Signs and symptoms of Migraine headaches

1. Learning Outcomes # 2.
Clinical manifestations and neurological symptoms.
Ange M. Pompee-Synsmir, MSN ARNP FNP-BC

2. Learning Objectives
By the end of the session, participants will:
1. Describe clinical manifestations, signs and symptoms of
migraine headaches.
2. Develop proficiency and demonstrate a systematic approach in
the evaluation of patients who present with acute migrainous
headache.
Participants will receive a self assessment quiz and an evaluation at
the end of the lecture; and will receive immediate feedback to
clarify any misunderstandings.

3. Migraine Headaches

4. Signs and Symptoms of Migraine
• Throbbing, pulsating headache
• Unilateral and localized pain in the frontotemporal and ocular area.
• Nausea and vomiting
• Photophobia and Phonophobia
Neurologic symptoms may include:
Hemiparesis (this symptom defines hemiplegic migraine)
Aphasia
Visual Field defects (scotoma, light flashes, visual hallucinations)
Confusion
Paresthesias or numbness
(http://emedicine.medscape.com/article/1142556-clinical)

5. Migraine Symptoms and Stages

6. Migraine Without Aura
Attacks lasting 4-72 hours
At least two of following characteristics: unilateral,
pulsating, moderate to severe, aggravated by movement
At least one associated symptom: nausea or vomiting,
photophobia and phonophobia.
http://www.achenet.org/resources/types_of_headaches/

7. Migraine with Aura
One or more transient focal aura symptoms
Gradual development of aura symptom over >4 minutes
Aura symptoms last 4 to 60 minutes
Headache follows or accompanies the aura within 60
minutes

8. Migraine Variants
Hemiplegic (familial)
Basilar
Ophthalmologic
Transient migrainous accompaniments
http://www.achenet.org/resources/types_of_headaches/

9. Migraine Variants
Hemiplegic (familial)
Basilar
Ophthalmologic
Transient migrainous accompaniments
http://www.achenet.org/resources/types_of_headaches/

10. Migraine headaches cont’d.

11. Migraines

12. Migraine Assessment

13. Goal of Therapy in Treatment of Migraine
The goals of both pharmacologic and nonpharmacological treatment
of migraine are:
Reduce attack frequency, severity, and disability
Reduce reliance on poorly tolerated, ineffective, or unwanted acute
pharmacotherapies
Improve quality of life
Avoid acute headache medication escalation
Educate and enable patients to manage their disease to enhance
personal control of their migraine
Reduce headache-related distress and psychological symptoms

14. The End