Previous term: Common migraine, hemicrania simplex.
Description:
Recurrent headache attacks with manifestation for 4-72 hours. Characteristics unilateral head pain, throbbing, moderate intensity or severe, worsen with routine physical activity and followed with nausea and photophobia and phonophobia or.
Diagnostic criteria:
a. At least 5 attacks occurred that meet the criteria b-d
b. Attacks of headache lasting for 4-72 hours (not successfully treated or not treated).
c. Headache has at least two of the characteristics the following:
1. location unilateral
2. throbbing quality
3. Moderate or severe pain intensity
4. Circumstances gain severe by physical activity or patient avoid regular physical activity (such as walking or riding stairs).
d. During headache accompanied by one of the following:
1. and nausea or vomiting
2. photophobia and phonophobia.
e. Not associated with other abnormalities.
a. At least 5 attacks occurred that meet the criteria b-d
b. Attacks of headache lasting for 4-72 hours (not successfully treated or not treated).
c. Headache has at least two of the characteristics the following:
1. location unilateral
2. throbbing quality
3. Moderate or severe pain intensity
4. Circumstances gain severe by physical activity or patient avoid regular physical activity (such as walking or riding stairs).
d. During headache accompanied by one of the following:
1. and nausea or vomiting
2. photophobia and phonophobia.
e. Not associated with other abnormalities.
B. Migraine with Aura
Glossary Previous: Classical Migraine, ophthalmic, hemiparestetik, hemiplegi or aphasia migraine, migraine accompagnee, migraine complications .
Description :
A recurrent headache attacks which preceded symptoms reversible focal neurological 5-20 minutes and gradually lasted less than 60 minutes . Headache picture resembling migraine without aura aura symptoms usually occur after .
Glossary Previous: Classical Migraine, ophthalmic, hemiparestetik, hemiplegi or aphasia migraine, migraine accompagnee, migraine complications .
Description :
A recurrent headache attacks which preceded symptoms reversible focal neurological 5-20 minutes and gradually lasted less than 60 minutes . Headache picture resembling migraine without aura aura symptoms usually occur after .
Diagnostic criteria :
a. At least 2 attacks occurred that meet the criteria b
b. Migraine with aura fulfilling criteria b and c of the between B.1-B.6 .
c. Not associated with other abnormalities .
B.1 . Migraine with typical aura .
Description :
A typical aura consists of visual symptoms and/or sensory and/or speaking. Which develop gradually, the duration is not more than 1 hour, mixed picture of positive and negative, then disappeared perfect that meet the criteria of migraine without aura .
Diagnostic criteria :
a. At least 2 attacks occurred that meet the criteria of b - d .
b. The presence of aura which comprises at least one of the following but no found motor weakness :
1. Reversible visual disturbances such as: positive (light blinking, spots or lines) and negative (loss of vision).
2. Reversible sensory disorders including positive (pins and needles), and or negative (missing flavor / numbness).
3. Dysphasia speech disorders which, perfectly reversible .
c. At least two of the following :
1. Homonymous visual symptoms and / or unilateral sensory symptoms
2. at least one kind of aura arises gradually > 5 minutes and / or other types of auras > 5mn .
3. each symptom lasts > 5 and < 60 minutes .
d. Headache fulfilling criteria b - d of Migraine without aura started simultaneously with or after the aura aura for 60 minutes .
e. Not associated with other abnormalities.
a. At least 2 attacks occurred that meet the criteria b
b. Migraine with aura fulfilling criteria b and c of the between B.1-B.6 .
c. Not associated with other abnormalities .
B.1 . Migraine with typical aura .
Description :
A typical aura consists of visual symptoms and/or sensory and/or speaking. Which develop gradually, the duration is not more than 1 hour, mixed picture of positive and negative, then disappeared perfect that meet the criteria of migraine without aura .
Diagnostic criteria :
a. At least 2 attacks occurred that meet the criteria of b - d .
b. The presence of aura which comprises at least one of the following but no found motor weakness :
1. Reversible visual disturbances such as: positive (light blinking, spots or lines) and negative (loss of vision).
2. Reversible sensory disorders including positive (pins and needles), and or negative (missing flavor / numbness).
3. Dysphasia speech disorders which, perfectly reversible .
c. At least two of the following :
1. Homonymous visual symptoms and / or unilateral sensory symptoms
2. at least one kind of aura arises gradually > 5 minutes and / or other types of auras > 5mn .
3. each symptom lasts > 5 and < 60 minutes .
d. Headache fulfilling criteria b - d of Migraine without aura started simultaneously with or after the aura aura for 60 minutes .
e. Not associated with other abnormalities.
