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  • Chronic Daily Headache - Migraine
    over a period of at least six months Also known as transformed migraine patients usually have a history of migraine attacks that gradually worsen over a period of months or years The I H S criteria for diagnosing chronic migraine are outlined below Headache pain and the other symptoms usually associated with migraine become less severe as the frequency increases but also become less responsive to treatment As the nature of the headaches transform many patients will experience breakthrough migraine attacks on top of the background headache Like with CTTH the overuse of acute treatments for migraine including analgesics ergot derivatives and triptans can be responsible for transforming migraine into a chronic condition However the transformation may also occur as part of the natural history of the condition In cases of Chronic Migraine attention should be paid to the possible existence of comorbid conditions such as anxiety and depression both of which have been shown to be more frequent in patients who have migraine than in non migraine control subjects It is believed that migraine and depression share the same etiologies rather than the depression resulting from the disability caused by chronic migraine Some features of comorbid depression show improvement when the cycle of CDH is broken Treatment options for chronic migraine include Amitriptyline or Gabapentin The I H S Criteria for diagnosing Chronic Migraine A Headache fulfilling criteria B and C on 15 days a month for 3 months B Headache has at least two of the following characteristics Unilateral location Pulsating quality Moderate or severe pain intensity Aggravation by or causing avoidance of routine physical activity C During headache at least one of the following Nausea and or vomiting Photophobia Phonophobia D Not attributed to another disorder Home Health Professionals and Migraine Migraine Diagnosis Chronic Daily Headache Chronic Daily Headache Chronic daily headache CDH is a descriptive term rather than a specific diagnosis It can evolve from any primary headache disorder or can be de novo Studies in the US and Europe indicate that 4 5 of the general population are affected by CDH It is becoming more frequent in general practice and is a major reason for consultation in Headache Migraine clinics Like migraine CDH can significantly affect an individual s ability to function within the family in society and in the workplace In general headache occurring more often than fifteen days per month over at least six months and lasting for four hours a day can be considered CDH The leading cause is chronic tension type headache followed by chronic migraine Chronic Tension Type Headache People with chronic tension type headache CTTH usually have a history of episodic tension type headache but may have no history of migraine Many patients use excessive amounts of analgesics and they may also have concomitant depression CTTH usually present as diffuse or bilateral and frequently involve the posterior head and neck The I H S diagnostic criteria are outlined below The overuse of analgesics may convert episodic tension type headaches

    Original URL path: http://www.migraine.ie/health-professionals-and-migraine/migraine-diagnosis/chronic-daily-headache/#usermessagea (2014-07-21)
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  • Impact of Migraine - Migraine
    line as well as paper versions are available for both The Headache Impact Test HIT The patient answers six questions relating to the severity and impact of their headache For each question there are five alternatives with a scoring scale from 6 to 13 points The higher the overall score the greater the impact on the patients life There are four levels of impact that an individual can fall under ranging from No Little impact to Very Severe The web based version formulates a personalised report based on the patients individual answers and a pool of collected data An interpretation of the score and suggested action steps are also recommended View Online Headache Impact Test The MIDAS Migraine Disability Assessment Score Consists of seven questions five of which are attributed scores and two that are included to provide qualitative information The five scoring questions calculate the number of days lost by the patient in Work education Household work Non work activities leisure social time The MIDAS score is calculated by adding up the total days lost in the last three months in each of the areas There are four grades of severity defined in terms of the disability suffered Treatment recommendations are given corresponding to each grade MIDAS Questionnaire Why use Impact Tests These tests have a number of key benefits for medical professionals and patients alike They are useful in summarising the effect of headache migraine on the individual Standardised approaches to measuring headache related disability They have both been validated and proved accurate They offer an opportunity to allow better communication between doctor and patient They are both easy to follow and access Patients can use the tests to see if their condition is improving or worsening Home Health Professionals and Migraine Impact of Migraine Impact of Migraine Background Information The impact of migraine is that it is the most common neurological condition in the world It is also the most frequently seen disabling headache in primary care In Ireland 12 15 of the population have migraine Only about half of these 500 000 people are actually diagnosed and even fewer are receiving treatment for their condition Because of this migraine continues to have a huge impact not only on people s professional social and family lives but also on the Irish economy in general Indeed it is this impact that distinguishes migraine from other benign headache disorders It is common for patients with severe migraine to say that the condition has taken control of their lives Many claim that at its height migraine is the worst pain they have ever experienced Despite the severity of the pain involved and the huge personal impact it has some people still do not seek treatment at all in the mistaken belief that headache disorders are untreatable or not recognised as real medical conditions The truth of the matter is that migraine is an increasingly well understood condition that can be effectively managed through primary care in the majority of cases

