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Year 3: Neuro > Migraine > Flashcards

Flashcards in Migraine Deck (12)
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1
Q

definition of a migraine?

A
severe episodic headache that may have a prodrome of focal neurological symptoms (aura) and is associated with systemic disturbance. 
can be classified as: 
migraine with aura 
migraine without aura 
migraine variants
2
Q

what are the common triggers for migraine?

A
o	Tiredness/stress 
o	Alcohol 
o	COCP
o	Lack of food or water 
o	Cheese, chocolate, red wine, citrus fruits 
o	Menstruation 
o	Bright lights
3
Q

what criteria need to be fulfilled for a diagnosis of migraines?

A

Headache attacks lasting 4-72 hours* (untreated or unsuccessfully treated)
Headache has at least two of the following characteristics:

• 1. unilateral location*
• 2. pulsating quality (i.e., varying with the heartbeat)
• 3. moderate or severe pain intensity
• 4. aggravation by or causing avoidance of routine physical activity (e.g., walking or climbing stairs)
During headache at least one of the following:

• 1. nausea and/or vomiting*
• 2. photophobia and phonophobia
Not attributed to another disorder (history and examination do not suggest a secondary headache disorder or, if they do, it is ruled out by appropriate investigations or headache attacks do not occur for the first time in close temporal relation to the other disorder)

4
Q

epidemiology of migraines?

A
  • Usually occurs in adolescence and early adulthood more common in women x3
  • Usually occurs in adolescence and early adulthood
5
Q

symptoms of a migraine?

A
o	Unilateral throbbing headache 
o	Nausea 
o	Photophobia 
o	Phonophobia 
o	Duration 4-72 hrs
6
Q

symptoms of an aura?

A
  • Flashing lights
  • Spots
  • Blurring
  • Zigzag lines
  • Blind spots (scotomas)
  • Tingling/numbness in the limbs
7
Q

investigations for migraine?

A
  • Diagnosis is usually based on HISTORY
  • Investigations may be useful for excluding other diagnoses
  • Bloods, CT/MRI, lumbar puncture
8
Q

management plan for acute migraines?

A

o First line: offer combination therapy with oral triptan and NSAID
o Or oral triptan and paracetamol
o Young people: 12-17 offer nasal triptan
o If not effective offer non oral metoclopramide (although be careful with young people)

9
Q

management plan for migraine prophylaxis?

A

o Needs to be given to patients experiencing 2 or more attacks per month
o Topiramate or propranolol as first line
o Propranolol to be prioritised in women of child bearing age
o Topiramate can be teratogenic
o If these fail acupuncture for 5-8 weeks

10
Q

advice for migraine sufferers?

A

o Avoid triggers

o Rest in a quiet dark room during episodes

11
Q

what are the complications of a migraine?

A
  • Disruption of daily activities

* Can lead to analgesia-overuse headaches

12
Q

prognosis for patients with a migraine?

A
  • Usually CHRONIC

* Most cases can be managed well with preventative/early treatment measures