Neuro: Migraine: Free MSRA Podcast

⚕️ FREE MSRA PODCAST – Migraine🎧 A clear, high-yield breakdown of this complex neurological disorder with recurrent headaches – ideal for exam prep and clinical practice.🧠 Key Learning Points📌 Definition• Migraine = recurrent, moderate-severe headaches, often with nausea, photophobia (light), phonophobia (sound)• May occur with or without aura (reversible neurological symptoms)💡 Mnemonic for diagnosis: P-U-M-A • Pulsating • Unilateral • Moderate/severe • Aggravated by activity📌 Causes & Risk Factors• Genetic predisposition plus environmental/lifestyle triggers• Triggers: stress, hormones (menstruation, pregnancy, menopause), poor sleep, alcohol, certain foods, sensory stimuli, weather• Risk factors: family history, female sex (2–3× more common), depression/anxiety, epilepsy, lack of sleep, excess caffeine/alcohol📌 Pathophysiology• Activation of trigeminovascular system → neurogenic inflammation• Cerebral vasodilation, neurotransmitter imbalance• Dynamic, not just a headache!📌 Symptoms• Unilateral, throbbing/pulsating pain, 4–72h, worsened by routine activity• Associated: nausea/vomiting, photophobia, phonophobia• ± Aura: visual (scintillating scotoma, hemianopia), sensory, or speech symptoms• Stages: prodrome, aura, headache, postdrome (“migraine hangover”)📌 Differential Diagnosis• Cluster headache, tension-type headache, medication-overuse headache• Brain tumour, subarachnoid haemorrhage, temporal arteritis, IIH, stroke, sinusitis📌 Diagnosis• Clinical (ICHD-3 criteria): ≥5 attacks, 4–72h, ≥2/4 PUMA features, ≥1 of N/V or photo/phonophobia• Red flags (investigate!): new onset after 50, atypical aura, “worst ever” headache, focal neuro deficit, papilloedema, seizures, thunderclap onset• Tests if red flags: ESR (GCA), LP (SAH/meningitis), CT/MRI (tumour), fundoscopy📌 ManagementAcute:• Oral triptan + NSAID/paracetamol• Nasal triptan (age 12–17)• Anti-emetics (metoclopramide/prochlorperazine)Prophylaxis:• Topiramate or propranolol (tailored to patient)• Acupuncture, riboflavin (vitamin B2)• Menstrual: mini-prophylaxis (frovatriptan/zolmitriptan)• Lifestyle: sleep hygiene, trigger avoidance, mindfulness/CBTSpecial:• Combined pill contraindicated with aura (↑stroke risk): use progestogen-only• Pregnancy: paracetamol preferred, avoid triptans if possible, consider propranolol/amitriptyline if needed📌 Complications• Chronic daily headache, status migrainosus (>72h), migrainous infarction (rare stroke)• Medication overuse headache• Psychiatric: depression, bipolar, anxiety• ↑ Risk of stroke (esp. with aura), significant impact on work/social life📌 Prognosis• Chronic, but often improves with age/menopause; pregnancy can lessen attacks• Attacks/disability vary by person and triggers📎 More MSRA Resources for Migraine📝 Revision Notes: https://www.passthemsra.com/topic/migraine-revision-notes-2/🧠 Flashcards: https://www.passthemsra.com/topic/migraine-flashcards-2/💬 Accordion Q&A Notes: https://www.passthemsra.com/topic/migraine-accordion-qa-notes-2/🚀 Rapid Quiz: https://www.passthemsra.com/topic/migraine-rapid-quiz-2/🎓 Full Course: https://www.passthemsra.com/courses/neurology-for-the-msra/Learn more and test yourself athttps://www.passthemsra.com/https://www.freemsra.com/#MSRA #MSRARevisionNotes #MSRATextbook #MSRAQuiz #MSRAQuestionBank #MSRAFlashcards #MSRAQANotes #MSRAAccordions #MultiSpecialityRecruitmentAssessment #MSRAOnlineRevision #MSRARevisionWebsite #Migraine #Neurology