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Migraine is primarily classified as a chronic infectious disease.
Answer: False
Migraine is classified as a complex neurological disorder, not an infectious disease.
Migraine is considered a highly consistent condition with a single distinct clinical presentation.
Answer: False
Migraine is considered a highly heterogeneous condition, presenting differently in various individuals, and is better understood as a spectrum disease rather than a single distinct clinical entity.
Hemiplegic migraine is characterized by temporary weakness on one side of the body.
Answer: True
Hemiplegic migraine is a specific type of migraine characterized by temporary motor symptoms, including weakness on one side of the body.
Status migrainosus is defined as a migraine attack lasting less than 24 hours.
Answer: False
Status migrainosus is defined as a migraine attack that lasts longer than 72 hours, not less than 24 hours.
A silent migraine involves experiencing aura symptoms without any subsequent headache.
Answer: True
A silent migraine, also known as acephalgic migraine, occurs when a person experiences aura symptoms without a subsequent headache.
Familial hemiplegic migraine is a rare form of migraine linked to single-gene disorders affecting ion transport or axonal proteins.
Answer: True
Familial hemiplegic migraine is a rare form of migraine linked to single-gene disorders affecting ion transport or axonal proteins.
According to the IHS '5, 4, 3, 2, 1 criteria', a migraine without aura requires at least three associated symptoms like nausea or photophobia.
Answer: False
According to the International Headache Society's '5, 4, 3, 2, 1 criteria' for migraine without aura, at least one associated symptom, such as nausea/vomiting or photophobia/phonophobia, must be present.
Migraine without aura and migraine with aura are the only two subclasses of migraine recognized by the ICH.
Answer: False
The International Classification of Headache Disorders recognizes multiple subclasses of migraine, including migraine without aura, migraine with aura (which encompasses various subtypes), probable migraine, and chronic migraine, among others.
Chronic migraine is defined as having headaches on fewer than 10 days per month for over three months.
Answer: False
Chronic migraine is defined by headaches occurring on 15 or more days per month for longer than three months, with specific criteria for migraine headaches on at least 8 of those days.
Migraine should be differentiated from tension headaches, which are typically unilateral and pulsating.
Answer: False
Migraine should be differentiated from tension headaches, which are typically bilateral, non-pulsating, and less disabling, unlike the unilateral and pulsating nature of migraine.
The term 'migraine' originates from the Greek word 'hemikrania', meaning 'pain in half of the head'.
Answer: True
The term 'migraine' is derived from the Greek word 'hemikrania,' which translates to 'pain in half of the head'.
Early descriptions of symptoms consistent with migraine are found in texts dating back to the 17th century.
Answer: False
Early descriptions consistent with migraine can be found in texts dating back much earlier, such as ancient Egyptian papyri (c. 1500 BCE) and writings from the Hippocratic school (c. 200 BCE).
Galen of Pergamon proposed in the second century CE that migraine pain arose from the meninges and blood vessels of the head.
Answer: True
In the second century CE, Galen of Pergamon proposed that migraine pain originated from the meninges and blood vessels of the head, influencing medical thought for centuries.
The distinction between migraine with and without aura was first made in the 20th century.
Answer: False
The distinction between migraine with aura and migraine without aura was first made in 1887 by Louis Hyacinthe Thomas.
Trepanation, drilling holes in the skull, was recommended for migraine treatment by William Harvey in the 17th century.
Answer: True
Trepanation, the historical practice of drilling holes into the skull, was recommended by William Harvey in the 17th century as a potential treatment for migraine.
Migraine is considered a spectrum disease, meaning it presents similarly across all affected individuals.
Answer: False
Migraine is considered a spectrum disease due to its heterogeneity, meaning it presents differently across individuals, rather than similarly.
Which of the following best describes migraine?
Answer: A neurological disorder characterized by recurrent moderate-to-severe headaches, often unilateral.
Migraine is primarily classified as a complex neurological disorder, characterized by recurrent episodes of moderate to severe headaches, which are typically unilateral and often accompanied by sensory disturbances.
Which type of migraine is characterized by motor symptoms, specifically weakness?
Answer: Hemiplegic migraine
Hemiplegic migraine is a type of migraine characterized by motor symptoms, specifically weakness, which indicates motor involvement in the aura.
What is status migrainosus?
Answer: A migraine attack lasting longer than 72 hours.
Status migrainosus is defined as a migraine attack that persists for longer than 72 hours, representing a prolonged and severe form of the condition.
What is a silent migraine, also known as acephalgic migraine?
Answer: A migraine attack with aura but no subsequent headache.
A silent migraine, also known as acephalgic migraine, occurs when a person experiences aura symptoms without a subsequent headache.
According to the IHS '5, 4, 3, 2, 1 criteria', how many associated symptoms (like nausea or photophobia) are required for a migraine without aura diagnosis?
Answer: At least one
According to the International Headache Society's '5, 4, 3, 2, 1 criteria' for migraine without aura, at least one associated symptom, such as nausea/vomiting or photophobia/phonophobia, must be present.
Which of the following is NOT listed as a main subclass of migraine by the ICH?
Answer: Migraine with brainstem aura
The International Classification of Headache Disorders lists main subclasses including migraine without aura, migraine with aura (which encompasses various subtypes), probable migraine, and chronic migraine. 'Migraine with brainstem aura' is a subtype of migraine with aura, not listed as a distinct main subclass.
Chronic migraine is defined by headaches occurring on how many days per month for over three months?
Answer: 15 or more days
Chronic migraine is defined by the occurrence of headaches on 15 or more days per month for longer than three months, with specific criteria for migraine headaches on at least 8 of those days.
Which condition is considered in the differential diagnosis of migraine and is characterized by typically bilateral, non-pulsating pain?
