Migranes

Question 1

Why are migraines harmless?

Answer 1

• They don’t inherently threaten health
• They are self-limiting
• The frequency often reduces with age

Question 2

What is a migraine?

Answer 2

severe throbbing or pulsing headache which is often temporal or retrobulbar. Can often accompanied by nausea & vomiting

Question 3

What are the two classifications of a migraine?

Answer 3

• migraine with aura
• migraine without aura

Question 4

What is a retinal migraine?

Answer 4

repeated attacks of monocular visual disturbance including scotoma or blindness, associated with migraine headaches

Question 5

What are the 4 phases of a migraine with aura?

Answer 5

• prodromal phase
• aura phase
• headache phase
• postdromal phase

Question 6

What is the migraine prodromal phase?

Answer 6

• They feel a sense of premonition regrading an imminent migrane episode
  The migraineur may feel irritable, depressed or abnormally tired and an exhibit sensory hypersensitivity e.g noise and bright lights

Question 7

What is the migrane aura phase?

Answer 7

Occurs 5-30 mins prior to next stage. Sensory function disturbance can occur and is frequently visible. Can be coloured or described as zigzagging

Question 8

What is the headache phase of the migraine?

Answer 8

unilateral throbbing behind the eye or temporally. Pain can last 4 hours to several days. Nausea is also a common symptom as well as sensory hypersensitivity

Question 9

What is the postdromal phase of a migraine?

Answer 9

Person affected can feel abnormally fatigued and emotionally depressed. They can also have a reduced lack of energy for a couple days after the episode

Question 10

What is the depolarization theory?

Answer 10

Known as the cortical spreading depression. The neurological activity is depressed over an area of the cortex of the brain. This releases inflammatory mediators leading to irritation of the cranial roots

Question 11

What is the vascular theory?

Answer 11

When the blood vessels in the brain contract and expand. Starts in the occipital lobe. The reduced blood to the occipital lobe triggers the aura

Question 12

What is the serotonin theory?

Answer 12

A neurotransmitter which helps control mood. Low serotonin levels in the brain lead to constriction and dilation of blood vessels triggering a migraine

Question 13

What are precipitating factors of a migraine?

Answer 13

caffeine
chocolate
alcohol
MSG
anxiety
psycho-social stress

Question 14

What are the differential diagnoses for migraine without aura?

Answer 14

• tension
• dehydration
• cluster headache
• drug related or rebound headache
• intracranial disorders

Question 15

What are the differential diagnoses for migraine with aura?

Answer 15

• TIA
• cerebral embolus
• arterio-venous malformations
• oestrogen-induced cerebrovascular compromise

Question 16

What are relieving factors for a migraine?

Answer 16

• Caffeine
• OTC meds - co-codamol, ibuprofen
• acupuncture
• physiotherapy
• magnesium, vit B supps and herbal meds