Complicated Migraine
Headaches are of different type such as tension headache, common headache and migraine hea... more and also
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Headaches are of different type such as tension headache, common headache and migraine headache. Among the headaches unbearable type and which lasts for days together, these are known as migraine headaches. There are many kinds of complicated migraine. Migraine often, affects the nerves that are responsible for the movement of the eye, paralyzed partially or completely. The retinal migraine, on the other hand, is characterized by presenting visual disturbance in the retina, unlike migraine with aura that affects the part of the brain that is responsible for vision. Hemiplegic's migraine is characterized because it can be inherited (linked to a chromosome), symptoms of heart attack, pain and / or muscle fatigue. Migraine of the basilar artery, previously known as Bickerstaff syndrome, has symptoms similar to migraine with aura. Afterwards neurological symptoms associated with the base of the brain (brainstem), and affect the back of the head, causing severe vomiting as a result. Unlike migraine with aura, characterized by their pain affects only one side of the body (unilateral), migraine affects basilar artery of both sides (bilateral).
There is a possibility that all these types of complicated migraine increase the risk of permanent neurological changes which are not irreversible, and also affect the results of the Magnetic Resonance Imaging (MRI), as in the case of heart attack. To reduce the risk of heart attack and / or long-term consequences, we should avoid smoking and the usage of drugs such as beta-blockers, triptans and ergotamine; we should also avoid the use of hormones during menopause, and birth control pills. Calcium blockers and antiepileptic drugs are often the best alternative for preventing complicated migraine.
The complicated migraine referred to a neurological disfunction related to an episode of migraine describes four types of migraines are complicated: Often, hemiplegic's, and basilar confessional. For the neurological dysfunction, and by having differential diagnosis of acute etiology, frequently require studies with neurolemma, EEG and other laboratory equipment. Often the diagnosis is made retrospectively.
Migraine oftalmopléjica
According to ICD, 10 criteria for migraine oftalmopléjica are:
Unilateral pain, retroocular, severe, Paresis of the third pair with exoforia, ptosis, and diplopia Mydriasis. The paresis may be prior, concurrent or subsequent to pain, Paresis lasts hours, days or weeks
It is suspected that the etiology is due to edema of the internal carotid artery in the cavernous sinus or the basilar artery. They are not recommended as treatment medication vasoconstrictors (ergotamine, triptans) and seem to have a good response to treatment with steroids. It has been used as a prophylactic treatment and the flunaricina valproic acid. The differential diagnosis is made up of a tumor paraselar, between the aneurysm and internal carotid artery previous caller, myasthenia gravis and Tolosa Hunt Syndrome 2.10.
Hemiplegics migraine
Hemiplegics migraine is characterized by the deficit mentioned, usually contralateral to the headache, and it can be prior, during or after the pain. It is often associated with language difficulties or defects in the visual field. Has been identified as family with autosomal dominant inheritance and apparently genes located on chromosome 19p13 and 1q31.
The differential diagnosis is extensive and includes: Event occlusive stroke, arteriovenous malformation, cerebral hemorrhage, coagulopathy, amphetamines or cocaine intoxication, tumor, vasculitis, MELAS, cardiogenic embolism, sickle cell anemia and the use of oral contraceptives 2.
Basilar migraine
Basilar migraine is the most frequent migraines complicated compromises structures irrigated by the basilar artery such as the stem, the cerebellum, the occipital lobe and the bottom of the temporal lobes. The clinical manifestations will be presented to the chord structures are compromised as ataxia, nausea, vomiting, dizziness, visual field defects, paresthesias, dysarthria, hemiparesis, tinnitus and impairment of consciousness.
The differential diagnosis is broad as the occipital lobe epilepsies, particularly those of benign childhood that are associated with headache and vomiting, neck aftermath of trauma, congenital abnormalities of the union craneocervical, tumors, demyelinating diseases, poisoning and psychiatric disorders 25, 26, 27, 28.
The treatment consists of common painkillers but not vasoconstrictores, and it is possible that steroids are effective. As in migraine, oftalmopléjica used prophylactically in the valproic acid and flunaricina.
Confessionals migraine
The characteristics of this type of headache are the commitment of the variable state of consciousness with psychomotor agitation, aggressiveness, confusion and even coma. Generally, this rule is after the headache. When the emergency doctor faces a similar clinical picture very often suspected abuse of psychoactive substances, which are not detected. The duration of the altered mental status is approximately 3 to 6 hours. The diagnosis is usually retrospective.
Additional Resources for Complicated Migraine
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Home > Headache Education > Headache Topic Sheets > Complicated Migraine ... with these types of unusual migraines should be evaluated and treated by a specialist. ...
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