Migraines and Headaches Flashcards
What is Migraine?
Migraine is a chronic and episodic disorder,
characterized by headache attacks.
Decreased ability to function in everyday situations
Migraine duration?
Recurrent headaches lasting 4-72 hours
Migraine Site?
One-sided, pulsating, moderate-to-severe pain
Migraine Symptoms?
- Nausea and/or vomiting
- Sensitivity to light (called photophobia)
- Sensitivity to sound (called phonophobia)
Number of Migraine Symptoms?
Often 2 of these 3 key symptoms are present (attack)
Additional migraine symptoms?
may include sweating or cold hands,
diarrhea, pale skin color, and scalp tenderness or pain
from touch or pressure (such as a necklace touching
skin, hair brushing, or shaving)- called allodynia.
Frequent migraines symptoms?
- Nausea in 73% of patients
- Vomiting in 29% of patients
- Sensitivity to light in 80% of
patients - Sensitivity to sound in 76% of
patients
The five stages of an attack - Migraine?
- The prodrome (warning) stage: Signs, such as mood
changes, tiredness, anunusual hunger or thirst can
happen up to 48 hours before an attack. - The aura: This part of the attack can last up to an hour
and usually precedes the headache. Symptoms may
include visual disturbances, pins and needles, confusion
etc. - The main stage of the attack: A headache will often be
present along with other symptoms, such as nausea and/ or vomiting and can last between 4 and 72 hours. - Resolution / postdrome stage: The pain gradually eases
or may disappear, but feelings of lethargy or being
‘washed-out’ may remain. - Recovery stage: It can take a few days to fully recover, or
for the more lucky ones, recovery can be surprisingly
quick
MIgraine trigger?
A migraine trigger is any environmental,
dietary, or physiologic factor that can provoke
migraine activity in the brain.
What Can Trigger a Migraine?
- Menstruation
- Shortness – irregular- too much (sleep)
- Stress (or in some patients, relaxation from
stress) - Alcohol (e.g., red wine)
- Caffeine (e.g., coffee, chocolate)
- Foods containing glutamate or aspartame
- Dehydration
- Vasodilating drugs (e.g., nitrates)
What to Do When Nausea Is an Issue?
- Antiemetics/prokinetics, such as domperidone or metoclopramide, can
improve nausea. - These medications are sometimes given
before the analgesics to improve absorption
of the medication.
Pharmacological prevention of chronic migraine?
Topiramate or Botulinum toxin injections
Medication Overuse?
- Can produce rebound headache.
- Can reduce the efficacy of preventive therapy.
- Can mask the headache phenotype.
Treatment options in migraines?
- Lifestyle Modification
- Nonpharmacolgic and complementary therapies
- Acute Medications
- Preventative Medications
Tension Headache?
A mild to moderate pain often described as feeling like a tight band around the head.
