Migraines

Question 1

who gets migraines

Answer 1

6% of men, 18% of women

first attack often in kids

FH in many

Question 2

What things can cause migraines

Answer 2

Oral contraceptive
Caffeine (or caffeine withdrawal)
alcohol 
travel 
exercise

chocolate/ cheese

50% of cases have no obvious trigger

Question 3

how do migraines present

Answer 3

unilateral, throbbing headache

often preceded by aura (visual (lines/ zigazags) or sensory (paraesthesia))

associated photophobia/ phonophobia

associated n and v

last for 4-72 hours

Question 4

how do you manage a migraine

Answer 4

Oral triptans e.g. Sumatriptan
with NSAIDs e.g. naproxen

antiemeticse.g. Metoclopramide

Avoid triggers

prophylaxis with propranolol

Question 5

how do triptans work to treat migraines

Answer 5

they are serotonin (5HT) receptor agonists

causes vasoconstriction in the brain

Question 6

how do you diagnose a migraine

Answer 6

presence of aura

or

5 headaches lasting 4-72 hours
n and v or photo/phonophobia

AND 2 OF:
unilateral headache
pulsating character
worsened by daily activities

Question 7

what are the DDs for migraines

Answer 7

cluster headache
tension-type headache
sinusitis
brain tumour
giant cell arteritis
TIA