Migraine headache: Difference between revisions

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** Fatigue and irritability
** Fatigue and irritability
* Pain is generally made worse by physical activity.
* Pain is generally made worse by physical activity.
* '''Up to one-third''' of people have an aura: typically a short period of visual disturbance that signals that the headache will soon occur.  
* Aura (33%): typically a short period of visual disturbance that signals that the headache will soon occur.


=== Sign / Symptoms ===
=== Sign / Symptoms ===
Migraine has three stages
Migraine has three stages


* Aura '''phase'''
* Aura phase


* Pain '''phase'''
* Pain phase


* Postdrome
* Postdrome
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Symptoms can be '''visual''', '''sensory''' or '''motor'''
Symptoms can be '''visual''', '''sensory''' or '''motor'''


* Visual effects occur most frequently; they occur in up to 99% of cases and in more than 50% of cases are not accompanied by sensory or motor effects.
* Visual effects  
** '''Visual''': Flickering animation a scintillating scotoma. The scintillations are of a zigzag pattern starting in the center of vision, surrounded by a somewhat larger area with distortion of shapes
** Flickering animation a scintillating scotoma. The scintillations are of a zigzag pattern starting in the center of vision, surrounded by a somewhat larger area with distortion of shapes
** Some people lose part of their field of vision known as hemianopsia while others experience blurring.
** Hemianopsia or Blurring
** Sensory aura occur in '''30–40% of people with auras'''. Feeling of '''pins-and-needles''' begins on one side in the hand and arm and spreads to the nose–mouth area on the same side.  
** Sensory aura (30–40%) Feeling of pins-and-needles begins on one side in the hand and arm and spreads to the nose–mouth area on the same side.
** '''Numbness''' usually occurs after the '''tingling''' has passed with a loss of position sense.  
** Numbness usually occurs after the tingling has passed with a loss of position sense.
** Aura phase can include '''speech or language disturbances''', world spinning, and less commonly motor problems.  
** Speech or language disturbances: World spinning and less commonly motor problems.
** Motor symptoms indicate that this is a hemiplegic migraine, and weakness often lasts longer than one hour unlike other auras.  
** Motor symptoms: Hemiplegic migraine, weakness often lasts longer than one hour unlike other auras.
** Auditory hallucinations or delusions have also been described.
** Auditory hallucinations or delusions have also been described.


==== Pain phase ====
==== Pain phase ====


* Classically the headache is unilateral, throbbing, and moderate to severe in intensity. It usually comes on gradually and is aggravated by physical activity.
* Unilateral, throbbing + Moderate to severe intensity.  
* In more than 40% of cases, however, the pain may be '''bilateral''' and '''neck pain''' is commonly associated with it.
* Usually comes on gradually  
* Bilateral pain is particularly common in those who have migraines without an aura.
* Agg by physical activity
* Less commonly pain may occur primarily in the back or top of the head.  
* Pain may be bilateral (40%)
* Neck pain is commonly associated with it.


===== Basilar migraine =====
===== Basilar migraine =====
A migraine with neurological symptoms related to the brain stem or with neurological symptoms on both sides of the body, common effects include a  
A migraine with neurological symptoms related to the brain stem or with neurological symptoms on both sides of the body, common effects include a  


* Sense of the world spinning
* Sense of the world spinning /Light-headedness /Confusion
* Light-headedness
* Nausea (90%) / Vomiting (33%).  
* Confusion
* Dark and quiet room amel
* '''Nausea occurs in almost 90%''', and vomiting occurs in 33%. Many thus seek a dark and quiet room.
* Blurred vision, Nasal stuffiness, Diarrhea, Frequent urination, pallor, or sweating.
* Other symptoms may include blurred vision, nasal stuffiness, diarrhea, frequent urination, pallor, or sweating.  
* Swelling or tenderness of the scalp may occur as can neck stiffness.  
* Swelling or tenderness of the scalp may occur as can neck stiffness.  


===== Acephalgic migraine =====
===== Acephalgic migraine =====


* Rarely, an aura occurs without a subsequent headache.
* Aura occurs without a subsequent headache
* Also known as  silent migraine; however, it is difficult to assess the frequency of such cases because people who do not experience symptoms severe enough to seek treatment may not realize that anything unusual is happening to them and dismiss it without reporting any problems.
* Also known as  silent migraine  
 


==== Postdrome ====
==== Postdrome ====
The migraine postdrome could be defined as that constellation of symptoms occurring once the acute headache has settled. Many report a sore feeling in the area where the migraine was, and some report '''impaired thinking''' for a few days after the headache has passed. The person may feel tired or "'''hung over'''" and have head pain, '''cognitive difficulties''', '''gastrointestinal symptoms''', '''mood changes''', and '''weakness'''. According to one summary, "Some people feel '''unusually refreshed''' or '''euphoric''' after an attack, whereas others note '''depression''' and malaise." For some individuals this can vary each time.
 
