What is migraine?
Common problem, recurrent, incapacitating, unilateral headaches which are usually supraorbital
HPC Migraines
Usually supraorbital
Last hours days
Spontaneous remission not uncommon
Nausea, vomiting, photophobia
Cause of migraine?
Serotonin release, cerebral artery dilation, increased midbrain grey matter metabolic activity
Precipitating factors for migraine
Stress Alcohol Ripe banana Chocolate OCP May have preceding warnings - aura, light, smells
Diagnosis
Clinical
Management of migraine
Aspirin / paracetamol / NSAID
Lysine acetylsalicylate with metoclopramide in acute attacks
Sumatriptan
Prophylaxis: NSAID, Propranolol, Pizotifen
Botox