MEDI7212 Lecture 11: W2 - Old primary headaches
Document Summary
F:m is 3:1 ratio, start in adolescence or 20s, largest prevalence at 35-45yo: complex, polygenic pattern of inheritance. Familial hemiplegic migraine (fhm) - autosomal dominant, aura is attacks of lateralised weakness: mutations in 3 associated genes - atp1a2, cacna1a, scn1a - account for 75% cases, pathophysiology. > reflex increase for several minutes causing raised icp via vasodilation [migraine headache] Family hx of migraine is common: migraine triggers, emotional or physical stress, missed meals, specific foods (ie chocolate), alcohol, caffeine, tyramine or msg containing. Lack or excess sleep food: bright lights, loud noise [sensory stimulation, menstruation, use of ocps, criteria. Sensory (paresthesia/ numbness/ vertigo), motor (ophthalmoplegia, limb or facial weakness) and/or cognitive symptoms (speech disturbance) may also occur. Symptomatic therapy: during acute attacks, rest in a quiet, dark room. First line: nsaids (ibuprofen, paracetamol + aspirin + caffeine, ergotamines (moderate to severe migraines) 6 per day, 10 per week) or rectal suppositories if vomiting (3 per day,