* for a few days after the headache has passed
* Feel tired or "hung over"  
* Cognitive difficulties / Impaired thinking
* Gastrointestinal symptoms,  
* Mood changes  
* Weakness
* Feel unusually refreshed / Euphoric
* Depression / Malaise
 




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=== Migraine Miasms ===
=== Migraine Miasms ===
* Is migraine a seizure with autonomic presentation. Its aura is due to seizure and its angiospasm is due to autonomic presentation
* If so then, [[SAHF, South American Hemorrhagic Fever|SAHF]] is the best miasm, since it covers Seizure + Headache + Vasoconstriction
{| class="wikitable"
{| class="wikitable"
!Aura
!Aura

Revision as of 20:55, 20 May 2023

Clinic

  • A migraine is a primary headache disorder characterized by recurrent headaches that are moderate to severe.
  • Typically, the headaches affect one half of the head, are pulsating in nature, and last from a few hours to 3 days.
  • Associated symptoms may include
    • Nausea, vomiting
    • Sensitivity to light, sound, or smell
    • Fatigue and irritability
  • Pain is generally made worse by physical activity.
  • Aura (33%): typically a short period of visual disturbance that signals that the headache will soon occur.

Sign / Symptoms

Migraine has three stages

  • Aura phase
  • Pain phase
  • Postdrome

Aura phase

Symptoms can be visual, sensory or motor

  • Visual effects
    • Flickering animation a scintillating scotoma. The scintillations are of a zigzag pattern starting in the center of vision, surrounded by a somewhat larger area with distortion of shapes
    • Hemianopsia or Blurring
    • Sensory aura (30–40%) Feeling of pins-and-needles begins on one side in the hand and arm and spreads to the nose–mouth area on the same side.
    • Numbness usually occurs after the tingling has passed with a loss of position sense.
    • Speech or language disturbances: World spinning and less commonly motor problems.
    • Motor symptoms: Hemiplegic migraine, weakness often lasts longer than one hour unlike other auras.
    • Auditory hallucinations or delusions have also been described.


Pain phase

  • Unilateral, throbbing + Moderate to severe intensity.
  • Usually comes on gradually
  • Agg by physical activity
  • Pain may be bilateral (40%)
  • Neck pain is commonly associated with it.
Basilar migraine

A migraine with neurological symptoms related to the brain stem or with neurological symptoms on both sides of the body, common effects include a

  • Sense of the world spinning /Light-headedness /Confusion
  • Nausea (90%) / Vomiting (33%).
  • Dark and quiet room amel
  • Blurred vision, Nasal stuffiness, Diarrhea, Frequent urination, pallor, or sweating.
  • Swelling or tenderness of the scalp may occur as can neck stiffness.


Acephalgic migraine
  • Aura occurs without a subsequent headache
  • Also known as silent migraine


Postdrome

  • for a few days after the headache has passed
  • Feel tired or "hung over"
  • Cognitive difficulties / Impaired thinking
  • Gastrointestinal symptoms,
  • Mood changes
  • Weakness
  • Feel unusually refreshed / Euphoric
  • Depression / Malaise


Related disease

  • Migraines are associated with MDD, bipolar disorder, anxiety disorders, and OCD. These psychiatric disorders are approximately
  • 2–5 times more common in people without aura
  • 3–10 times more common in people with aura


Migraine Miasms

  • Is migraine a seizure with autonomic presentation. Its aura is due to seizure and its angiospasm is due to autonomic presentation
  • If so then, SAHF is the best miasm, since it covers Seizure + Headache + Vasoconstriction
Aura Visual Sensory Speech Motor World spinning Hallucinations

Delusions

Entities

Rubrics

Retinitis

Visual field deficit

Paresthesia

Hyperstasia

Aphasia Hemiplegia

Hemiparesis

Vertigo

Dizziness

Auditory hallucination
Basilar migraine
World spinning Blurred vision Nasal stuffiness Diarrhea Frequent urination Pallor Sweating
Entities

Rubrics

Vertigo

Dizziness

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