    Original URL path: http://www.migraine.ie/health-professionals-and-migraine/impact-of-migraine/#usermessagea (2014-07-21)
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  • Diagnosing migraine
    Management Migraine at School Migraine and the Leaving Cert Other Headache Chronic Daily Headache Chronic Tension Headache Chronic Transformed Migraine Medication Overuse Headache Other Primary Headache Sinus Headache Benign Exertional Headache Ice Cream Headache Caffeine Withdrawal Headache Tension Headache Cluster Headaches THE MIGRAINE Association Of Ireland Providing information support and reassurance to migraine sufferers and those with other headache disorders THE MIGRAINE Association Of Ireland Providing information support and reassurance to migraine sufferers and those with other headache disorders Latest News Latest News and Research from the Migraine World 17th July 2014 Read our submission on chronic migraine and medical card eligibility 14th July 2014 Loss of funding may cost MAI one third of staff 26th June 2014 Take this important survey on chronic migraine and medical card eligibility View All News Become a Member Sign up or Log in Events Upcoming Events from the MAI No events View All Events Home Health Professionals and Migraine Migraine Diagnosis Diagnostic Resources Diagnostic Resources Diagnosing Migraine Migraine Diagnostic Questionnaire 15 Key Questions GP Migraine Algorithm The Treatment of Migraine Patient Treatment Plan IHS Classification of Headache Disorders NICE Guidelines on Headache Home Health Professionals and Migraine Migraine Diagnosis Diagnostic Resources Diagnostic Resources Diagnosing Migraine Migraine Diagnostic Questionnaire 15 Key Questions GP Migraine Algorithm The Treatment of Migraine Patient Treatment Plan IHS Classification of Headache Disorders NICE Guidelines on Headache Donate Now Will you help us to continue our work We are only too aware of the devastating impact migraine can have upon a person s life There are half a million migraine sufferers in Ireland and we cannot reach them all without your support Please note that no fundraised money goes towards salaries Below are some of the things your donations will allow us to do Update and reprint our information leaflets

    Original URL path: http://www.migraine.ie/health-professionals-and-migraine/migraine-diagnosis/diagnosing-migraine-diagnostic-resources/#usermessagea (2014-07-21)
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  • The Migraine Attack - Migraine
    World 17th July 2014 Read our submission on chronic migraine and medical card eligibility 14th July 2014 Loss of funding may cost MAI one third of staff 26th June 2014 Take this important survey on chronic migraine and medical card eligibility View All News Become a Member Sign up or Log in Events Upcoming Events from the MAI No events View All Events Home Health Professionals and Migraine The Migraine Attack The Migraine Attack The Migraine Attack The typical migraine attack is split into four phases Prodrome Aura Headache Phase Postdrome Not every patient will experience all four phases and even in patients that do the phases can vary from one attack to the next More From This Section Migraine Prodrome Migraine Prodrome Although the migraine Prodrome occurs hours or even days before the headache begins it is considered to be an integral component of the migraine process It often acts as a warning sign that a migraine is imminent About 60 of read more Migraine Aura Migraine Aura The migraine aura phase involves the occurrence of one or more fully reversible focal neurological symptoms It is experienced by about 20 of migraine sufferers although not all patients with Migraine with Aura will experience read more Headache Phase The headache phase is the most disabling feature of a migraine attack and is the most common reason for consultation Typically the following characteristics apply Headache lasts from 4 72 hours Moderate or severe pain Usually gradual in read more Migraine Postdrome Migraine Postdrome The postdromal or resolution phase follows the headache and may last for up to 48 hours Many of the symptoms of this phase appear initially during the prodrome or with the headache phase Typically these read more Home Health Professionals and Migraine The Migraine Attack The Migraine Attack The Migraine Attack The typical migraine attack is split into four phases Prodrome Aura Headache Phase Postdrome Not every patient will experience all four phases and even in patients that do the phases can vary from one attack to the next More From This Section Migraine Prodrome Migraine Prodrome Although the migraine Prodrome occurs hours or even days before the headache begins it is considered to be an integral component of the migraine process It often acts as a warning sign that a migraine is imminent About 60 of read more Migraine Aura Migraine Aura The migraine aura phase involves the occurrence of one or more fully reversible focal neurological symptoms It is experienced by about 20 of migraine sufferers although not all patients with Migraine with Aura will experience read more Headache Phase The headache phase is the most disabling feature of a migraine attack and is the most common reason for consultation Typically the following characteristics apply Headache lasts from 4 72 hours Moderate or severe pain Usually gradual in read more Migraine Postdrome Migraine Postdrome The postdromal or resolution phase follows the headache and may last for up to 48 hours Many of the symptoms of this

