Difference between revisions of "Migraine headache"

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==Treatment==
 
==Treatment==
*1st line: [[Prochlorperazine]] (compazine) 10mg IV (+/- [[diphenhydramine]] 12.5 mg IV)
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*1st line: [[Prochlorperazine]] (compazine) 10mg IV (+/- [[diphenhydramine]] 12.5 mg IV)<ref>Coppola et al, Annals of Emergency Medicine, Nov 1995. Randomized, Placebo-Controlled Evaluation of Prochlorperazine Versus Metoclopramide for Emergency Department Treatment of Migraine Headaches.</ref>
 
**Most effective therapy  
 
**Most effective therapy  
 
*2nd line:
 
*2nd line:
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*International Headache Society Diagnostic Criteria
 
*International Headache Society Diagnostic Criteria
 
*Detsky et. al, JAMA  '06 Does this Patient with a Headache have a Migraine or need Neuroimaging?
 
*Detsky et. al, JAMA  '06 Does this Patient with a Headache have a Migraine or need Neuroimaging?
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<references>Coppola et al, Annals of Emergency Medicine, Nov 1995. Randomized, Placebo-Controlled Evaluation of Prochlorperazine Versus Metoclopramide for Emergency Department Treatment of Migraine Headaches.</references>
  
 
[[Category:Neuro]]
 
[[Category:Neuro]]

Revision as of 15:12, 16 June 2015

Background

Definition: Migraine Headache without Aura

  • At least 5 attacks of headache fulfilling the following criteria:
    • HA attacks lasting 4–72 hr (untreated or unsuccessfully treated) (>1 h for children)
    • HA has at least 2 of the following characteristics:
      • Unilateral location
      • Pulsating quality
      • Moderate or severe pain intensity
      • Aggravation by or causing avoidance of routine physical activity
    • During HA at least one of the following occurs:
      • Nausea and/or vomiting
      • Photophobia and phonophobia (may be inferred from behavior)
    • Not attributed to another disorder

Diagnosis

  • If pt has at least 4 of the following 5 "POUNDing" features LR of migraine is 24
  1. Pulsatile quality
  2. duration of 4-72 hOurs
  3. Unilateral
  4. Nausea or vomiting
  5. Disabling in quality

Differential Diagnosis

Headache

Common

Killers

Maimers

Others

Aseptic Meningitis

Treatment

See Also

Source

  • International Headache Society Diagnostic Criteria
  • Detsky et. al, JAMA '06 Does this Patient with a Headache have a Migraine or need Neuroimaging?
  1. Coppola et al, Annals of Emergency Medicine, Nov 1995. Randomized, Placebo-Controlled Evaluation of Prochlorperazine Versus Metoclopramide for Emergency Department Treatment of Migraine Headaches.