This presentation mainly focus on the types, cause and treatment method of Migraine headache.

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
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3. Pokhara University
School of Health and Allied Sciences
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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.
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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.
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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.
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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.
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People with migraine . . . .
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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
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School of Health and Allied Sciences
Causes
• Triggers do not always cause migraines, and avoiding triggers
does not always prevent migraines.
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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
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School of Health and Allied Sciences
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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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.
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School of Health and Allied Sciences
Stages of Migraine
• Prodrome
• Aura
• Headache
• Postdrome
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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
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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
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School of Health and Allied Sciences
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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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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
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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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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)
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