1. Migraine Headaches

2. Theories of Migraine Headaches Much about migraines still is not understood. Trigeminal nerve system Brain chemicals

3. Triggers / Thresholds Stress, sleep changes, weather patterns Glaring or flickering lights Menstruation, perfumes or chemical fumes largely genetically determined

4. Migraine Features Pulsating or throbbing head pain Nausea / Vomiting / Diarrhea Photophobia (light sensitivity) Phonophobia (sound sensitivity)

5. Treatment Pain relieving medications Nonsteroidal anti-inflammatory drugs : Advil, Motrin, Aspirin, Excedrin (asa & caffeine) Triptan s : Imitrex, Maxalt, Amerge Anti-nausea medications : Metoclopramide, Prochlorperazine

6. Treatment Preventative medications Cardiovascular drugs : Beta blockers, Calcium channel blockers. Antidepressants : Tricyclic antidepressants Anti-seizure drugs : Depakote, Topamax

7. Statistics Lost productivity - 13 billion dollars/year 10 million doctor visits/year 28 million people suffer –25% - 4 or more attacks/month –35% - 1 to 4 attacks/month –40% - less than 1attack/month

8. Famous migraine suffers Julius Caesar Ulysses s. Grant Thomas Jefferson Robert E. Lee Charles Darwin

9. Resources Migraine and Other Headaches, William B. Young, MD – Stephen D. Silberstein, MD www.mayoclinic.com/health/mi graine-headachewww.mayoclinic.com/health/mi graine-headache