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Acute Treatment of Migraine

- BWH Medicine Chiefs @BrighamChiefs

#Migraine #Treatment #management #neurology #headache #medications
Acute Treatment ... of Migraine - ... #Treatment #management ... #neurology #headache ... #medications
Acute Treatment of Migraine
Mild Attacks: NSAIDs, Simple Analgesics
Moderate/Severe Attacks: Triptans, Ditans, Gepants, Ergots
Non-pharmacologic Treatment: Neuromodulation, Rest,
Acute Treatment ... of Migraine Mild ... Rest, Hydration, Meditation ... neudrawlogy #Migraine ... #management #neurology
Pharmacotherapy for Migraine Prophylaxis 

Who is indicated for migraine prophylaxis? Patients who experience more than 3
Pharmacotherapy for Migraine ... indicated for migraine ... appropriate acute treatment ... #Prophylaxis #Medications ... Pharmacology #Management #Neurology
Prophylactic Migraine Medications

Established Efficacy: 
 • Metoprolol, Propranolol, Timolol, Divalproex, Valproate, Topiramate, Frovatriptan
Probably Effective: 
 •
Prophylactic Migraine ... Medications ... Cyproheptadine #Migraine ... #prophylaxis #Medications ... pharmacology #EBM #neurology
Migraine Treatment Overview

 • What is a Migraine?
 • Pathophysiology
 • Common Migraine Triggers
 • Diagnosis
Migraine Treatment ... • What is a Migraine ... Triggers • Diagnosis ... • Non-Drug Treatment ... #prophylaxis #neurology
Photophobia and Headache - Differential Diagnosis Framework

Why?
• The coexistence of photophobia and headache suggests the potential
- Differential Diagnosis ... • In migraines ... > episodic migraine ... #differential #diagnosis ... ophthalmology #Neurology
Acute ED Migraine Therapy and Preventative Therapy Algorithm:
Acute migraine
 • IV NS IL bolus then infusion
Acute ED Migraine ... Algorithm: Acute migraine ... Preventative Medications ... Cortel-LeBlanc #Migraine ... management #algorithm #treatment
Causes of Secondary / Provoked Seizures - Differential Diagnosis Algorithm
Febrile
Infection
 • Sepsis
 • Encephalitis
 • Meningitis
Metabolic
- Differential Diagnosis ... Neurological • Migraine ... Dyskinesia, Chorea) Cardiovascular ... Provoked #Seizures #Neurology ... #Differential #Diagnosis
Migraine - Preventative Treatments

 • Anticonvulsants: *Topiramate, *Sodium valproate, Gabapentin, Pregabalin
 • Antidepressants: Amitriptyline, Venlafaxine, Duloxetine,
Migraine - Preventative ... Treatments ... neudrawlogy #Migraine ... #Preventative #Treatment ... #pharmacology #neurology
Triptan Selection - Migraine Management
Choosing triptans:
 • Reponse to given triptan do not predict to others
Triptan Selection - Migraine ... month to avoid medication-overuse ... Rapidly progressing migraine ... 001167 #Triptans #Migraine ... #Management #treatment