MIGRAINE (Hemicrania)

migraine

Ques : 1    What is Migraine?

Ans :         Migraine is characterized by periodic headache which are usually unilateral and are often associated with visual disturbance and vomiting.

Ques : 2    What is the pathogenesis of migraine?

Ans :         It is believed to be a disturbance of the carotid and vertebra-basilar system. Primarily there is vasoconstriction which leads to cortical and brain stem ischaemia resulting in Aura-Followed by vasodilatation of the extracranial blood vessels which causes stretching & irritation of nerve endings in the arterial wall, followed by muscular contraction which prolongs headache.

Ques : 3    What are the causes of migraine?

Ans :         The exact cause is unknown. Age-young adult; Sex-mostly females; Family history may be present. Other factors- anxiety, overwork, emotional upsets, hypertension, menopause, cerebral tumour, fasting state, premenstrual tension, some food allergy, etc.

Ques : 4    Which are the types of migraine?

Ans :         (1) Neuralgic. (2) Retinal. (3) Ophthalmoplegic. (4) Facioplegic. (5) Basilar, etc. (6)Hemiplegic. (7) Post traumatic.

Ques : 5    What are the clinical Features of migraine?

Ans :         (1) Visual disburbances, e.g. dazzles, scintillating scotoma, coloured lights, hemianopic, loss of Headache- usually severe, gradually increasing in intensity having a throbbing nature. During the attack of headache there may be vomiting, photophobia, sweating, pallor and exhaustion. Usually the headache may last for 10 to 20 hours, but shorter or long attacks may occur.

(2) Weakness, lassitude, depression etc. may be present.

Ques : 6    What is the treatment of migraine?

Ans :         The treatment of migraine involves :-

  1. Regulate normal life so as to avoid both physical and mental stresses and strains.
  2. Precipitating factors should be corrected or avoided as far as possible.
  3. A carefully recorded history and a meticulous examination followed by a full explanation of the nature and phenomena of migraine often relieves the patient’s anxiety about the possibly sinister significance of his headache.
  4. Treatment of a migrainous episode is based on the use of ergotamine, which should be given as early as possible during the premonitory stages (contra-indication during pregnancy, heart diseases or hypertension).

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