What is Migraine
Objectives
· To learn about definition, triggers and phases of Migraine
· To learn about pathophysiology, diagnosis, investigation, treatment of migrane, quality of life and management of Migraine.
Migraine
· Migraine is a familial disorder.
Characterized by recurrent attacks of headache widely variable in intensity, frequency and duration. Attacks are commonly unilateral and are usually associated with.
Migraine Triggers
· Disturbed sleep pattern
· Hormonal changes
· Drugs
· Weather changes
· Hunger
· Olfactory visual and auditory stimuli
Phase
1. Prodrome
2. Aura
3. Headache
4. Postdrome
1 -Prodrome
· Vague premonitory symptoms that begin from 12 to 36 hours before the aura and headache
· Symptoms: Excitation, depression, craving or distance for various foods.
· Duration:15 to 20 min.
2-Aura
· Aura is a warning or signal before onset of headache.
· Symptoms: Flashing of light, zig-zag lines, difficulty in focusing
· Duration: 15 to 30 min
3-Headache
· Headache is generally unilateral and is associated with symptoms like:
· Anorexia, nausea, vomiting, photophobia, phonophobia
· Duration: 4- 72hrs
4-Postdrome
· Following headache, patient complains of fatigue, depression, severe exhaustion, some patient feel unusually fresh
· Duration: Few hours or up to 2 days
Pathophysiology
Vascular theory:
Intracranial/extracranial blood vessel vasodilation --- headache.
Intracerebral blood vessel vasoconstriction ----------- aura.
Serotonin theory:
Decreased serotonin levels linked to migraine.
Specific serotonin receptors found in blood vessels of brain.
Diagnosis
Medical history, headache diary, migraine triggers,
Investigations:
ECG, CT brain, MRI
Treatment Quality Of Life
Reducing the attack frequency and severity.
Avoiding escalation of headache medication.
Educating and enabling the patient to manage the disorder.
Improving the patient’s quality of life.
Management
Non-pharmacological treatment:
Identification of triggers
Medication, relaxation training, psychotherapy
Pharmacotherapy:
Abortive therapy, preventive therapy
Aborative Therapy
Non specific treatment:
Aspirin
Paracetamol
Ibuprofen
Naproxen
Specific treatment:
Ergotamine
Dihydroergotamine
Sumatriptan
Rizatriptan
Preventive Treatment
Betablockers.
Propranolol
Calcium channel
Flunarizine
Verapamil
TCAS
Amitriptyline
SSRI
Fluoxetine
LIFESTYLE CHANGES TO PREVENT MIGRANE
Exercise often
Quit smoking and alcohol
Take balanced diet
Manage a good sleeping schedule
Try to meditate once a day
Keep your mind positive
Avoid taking more stress
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| PREVENT MIGRANE FOR HEALTHY LIFE |
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