Difference between revisions of "Migraine headache"

(Clinical Features)
(Clinical Features)
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''If at least 4 of the following "POUNDing" features, LR of migraine is 24''
 
''If at least 4 of the following "POUNDing" features, LR of migraine is 24''
 
*'''P'''ulsatile quality
 
*'''P'''ulsatile quality
*'''O'''nset of 4-72 hours
+
*'''O'''nset/duration of 4-72 hours
 
*'''U'''nilateral
 
*'''U'''nilateral
 
*'''N'''ausea or [[vomiting]]
 
*'''N'''ausea or [[vomiting]]

Revision as of 02:32, 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
  • Onset/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?