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BRS 1b > Migraines & Headaches > Flashcards

Migraines & Headaches Flashcards

1
Q

What are three main migraine attacks?

A

1) Pain
2) Pain and focal symptoms
3) Focal symptoms

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2
Q

What are the five main phases of migraines?

A

Prodrome
Aura
Headache
Resolution Recovery

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3
Q

What is the prodrome phase of a migraine?

A

This is the predecessor phase for migraines, upon a trigger these symptoms precede the development of headache and migraine-like features.

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4
Q

What symptoms are associated with a prodrome headache?

A 
Changes in mood
Urination 
Fluid retention
Food craving 
Yawning
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5
Q

What are the typical features of a migraine aura?

A

Visual (Scintillating scotomas and blindspots) and sensory disturbances ( Numbness/paraesthesia)

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6
Q

What are the two types of visual disturbances in patients experiencing a migraine aura?

A

Positive signs: Scintillating scotomas.

Negative signs: Blind spots and visual occlusions

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7
Q

What is a scintillating scotoma?

A

A positive visual aura sign in individuals experiencing a migraine.
There is a zig-zag crescent progressively expanding towards the periphery as the electrical depression grows across the cerebral and visual cortex

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8
Q

What sensory disturbances are experienced in individuals with an aura migraine?

A

Numbness
Paraesthesia
Weakness
Speech arrest

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9
Q

Scintillations and blind spots are associated with which face of a migraine?

A

Aura

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10
Q

Which phase proceeds the aura phase of migraine?

A

Headache: Head and body (pulsating hemicranial), nausea and photophobia (irritation to light).

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11
Q

Photophobia is associated with which migraine phase?

A

Headache phase

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12
Q

Which phase proceeds the headache phase of a migraine?

A

Resolution phase

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13
Q

What is the resolution phase of a migraine?

A

This periods alleviates the associated symptoms and pain, enabling patients to rest and sleep.

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14
Q

Which is the final phase of a migraine?

A

Recovery

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15
Q

What is the recovery phase of a migraine?

A

Sensitivity to the migraine effects, there are associated mood disturbances, food intolerances and the feeling of being hungover.

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16
Q

What is the typical duration of a migraine?

A

3-12 hours

17
Q

What class of drug is metoclopramide in terms of migraine treatment?

A

Anti-emetic and a pro-kinetic agent

18
Q

Why is metoclopramide used for migraine treatment?

A

As a pro-kinetic agent it stimulates peristalsis (gastric paresis in patients with migraines), therefore reducing the sensation of nausea and vomiting.

Soluble preparations are prepared to aid absorbed

19
Q

What are the common forms of pharmacological treatment in migraine patients?

A

Aspirin/Ibuprofen (Non-steroidal) and paracetamol and metoclopramide

Triptans

20
Q

What is the mechanism of triptans?

A

Triptans are selective 5HT1 receptor agonists, inducing vasoconstriction within pain-sensitive intracranial vessels.

21
Q

Which combination of drugs results to greater recovery outcomes in patients with a migraine?

A

Synergise with non-steroidal (ibuprofen) with triptan.

22
Q

What preparations are available for triptans?

A

Tablets, melts, nasal sprays, s/c injections

23
Q

Why should opioids be prescribed with cauation?

A

Opioids exhibit an analgesic abuse potential. There are fluctuations with the associated headache pain, thus reoccurrence of headaches encourages individuals to take more painkillers.

24
Q

How can a transcranial magnetic stimulation alleviate the symptoms of a migraine?

A

TMS interrupts complex networks that trigger and perpetuate migraine, which is caused by spreading electrical depression across the cerebral cortex.

25
Q

What is a possible explanatory reason for migraineurs having sensitive heads?

A

There is a genetic predisposition within individuals resulting in an increased sensitivity to environmental triggers, since overstimualtion of the cortex

26
Q

What can migraineurs do to avoid migraines?

A

Identify particular triggers for a migraine, and avoid them.

  • Identify any dietary triggers (Citrus, dairy chocolate, alcohol)
  • Identify any changes in the environment including light, ventilation and barometric pressure
  • Dehydration (recommended to drink 2L water a day
  • Avoid caffeinated drinks
  • Avoid stress (individuals should plan accordingly their daily activities to minimise stress).
  • Never skip meals (avoid takeaways and ready meals). Preservatives could trigger migraines.
27
Q

What over the counter treatment can be used for migraines as a prophylaxis?

A

Feverfew, coenzyme Q10, riboflavin, magnesium, EPO, nicotinamide

28
Q

Which TCA can reduce the severity and frequency of headaches?

A

Amitriptyline at 7pm

29
Q

Which migraine prophylaxis is effective?

A

Pizotifen (Serotonin antagonists)

30
Q

How does erenumab antibodies work when treating patients with migraines?

A

Disables calcitonin gene-related peptides or receptor (CRGP mAbs)

31
Q

What are tension-type headaches?

A

Tight muscles around head and neck bilaterally.

32
Q

Which types of pharmacological interventions are preferred in patients with tension type headaches?

A

NSAIDs

33
Q

What are the acute forms of treatment for individuals with a cluster headache?

A

Inhaled oxygen, oxygen inhibits neuronal activation in the trigeminocervical complex

34
Q

Which complex is inhibited by oxygen therapy in patients with cluster headached?

A

Trigeminocervical complex

35
Q

Which drug is typically prescribed in individuals with cluster headaches?

A

Sumatriptan

36
Q

What is the typical duration of a cluster headache?

A

45 minutes - 3 hours

37
Q

Which type of headache is mainly concerned with nausea and vomitting?

A

Migraines

38
Q

What type of headache is associated with pulsating hemicranial pain?

A

Migraines

BRS 1b (62 decks)

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