Migraine Flashcards
(43 cards)
What is a migraine?
Migraine is a common type of primary headache characterized by a severe, unilateral, throbbing headache associated with nausea, photophobia, and phonophobia.
How long can migraine attacks last?
Attacks may last up to 72 hours.
What do patients typically do during a migraine attack?
Patients characteristically go to a darkened, quiet room during an attack.
What is a ‘classic’ migraine?
‘Classic’ migraine attacks are precipitated by an aura, which occurs in around one-third of migraine patients.
What are typical characteristics of a migraine aura?
Typical aura are visual, progressive, last 5-60 minutes, and are characterized by transient hemianopic disturbance or a spreading scintillating scotoma.
What is the prevalence of migraines in men and women?
Migraine is 3 times more common in women; prevalence in men is around 6%, in women 18%.
What are common triggers for a migraine attack?
Common triggers include tiredness, stress, alcohol, combined oral contraceptive pill, lack of food or dehydration, cheese, chocolate, red wines, citrus fruits, menstruation, and bright lights.
What are the diagnostic criteria for migraines?
A: At least 5 attacks fulfilling criteria B-D. B: Headache lasting 4-72 hours. C: At least two characteristics: unilateral location, pulsating quality, moderate/severe pain, aggravation by routine physical activity. D: At least one of the following: nausea/vomiting, photophobia, phonophobia. E: Not attributed to another disorder.
What is hemiplegic migraine?
Hemiplegic migraine is a variant of migraine in which motor weakness is a manifestation of aura in at least some attacks.
What is the estimated prevalence of hemiplegic migraine?
Hemiplegic migraine is very rare, with an estimated prevalence of 0.01% (around 1 in 1,000 migraine patients), more common in adolescent females.
Migraine Diagnostic Criteria
What are the diagnostic criteria for migraine without aura?
At least 5 attacks fulfilling criteria B-D.
What is the duration of headache attacks in migraine without aura?
Headache attacks lasting 4-72 hours (untreated or unsuccessfully treated).
What are the characteristics of headache in migraine without aura?
Headache has at least two of the following characteristics:
1. unilateral location
2. pulsating quality
3. moderate or severe pain intensity
4. aggravation by or causing avoidance of routine physical activity.
What symptoms may occur during a migraine headache?
During headache at least one of the following:
1. nausea and/or vomiting
2. photophobia and phonophobia.
What is the requirement for migraine diagnosis regarding other disorders?
Not attributed to another disorder.
How do migraine symptoms differ in children?
In children, attacks may be shorter-lasting, headache is more commonly bilateral, and gastrointestinal disturbance is more prominent.
What is the typical aura in migraine with aura?
Typical aura includes a transient hemianopic disturbance or a spreading scintillating scotoma (‘jagged crescent’).
What percentage of migraine patients experience migraine with aura?
Migraine with aura is seen in around 25% of migraine patients.
What are the NICE criteria for migraines regarding aura?
NICE suggests migraines may be unilateral or bilateral and gives more detail about typical auras.
What are the characteristics of auras according to NICE?
Auras may occur with or without headache, are fully reversible, develop over at least 5 minutes, and last 5-60 minutes.
What are atypical aura symptoms that may prompt further investigation?
Atypical aura symptoms include:
1. motor weakness
2. double vision
3. visual symptoms affecting only one eye
4. poor balance
5. decreased level of consciousness.
What are the general rules for 5-HT receptor agonists and antagonists in migraine management?
5-HT receptor agonists are used in the acute treatment of migraine, while 5-HT receptor antagonists are used in prophylaxis.
What did NICE produce in 2012 regarding migraines?
NICE produced guidelines on the management of headache, including migraines.
