Date post: | 20-Jan-2017 |
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Learning Outcomes # 2. Clinical manifestations and neurological symptoms.
Ange M. Pompee-Synsmir, MSN ARNP FNP-BC
Learning Objectives
By the end of the session, participants will:1. Describe clinical manifestations, signs and symptoms of migraine
headaches.2. Develop proficiency and demonstrate a systematic approach in
the evaluation of patients who present with acute migrainous headache.
Participants will receive a self assessment quiz and an evaluation at the end of the lecture; and will receive immediate feedback to clarify any misunderstandings.
Migraine Headaches
Signs and Symptoms of Migraine• Throbbing, pulsating headache• Unilateral and localized pain in the frontotemporal and ocular area.• Nausea and vomiting• Photophobia and PhonophobiaNeurologic symptoms may include:Hemiparesis (this symptom defines hemiplegic migraine)AphasiaVisual Field defects (scotoma, light flashes, visual hallucinations)ConfusionParesthesias or numbness
(http://emedicine.medscape.com/article/1142556-clinical)
Migraine Symptoms and Stages
Migraine Without Aura
Attacks lasting 4-72 hours
At least two of following characteristics: unilateral, pulsating, moderate to severe, aggravated by movement
At least one associated symptom: nausea or vomiting, photophobia and phonophobia.
http://www.achenet.org/resources/types_of_headaches/
Migraine with AuraOne or more transient focal aura symptoms
Gradual development of aura symptom over >4 minutes
Aura symptoms last 4 to 60 minutes
Headache follows or accompanies the aura within 60 minutes
Migraine VariantsHemiplegic (familial)
Basilar
Ophthalmologic
Transient migrainous accompaniments
http://www.achenet.org/resources/types_of_headaches/
Migraine VariantsHemiplegic (familial)
Basilar
Ophthalmologic
Transient migrainous accompaniments
http://www.achenet.org/resources/types_of_headaches/
Migraine headaches cont’d.
Migraines
Migraine Assessment
Goal of Therapy in Treatment of Migraine
The goals of both pharmacologic and nonpharmacological treatment of migraine are:Reduce attack frequency, severity, and disabilityReduce reliance on poorly tolerated, ineffective, or unwanted acute
pharmacotherapies Improve quality of lifeAvoid acute headache medication escalationEducate and enable patients to manage their disease to enhance
personal control of their migraineReduce headache-related distress and psychological symptoms
The End