B.2. Headache non typical migraine with aura .
Description :
Aura consists of visual disturbances and or sensory disturbance and or speech disorders. Gradual progression, duration does not exceed 1 hour, mixed with positive and negative overview and contains complete of the characteristics of the aura of a migraine that does not qualify without aura
Diagnostic criteria :
a. At least 2 attacks fulfilling criteria b-d .
b. The presence of aura which contains at least one of the following but no found motor weakness :
1. Recurrent visual disturbances such as: positive (light blinking, spots or lines ) and negative (loss of vision) .
2. Sensory disorders including positive (pins and needles), and or negative (missing sense).
3. Dysphasia speech disorders .
c. At least two of the following :
1. And homonymous visual symptoms or unilateral sensory symptoms .
2. At least 1 aura symptoms gradually lead > 5 minutes and / or other aura symptoms are > 5 minutes.
3. Each symptom lasts > 5 and < 60 minutes .
d. Headache that does not meet the criteria of b-d in . migraine without aura begins during the aura or aura followed during 60 minutes.
e. Not associated with other abnormalities.
Description :
Aura consists of visual disturbances and or sensory disturbance and or speech disorders. Gradual progression, duration does not exceed 1 hour, mixed with positive and negative overview and contains complete of the characteristics of the aura of a migraine that does not qualify without aura
Diagnostic criteria :
a. At least 2 attacks fulfilling criteria b-d .
b. The presence of aura which contains at least one of the following but no found motor weakness :
1. Recurrent visual disturbances such as: positive (light blinking, spots or lines ) and negative (loss of vision) .
2. Sensory disorders including positive (pins and needles), and or negative (missing sense).
3. Dysphasia speech disorders .
c. At least two of the following :
1. And homonymous visual symptoms or unilateral sensory symptoms .
2. At least 1 aura symptoms gradually lead > 5 minutes and / or other aura symptoms are > 5 minutes.
3. Each symptom lasts > 5 and < 60 minutes .
d. Headache that does not meet the criteria of b-d in . migraine without aura begins during the aura or aura followed during 60 minutes.
e. Not associated with other abnormalities.
B.3 Typical aura without headache
Description :
Aura is a typical form of visual disturbances and / or sensory with or speak without interruption. Arise gradually, not exceeding the duration from 1 hour , the mixture of positive and negative picture, and will recover perfectly reversible and not associated with headache .
Diagnostic criteria :
a. At least 2 attacks fulfilling criteria b-d .
b. There is an aura of at least one of the following and found no motor weakness :
1. Reversible visual disturbances such as: positive (flickering light, spots or lines) and/or negative (loss of vision) .
2. Reversible sensory disorders such as positive (pins and needles), and/or negative (missing flavor/ numbness)
c. At least two of the following :
1. Homonymous visual symptoms and / or unilateral sensory symptoms.
2. At least one aura symptom that gradually lead > 5 minutes and / or other aura > 5mn .
3. Each symptom lasts > 5 and < 60 minutes.
d. Not found headache during or after the onset of aura aura within 60 minutes.
e. Not associated with other abnormalities.
e. Not associated with other abnormalities.
B.4. Familial hemiplegic migraine ( FHM )
Description :
Migraine with aura including motor weakness and at least one first or second descent of the family suffering from migraine with aura including motor weakness .
Diagnostic criteria:
a. At least 2 attacks fulfilling criteria b and c
b. The presence of aura in the form of a reversible motor weakness accompanied by at least one of the following:
1. perfectly reversible visual symptoms in the form of symptoms: positive (flickering light, spots or lines) and negative (loss of vision).
2. Perfectly reversible sensory symptoms in the form of positive (pins and needles), and or negative (missing Taste/numbness).
3. Dysphasia speech disorders are reversible .
c. At least two of the following :
1. at least one aura symptom that develops gradually > 5mn and / or other aura occurs > 5mn.
2. Each aura symptom lasts > 5 minutes and < 24 hours
3. Headache fulfilling criteria b - d at migraine without aura begins during the aura or after the onset of aura within 60 minutes.
d. At least one of the first or second ancestry families who suffered attacks fulfilling criteria a - e .
e. Not associated with other abnormalities .
B.5. Sporadic hemiplegic migraine
Description:
Migraine with aura including motor weakness but there is no family on the first or second ancestry that has aura including motor weakness .
Diagnostic criteria :
a. At least 2 attacks fulfilling criteria b and c.
b. There is an aura consisting of perfectly reversible motor weakness and at least one accompanied by the following :
1. Perfectly reversible visual symptoms such as: positive (flickering light, spots or lines) and negative (loss of vision).
