Migraine and Consultation Meeting 22nd June 2022

Dr Hussain shared Consultation Tips with the group, outlining principles to bear in mind when dealing with patients who are Medical Doctors. The presentation was based around her own personal insights and reflections following a recent hospital admission. 
The presentation is attached below: 
Dr Sophie Newton presented an overview of Migraine in Adults with a case based discussion. 
Key learning points included: 
1. Migraine is the sixth most disabling disorder globally by the WHO, and the most disabling of all neurological disorders.
2. There are 4 stages of a migraine attack;
  • Prodromal symptoms may occur 1-2 days before other symptoms including fatigue, mood changes, yawning 
  • Aura ( for 25 % of sufferers) 
  • Headache 
  • Postdromal symptoms can then go on for another 48 hours
3. Migraine is an under-diagnosed condition
4. Diagnostic criteria for migraine with or without aura 
5. People with migraine have twice the risk of ischaemic stroke compared to those without 
6. Opioids are not effective in headache and can worsen nausea and vomiting  as well as be a cause of medication overuse headache. As an alternative, try 400-600mg ibuprofen or 900mg of soluble aspirin as soon as the migraine attack begins , or try a diclofenac suppository if vomiting. 
7. Potential prophylactic alternative therapies include CBT, acupuncture and riboflavin 400mg OD as per NICE guidance. 
Magnesium Citrate 600mg OD and Coenzyme Q10 supplements are other options that can improve migraine in some people. 
8. Preventative medication can be useful if lifestyle changes and acute medication fails, but it is not a cure.
9. There are a multitude of specialist treatments available with new breakthroughs including monoclonal antibody therapies.
The presentation is attached below: 

Please be aware that information in the field of medicine changes all the time, so we cannot guarantee the accuracy of this data when you read it, it is here for General Practitioners to learn.