Slide 1: PROJECT REPORT ON
MIGRAINE HEADACHE INTRODUCTION : INTRODUCTION Migraine is a common, often familial disorder.
Characterized by unilateral throbbing headache.
Onset: Childhood/early adulthood
Family history: 70% cases FORMS OF MIGRAINE : FORMS OF MIGRAINE Migraine with AURA : Migraine with AURA Warning of visual, sensory or motor type followed by headache(throbbing and unilateral)
Worsened by bright light
Relieved by sleep
Associated with nausea and vomitting. Migraine without AURA : Migraine without AURA Common Migraine.
Absence of aura.
“Tension” headache. Characteristics of AURA… : Characteristics of AURA… Several forms of aura ;
1.Visual:comprise of flashing lights,zig-zag fortifications, scintillating scotoma.
2.Visual field defects:auras of occipital cortex area.
3.Headache is recurrent, lasting for 2-48 hrs. and rarely occur >2 times/week. Mechanisms : Mechanisms Mutations in mtDNA and Ca channel: familial cases
Vascular and neuronal processes and changes in SEROTONIN activity : causes severe attacks. Types of Migraine with aura : Types of Migraine with aura Detailed descriptions : Detailed descriptions 1.)BASILAR: bilateral visual symptoms, vertigo, dysarthria, unsteadiness, affects young females.
2.)HEMIPLEGIC: aura of unilateral paralysis, usually lasts for some days after setting. (When it is familial, Mendelian Dominant Disorder Inheritance is seen.) Recovery is rule. Contd…. : Contd…. 3.)OPTHALMOPLEGIC: Extra ocular nerve palsies, usually IIIrd or rarely VIth. May result from dilatation of ICA within Cavernous sinus.
4.)RETINAL: Monocular visual loss which is reversible and followed by headache.
Note: Rarely Migraine can present as an episodic coma, this is called as MIGRAINE COMA. Precipitating factors : Precipitating factors DIAGNOSIS : DIAGNOSIS Clinical History with:
1.) +ve family history
2.) Travel sickness/migraine equivalents in childhood
3.) Onset of adolescence, early adulthood, menopause, etc.
Note: ALWAYS distinguish Migraine from AV malformation/ Hypoglycemia/ partial focal epilepsy and aneurysms compressing IIIrd nerve. MANAGEMENT : MANAGEMENT >Identify and avoid precipitating factors.
>Prophylaxis is used for frequent and severe attacks.
may be useful.
Eg)Topiramate Contd… : Contd… Slide 15: THANK YOU…..
Charu Dutt Arora