Podcast
Questions and Answers
Which phase of migraine is characterized by symptoms such as zigzag lines, blurred vision, and blind spots?
Which phase of migraine is characterized by symptoms such as zigzag lines, blurred vision, and blind spots?
Which type of migraine is more common, with or without aura?
Which type of migraine is more common, with or without aura?
At what age does the onset of migraine usually occur?
At what age does the onset of migraine usually occur?
Which structures are believed to be the origin of migraine?
Which structures are believed to be the origin of migraine?
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Which type of nerves innervate the large cranial vessels, smaller meningeal vessels, meninges, trigeminal nucleus caudalis, and spinal cord trigeminocervical complex?
Which type of nerves innervate the large cranial vessels, smaller meningeal vessels, meninges, trigeminal nucleus caudalis, and spinal cord trigeminocervical complex?
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Which of the following substances is released by C-fibers in response to stimuli, such as heat, pressure, and injury?
Which of the following substances is released by C-fibers in response to stimuli, such as heat, pressure, and injury?
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What is the role of the trigeminal ganglion in migraine?
What is the role of the trigeminal ganglion in migraine?
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What is the effect of vasodilation of intracranial and meningeal blood vessels in migraine?
What is the effect of vasodilation of intracranial and meningeal blood vessels in migraine?
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What is the pathway of pain sensation in migraine, starting from the trigeminal ganglion?
What is the pathway of pain sensation in migraine, starting from the trigeminal ganglion?
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Which type of receptor is inhibitory and coupled to Gi protein?
Which type of receptor is inhibitory and coupled to Gi protein?
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Which neurotransmitter is implicated in migraine?
Which neurotransmitter is implicated in migraine?
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Which receptors are found on intracranial blood vessels in migraine?
Which receptors are found on intracranial blood vessels in migraine?
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Which class of drugs inhibits COX to prevent prostaglandin synthesis and is most effective when given early or right before a migraine attack?
Which class of drugs inhibits COX to prevent prostaglandin synthesis and is most effective when given early or right before a migraine attack?
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Which class of drugs causes vasoconstriction, blocks trigeminal nerve transmission, and is contraindicated in cardiovascular disease?
Which class of drugs causes vasoconstriction, blocks trigeminal nerve transmission, and is contraindicated in cardiovascular disease?
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Which class of drugs inhibits trigeminal nerve transmission peripherally and centrally, inhibits release of vasoactive peptides from meningeal blood vessels, and causes vasoconstriction via stimulation of 5-HT1B receptors?
Which class of drugs inhibits trigeminal nerve transmission peripherally and centrally, inhibits release of vasoactive peptides from meningeal blood vessels, and causes vasoconstriction via stimulation of 5-HT1B receptors?
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Which class of drugs differ mainly in the length of their half-lives and are agonists of 5-HT1B/1D/1F receptors?
Which class of drugs differ mainly in the length of their half-lives and are agonists of 5-HT1B/1D/1F receptors?
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What is the treatment resistance rate for migraine patients?
What is the treatment resistance rate for migraine patients?
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Which class of drugs is known to cause weight gain as a side effect?
Which class of drugs is known to cause weight gain as a side effect?
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Which class of drugs alters ion channel activity to reduce excitability of the cortex?
Which class of drugs alters ion channel activity to reduce excitability of the cortex?
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Which class of drugs increases the concentrations of 5-HT and NAd by inhibiting their transporters?
Which class of drugs increases the concentrations of 5-HT and NAd by inhibiting their transporters?
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Which class of drugs is currently being investigated as a 5-HT1F antagonist?
Which class of drugs is currently being investigated as a 5-HT1F antagonist?
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Study Notes
Migraine Characteristics
- The aura phase of migraine is characterized by symptoms such as zigzag lines, blurred vision, and blind spots.
- Migraine without aura is more common than migraine with aura.
Age of Onset and Origin
- The onset of migraine usually occurs during adolescence and early adulthood.
- Migraine is believed to originate from the dura mater, pia mater, and large cranial vessels.
Nerve Innervation
- The trigeminal nerves innervate the large cranial vessels, smaller meningeal vessels, meninges, trigeminal nucleus caudalis, and spinal cord trigeminocervical complex.
Neurotransmission
- C-fibers release the neurotransmitter calcitonin gene-related peptide (CGRP) in response to stimuli such as heat, pressure, and injury.
- The trigeminal ganglion plays a key role in transmitting pain signals to the brain in migraine.
Vasodilation and Pain Pathway
- Vasodilation of intracranial and meningeal blood vessels contributes to migraine pain.
- The pathway of pain sensation in migraine starts from the trigeminal ganglion, passes through the spinal tract and nucleus, and ends in the thalamus and cortex.
Receptors and Neurotransmitters
- The 5-HT1 receptor is inhibitory and coupled to Gi protein.
- Serotonin (5-HT) is a neurotransmitter implicated in migraine.
- 5-HT1D and 5-HT1F receptors are found on intracranial blood vessels in migraine.
Migraine Treatment
- NSAIDs (non-steroidal anti-inflammatory drugs) inhibit COX to prevent prostaglandin synthesis and are most effective when given early or right before a migraine attack.
- Ergotamines cause vasoconstriction, block trigeminal nerve transmission, and are contraindicated in cardiovascular disease.
- Triptans inhibit trigeminal nerve transmission peripherally and centrally, inhibit release of vasoactive peptides from meningeal blood vessels, and cause vasoconstriction via stimulation of 5-HT1B receptors.
- Different triptans differ mainly in the length of their half-lives and are agonists of 5-HT1B/1D/1F receptors.
Treatment Resistance and Side Effects
- The treatment resistance rate for migraine patients is approximately 30-40%.
- Anticonvulsants can cause weight gain as a side effect.
- Anticonvulsants and membrane stabilizers alter ion channel activity to reduce excitability of the cortex.
- Antidepressants increase the concentrations of 5-HT and NAd by inhibiting their transporters.
- 5-HT1F antagonists are currently being investigated as a potential new treatment for migraine.
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Description
Test your knowledge about migraine with this quiz! Learn about the prevalence, onset, and different forms of migraine. Explore the phases and symptoms associated with this condition. Are you familiar with the zigzag lines and other common symptoms? Take the quiz to find out!
