Migraine Flashcards
1
Q
Define migraine
A
Severe episodic headache which may have a prodrome of focal neurological symptoms (aura)
2
Q
What are the causes/risk factors of migraine?
A
Risk Factors
• Family history of migraine
• Female
Triggers • Cheese • Alcohol • Caffeine • Chocolate • Stress • Lack of sleep • Exercise • OCP
3
Q
What are the symptoms of migraine?
A
Aura • Visual disturbance • Flashing lights, spots • Blurring • Zig-zag lines (fortification spectra) • Blindspots (scotomas) • Tingling • Numbness
Headache (4-72h) • Pulsating headache – unilateral > bilateral • Nausea • Vomiting • Photophobia • Phonophobia
4
Q
What are the signs of migraine?
A
No physical findings
5
Q
What investigations are carried out for migraine?
A
Clinical diagnosis • Bloods - FBC - ESR – exclude GCA • CT/MRI – exclude SAH, raised ICP, SOL • Lumbar puncture – exclude meningitis, SAH
6
Q
What is the management for migraine?
A
Acute • Analgesia plus antiemetics e.g. metoclopramide - NSAIDs e.g. naproxen - Paracetamol - Codeine • Hydration • 5-HT1 agonists e.g. sumitriptan
Prophylaxis • Beta-blockers • Amitryptilline • Sodium valproate • 5-HT2 antagonist e.g. pizotifen • CCB e.g. flunarizine
Advice • Regular meals and sleep • Caffeine restriction • Reduce stress • Avoid triggers
7
Q
What are the complications of migraine?
A
- Disruption of daily activities
- Analgesia-overuse headache
- Depression
