الصداع النصفي

Definition

Migraine is a neurological disorder causing recurrent headache attacks, more common in women.

Symptoms

• Moderate to severe throbbing headache, often one-sided, lasting 4–72 hours
• Nausea and vomiting
• Light and sound sensitivity
• Worse with activity
• Aura: zig-zag lights or blind spots before the headache in some

Triggers

Lack of sleep, hunger, stress, menstruation, certain foods and bright light.

Red flags needing urgent review

Thunderclap onset, fever with neck stiffness, neurological deficit, or new headache after 50.

Treatment

• Attack: early paracetamol or NSAIDs, or a triptan (contraindicated in vascular disease), plus an antiemetic
• Prevention: for frequent attacks, such as propranolol, topiramate, amitriptyline or CGRP drugs

Nursing care

• A quiet, dark room during attacks
• A diary to identify triggers
• Teach against analgesic overuse

Exam point

Painkillers on more than 10–15 days a month can cause daily medication-overuse headache.