Migraine Flashcards
What is a migraine?
A paroxysmal headache that is severe and tends to be unilateral with aura
What is an aura?
A type of prodrome that can involve the eyes, sense of smell, motor function or speech
What causes migraines?
The full cause is not fully known but is thought to be due to Episodic Cerebral Oedema caused by dilation of intracerebral vessels
What problems does it cause?
Migraines often have disabling pain and neurological effects on the patient
Are migraines common?
Yes, they affect 6% of men and 18% of women
When do migraines start?
The first attack is often in childhood, but severity decreases with increasing age
Risk factors (8)
Obesity, hypertension, diabetes, female, Patent foramen ovale, Hyperlipidaemia, Family history, smoking
What triggers can bring on a migraine?
Chocolate, hangovers, orgasms, cheese, oral contraceptives, lie-ins, alcohol, exercise
Symptoms (5)
Chronic headache on at least 15 days of the month, visual/other aura lasting 15-30 mins, unilateral throbbing headache, vomiting, photophobia
Differentials (8)
Cluster, tension, cervical spondylitis, hypertension, intracranial pathology, sinusitis, Otitis Media, TIA
Investigations
Investigations are only required if the healthcare provider suspects an alternative diagnosis
Drug treatment (8)
NSAIDs, Triptans e.g Rizatriptan, Ergotamine as the headache starts, Botulinum Toxin Type A injections, Propanolol, Amitriptylline, Topiromate, Calcium Blocker
Other treatments (6)
Avoidance of triggers, relaxation therapy, CBT, psychotherapy, acupuncture, avoid COCP
Complications (6)
Depression, bipolar, generalised anxiety, status Migrainosus (lasts >72 hours), Migrainus Infarction (when ceberal infarction happens during an attack), increased risk of ischaemic and haemorrhagic stroke