2. Perfectly reversible sensory symptoms including positive (pins and needles), and / or negative (missing sense ) .
3. Speech disorders are reversible dysphasia perfect .
c. At least two of the following :
1. At least one aura symptom that develops gradually > 5mn and / or other aura symptoms > 5mn.
2. Each aura symptom lasts > 5 minutes and < 24 hours
3. Headache fulfilling criteria b - d at migraine without aura begins during the aura or after the onset of aura within 60 minutes .
d. There is no family history of first-degree or second attack that meet the criteria a - e .
e. Not associated with other abnormalities .
B.6 Basilar -type Migraine
Previous term : basilar artery migraine, basilar migraine.
Description :
Migraine with aura emanating from the involvement of the brain stem and or involvement of both hemispheres simultaneously but not encountered motor weakness .
Diagnostic criteria :
a. At least 2 attacks fulfilling criteria b - d .
b. met at least 2 attacks reversible aura perfectly, with no motor weakness :
1. dysarthria
2. vertigo
3. tinnitus
4. Hypacusia
5. diplopia
6. visual symptoms simultaneously both temporal visual field and nasal from both eyes .
7. ataxia
8. decreased awareness
9. parestesis bilateral simultaneous .
c. At least one of the following :
1. At least one aura symptom that develops gradually > 5mn and / or other aura symptoms that occur more than 5 minutes .
2. Each aura symptom lasts > 5 minutes and < 60 minutes .
d. Headache fulfilling criteria b - d at migraine without aura arises when bersaman with aura or after the onset of aura within 60 minutes.
e. Not associated with other abnormalities .
C. Periodic Syndrome in children is often a precursor migraine
C.1 Cyclical Vomiting
Description :
Cyclic vomiting is a recurrent episodic attacks, usually stereotyped in one form of vomiting and nausea continued constantly. The attack is accompanied with pale skin and lethargie. between get two attacks in complete resolution of symptoms .
Diagnostic criteria :
a. At least 5 attacks occurred that meet the criteria b & c
b. Attacks episodic, stereotyped in one form of nausea continues constantly, vomiting which lasts from 1 hour to 5 days.
c. Vomiting during attacks lasted at least 4x/jam for 1 hour
d. In the second attack, symptoms are not there.
e. Not associated with other abnormalities.
The symptoms that usually accompany cyclical vomiting: Abdominal pain, diarrhea, headache, fever, Social withdrawal, Dehydration, photophobia,
Trigger factors: stress, fatigue, motion sickness.
therapy :
Therapy during attacks
1. Erythromycin ethylsuccinate 20 mg / kg / day in divided doses 2x/day for 7 days
2. anti- migraine
3. anti- vomiting
Prophylactic therapy :
1. Amitriptillin
2. Cyproheptadin
C.2 Abdominal Migraines
Description :
An idiopathic disorder and repetitive, especially in children which is characterized by abdominal pain middle, and episodic lasts between 1-72 hours with free episodes of symptoms among 2 attack. The intensity of moderate to severe pain usually accompanied vasomotor symptoms, nausea and vomiting.
Diagnostic criteria :
a. At least 5 attacks fulfilling criteria B - D
b. Attacks of abdominal pain lasting between 1-72 hours ( without treatment / therapy failed )
c. Abdominal pain has the following characteristics :
1. Location midline , peri - umbilical or difficult to localize
2. dull pain
3. Moderate to severe intensity
d. During abdominal pain attacks are at least 2 accompanying symptoms are:
1. anorexia
2. nausea
3. gag
4. pale
e. Not associated with other abnormalities
Note :
Abdominal migraine attacks can be provoked by: stress, fatigue, lack of sleep, one meal. Usually not found a specific aura. on some children reported experiencing non -specific prodromal symptoms : changes in behavior, feeling unwell, headache and anorexia .
Therapy :
1. Anti- emetic : metoclopramide
2. Analgesics : paracetamol , diclofenac , codeine
3. Ergotamine
4. triptans
5. Fluid therapy if severe vomiting .
6. hydrotherapy
7. Abdominal castor oil
Prophylactic therapy:
Beta blockers, Cyproheptadin, tricyclic antidepressants, Pizatifen, Aspirin, Diets high in fiber, Anti anticonvulsants
C.3 Benign paroxysmal vertigo in children
Description :
A heterogeneous disorder with episodic vertigo attacks characteristics, recurrence occurs without warning and usually resolve spontaneously .
