Migraines

A video lecture all about migraine - mainly focusing on diagnosis and treatment of this very common neurological problem.

 

Lecture by

Video Duration: 11 minutes

  • Migraine
    Created by Dr Ed Wallitt
    General
    Epidemiology

    Common (up to 12% population). Twice as common in women.

    Pathology

    Not known. Possibly related to dilation/constriction of cerebral blood vessels and calcitonin gene related peptide.

    Top three causes

    50% have precipitants (chocolate, oral contraceptive, cheese, caffeine, alcohol, exercise)

    Clinical Features
    Symptoms

    Unilateral headache. 30% have aura (sensory). Photophobia, vomiting.

    Signs

    No clinical or neurology signs (important negative finding)

    Investigations
    Cultures

    None

    Bloods

    None

    Imaging

    None

    Scopic/Biopsy

    None

    Functional

    None

    Treatment
    Conservative

    Simple analgesia for pain (paracetamol, aspirin) +/- anti-emetic (e.g. metoclopramide)

    Medical

    5HT agonists (triptans) e.g. sumitriptan.

    If > 2 attacks/month can try pizotifen, beta-blockers or amytriptyline

    Surgical

    None