Migraine Headaches PDF - NUR3225 Module 1 Neurological - 2021

MIGRAINE HEADACHES Patho Cause Disease Course & Expected Findings Risk Factors Labs & Diagnostics Meds Cerebral artery vasodilation→prostaglandins released→brain tissue inflammation Genetics? many triggers • Photophobia and phonophobia (sensitivity to sounds) • Nausea and vomiting • Stress and anx...

MIGRAINE HEADACHES Patho Cause Disease Course & Expected Findings Risk Factors Labs & Diagnostics Meds Cerebral artery vasodilation→prostaglandins released→brain tissue inflammation Genetics? many triggers • Photophobia and phonophobia (sensitivity to sounds) • Nausea and vomiting • Stress and anxiety • Unilateral pain, often behind one eye or ear • Health history and family history for headache patterns • Alterations in ADLs for 4-72 hr • Manifestations that are similar with each headache w/aura (classic migraine) Without aura (common) Atypical • Prodromal stage→ Aware • Pain is aggravated by • Status migrainous: >72hrs it’s coming, irritated, food physical activity. • Migrainous infarction: cravings, depressed • Unilateral, pulsating pain. Neuro sx for > 7 days, • Aura stage→ minutes to • One or more manifestations imaging may show ischemic hours, n & t of face, mouth, present: photophobia, infarct. acute confusion, vision phonophobia, N/V • Unclassified: Does not fit problems (light flashes, • Persists for 4-72 hr. Often other criteria bright spots) occurs in early AM, during • Second stage: Severe, stress, or with premenstrual throbbing, incapacitating tension or fluid retention. HA • Third stage (4-72hr): Dull HA • Recovery: Pain & Aura subsiding, increased muscle spasms & myalgia • Older adult→ Visual Migraine, Aura w/o pain All ages, women affected more than men. May be associated with other conditions like colds, allergies, stress, low BS, or muscle tension. Migraine sufferers are at r/f stroke & epilepsy. Neuroimaging if neuro findings present or >50yo w/new onset Abortive Therapy – during aura or soon after starting • NSAIDS (ibuprofen), Tylenol (acetaminophen), • Antiemetics: Reglan (metoclopramide) Severe migraines • Triptans: produce vasoconstrictive effect Imitrix (sumatriptan)-contraindicated in heart disease • Ergotamine preparations with caffeine: vasoconstriction & decreases inflammation NUR3225 Module 1: Neurological Updated 8/23/2021 MR Preventative Therapy – for freq HA or when other therapies are ineffective • NSAIDS • Beta Blockers-Take even when asymptomatic for prevention to prevent vascular changes. • Botox 1 Complications & Nursing Care • • • • Focus on pain mgmt during HA (dark environment, HIB elevated, meds) HA diary for patterns & triggers Trigger avoidance Avoid foods with tyramine (pickles, caffeine, beer, wine, ages cheese, artificial sweeteners) & foods with MSG • Manage anger & conflict • Avoid glare & flickering lights • Adequate sleep/rest • Avoid environmental triggers like odors, perfumes, & tobacco smoke • Yoga, meditation, exercise, acupuncture, external trigeminal nerve stimulator (wearable head band that stimulates branches associated with HA (not to be used for >20min/day) NUR3225 Module 1: Neurological Updated 8/23/2021 MR 2