Migraine
Migraine is the most common primary headache1.
Epidemiology
Pathophysiology
Note
Migraine and cluster headaches were previously termed “vascular disorders” but this term is innaccurate since it ignores the electrophysiological, inflammatory, autonomic, serotonergic, and neuroendocrine factors that impact their pathophysiology2.
There is still the idea that there is a vascular component since caffeine helps to reduce migraines, presumably through vasoconstriction
Etiology
- 75% of migraine patients have a family history of migraines, suggesting a genetic component2.
Triggering and Precipitating Factors
Migraines can be provoked by:
Clinical presentation
Precipitating factors
- Stress
- Exertion
- Food
- Bright lights
- Noise
- Menstruation
Preceding factors:
- Possibley some of the triggering factors
- Aura: warning symptoms (visual blurring, shimmering, scintillating distortions, or fortification scotoma)2
Onset: Rapid onset, can awaken w ha, aura can proceed the HA
Area of symptoms:
- Unilateral
- Temporal
- Frontal or retro orbital
- Can change sides
Quality of symptoms:
- Throbbing
- Pounding
- Moderate to severe
Associated symptoms:
- Nausea
- Vomiting
- Photophobia
- Phonophobia
DDX
- Unilateral
Prevention
- As soon as u have aura, take drug to limit severity
- Excedrin: Contains caffeine
- Caffeine can help by dilating blood vessels
Treatment
- Botox in suboccipital area has been beneficial in cases
Physical Therapy
References
1.
Blumenfeld H. Neuroanatomical Basis of Consciousness. In: The Neurology of Conciousness. 2nd ed. Elsevier; 2016:3-29. doi:10.1016/B978-0-12-800948-2.00001-7
2.
Blumenfeld H. Neuroanatomy Through Clinical Cases. 3rd ed. Oxford university press; 2022.
Citation
For attribution, please cite this work as:
Yomogida N, Kerstein C. Migraine. https://yomokerst.com/The
Archive/Signs and Symptoms/Headache/migraine.html