Pradeep Paudel :Migraine

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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

Transcript of Pradeep Paudel :Migraine

Page 1: Pradeep Paudel :Migraine

Pokhara UniversitySchool of Health and Allied Sciences

Migraine

Pradeep PaudelFourth Semester, B Pharm

Roll.no:18

School of Health and Allied SciencesPokhara University, Dhungepatan, Lekhnath, Kaski , Nepal

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Pokhara UniversitySchool of Health and Allied Sciences

Topics Under Discussion• Introduction• Symptoms• Causes • Types of migraine• Stages of migraine• Treatment method• Conclusion• References

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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.

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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.

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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.

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Menstrual MigraineMenstrual 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 accompaniedby nausea or vomiting.

– Headache occurs more frequently.

– Menstrual migraine is more difficult to treat.

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People with migraine . . . .

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SymptomsFollowing 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

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Pokhara UniversitySchool of Health and Allied Sciences Causes

• Triggers do not always cause migraines, and avoiding triggers does not always prevent migraines.

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How is migraine caused?

1Migraine originates deep within the brain

2Electrical impulses spread to other regions of the brain

3Changes in nerve cell activity and blood flow may result in visual disturbance, numbness or tingling, and dizziness

4Chemicals in the brain cause blood vessel dilation and inflammation of the surrounding tissue

5The inflammation irritates the trigeminal nerve, resulting in severe or throbbing pain

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Types of Migraine

Migraine with aura (classical migraine)

Migraine without aura (common migraine)

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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.

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• 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.

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Stages of Migraine

• Prodrome

• Aura

• Headache

• Postdrome

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PRODROMEIt’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

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• 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

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Pokhara UniversitySchool 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

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POSTDROME Following headache, patient complains of:

• Fatigue

• Depression

• Severe exhaustion

• Some patients feel unusually fresh

Duration: Few hours or up to 2 days

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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

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Nonpharmacologic and Complementary Therapies

• Relaxation training

• Hypnotherapy

• Biofeedback training

• Cognitive/behavioral management

• Acupuncture

• Nutritional supplements (B2 and others)

• Physical therapy and/or massage1 May 2023 Migraine 23

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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.

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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)

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