Migraines Flashcards
What are the four main types?
Migraine without aura
Migraine with aura
Silent migraine
Hemiplegic migraine
What are the five stages of migraine?
Prodromal stage
Aura - lasts up to 60 minutes
Headache stage
Resolution stage
Postdromal/recovery phase
Not all patients experience all these stages
How long do migraines last?
4 and 72 hours
What are typical features?
Usually unilateral
Pounding
Photophobia
Phonophobia
Osmophobia
Aura
N+V
What are visual sx of aura
Sparks in vision
Blurred vision
Lines across the vision
Loss of visual fields
What are other potential symptoms of aura?
Sensory - tingling or numbness
Language - dysphasia
What are features of hemiplegic migraines?
Unilateral limb weakness
Ataxia
Impaired consciousness
How can hemiplegic migraine be inherited if familial?
autosomal dominant
What is the acute management of migraine?
Triptan + NSAID
Triptan + paracetamol
Antiemetics - metoclopramide or prochlorperazine
What medication should be avoided in acute management?
Opiates
How are triptans taken?
If it works the first time and has a second attack can be used again
If it does not work the first time they shouldn’t have a second dose for the same attack
What are contraindications of triptans?
Relate to risks associated with vasoconstriction e.g.
HTN
Coronary artery disease
Previous stroke
TIA
MI
What are usual meds for prophylaxis of migraines?
Propanolol
Amitriptyline
Topiramate
What must be taken with topiramate and why?
Contraception as very teratogenic
What are medical treatments for menstrual migraines?
Prophylactic triptans e.g. zolmitriptan
