1. Step 9
1.1. Review session 2
1.2. mechanism flow chart
1.2.1. genatic
1.2.2. stressures
1.2.3. had the migraine when she was young
1.3. 20 minutes
2. Step 10
2.1. Management
2.1.1. acute
2.1.1.1. depends on the severity
2.1.1.1.1. mild to modarate
2.1.1.1.2. moderate sever
2.1.1.2. never start treatment orally until you check swallowing
2.1.1.3. hydration
2.1.2. goals of manegment
2.1.2.1. remove causative factor
2.1.2.2. treat the attach
2.1.2.3. prevent further attacks
2.1.2.4. increase quality of life
2.1.2.5. educate the patient to manege their symptoms
2.1.2.6. reduce frequancy
2.1.2.7. remove the stressors
2.1.2.8. minimal side effects of the medication
2.2. Prevention
2.2.1. realieve stressures
2.2.2. prophylactic
2.2.2.1. use beta-blockers
2.2.2.2. relaxation and CBT
2.2.2.2.1. reduce migraine to 40-50%
2.2.2.3. deealing with stressures
2.2.2.3.1. if very sever we deal with it by medications
2.2.2.4. CCB
2.2.2.5. aniconvulsants
2.2.2.6. give the drug for 3 more month after the symptoms are all gone
2.2.2.7. patient should have symptoms 3 times a month at least and affecting his life quality to start treatment
2.2.2.8. the purposs of prophylactic is to reduce the attack
2.2.2.9. deal with the triggers
2.2.2.10. botucs can be used as prophylactic therapy
2.2.2.11. oral contrasiptives should be avoided because it can be the trigger
2.2.2.12. CCB doesnt show result untill 8 weeks
2.2.2.13. supplimints can be benifecial
2.2.2.14. take magnesium pills , patient with migraine have low magnisume
2.2.3. prognosis
2.2.3.1. patient will resolve completly but might take time
2.2.3.2. some patient will have neurologgical deffesets