Migraine Flashcards
1
Q
What is the definition of a migraine?
A
Recurrent headache associated with visual and GI disturbances
2
Q
How common are migraines?
A
Common
3
Q
What is the pathophysiology of a migraine?
A
- Change in bloodstem blood flow
- = unstable trigeminal and basal thalamus nuclei
- Release of CGRP and substance P
- Inflammation
- A wave of neuronal and glial depolarisation causes cortical spreading depression = aura
- 3 types:
- Migraine with aura (classic)
- Migraine without aura (common)
- Migraine variants (unilateral motor/sensory symptoms)
4
Q
What are the risk factors/aetiology of migraines?
A
- Woman
- Before the age of 40 years old
- Chocolate
- Cheese
- Too much/too little sleep
- Noise
- Irritating lights
- Pre-menstruation
- OCP
5
Q
What are the signs/symptoms of migraine?
A
- Aura
- Scotomata
- Unilateral blindness
- Hemianoic field loss
- Flashes
- Fortification spectra – bright, shimmering, jagged lines that spread from the centre of the visual field outwards
- Aphasia
- Tingling
- Numbness
- Weakness of one side of the body
- Headache
- Unilateral
- Throbbing
- Builds up over minutes to hours
- Nausea/vomiting
- Photophobia – prefers the dark
- May last for some days
- Made worse by physical exertion
- Irritable
- Fatigue
- Changes in mood/appetite
6
Q
What diseases present similarly to migraine?
A
- Stroke/TIA
- Meningitis
- Subarachnoid haemorrhage
7
Q
How are migraines diagnosed?
A
Clinical diagnosis
8
Q
What are the pharmacological treatment for migraines?
A
- Prophylaxis – for patients with >2 attacks per month
- Pizotifen
- Beta blockers
- Amitriptyline
- Mild attack
- Paracetamol/NSAIDs
- Antiemetic
- Moderate/severe attacks
- Serotonin 1B/1D agonists e.g. Sumatriptan
- Botilinum toxin type A – if >15 headaches a month
9
Q
What are the non pharmacological treatment for migraines?
A
- Sleep
- Avoid triggers
- Stop taking hormones
