Migraine

Question 1

What is a migraine

Answer 1

Recurring throbbing headache presented with aura and visual changes

Question 2

What is a prodrome

Answer 2

Yawning, Craving and mood change before migraine

Question 3

What is an aura

Answer 3

Visual disturbance or paraethesia before migraine

Question 4

What are the CHOCOLATE causes of migraines

Answer 4

C - Chocolate
H- Hangover
O- Orgasm
C- Cheese
O- Oral contracptives
L - Lay in
A - Alcohol
T - Tumult (Loud noise)
E - Exercise

Question 5

How would you diagnose a patient with migraines

Answer 5

Presence of aura confirms migraine
Or.....
5 headaches in 3 days with N/V, Photophobia and 2
- Unilateral headache
- Throbbing pain
- Worse with activity

Question 6

What are the red flags for a CT/MRI/Lumbar puncture

Answer 6

Thunderclap headache
over 50
Neuro signs
Epilepsy

Question 7

How would you manage a migraine

Answer 7

Sumatriptan (CI in IHD) or Aspirin 900mg
Paracetemol/NSAID
Stop OCP

Question 8

How would you prevent migraine

Answer 8

Avoid triggers
Propanolol Prophylaxis
Amitryptiline

Question 9

An asthmatic patient with migraines wants a prophylaxis for migraines, what is given

Answer 9

Topiramate as they can’t take beta blockers like propanolol

Question 10

At what dose should aspirin be given to treat migraines if sumatriptans are avoided

Answer 10

900 mg

Question 11

Why should oral contraceptives be stopped in migraines

Answer 11

Triggers it
Increases stroke risk
Decrease effect of triptan

Question 12

What is the line of migraine events from prodrome to headache

Answer 12

Prodrome = Mood change (<days)
Aura = Visual change (<attack)
Throbbing headache (<3 days)