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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
Photophobia and Headache - Differential Diagnosis Framework

Why?
• The coexistence of photophobia and headache suggests the potential
• In migraines ... with aura > migraine ... > episodic migraine ... subarachnoid hemorrhage (SAH ... ophthalmology #Neurology
Medication overuse headaches or rebound headaches are caused by regular, long-term use of medication to treat headaches, such as migraines.

Treatment of medication overuse
 headaches are caused ... headaches, such as migraines ... Treatment of medication ... #diagnosis #causes ... symptoms #management #treatment
Mydriasis and Miosis - Differential Diagnosis Framework

Causes of Mydriasis:
Dilated pupils (mydriasis) more than 7mm
 • Unilateral
Diagnosis Framework Causes ... Adie's tonic pupil, Migraine ... Hypothermia Causes ... Robertson pupils), DM, SAH ... ophthalmology #causes
Acute ED Migraine Therapy and Preventative Therapy Algorithm:
Acute migraine
 • IV NS IL bolus then infusion
Acute ED Migraine ... 20 mg/min -> Neurology ... Preventative Medications ... management #algorithm #treatment ... #prophylaxis #neurology
Migraine Treatment Overview

 • What is a Migraine?
 • Pathophysiology
 • Common Migraine Triggers
 • Diagnosis
Migraine Treatment ... • What is a Migraine ... Prophylactic Treatment ... #Treatment #management ... #prophylaxis #neurology
Migraine - Preventative Treatments

 • Anticonvulsants: *Topiramate, *Sodium valproate, Gabapentin, Pregabalin
 • Antidepressants: Amitriptyline, Venlafaxine, Duloxetine,
Migraine - Preventative ... Treatments ... neudrawlogy #Migraine ... #Preventative #Treatment ... #pharmacology #neurology