Migraine - Headaches Flashcards
(11 cards)
18F - recurrent headache
Past H - during exam/stressful situations
past 3 months - 4 episodes of severe H
H - left sided + throbbing + N resolve 12-24 hours
Numbness + tingling - in extremities
Sexually active with BF - use OCP
next step for Mx of the Pt ?
stop OCP
Dx of pt ?
migraine with aura
unilateral - throbbing H
photophobia phonophobia N+V
Symptoms of aura in migraine are ?
visual - wavy lines + visual loss
sensory - paresthenia + numbness + tingling
auditory - sound hearing loss
motor - tremors + weakness
why OCP is contraindicated in migraine female ?
risk of ischemic stroke
OCP – thrmbosis
32 F - H-N-V
H- pounding + localized to the left side
bright spots in her visions
discomfort to bright light
Tx given with - metoclopramide & diphenhydramine
why D is given?
migraine H
- to prevent abnormal motor reaction
Tx of migraine ?
Severe migraine headache with nausea and vomiti ng is typically treated with a serotonin 1B/ 1D agonist (ie,triptans) or a dopamine receptor blocker (eg, metoclopramide, prochlorperazine) to abort the migraine and treat
associated nausea and vomiting
adverse effect of dopamine receptor blockers ?
Dopamine receptor blockade in the basal ganglia can also cause excess cholinergic activity that manifests as
significant extrapyramidal symptoms, such as acute dystonic reaction (eg, torticollis, oculogyric crisis).
why diphenhydramine is co-administrated with dopamine blockers ?
diphenhydramine can be co-administered with metoclopramide or prochlorperazine to prevent such
reactions due to its anticholinergic activity.
migraine pathogenesis ?
Increased cerebral
excitability (cortical
spreading depression) = CGRP ( calcitonin gene related peptide ) = vasodilation + inc neurogenic inflammation = sensitization of meningeal trigeminal afferents = inc pain
triptan effect in migraine ?
dec CGRP ( calcitonin gene related peptide ) = vasoconstrcition + dec neurogenic inflammation
