Migraines Flashcards
What are the two different type of migraines?
- Migraine WITHOUT aura & Migraine WITH aura
What is a migraine WITHOUT aura?
- At least 5 attacks
- Headache lasting 4-72 hours
- Unilateral, Pulsating, moderate pain
- SE: Nausea, Vomiting, Photophobia, Phonophobia
What is a migraine WITH aura?
- Two attacks
- One fully reversible aura
- NO aura lasting 60 mins -> headache within 60 mins
- SE: Visual, Sensory, speech, motor, brainsteam, retinal
What are some of the other migraine types [not WITH or WITHOUT aura]?
- Status Mirgrainosus: Attack lasting > 72 hours
- Basilar-Type Migraine: Bilateral pain in back of the head
- Hemiplegic Migraine: Temporary paralysis on one side of the body
What are the four phases of migraine headache?
- Prodome, Aura, Migraine Headache, Postdromal
What is the Prodrome phase of Migraine headaches?
- Can feel the symptoms of a migraine hours or days BEFORE onset
- SE: Euphoria, Depression, Irritability, Food Craving, Constipation, Neck stiffness, Yawning
What is the Aura phase of Migraine Headaches?
- Most commonly visual [maybe sensory, sensory, motor] issues
- BEFORE or DURING the migraine lasting 60 mins
- SE: Photopsia, Scotoma, Zigzag Lines; Numbness/Tingling in arms, legs, face
What is the Migraine Headache phase of Migraine Headache??
- Dull aches
- Unilateral and throbbing
- SE: Phonophobia and/or photophobia
What is the Postdromal phase of Migraine headaches?
- Headache like symptoms that last for several days after the headache has ended
- SE: Tiredness, head pain, GI Issues, Weakness, Cognitive Difficultes
What are some of the triggers for Migraines?
- Medication overuse
- Medications: OC, Hydralazine, NTG, Nifedipine…
- Foods: Choclate, oranges, tomatoes, CAFFEINE, alcohol…
- Additives/Presevatives: Aspartame and MSG
- Environment
- Too LITTLE or too MUCH sleep, skipping meals, stress…
How is a migraine caused from medication overuse?
- Its is a rebound headache that result from the body becoming use to using meds to help with the headache
- Associated with analgesics, ergots, triptans
- Treated with low dose NSAID
What are the two type of treatment for migraines?
- Abortive & Preventive
What is Abortive treatment for migraines?
- Acute treatment; ALL patients should be offered
- EDUCATE to avoid overuse
- Mild-Moderate: NSAIDS or Acetaminophen
- Moderate-Severe: Triptans or Ergots
What is Preventive treatment for mirgraines?
- Four or more attacks/months with disability at least 3 days/month
- FAIL abortive treatment or USING abortive meds more than twice a week
- Cheaper than acute meds
What are some of the medications that are used in abortive treatment for migraines?
- 1st Line: Triptans, NSAIDS [Ergots, Butorphanol]
- 2nd Line: NSAIDS [Ergotamines, combo products]
- 3rd Line: Contraindications or Failure to respond use IV Valproate
What are some of the medications that are used in Prevention treatment of Migraines?
- 1st Line: Valproate, Topiramate, Metoprolol, Propranolol [Botox?]
- 2nd Line: Amitriptyline
- 3rd Line: Calcitonin Gene-Realted, Peptide (CGRP) Receptor Antagonist
What are some of the non-pharmacological therapy for migraines?
- Biofeedback and Relaxation Therapy
- Cognitive Behavioral Therapy
- Diet
- Sleep
-Transcutaneous Electrical Nerve Stimulation Device - Exercise, Massage, Acupuncture…
- Headache Diary [Avoid Triggers]