Migraine Flashcards
What are the prodomal symptoms of migraine?
- Yawning
- Graving for food
- Tiredness
- Irritability
- etc
What are the predomal symptoms for migraine?
- Feeling of “hangover”
- Tiredness
- Sudden burst of energy
- lethargy
What are the aura symptoms?
Visual, sensory and speech disturbance
Symptoms of vascular headache?
- Moderate or severe, pulsating, made worse by physical activity, associated with nausea, vomiting and sensitivity of light and sound.
Key pathway of migraine?
Trigeminal vascular activation:
1) Meninges: Neurogenic inflammation and vessel dilation
2) Trigeminal ganglion activation of pain signaling
3) Second order brainstem neurons
4) brainstem neurons input to sensory cortex -> headache pain
Treatment of migraine?
- Avoidance of triggering factors
- Acupuncture
- Medicine: Preventive medication, acute medication. Choice of medicine is based on attack
How is diagnose of migraine maid?
- By clinical examination
- Based on signs and symptoms
- Based on red flags: SNOOP
What are the parts of SNOOP?
- Systemic symptoms or secondary risk factors (e.g. HIV)
- Neurologic symptoms (e.g. confusion)
- Onset
- Older
- Previous headache history
Risk factors for migraine?
- Gender (female)
- Stress
- Too much pain medications
- Positive family history
- Obesity
- Diabetes
- High frequency of attacs
Genetics of migraine?
- Genome-wide studies have found one DNA variant in the MTDH gene for migraine with aura and six DNA variant in the MTDH gene for migraine without aura.
- FHM (Familial hemisphere migraine) mutatios in severe genes and it is autosomal dominant.
Is migraine inherited?
-Migraine do run in families (90%), but there is still no clear pattern of inheritance. If both parent have migraine, the child have 75% chance of getting it. If only one parent have migraine, the child has 50% chance to inhere it.
How long before the actual migraine attack the premonitory symptoms can start?
Couple of days before: neck stiffness, low concentration, fatigue etc.
