS
- Use prochlorperazine buccal tablet for N + V
SPECIFIC Tx
- Triptans (5HT1- receptor agonist)
- Ergotamine (SE: N+V, abdo pain - use limited by absorption problems)