    Original URL path: http://www.migraine.ie/health-professionals-and-migraine/the-migraine-attack/#usermessagea (2014-07-21)
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  • Prodrome - Migraine
    of staff 26th June 2014 Take this important survey on chronic migraine and medical card eligibility View All News Become a Member Sign up or Log in Events Upcoming Events from the MAI No events View All Events Home Health Professionals and Migraine The Migraine Attack Migraine Prodrome Migraine Prodrome Migraine Prodrome Although the migraine Prodrome occurs hours or even days before the headache begins it is considered to be an integral component of the migraine process It often acts as a warning sign that a migraine is imminent About 60 of people with migraine experience prodromal symptoms Typical prodrome symptoms can include Physical symptoms Muscle stiffness especially in the neck Altered perception of heat and cold Increased thirst Increased urination Food cravings Loss of appetite Yawning Constipation Diarrhoea Fluid retention Sensitivity to light and or sound Psychological symptoms Depression Euphoria Irritability Restlessness Hyperactivity Fatigue Drowsiness Difficulty in concentration Some patients are not always aware of these symptoms or may mistake them for migraine triggers A Migraine Diary can help patients discover their prodromal symptoms thus giving them valuable time to prepare for the later stages of the attack Home Health Professionals and Migraine The Migraine Attack Migraine Prodrome Migraine Prodrome Migraine Prodrome Although the migraine Prodrome occurs hours or even days before the headache begins it is considered to be an integral component of the migraine process It often acts as a warning sign that a migraine is imminent About 60 of people with migraine experience prodromal symptoms Typical prodrome symptoms can include Physical symptoms Muscle stiffness especially in the neck Altered perception of heat and cold Increased thirst Increased urination Food cravings Loss of appetite Yawning Constipation Diarrhoea Fluid retention Sensitivity to light and or sound Psychological symptoms Depression Euphoria Irritability Restlessness Hyperactivity Fatigue Drowsiness Difficulty in concentration

    Original URL path: http://www.migraine.ie/health-professionals-and-migraine/the-migraine-attack/migraine-prodrome/#usermessagea (2014-07-21)
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  • Migraine Aura - Migraine
    Events from the MAI No events View All Events Home Health Professionals and Migraine The Migraine Attack Migraine Aura Migraine Aura Migraine Aura The migraine aura phase involves the occurrence of one or more fully reversible focal neurological symptoms It is experienced by about 20 of migraine sufferers although not all patients with Migraine with Aura will experience the aura symptoms with every attack This phase occurs just before the headache phase begins but in some patients the migraine aura phase can overlap with the later headache phase Aura usually develops over five to twenty minutes and lasts for up to one hour Aura symptoms are most commonly visual though they can also be sensory or more rarely motor Aura symptoms include Scintillation scotomas e g Bright rim around an area of visual loss fortification spectra Flashing lights Jagged lines that block the visual field Visual resizing or reshaping of objects Blurred vision Unilateral sensory parasthesia that usually begins as numbness in the hand and migrates up the arm before moving into the face lips and tongue Muscular weakness Partial paralysis on one side of the body Temporary dysphasia Home Health Professionals and Migraine The Migraine Attack Migraine Aura Migraine Aura Migraine Aura The migraine aura phase involves the occurrence of one or more fully reversible focal neurological symptoms It is experienced by about 20 of migraine sufferers although not all patients with Migraine with Aura will experience the aura symptoms with every attack This phase occurs just before the headache phase begins but in some patients the migraine aura phase can overlap with the later headache phase Aura usually develops over five to twenty minutes and lasts for up to one hour Aura symptoms are most commonly visual though they can also be sensory or more rarely motor Aura

