migraine headache

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Post on 07-May-2015



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  • 1.Mohammed Nabil J AlAli 5th Year Medical Student At King Faisal University Group B (210006209)

2. OUTLINES : - DEFINITION - SIGNS AND SYMPTOMS - MANAGMENT 3. The word derives from the Greek (hemikrania) : pain on one side of the head ( hemi- "half , kranion "skull )Migraine is a familial disorder characterized by recurrent attacks of headache widely variable in intensity, frequency and duration. Attacks arecommonly unilateral and are usually associated with anorexia, nausea and vomiting 2/23/20143 4. According to stage : is the complex of neurological symptoms that occurs just before or at the onset of migraine headacheVague symptoms that begin from 12 to 36 hours before the aura and headache1- Prodrome2- Aura4- Postdrome3- Headacheresolution stage , recovery -Deprresion - fatigue For hours to two days 2/23/2014from 4 to 72 hours4 5. Throbbing or pulsatile headache, with moderate to severe pain that intensifies with movement or physical activityUnilateral and localized pain in the frontotemporal and ocular area, but the pain may be felt anywhere .Pain builds up over a period of 1-2 hours, progressing posteriorly and becoming diffuseHeadache lasts 4-72 hoursNausea (80%) and vomiting (50%), including anorexia and food intolerance, and light-headednessSensitivity to light and sound2/23/20145 6. May precede or accompany the headache phase or may occur in isolationUsually develops over 5-20 minutes and lasts less than 60 minutesMost commonly visual (can be sensory, motor, or combination )Visual symptoms may be positive or negativeScintillating scotoma is the most common positive visual phenomenon .2/23/20146 7. 2/23/20147 8. Non-pharmacologicalPharmacological- Identification of triggers - Meditation ( Yoga ) - Relaxation training - PsychotherapyClassified as :2/23/2014-Abortive ( acute phase ) - Prophylactic (preventive).8 9. Selective serotonin receptor (5-hydroxytryptamine1, or 5-HT1) agonists (triptans) 2/23/2014Ergot alkaloids (eg, ergotamine, dihydroergotamine [DHE]) Analgesics NSAIDs Combination products Antiemetics 9 10. Some indications :Frequency ( greater than 2 per month) Duration of attacks ( longer than 24 hours) Cause major disruptions in the patient's lifestyle, with significant disability that lasts 3 or more days Abortive therapy fails or is overused Symptomatic medications are contraindicated or ineffective Use of abortive medications more than twice a week Risk of permanent neurologic injury[ 2/23/201410 11. 2/23/2014Antiepileptic drugs Beta blockers Tricyclic anti-depressants Calcium channel blockers Selective serotonin reuptake inhibitors (SSRIs) NSAIDs Serotonin antagonists Botulinum toxin 11 12. In December 2013, the FDA approved the Cerena Transcranial Magnetic Stimulator (Cerena TMS), the first device to relieve pain caused by migraine headache with aura for use in patients aged 18 years and older .2/23/201412 13. 2/23/2014http://www.healandhealth.com14 14. Thank you


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