Monday, 4 April 2011

Migraine ( next post covering all headache types)

Migraine

Prevalence in Men 6 % in women 18%

Typical Characteristics

Can be preceded by aura, visual or auditory or nausea and vomiting

Aggravated or starting with physical activity

Unilateral, throbbing (pulsating), moderate to severe, lasts 4hrs to 24hrs

Better with staying in dark room

Common triggers

Light, chocolate, wine, alcohol, cheese, citreous juices, tiredness, stress, menstruation and COP

Treatment

Acute attack

Paracetamol + NSAIDs + antiemetic

Sumatriptans (5HT 1 agonist) Start as soon as the attack starts

S/E chest tightness/heaviness

Contraindications IHD/ MI/cerebrovascular disease

Prophylaxis

B-Blocker /gabapentin/ sodium valoprate/ venlafaxine/  5HT2 antagonist

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