Migraine headaches

• Facts:
  Affects females > males, with a usual onset in the 20s
  
  Triggers can include certain foods (eg. red wine), fasting, stress, OCPs, bright lights
  
  Thought to be caused by cortical spreading depression
• History / PE:
  Nausea, vomiting
  Photophobia, phonophobia
  Unilateral, frontotemporal cephalgia
  Visual auras
• Treatment:
  Avoid known triggers
  
  Abortive
  NSAIDs , ASA
  Sumatriptans
  Ergot alkaloids (ergotamine)
  Metoclopramide
  Chlorpromazine
  Prochlorperazine
  
  Prophylaxis
  Anticonvulsants (eg. depakote )
  Calcium channel blockers
  Beta blockers
  Tricyclic antidepressants
• Complications:
  Status migrainosus (DHE protocol)
• Associated With:
  Vascular and neurotransmitter (serotonin) changes