Clinical features
Prodrome
- Teichopsia (flashes)
- Jagged lines
- Unilateral patchy scotoma
- Lasts 15 minutes to 1 hour
Headache hemicranial or generalised
- Nausea and vomiting
- Generally irritable
- Preference for the dark
- Sleeping
Other patterns
- Migraine without aura
- Hemiplegic migraine
Differential diagnosis
- Subarachnoid haemorrhage
- Transient ischaemic attack
- Partial seizures
Management
- Avoid precipitating factors
During attack
- Paracetamol
- Antiemetics
- Sumatriptan (5HT agonist)
- Ergotamine
Prophylaxis
- Pizotifen, methysergide (5HT antagonists)
- Propranolol
- Amitriptyline (low-dose)
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