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Migræne
Jørn
Aura
Sensory Symptoms
.. Often before
... often visual
May preceede may by isolated
80% of migrains without aura.
Aura examples
Zig-zag
Scotomas
Fran Visual field loss
Headache
... Throbbing pulsatile.
... unilateral frontotemporal (sub-ocular).
... increase with movement and activity.
... Pian building 1-2 hours (posterior progression)
.. Lasts 4-72 hours.
... Light and sound sensitivity
... Nausea & vomiting
... Food intolerance
Physical symptoms
Cranial/cervical muscle tenderness
Conjunctival injection
Physical symptoms
Migraine types
Basilar-type migraine
Unilateral paralysis/weakness
Ophthalmoplegic migraine
.... and more..
Intracranial vasoconstriction
Intracranial vasoconstriction
Neurovascular thoery
Migraine is a neurogenic process.
.. Secondary changes in cerebral perfusion.
Neurovascular thoery
Cortical Speading Depression
.. spreading oligemia.
Cortical Speading Depression
trigeminovascular system
CSD stimmulateNociceptive neurons ... dural vessels release pain-generating substances ... sterile inflamation.
Pain generating substances
Calcitonin-gene related protein
substance P
vasoactive intestinal peptide
neurokinin A
Tonabersat
.. inhibits Cortical spreading depression
Affect only on migraine with aura.
Tonabersat
Dopamine hypersensitivity
Migraine symptoms related to dopamine:
nausea
vomiting
irritabillity
yawning
hypotension
hypertension
Mg-migraine
Magnesium defficiency is a suspect.
Mg-migraine
Disposition
70% have a 1st-degree relative with migraine.
Disposition
Precipitants
Stess
Excessive or insufficient sleep
bright or flourocent light
lack of exercise
fasting or skipping meals
Foods
caffeine
monosodium glutamate
foods containing tyramine (aged cheese)
citrus fruits
artificial sweetener
tyramine rich food
Tyramine rich
Aged cheese
Smoked-ish meat
vinegars
sourdough
pickled food
Vascular risk
Migraine with aura increase risk of:
myocardial infarction
ischemic stroke
(different for non-aura migraine)