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Pradeep Paudel :Migraine
- 1. Pokhara University School of Health and Allied Sciences Migraine Pradeep Paudel Fourth Semester, B Pharm Roll.no:18 School of Health and Allied Sciences Pokhara University, Dhungepatan, Lekhnath, Kaski , Nepal
- 2. Pokhara University School of Health and Allied Sciences Topics Under Discussion • Introduction • Symptoms • Causes • Types of migraine • Stages of migraine • Treatment method • Conclusion • References 29 February 2016 Migraine 2
- 3. Pokhara University School of Health and Allied Sciences 29 February 2016 Migraine 3
- 4. Pokhara University School of Health and Allied Sciences Introduction • Derived from the Greek word “ hemikranios” = half head • A neurological disorder characterized by hyper excitability of the nervous system that leads to recurrent moderate to severe headache. • Migraine attacks are characterized by unilateral and pulsating severe headache, lasting 4-72 hours. 29 February 2016 Migraine 4
- 5. Pokhara University School of Health and Allied Sciences CLINICAL FEATURES • Migraine is the second most common cause of headache, affecting approximately 15% of women and 6% of men. • It is usually an episodic throbbing headache associated with certain features like: sensitivity to light, sound or movement, nausea and vomiting. 29 February 2016 Migraine 5
- 6. Pokhara University School of Health and Allied Sciences Migraine and Women Hormonal fluctuation plays an important role in migraine for many women. • 60% of women with migraine experience “menstrual migraine”. • Headaches are associated with change in estrogen levels right before menses and most often occur up to 2 days before or during menses. • Oral contraceptives may either exacerbate or alleviate the frequency, severity and duration of headaches. 29 February 2016 Migraine 6
- 7. Pokhara University School of Health and Allied Sciences Menstrual Migraine Menstrual migraine differs somewhat from other migraine. They differ in following ways: – Pain may persist longer and be more severe. – Headache attack is more likely to be accompanied by nausea or vomiting. – Headache occurs more frequently. – Menstrual migraine is more difficult to treat. 29 February 2016 Migraine 7
- 8. Pokhara University School of Health and Allied Sciences People with migraine . . . . 29 February 2016 Migraine 8
- 9. Pokhara University School of Health and Allied Sciences Symptoms Following symptoms are observed during migraine attack: • Eye pain • Extreme sensitivity to light or sound • Nausea • Vomiting • Severe pain, usually on one side of the head 29 February 2016 Migraine 9
- 10. Pokhara University School of Health and Allied Sciences Causes • Triggers do not always cause migraines, and avoiding triggers does not always prevent migraines. 29 February 2016 Migraine 10
- 11. Pokhara University School of Health and Allied Sciences How is migraine caused? 1 Migraine originates deep within the brain 2 Electrical impulses spread to other regions of the brain 3 Changes in nerve cell activity and blood flow may result in visual disturbance, numbness or tingling, and dizziness 4 Chemicals in the brain cause blood vessel dilation and inflammation of the surrounding tissue 5 The inflammation irritates the trigeminal nerve, resulting in severe or throbbing pain 29 February 2016 Migraine 11
- 12. Pokhara University School of Health and Allied Sciences Types of Migraine Migraine with aura (classical migraine) Migraine without aura (common migraine) 29 February 2016 Migraine 12
- 13. Pokhara University School of Health and Allied Sciences Migraine without Aura Migraine With Aura No aura or prodrome. Aura or prodrome is present. Unilateral throbbing headache may be accompanied by nausea and vomiting. Unilateral throbbing headache and later becomes generalized. During headache, patient complains of phonophobia and photophobia. Patient complains of visual disturbances and may have mood variations. 29 February 2016 Migraine 13
- 14. Pokhara University School of Health and Allied Sciences • Migraine sometimes accompanied with some warning signs are called "aura". Most of these signs are sensory stimulations, such as flashes of light or dark spots. 29 February 2016 Migraine 14
- 15. Pokhara University School of Health and Allied Sciences Stages of Migraine • Prodrome • Aura • Headache • Postdrome 29 February 2016 Migraine 15
- 16. Pokhara University School of Health and Allied Sciences PRODROME It’s the first stage of migraine which starts 2 days before the attack, including: • Depression • Diarrhea or Constipation • Neck stiffness • Irritability or Hyperactivity • Food cravings 29 February 2016 Migraine 16
- 17. Pokhara University School of Health and Allied Sciences AURA • Not all the people with migraine headaches experience aura. It is usually visual experiences, but can also be sensory, motor or verbal disturbances. These experiences last 10 to 30 minutes. They include: • Visual disturbances, bright spots or flashes of light • Zig-zag lines • Difficulty in focusing 29 February 2016 Migraine 17
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- 20. Pokhara University School of Health and Allied Sciences HEADACHE • Migraine headache typically last from 4 to 72 hours, but the frequency with which headaches occur varies from person to person. During a migraine, people may experience some of the following symptoms: • Pain on one side of head or both • Pain that has a pulsating, throbbing quality • Sensitivity to light, sounds and sometimes smells • Nausea and vomiting • Blurred vision 29 February 2016 Migraine 20
- 21. Pokhara University School of Health and Allied Sciences POSTDROME Following headache, patient complains of: • Fatigue • Depression • Severe exhaustion • Some patients feel unusually fresh Duration: Few hours or up to 2 days 29 February 2016 Migraine 21
- 22. Pokhara University School of Health and Allied Sciences Treatment method • A variety of drugs have been used to treat migraines. • Pain relieving medications are taken during migraine attacks and are designed to stop symptoms that have already begun. • Pain-relievers • Triptans • Ergot • Ergotamine and caffeine combination drugs • Anti-nausea medications • Opiates • Dexamethasone 29 February 2016 Migraine 22
- 23. Pokhara University School of Health and Allied Sciences Nonpharmacologic and Complementary Therapies • Relaxation training • Hypnotherapy • Biofeedback training • Cognitive/behavioral management • Acupuncture • Nutritional supplements (B2 and others) • Physical therapy and/or massage 29 February 2016 Migraine 23
- 24. Pokhara University School of Health and Allied Sciences Conclusion • Hence, Migraine is a neurological disorder characterized by recurrent moderate to severe headaches. But one should know that not all headaches represent migraines, and migraine is not the only condition that can cause severe and debilitating headaches. • Self-care is recommended to reduce the migraine severity and frequency. 29 February 2016 Migraine 24
- 25. Pokhara University School of Health and Allied Sciences References • Walker BR and Ralston SH (2010) Davidson’s Principles and Practice of Medicine (21st Ed.), Elsevier, Edinburg, pp1267- 1268 • http://www.medicinenet.com/migraine/article.htm (Accessed on: Dec 20, 2015) • https://en.wikipedia.org/wiki/Migraine (Accessed on : Dec 20, 2015) 29 February 2016 Migraine 25
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Editor's Notes
- Here are some examples of nonpharmacologic and complementary therapies used to treat migraine. These approaches may be well suited for patients who have exhibited a poor tolerance or poor response to drug therapy, or who have a medical contraindication to drug therapy. Nonpharmacologic intervention may also be useful in patients with significant stress or in patients who are pregnant, are planning to become pregnant or are nursing. These therapies vary in effectiveness from patient to patient. Talk to your healthcare provider and together you can decide which, if any, may be a good choice for you.