Diagnostic criteria:
a. At least 5x attacks fulfilling criteria b
b. multiple episodes of severe vertigo , occurring without warning and improved spontaneously after a few minutes up to 1 hour
c. On neurological examination normal audiometric and vestibular function during attacks
d. normal EEG
Note :
According to the age at occurrence , CPV divided by 2 forms :
1 . Early Childhood CPV
symptoms :
- Disruption of balance , nystagmus , paleness which happens suddenly and severely
- There was no headache or loss of consciousness
- At the age of < 1 year torticollis obtained for several hours to several days accompanied by vomiting and head turned to one side .
2 . Idiopatic CPV
Symptoms : pallor and nausea and vertigo that lasts 5-10 minutes and can be elongated up to 2 hours .
therapy :
- There is no specific therapy
- Usually recover spontaneously with rest
Description :
Migraine with aura including motor weakness and at least one first or second descent of the family suffering from migraine with aura including motor weakness .
Diagnostic criteria:
a. At least 2 attacks fulfilling criteria b and c
b. The presence of aura in the form of a reversible motor weakness accompanied by at least one of the following:
1. perfectly reversible visual symptoms in the form of symptoms: positive (flickering light, spots or lines) and negative (loss of vision).
2. Perfectly reversible sensory symptoms in the form of positive (pins and needles), and or negative (missing Taste/numbness).
3. Dysphasia speech disorders are reversible .
c. At least two of the following :
1. at least one aura symptom that develops gradually > 5mn and / or other aura occurs > 5mn.
2. Each aura symptom lasts > 5 minutes and < 24 hours
3. Headache fulfilling criteria b - d at migraine without aura begins during the aura or after the onset of aura within 60 minutes.
d. At least one of the first or second ancestry families who suffered attacks fulfilling criteria a - e .
e. Not associated with other abnormalities .
B.5. Sporadic hemiplegic migraine
Description:
Migraine with aura including motor weakness but there is no family on the first or second ancestry that has aura including motor weakness .
Diagnostic criteria :
a. At least 2 attacks fulfilling criteria b and c.
b. There is an aura consisting of perfectly reversible motor weakness and at least one accompanied by the following :
1. Perfectly reversible visual symptoms such as: positive (flickering light, spots or lines) and negative (loss of vision).
2. Perfectly reversible sensory symptoms including positive (pins and needles), and / or negative (missing sense ) .
3. Speech disorders are reversible dysphasia perfect .
c. At least two of the following :
1. At least one aura symptom that develops gradually > 5mn and / or other aura symptoms > 5mn.
2. Each aura symptom lasts > 5 minutes and < 24 hours
3. Headache fulfilling criteria b - d at migraine without aura begins during the aura or after the onset of aura within 60 minutes .
d. There is no family history of first-degree or second attack that meet the criteria a - e .
e. Not associated with other abnormalities .
B.6 Basilar -type Migraine
Previous term : basilar artery migraine, basilar migraine.
Description :
Migraine with aura emanating from the involvement of the brain stem and or involvement of both hemispheres simultaneously but not encountered motor weakness .
Diagnostic criteria :
a. At least 2 attacks fulfilling criteria b - d .
b. met at least 2 attacks reversible aura perfectly, with no motor weakness :
1. dysarthria
2. vertigo
3. tinnitus
4. Hypacusia
5. diplopia
6. visual symptoms simultaneously both temporal visual field and nasal from both eyes .
7. ataxia
8. decreased awareness
9. parestesis bilateral simultaneous .
c. At least one of the following :
1. At least one aura symptom that develops gradually > 5mn and / or other aura symptoms that occur more than 5 minutes .
2. Each aura symptom lasts > 5 minutes and < 60 minutes .
d. Headache fulfilling criteria b - d at migraine without aura arises when bersaman with aura or after the onset of aura within 60 minutes.
e. Not associated with other abnormalities .
C. Periodic Syndrome in children is often a precursor migraine
C.1 Cyclical Vomiting
Description :
Cyclic vomiting is a recurrent episodic attacks, usually stereotyped in one form of vomiting and nausea continued constantly. The attack is accompanied with pale skin and lethargie. between get two attacks in complete resolution of symptoms .
Diagnostic criteria :
a. At least 5 attacks occurred that meet the criteria b & c
b. Attacks episodic, stereotyped in one form of nausea continues constantly, vomiting which lasts from 1 hour to 5 days.
c. Vomiting during attacks lasted at least 4x/jam for 1 hour
d. In the second attack, symptoms are not there.
e. Not associated with other abnormalities.
