7.2 Headache and Migraine Flashcards
1
Q
What are some prodromal symptoms of migraine?
A
- Altered perception
- Tired yawning
- Fluid retention
2
Q
What are some postdromal symptoms of migraine?
A
- Diuresis
- Feeling low
- Tiredness
3
Q
Describe the clinical presentation of migraine
A
- Prodromal symptoms/aura
- Headache (usually unilateral)
- Nausea/vomiting
- Dysphasia
- Unilateral weakness (rarer)
- Photophobia
- Phonophobia
4
Q
What lifestyle changes can be used to treat migraine?
A
- Regular sleep
- Regular meals
- Decreasing trigger foods/drinks (e.g. aged cheese, wine, citrus)
5
Q
Outline the pharmacological management of migraine
A
- Analgesia (aspirin, paracetamol, NSAID)
- Specific migraine drugs (-triptans)
- Metclopramide (prevents nausea)
6
Q
What are triptans used to treat? Outline their basic mechanism.
A
- Used to treat migraine
- Bind to serotonin receptors, vasoconstrict arteries
7
Q
What are some adverse effects of triptans?
A
- Chest/neck tightness (like angina, but not)
- Prolonged lethargy
8
Q
What drugs can be used in migraine prevention?
A
- Propanolol
- Amitripytline
- Valproate/topiramate
- Botox
- Anti-CGRP MAbs (why?)
9
Q
Describe paroxysmal hemicrania. Which drug must it be treated with in order to make a diagnosis?
A
- Repetitive; 2-45mins
- Boring severe, orbital
- Autonomic features (lacrimation, ptosis, pupil changes etc.)
- Preceipitated by alcohol
Must be treated with indomethacin (which is an NSAID)
10
Q
Which drugs are major culprits of rebound headaches?
A
- Caffeine
- Opiates (e.g. codeine)
- Triptans
11
Q
What is idiopathic intracranial hypertension? What risk factor is it strongly associated with? What are its symptoms? What can it cause?
A
- Raised ICP with no obvious cause
- Strongly associated with obesity
- Raised ICP (vision bluriness, LOC, nausea/vomiting etc.)
- Can cause blindness (to go with obesity)
