Migraine Flashcards
What are the risk factors of a migraine?
Female Family history Stress High caffeine intake Obesity
What are the symptoms of a migraine?
Dull throbbing headache - moderate/severe
Photophobia
N+V
Aura
How long does a migraine typically last?
4-72 hours
What is an aura?
Visual symptoms
- flickering lights
- spots
- partial loss of vision
Sensory symptoms
- numbness
- tingling
Speech disturbance
What are features of an atypical aura?
Motor weakness Double vision Visual symptoms only affecting one eye Poor balance Reduced consciousness
What should you do if there are features of an atypical aura?
Refer for further investigation
How is an acute migraine managed?
NSAID + triptan + metoclopramide/domperidone
Use as soon as headache starts
What advice should be given to patients?
Ensure a good routine
- plenty of sleep
- well hydrated
Keep a headache
- identify triggers
- avoid triggers
What can be given as prevention for episodic migraines?
Topiramate
B-blocker
What is a menstrual migraine?
Migraine which starts between 2 days before and 3 days after the start of the period for at least 2 out of 3 consecutive months
How often should migraine patients be followed up?
Yearly
What is the pathophysiology of a migraine?
Neurogenic inflammation of trigeminal sensory neurones that innervate blood vessels and meninges
Sensitises nerve fibres so normal pulsations are felt to be painful
