and uul Arabia. 14. Headache f his fever yesha, a 30-year-old lady presents to h

Question

and uul Arabia. 14. Headache f his fever yesha, a 30-year-old lady presents to her general practitioner (GP/with hree month's history of recurrent (3 to 4 times per month) episodes of headache. The headache is preceded by flashing lights in front of her eyes. Then there is gradual onset of throbbing headache, which is localized to the ight side of her head. It is of moderate severity. The headache is associated with nausea, vomiting and sensitivity to noise. It lasts 3 to 4 hours and is o be triggered by eating chocolate and also occurs during periods of There is no associated watering or redness of her eyes. Her headache es not have a relation with time of the day or season. tis relived by king analgesic tablets. There is no history of rade stress. ting in a darkened room and ta

Explanation / Answer

1)Ayesha is suffering from Migraine. A migraine is a primary headache disorder characterized by recurrent headaches that are moderate to severe.The main symptoms of migraine are unilateral headache, photo phobia, nause and vomiting, headache during movements, pulsating or throbbing pain, which are positive in case of ayesha.

2)Migraine triggers:Hormonal changes like premenstrual, perimenopausal, Hunger, Stress, Noises, Sleep deprivation or excess, Food like chocolate, cheese, alcohol like beer and wine, Caffeine, nitrates, humidit, bright light - Neuronal hypersensitivity which can cause corticol spreading depression which Release of vasoactive peptides which in turn leads to Dilatation/plasma protein extravasation causing Migraine aura.

3) Precipitating factors:

A) Hormonal changes:Premenstrual, perimenopausal

B) Stress

C) Sleep deprivation or excess

D) Food:Chocolate, cheese, alcohol like beer and wine, nitrates, caffeine.

E) Weather like excess humidity, bright light

F) Physical activities like intense exercise and sudden movement

4)

Symptoms

Migraines often begin in childhood, adolescence or early adulthood. Migraines may progress through four stages: prodrome, aura, headache and post-drome, though you may not experience all stages.

Prodrome

One or two days before a migraine, you may notice subtle changes that warn of an upcoming migraine, including:

Aura

Aura may occur before or during migraines. Most people experience migraines without aura.

Auras are symptoms of the nervous system. They are usually visual disturbances, such as flashes of light or wavy, zigzag vision.

Sometimes auras can also be touching sensations (sensory), movement (motor) or speech (verbal) disturbances. Your muscles may get weak, or you may feel as though someone is touching you.

Each of these symptoms usually begins gradually, builds up over several minutes and lasts for 20 to 60 minutes. Examples of migraine aura include:

Sometimes, a migraine with aura may be associated with limb weakness (hemiplegic migraine).

Attack

A migraine usually lasts from four to 72 hours if untreated. The frequency with which headaches occur varies from person to person. Migraines may be rare, or strike several times a month. During a migraine, you may experience:

Post-drome

The final phase, known as post-drome, occurs after a migraine attack. You may feel drained and washed out, while some people feel elated. For about 24 hours, you may also experience:

Sensitivity to light and sound

5)Differential diagnosis in a patient with headache can be:

Cerebral Aneurysms

Chronic Paroxysmal Hemicrania

Cluster Headache

Dissection Syndromes

Herpes Simplex Encephalitis

Intracranial Hemorrhage

Muscle Contraction Tension Headache

Temporal/Giant Cell Arteritis

Tolosa-Hunt Syndrome

Viral Meningitis

6)Main management is prevention or avoid the triggering factors.

Prevention

Until recently, experts recommended avoiding common migraine triggers. Some triggers can't be avoided, and avoidance isn't always effective. But some of these lifestyle changes and coping strategies may help you reduce the number and severity of your migraines:

Reduce the effects of estrogen. If you are a woman who has migraines and estrogen seems to trigger or make your headaches worse, you may want to avoid or reduce the medications you take that contain estrogen.These medications include birth control pills and hormone replacement therapy.

Then therapeutic management includes:

Medications

Antipsychotic:

Reduces or improves the symptoms of certain psychiatric conditions.

Analgesic:

Relieves pain.

Nonsteroidal anti-Inflammatory drug:

Relieves pain, decreases inflammation and reduces fever.

Stimulant:

Increases neurotransmitter levels, heart rate and blood pressure. Decreases appetite and sleep.

Nerve pain medication:

Blocks pain caused by damaged nerves.

Triptan:

Relieves pain and symptoms associated with migraines and cluster headaches.

Neurotoxin:

Reduces or eliminates muscle activity and spasms by paralysing muscles.

Dietary supplement:

7)Migraine is the third most common disease in the world (behind dental caries and tension-type headache) with an estimated global prevalence of 14.7% (that’s around 1 in 7 people).

The migraine prevalence was 2.6–5% in Saudi Arabia in 2009

Related Questions

Navigate

• Browse (All)
• Browse A
• Subjects

---

---

Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.