3. INTRODUCTION:
Migraine is one of the common causes of
recurrent headaches.
According to IHS, migraine constitutes 16% of
primary headaches.
Migraine afflicts 10-20% of the general
population.
In India, 15-20% of people suffer from
migraine.
Migraine is under diagnosed and undertreated. 3
4. “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 anorexia, nausea and
vomiting”.
DEFINITION:
4
7. PRODROME:
Vague premonitory symptoms that begin
from 12 to 36 hours before the aura and
headache.
Symptoms:
Yawning
Excitation
Depression
Lethargy
Craving or distaste for various foods
Duration: 15 to 20 min. 7
8. AURA:
Aura is a warning or signal before onset of
headache.
Symptoms:
Flashing of lights
Zig-zag lines
Difficulty in focussing
Duration : 15-30 min.
8
9. HEADACHE:
Headache is generally unilateral and is
associated with SYMPTOMS like:
1. Anorexia
2. Nausea
3. Vomiting
4. Photophobia
5. Phonophobia
6.Tinnitus
Duration: 4-72 hrs.
9
10. POSTDROME:
Following headache, patient complains of -
Fatigue
Depression
Severe exhaustion
Some patients feel unusually fresh
Duration: Few hours or up to 2 days.
10
11. CLASSIFICATION:
According to Headache Classification
Committee of the International
Headache Society, Migraine has been
classified as:
Migraine without aura (common migraine)
Migraine with aura (classic migraine)
Complicated migraine
11
12. PATHOPHYSIOLOGY:
VASCULAR THEORY:-
o Intracranial/Extracranial blood vessel vasodilation –
headache.
o Intracerebral blood vessel vasoconstriction – aura.
SEROTONIN THEORY:-
o Decreased serotonin levels linked to migraine.
o Specific serotonin receptors found in blood vessels of
brain. 12
15. GOALS FOR TREATMENT:
Establish diagnosis.
Educate patient.
Discuss findings.
Establish reasonable expectations.
Involve patient in decision.
Encourage patient to avoid triggers.
Choose the best treatment.
Create treatment plan.
15
16. LONGTERM TREATMENT:
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.
16
22. SUMMARY OF PREVENTION:
Use preventive medications when needed.
Treat long enough.
Avoid acute medications overuse.
Take coexisting conditions into account.
Use drug with best efficacy for individual
patient.
22
23. CONCLUSION:
It is more common in adults than children and in women
than men. While researchers have some idea of what
happens within the brain during migraine attacks, much
remains to be discovered about its underlying causes and
mechanisms.
In addition, treatment focuses on avoiding those things
that seem to trigger attacks, identifying drugs that
prevent or reduce the severity of attacks and drugs that
reduce the intense pain of a severe attack.
The good news is that several classes of drugs are
effective for different kinds of migraine and most
migraine sufferers can work with their doctor to
minimize migraine's effects. 23
24. REFERENCES:
Headache Classification Committee The International
Classification of Headache Disorders. 2nd edition.
Cephalalgia. 2004;24:1–160.
Lipton RB, Bigal ME, Diamond M, Freitag F, Reed ML,
Stewart WF. Migraine prevalence, disease burden, and the
need for preventive therapy. Neurology. 2007;68:343–9.
Lipton RB, Stewart WF, Diamond S, Diamond ML, Reed M.
Prevalence and burden of migraine in the United States:
Data from the American Migraine Study II. Headache.
2001;41:646–657.
Radat F, Swendsen J. Psychiatric comorbidity in migraine:
A review. Cephalalgia. 2004;25:165–178.
Lipton RB, Hamelsky SW, Kolodner KB, Steiner TJ,
Stewart WF. Migraine, quality of life and depression: A
population-based case control study. Neurology.
2000;55:629–35. 24
25. 25
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