Diagnóstico y tratamiento de migraña

1. Diagnóstico

1.1. > 50 años

1.1.1. ¿Ya sufría de migraña o tenía cefalea?

1.1.1.1. Si

1.1.1.1.1. Sospechar migraña y observar

1.1.1.2. No

1.1.1.2.1. Buscar causa secundaria

1.2. < 50 años

1.2.1. 3/5 de: • Pulsatil/Palpitante • 1 día duración • Unilateral • Nausea o vomito • Incapacita —> Actividades diarias

1.2.1.1. si

1.2.1.1.1. sin aura

1.2.1.1.2. con aura

1.2.1.1.3. ¿Cuando consultar?

1.2.1.2. no

1.2.1.2.1. Inicio progresivo

1.2.1.2.2. Inicio abrupto

1.2.1.2.3. ¿Es alguno de?: Change in previously existing headache (intensity, frequency, pattern) Daily or continuous headache Effort-related or positional headache Headache associated with change in personality or mental status Headache brought on by coughing, sneezing, or bending Headache brought on by exercise or orgasm Headache causing awakening from sleep Headache that becomes refractory to previously effective treatment Jaw pain (claudication) Migraine aura that begins or persists after the headache has dissipated New onset after age 50 y Persistent pain on 1 side of the head without contralateral attacks (“side-locked”) Previous head trauma Rapidly increasing headache frequency Subjective numbness or tingling inconsistent with sensory aura of migraine Sudden explosive onset of head- ache with rapid progression over seconds to minutes Worsens with Valsalva maneuver Worst headache of life

2. Tratamiento

2.1. Primero verificar que tratamiento no farmacológico está al alcance del paciente y recomendarlo.

2.1.1. ¿Necesita tratamiento antiemetico?

2.1.1.1. Si

2.1.1.1.1. Moderado a severo

2.1.1.1.2. Leve a moderado

2.1.1.2. No

2.1.1.2.1. Moderado a severo

2.1.1.2.2. Leve a moderado