Difference between revisions of "Migraine headache"

(added treatment reference)
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==Background==
 
==Background==
===Definition: Migraine Headache without Aura===
+
===Definition: Migraine Headache without Aura<ref>International Headache Society Diagnostic Criteria</ref>===
 
*At least 5 attacks of headache fulfilling the following criteria:
 
*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 attacks lasting 4–72 hr (untreated or unsuccessfully treated) (>1 h for children)
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**Not attributed to another disorder
 
**Not attributed to another disorder
  
==Diagnosis==
+
==Clinical Features==
*If pt has at least 4 of the following 5 "POUNDing" features LR of migraine is 24
+
''If at least 4 of the following "POUNDing" features, LR of migraine is 24''
#Pulsatile quality
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*'''P'''ulsatile quality
#duration of 4-72 hOurs
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*'''D'''uration of 4-72 hours
#Unilateral
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*'''U'''nilateral
#Nausea or vomiting
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*'''N'''ausea or [[vomiting]]
#Disabling in quality
+
*'''D'''isabling in quality
  
 
==Differential Diagnosis==
 
==Differential Diagnosis==
 
{{Headache DDX}}
 
{{Headache DDX}}
 +
 +
==Diagnosis==
 +
*Consider other causes of emergent [[headache]]
 +
*Diagnosis is normally clinical
  
 
==Treatment==
 
==Treatment==
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*[[Headache Red Flags]]
 
*[[Headache Red Flags]]
  
==Source==
+
==References==
*International Headache Society Diagnostic Criteria
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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>
 
*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?
<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 02:31, 17 September 2015

Background

Definition: Migraine Headache without Aura[1]

  • 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

Clinical Features

If at least 4 of the following "POUNDing" features, LR of migraine is 24

  • Pulsatile quality
  • Duration of 4-72 hours
  • Unilateral
  • Nausea or vomiting
  • Disabling in quality

Differential Diagnosis

Headache

Common

Killers

Maimers

Others

Aseptic Meningitis

Diagnosis

  • Consider other causes of emergent headache
  • Diagnosis is normally clinical

Treatment

See Also

References

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