The symptoms that usually accompany cyclical vomiting: Abdominal pain, diarrhea, headache, fever, Social withdrawal, Dehydration, photophobia,
Trigger factors: stress, fatigue, motion sickness.
therapy :
Therapy during attacks
1. Erythromycin ethylsuccinate 20 mg / kg / day in divided doses 2x/day for 7 days
2. anti- migraine
3. anti- vomiting
Prophylactic therapy :
1. Amitriptillin
2. Cyproheptadin
C.2 Abdominal Migraines
Description :
An idiopathic disorder and repetitive, especially in children which is characterized by abdominal pain middle, and episodic lasts between 1-72 hours with free episodes of symptoms among 2 attack. The intensity of moderate to severe pain usually accompanied vasomotor symptoms, nausea and vomiting.
Diagnostic criteria :
a. At least 5 attacks fulfilling criteria B - D
b. Attacks of abdominal pain lasting between 1-72 hours ( without treatment / therapy failed )
c. Abdominal pain has the following characteristics :
1. Location midline , peri - umbilical or difficult to localize
2. dull pain
3. Moderate to severe intensity
d. During abdominal pain attacks are at least 2 accompanying symptoms are:
1. anorexia
2. nausea
3. gag
4. pale
e. Not associated with other abnormalities
Note :
Abdominal migraine attacks can be provoked by: stress, fatigue, lack of sleep, one meal. Usually not found a specific aura. on some children reported experiencing non -specific prodromal symptoms : changes in behavior, feeling unwell, headache and anorexia .
Therapy :
1. Anti- emetic : metoclopramide
2. Analgesics : paracetamol , diclofenac , codeine
3. Ergotamine
4. triptans
5. Fluid therapy if severe vomiting .
6. hydrotherapy
7. Abdominal castor oil
Prophylactic therapy:
Beta blockers, Cyproheptadin, tricyclic antidepressants, Pizatifen, Aspirin, Diets high in fiber, Anti anticonvulsants
C.3 Benign paroxysmal vertigo in children
Description :
A heterogeneous disorder with episodic vertigo attacks characteristics, recurrence occurs without warning and usually resolve spontaneously .
Diagnostic criteria:
a. At least 5x attacks fulfilling criteria b
b. multiple episodes of severe vertigo , occurring without warning and improved spontaneously after a few minutes up to 1 hour
c. On neurological examination normal audiometric and vestibular function during attacks
d. normal EEG
Note :
According to the age at occurrence , CPV divided by 2 forms :
1 . Early Childhood CPV
symptoms :
- Disruption of balance , nystagmus , paleness which happens suddenly and severely
- There was no headache or loss of consciousness
- At the age of < 1 year torticollis obtained for several hours to several days accompanied by vomiting and head turned to one side .
2 . Idiopatic CPV
Symptoms : pallor and nausea and vertigo that lasts 5-10 minutes and can be elongated up to 2 hours .
therapy :
- There is no specific therapy
- Usually recover spontaneously with rest
D Retinal Migraines
Description :
recurrent attacks of monocular visual disturbances including scintillation, scotoma or blindness in migraine attacks.
Diagnostic criteria :
a. At least 2 attacks fulfilling criteria b and c
b. Visual Phenomena positive / negative fully reversible monocular (scintillation, scotoma, blindness ) as evidenced by examination of the patient during an attack or describe a picture of the visual field defect during an attack monoculer
c. Headache fulfilling criteria b - d for migraine without aura begins during the attack or afterwards during less than 60 minutes .
d. ophthalmologic examination between attacks is normal .
e. Not associated with other abnormalities
therapy :
Prophylactic Therapy : Calcium Channel Blockers, Beta Blockers
Source:
1. Picture: http://www.migrelief.com/pain-medication-may-worsen-migraine-diagnosis
Description :
recurrent attacks of monocular visual disturbances including scintillation, scotoma or blindness in migraine attacks.
Diagnostic criteria :
a. At least 2 attacks fulfilling criteria b and c
b. Visual Phenomena positive / negative fully reversible monocular (scintillation, scotoma, blindness ) as evidenced by examination of the patient during an attack or describe a picture of the visual field defect during an attack monoculer
c. Headache fulfilling criteria b - d for migraine without aura begins during the attack or afterwards during less than 60 minutes .
d. ophthalmologic examination between attacks is normal .
e. Not associated with other abnormalities
therapy :
Prophylactic Therapy : Calcium Channel Blockers, Beta Blockers
Source:
1. Picture: http://www.migrelief.com/pain-medication-may-worsen-migraine-diagnosis
thank for information.. very useful
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