Migraines Flashcards
What are the 4 types of migraines?
1) migraine without aura
2) migraine with aura
3) silent migraine
4) hemiplegic migraine
What is a silent migraine?
Migraine with aura but without the headache
Give the 5 stages of migraines:
1) prodromal (subtle, early symptoms e.g. fatigue)
2) aura (up to 60 mins)
3) headache (4-72 hours)
4) resolution
5) post-dronal (recovery)
Give 8 symptoms associated with migraines:
1) unilateral pain
2) pounding/ throbbing character
3) visual changes
4) photophobia
5) osmophobia
6) phonophobia
7) vomiting
8) nausea
What is osmophobia?
discomfort with loud noises
Give 6 potential features of a migraine aura:
1) sparks in the vision
2) blurred vision
3) lines across the vision
4) loss of visual fields (scotoma)
5) dysphagia
6) tingling or numbness
Give 3 presentations associated with hemiplegic migraines:
1) unilateral limb weakness (hemiplegia)
2) ataxia (loss of coordination)
3) impaired consciousness
What genetic condition is characterised by hemiplegic migraines?
familial hemiplegic migraine disease
What is the inheritance path for familial hemiplegic migraine disease?
autosomal dominant
Give 8 triggers of migraines:
1) stress
2) bright light
3) strong smells
4) chocolate, cheese, caffeine
5) dehydration
6) menstruation
7) disrupted sleep
8) trauma
Give 4 pharmaceutical options for acute migraines:
1) NSAIDs (ibuprofen, naproxen)
2) paracetamol
3) triptans
4) antiemetics for vomiting
Give 2 examples of antiemetics used in migraine treatment:
1) metoclopramide
2) prochlorperzine
What triptan is given for acute migraines?
sumatriptan
True or false: opiates can make migraines worse
True
What receptor do triptans act on?
5-HT receptor agonists (especially 5HT1B and 5-HT1D)
Give 3 mechanisms of triptan action that make them effective in treating migraines:
1) stimulating cranial vasoconstriction
2) inhibiting the transmission of pain signals
3) inhibiting the release of inflammatory peptides
When should triptans be taken for acute migraines?
as soon as the migraine starts (should halt the attack)
Give 3 contraindications for triptan use:
1) hypertension
2) coronary artery
3) previous stroke/ TIA
Give 3 drugs used in migraine prophylaxis:
1) propanolol (non-selective beta blocker)
2) amitriptyline (tricyclic antidepressant)
3) topiramate
True or false: topiramate is highly teratogenic
True
Name two triptans that can be used for menstrual migraine prophylaxis:
1) frovatriptain
2) zolmitriptan
Why should a female patient who suffers migraines avoid the combined oral contraceptive pill?
both are risk factors for stroke