    Original URL path: http://www.migraine.ie/health-professionals-and-migraine/the-migraine-attack/migraine-aura/#usermessagea (2014-07-21)
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  • Headache Phase - Migraine
    one third of staff 26th June 2014 Take this important survey on chronic migraine and medical card eligibility View All News Become a Member Sign up or Log in Events Upcoming Events from the MAI No events View All Events Home Health Professionals and Migraine The Migraine Attack Headache Phase Headache Phase The headache phase is the most disabling feature of a migraine attack and is the most common reason for consultation Typically the following characteristics apply Headache lasts from 4 72 hours Moderate or severe pain Usually gradual in onset Throbbing pounding or pulsating in character although it may begin as a mild non throbbing headache Unilateral in 70 80 of patients but can alternate from one side to the other in different attacks Exacerbated by routine physical activity Extends from the periorbital and frontal areas backwards to the temporo parietal and occipital regions and can sometimes extend to the shoulder area Frequently is present on awakening in the morning However the headache is almost always accompanied by other symptoms which generally intensify along with the headache Nausea accompanies the headache in 70 90 and leads to vomiting in 20 50 Vomiting may occur early or late in the headache phase and when it occurs after the headache is well established it may result in a precipitious easing of the headache Photophobia Phonophobia and Osmophobia These symptoms lead patients to seek seclusion in a dark quiet room Stiffness or tenderness of the neck Other possible symptoms during this phase can include blurry vision diarrhoea abdominal cramps facial pallor sensations of heat or cold and localised edema of the scalp the face or the periorbital regions Cranial autonomic symptoms such as nasal congestion rhinorrhea and lacrimation can also occur Home Health Professionals and Migraine The Migraine Attack Headache Phase Headache Phase The headache phase is the most disabling feature of a migraine attack and is the most common reason for consultation Typically the following characteristics apply Headache lasts from 4 72 hours Moderate or severe pain Usually gradual in onset Throbbing pounding or pulsating in character although it may begin as a mild non throbbing headache Unilateral in 70 80 of patients but can alternate from one side to the other in different attacks Exacerbated by routine physical activity Extends from the periorbital and frontal areas backwards to the temporo parietal and occipital regions and can sometimes extend to the shoulder area Frequently is present on awakening in the morning However the headache is almost always accompanied by other symptoms which generally intensify along with the headache Nausea accompanies the headache in 70 90 and leads to vomiting in 20 50 Vomiting may occur early or late in the headache phase and when it occurs after the headache is well established it may result in a precipitious easing of the headache Photophobia Phonophobia and Osmophobia These symptoms lead patients to seek seclusion in a dark quiet room Stiffness or tenderness of the neck Other possible symptoms during this phase can

    Original URL path: http://www.migraine.ie/health-professionals-and-migraine/the-migraine-attack/headache-phase/#usermessagea (2014-07-21)
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  • Postdrome - Migraine
    to migraine sufferers and those with other headache disorders THE MIGRAINE Association Of Ireland Providing information support and reassurance to migraine sufferers and those with other headache disorders Latest News Latest News and Research from the Migraine World 17th July 2014 Read our submission on chronic migraine and medical card eligibility 14th July 2014 Loss of funding may cost MAI one third of staff 26th June 2014 Take this important survey on chronic migraine and medical card eligibility View All News Become a Member Sign up or Log in Events Upcoming Events from the MAI No events View All Events Home Health Professionals and Migraine The Migraine Attack Migraine Postdrome Migraine Postdrome Migraine Postdrome The postdromal or resolution phase follows the headache and may last for up to 48 hours Many of the symptoms of this phase appear initially during the prodrome or with the headache phase Typically these include Fatigue Sore muscles Food intolerance Malaise Alteration in mood Impaired concentration Scalp tenderness Decreased energy requiring a period of rest A minority of sufferers immediately after an attack feel energised euphoric and can return to normal activities at once Home Health Professionals and Migraine The Migraine Attack Migraine Postdrome Migraine Postdrome Migraine Postdrome The postdromal or resolution phase follows the headache and may last for up to 48 hours Many of the symptoms of this phase appear initially during the prodrome or with the headache phase Typically these include Fatigue Sore muscles Food intolerance Malaise Alteration in mood Impaired concentration Scalp tenderness Decreased energy requiring a period of rest A minority of sufferers immediately after an attack feel energised euphoric and can return to normal activities at once Donate Now Will you help us to continue our work We are only too aware of the devastating impact migraine can have

    Original URL path: http://www.migraine.ie/health-professionals-and-migraine/the-migraine-attack/migraine-postdrome/#usermessagea (2014-07-21)
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