Migraine

Post on 16-Jul-2015

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Transcript of Migraine

Dr. Angelo Smith M.DWHPL

Missed ≥ 1 day of work/school 25%

Work/school productivity reduced by ≥ 50% 28%

Did no household work 48%

Household productivity reduced by ≥ 50% 34%

Missed family or social activity 29%

School, Work, and Social Impact in Previous 3 Months

A neurological disorder characterized by hyper excitability of the nervous system

You don’t get migraines, you have migraine

Your body is more sensitive to stimuli that can cause a

headache attack Defining characteristics

Recurrent headache attacks lasting 4-72 hours

One-sided, pulsating, moderate-to-severe pain

Presence of 2 of 3 key characteristics: inability to function,

photophobia/phonophobia, nausea/vomiting

1Migraine originates deep within the brain

2Electrical impulses spread to other regions of the brain

3Changes in nerve cell activity and blood flow may result in visual disturbance, numbness or tingling, and dizziness

4Chemicals in the brain cause blood vessel dilation and inflammation of the surrounding tissue

5The inflammation irritates the trigeminal nerve, resulting in severe or throbbing pain

Type How common?

Migraine without aura 70%

Migraine with aura 25%

Migraine variants and complicated migraine

5%

scotoma (blind spots) Fortification (zig-zag patterns) Scintilla (flashing lights) Unilateral paresthesia/weakness Hallucinations Hemianopsia (blindness in one half of the

visual field)

Hormonal fluctuation plays an important role in migraine for many women

60% of women with migraine experience “menstrual

migraine”

Headaches are associated with changes in estrogenlevels right before menses and most often occur upto 2 days before or during menses

Oral contraceptives may either exacerbate or alleviate

the frequency, severity, and duration of headaches

Menstrual migraine differs somewhat fromother migraine

Pain may persist longer and be more severe

Headache attack is more likely to be accompaniedby nausea or vomiting

Headache occurs more frequently

Menstrual migraine is more difficult to treat

Recent online survey by NHF showed thatmigraine is the most common headachediagnosis in men (36%)

Yet, many men do not discuss migraine withtheir healthcare practitioners Nearly 1/3 of men suffering from headache have

not been diagnosed Nearly 1/4 did not visit their doctor because they

felt they should “tough it out”

Relaxation training Hypnotherapy Biofeedback training Cognitive/behavioral management Acupuncture

Nutritional supplements (B2 and others)

Physical therapy and/or massage