migraine headache

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Classification

Etiology

precipitating factors/agents, risk factors

* avoid estrogen-containing oral contraception if migraine with aura due to increase risk of stroke[24]

Epidemiology

  • 90% of outpatients who present with recurrent primary headache have migraine

Pathology

Genetics

Clinical manifestations

* prodrome is the earliest phase of a migraine preceding headache onset, characterised by non-aura symptoms

POUND mneumonic[24]

  • Pulsatile quality
  • One day's duration (4-72 hours)
  • Unilateral
  • Nausea & vomiting
  • Disabling intensity (patient goes to bed)

* > 3 POUND features 90% predictive of migraine[53]

Red Flags

Diagnostic criteria

Laboratory

  • not helpful except for exclusion of other disease

Radiology

Complications

Warning signs & symptoms of potentially serious cause of headache:

Differential diagnosis

Management

general

pharmacologic therapy

abortive therapy

prophylactic therapy

other therapy

* only topiramate & Botox effective for chronic migraine[24]

More general terms

More specific terms

Additional terms

References

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  2. Kaiser Permanente Drug Information/Professional Services
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