Skip to main content

MIGRAINE

MIGRAINE

           RECURRENT ,EPISODIC ATTACKS OF HEADACHE,VARIED IN INTENSITY,FREQUENCY AND length,COMMONLY UNILATERAL IN ONSET AND related to eating disorder someday WITH NAUSEA AND vomit,COSPICUOUS SENSORY,MOTOR AND MOOD DISTURBENCES.


ETIOLOGY


1.AGE


-onset could also be in childhood ,typical seem in adolescent and continues at till sixth decade.

2.SEX


-More common in girls

3.HEREDITORY INFLUENCES


-The transmitted issue being abnormal response of bone and different vasculature to bound external or endogenous stimuli.

4.PREDISPOSING FACTORS


-Prolong fast

-prolong exposure to sun light-weight

-some food like chees ,chocolates,citrus fruite ,coffee.

-mild associated head injury like heading soccer.

-chnges in degree of stress.


MECHANISMS


-famillial tendency towards increased vascular  contract ability in megrim patient manufacture sequence of constriction band dilatation.

-stimuli that ordinarily manufacture healthy flush might manufacture AN incordinated circulatory response in megrim patients leading to constriction of tiny vessels and dilatation of arteries and veins.

-serotonin discharged from plateletes causes
Vascular  construction.serotonin then gets absorbed into vessels wall and together with domestically discharged Lipo-Hepin and neurokinin produces pain.

CLINICAL FEATURE OF MIGRAIN


1.PRODROME


-vague yawning
-euphoria(excited happiness)
-lethargy

2.AURA


-Usually visual,flashing lights,zig-zag castellation,ball and filament of sunshine begin peripherally and centaraly,fragmentation.

-aura generally lasts 0.5 hour and is succeeded headache.

3.HEADACHE


-Unilateral or hemicranial or presently becomes generalised.

-starts as imprecise pain and builds up to a throbbing intensity related to pallidness ,anorexia,nausea,vomiting and photophobia.

-it could also be last for many hours and when vomit ,headache might decrease in intensity and followed by sleep.

-in some cases headache persist for forty eight hours or a lot of.

-during the headache the superficial cerebral artery could also be full and pulsing.

MANAGEMENT

A.DURING ATTACK OF MIGRAIN


1.ANALGESIC

-NSAIDS like diclofenac is given p.o. or by IM injection if vomit is in conjunction with headache.

2.ERGOTAMINE

-Most necessary medication for severe attacks

-ergotamine tartrates zero.25 to 0.50 mg IM or orally one to two mg pill ideally together with a hundred mg alkaloid

3.  5-HT one AGONISTS

- square measure thought to modulate centeral pain mechanism by reducing levels of the transmittent substance thyroid hormone factor connected amide.

-injection sumatriptan half dozen mg s.c. offers relife from headache in sixty minute,with corresponding improvement in nausea ,vomiting and photophobia.

-oral dose of 100mg sumatriptan tab provides relief at intervals two hours.


4. GENARAL MEASURES

-Lying in darkened and quite space and ice pack to the top might facilitate.


B.REDUCING FREQUENCY AND SEVERETY OF subsequent  megrim ATTACKS


1.ELIMINATION OF TRIGGER FACTORS

2.RELAXATION EXERCISES

3.DRUGS

(a)SEDATIBES like tab amitryptiline a hundred mg in the dead of night.

(b)SEROTININE INHIBITORS like tab flunarizine ten mg /day

(c)PROPRANOLON 20mg b.d. could also be helpful in some cases.

(d)CLONIDINE twenty mg b.d. is effective

(e)ERGOTAMINE TARTARATE

-1 mg orally or zero.25 mg by self administered injection is dictate for old.

Popular posts from this blog

mumps

MUMPS  it\'s microorganism unwellness caused by virus paramyxoma that largely affects youngsters below fifteen yrs.it spreads from human reservoir by direct contact, mobile droplets or fomites contaminated by infected spit.upper tract is portal of entry for virus than it unfold through blood stream and has tendency to multiply in organ structures like secretion glands. CLINICAL options  Incubation period sixteen to twenty one days parotid gland swellin pain or tenderness on pressure below angle of lower jawbone usually one secreter affected followed by alternative when a variable interval or just one secreter affected throughout or concurrent enlargement of each. parotid swelling reaches its most at concerning three days ,remains at its peak for concerning two days then slowly recedsthe lobe of ear is in center of the swelling that is tender on pressure. .FEVER may rise to forty c when look of redness remittent or intermittentfever fall by lysis in three ...
Read more

asthma

ASTHMA asthma may be a syndrome of variable flow obstruction.it is defined pathologically by bronchal inflamation with distinguished white corpuscle       infiltration,physiologically by cartilaginous tube hyper-reactivity and clinically by variable cough , chest tightness and wheeze. CLASSIFICATION accidental asthma attack(ATOPIC ASTHMA) applies to those that manufacture  excessive immunoglobulin E in response to allegens it\'s conjointly referred to as atopic {asthma|asthma attack|bronchial asthma attack|respiratory disease|respiratory illness|respiratory disorder} immediate allergy is that the principal associated of asthma in individual aged five to thirty affirmative and it\'s a state of disordered immunity during which predominant T- helper white blood corpuscle sort a pair of immune mechanism derived excess production  of immunoglobulin E on exposure to common environmental  antigens or allergens INTRINSIC ASTHMA(NON-ATOPIC ASTHMA) refers t...
Read more

chronic pancreatitis

CHRONIC rubor  chronic rubor is progressive,irreversible inflamation of exocrine gland defined by higher abdominal pain that is unhealthful and as illness progress exocrine  insufficiency manifest by weight loss and steatorrhoea and endocrine insufficiency manifest by DM. ETIOLOGY OF CHRONIC rubor one.CHRONIC CALCIFYING PANCREATITIS- ALCOHOL is major cause  - NUETRITIONAL causes particularly in tropical Africa and asia - HERIDATORY  causes -IDIOPATHIC. rubor a pair of.CHRONIC hindering rubor owing to -tumors of ampulla and exocrine gland -cystic lesions  -pancreatic duct injury owing to acute rubor,trauma -ampullary stricture or associated hernia -cholelithiasis typically cause acute rubor however some patient have chronic illness CLINICAL options one.SEVERE EPISODIC higher ABDOMINAL PAIN -severe episodic epigastric pain that radiates to back -it last for hours or days -may be eased by bending forwards or by forcing out -it typically precipited by giant me...
Read more