Migraine and Other Primary Headache Disorders

Question 1

How many migraine patients have an aura phase ?

Answer 1

20-25%

Question 2

Molecular targets of triptans and ditans ?

Answer 2

Triptans act as agonists at the 5-HT1B and 5-HT1D receptors, ditans are exclusive agonists of 5-HT1F receptors (they act only at neural targets)

Question 3

Define chronic migraine

Answer 3

Episodes of migraine on eight or more days per month and with at least 15 total days of headache per month

Question 4

5-HT1B/1D receptor agonists are contraindicated in…?

Answer 4

Individuals with a history of cardiovascular and cerebrovascular disease.

Question 5

Treatment of chronic TTH ?

Answer 5

Amitriptyline

Question 6

Patients with trigeminal autonomic cephalalgia should undergo…?

Answer 6

Pituitary imaging ( there is an excess of TAC presentations in patients with pituitary tumor-related headache)

Question 7

Characteristics of Cluster Headache regarding duration and frequency ?

Answer 7

The typical patient has daily bouts of one to two attacks of relatively short-duration (15-180 minutes) unilateral pain for 8-10 weeks

Question 8

Another characteristic of TACs ?

Answer 8

Unilateral Photophobia/ Phonophobia

Question 9

Acute attack treatment of cluster headache ?

Answer 9

Sumatriptan 6 mg SC, Sumatriptan 20 mg and zolmitriptan 5 mg nasal sprays (preventive treatment with verapamil)

Question 10

Side effects of verapamil ?

Answer 10

Constipation, Leg swelling, Gingival Hyperplasia, HEART BLOCK particularly at high doses (monitoring every 6 months with long-term treatment)