Question | Answer |
what is a migraine headache | Recurring primary headache, often initiated by a triggering event and usually accompanied by a neurologic dysfunction |
which gender are migraines more common in | more common in women than men |
are migraines genetic | yes, have a familial association and are thought to be an autosomal dominant trait |
how often do migraines occur and how long do they last | May occur daily or as infrequently as yearly
Can last from 4-72 hours |
what are the two types of migraines | with and without aura's |
what is the cause of migraines | No exact cause for migraines but an association with serotonin and migraines |
what causes the pain in migraines | Cerebral blood vessels narrow and reduce blood flow, followed by vasodilation, swelling and pain |
manifestation of migraines | Unilateral throbbing pain but can become bilateral as headache continues
Chills/nausea/vomiting
Fatigue/sensitivity to light |
manifestation of migraines | Sound/odor sensitivities
Blurred vision
Anorexia
Hunger
Diarrhea/abdominal cramps |
manifestations of migraines | Facial pallor
Sweating
Stiffness/tenderness of neck |
what happens after a migraine | headache area is sensitive to the touch, deep aching is present, and patients are exhausted |
what are precipitating factors for migraines | Rapid change in blood glucose levels
Stress
Emotional excitement
Fatigue |
what are precipitating factors for migraines | Alcohol intake
Stimuli (bright lights)
Foods high in tyramine (aged cheese, nuts, chocolate and alcohol)
Menstrual cycle |
what are some suggestions for reducing migraines | Wake up at the same time each day
Eat your meals and exercise on a regular schedule
No smoking or caffeine after 3pm |
what are some suggestions for reducing migraines | No artificial sweeteners of MSG
Reduce or eliminate red wine, cheese, alcohol, chocolate and caffeine
Practice relaxation techniques, yoga or meditation |
what medications can be used for migraines | Beta blockers (propranolol)
Tricyclic anti-depressants (Endep)
SSRI’s (Paxil)
Calcium channel antagonist (Canlan) |
what medications can be used for migraines | Imitrex in oral, nasal spray or subq injection
Zomig orally or nasal for treatment of headache
Demerol for pain
Antiemetics for nausea and vomitting |
what is a cluster headache | Extremely severe unilateral burning pain located behind or around the eyes |
what population do cluster headaches effect | Most common in men ages 20-40 |
how would a patient describe their cluster headache | The headaches occur in clusters or groups of 1-8 each day for several weeks or months followed by remission lasting months to years |
what are the causes of cluster headaches | Caused by a vascular disorder, disturbance of serotonergic mechanisms, sympathetic defect or dysregulation of hypothalamus |
what are the manifestations of cluster headaches | Pain beginning 2-3 hours after falling asleep
Awakes patient and lasts 15 minutes to 3 hours |
what are the manifestations of cluster headaches | Intense unilateral pain around or behind one eye accompanied by rhinorrhea, lacrimation, flushing, sweating, facial edema and possible mitosis on the affected head
The same side the head is involved in each cluster headache |
what are the precipitating factors of cluster headaches | Alcohol intake
Certain foods
Smoking
High altitude
Sleep cycle disturbances |
what medications can be used for cluster headaches | Ergotamine tartrate suppository at bedtime to prevent attacks
Inhaling 100% O2 at 7L/min for 15 minutes may relieve headaches |
what meds can be used to prevent cluster headaches | Calcium channel blockers
Lithium carbonate
Topiramate
Baclofen
Intranasal lidocaine |
what are the interventions for cluster headaches | combination of patient teaching, medications and measures to control contributing factors |