Answer: Tension headache
Tension headache is considered in the differential diagnosis of migraine, characterized by typically bilateral, non-pulsating pain, and generally less disabling symptoms compared to migraine.
The term 'migraine' originates from the Greek word 'hemikrania', which means:
Answer: Half of the head
The term 'migraine' is derived from the Greek word 'hemikrania,' which translates to 'pain in half of the head'.
Which historical figure proposed that migraine pain arose from the meninges and blood vessels of the head?
Answer: Galen of Pergamon
In the second century CE, Galen of Pergamon proposed that migraine pain originated from the meninges and blood vessels of the head, influencing medical thought for centuries.
Which historical practice, involving drilling holes in the skull, was recommended for migraine in the 17th century?
Answer: Trepanation
Trepanation, the historical practice of drilling holes into the skull, was recommended by William Harvey in the 17th century as a potential treatment for migraine.
Migraine headaches are typically bilateral and non-pulsating.
Answer: False
Migraine headaches are classically described as unilateral and pulsating. While bilateral pain can occur, it is not the typical presentation, and pulsating quality is a key characteristic.
Nausea and sensitivity to light are uncommon symptoms accompanying migraine headaches.
Answer: False
Nausea and sensitivity to light (photophobia) are common sensory disturbances frequently associated with migraine headaches.
Approximately two-thirds of individuals experiencing migraines report having aura.
Answer: False
Approximately one-third of individuals experiencing migraines report having aura, not two-thirds.
The prodrome phase of a migraine attack can include symptoms like fatigue and food cravings.
Answer: True
The prodrome phase of a migraine attack can indeed include symptoms such as fatigue and food cravings.
Aura refers to the headache pain itself during a migraine attack.
Answer: False
Aura refers to transient focal neurological symptoms that typically occur before or during a migraine headache, not the headache pain itself.
Visual disturbances are the least common type of aura experienced during a migraine.
Answer: False
Visual disturbances are the most frequent type of aura experienced during a migraine, occurring in up to 99% of cases.
A scintillating scotoma is a type of sensory aura involving tingling sensations.
Answer: False
A scintillating scotoma is a visual disturbance, not a sensory aura involving tingling sensations, which are typically described as paresthesias.
Sensory auras, manifesting as tingling sensations, are the most common type of aura.
Answer: False
Sensory auras, manifesting as tingling sensations, are the second most common type of aura; visual disturbances are the most frequent.
Migraine pain is always moderate in intensity and never severe.
Answer: False
Migraine pain is often described as moderate to severe in intensity and can be debilitating.
Neck pain is never associated with migraine headaches.
Answer: False
Neck pain is commonly associated with migraine headaches, particularly in individuals experiencing bilateral pain.
The postdrome phase of a migraine is characterized by sensory disturbances like nausea and photophobia.
Answer: False
Sensory disturbances like nausea and photophobia are typically associated with the pain phase or prodrome of a migraine, not the postdrome phase, which often involves fatigue or cognitive difficulties.
Migraine headaches typically worsen with physical activity.
Answer: True
The pain phase of a migraine typically worsens with physical activity.
What are common sensory disturbances frequently associated with migraine headaches?
Answer: Nausea, sensitivity to light, and sensitivity to sound.
Migraine headaches are frequently associated with sensory disturbances such as nausea, sensitivity to light (photophobia), and sensitivity to sound (hyperacusis).
What percentage of migraine sufferers typically report experiencing aura?
Answer: Approximately one-third (33%)
Approximately one-third of individuals experiencing migraines report having aura, which is a transient period of sensory disturbance that typically precedes or accompanies the headache.
Which phase of a migraine attack can involve symptoms like irritability, fatigue, and food cravings?
Answer: Prodrome phase
The prodrome phase of a migraine attack can include symptoms such as irritability, fatigue, and food cravings, occurring hours or days before the headache.
What is the most frequent type of aura experienced during a migraine?
Answer: Visual disturbances
Visual disturbances are the most frequent type of aura experienced during a migraine, occurring in up to 99% of cases. These can include scintillating scotoma or zigzag lines.
A scintillating scotoma is best described as:
Answer: An area of partial alteration in the visual field that flickers.
A scintillating scotoma is a visual disturbance often experienced during migraine aura, described as an area of partial alteration in the field of vision that flickers.
How is the pain phase of a migraine classically described?
Answer: Unilateral, pulsating, and moderate to severe.
The pain phase of a migraine is classically described as unilateral, pulsating, and moderate to severe in intensity. It typically worsens with physical activity.
The exact cause of migraine is fully understood and attributed solely to environmental factors.
Answer: False
The exact cause of migraine is not fully understood and is thought to result from a combination of environmental factors and genetic predispositions.
Genetics plays a minor role in migraine susceptibility, accounting for less than 10% of influence.
Answer: False
Genetics plays a significant role in migraine susceptibility, with studies indicating a substantial genetic influence ranging from approximately 34% to 51%.
Psychological stress and hunger are not considered triggers for migraine attacks.
Answer: False
Psychological stress and hunger are commonly reported triggers for migraine attacks.
Sex hormones, particularly estrogen fluctuations, are not believed to play a role in provoking migraine pain.
Answer: False
Estrogen fluctuations are believed to play a considerable role in provoking migraine pain, particularly in women, with episodes often correlating with menstrual cycles and other hormonal changes.
What percentage of migraine susceptibility is attributed to genetics?
Answer: Approximately 34-51%
Genetics plays a significant role in migraine susceptibility, with studies indicating a substantial genetic influence ranging from approximately 34% to 51%.
Which of the following is identified as a gene associated with familial hemiplegic migraine?
Answer: PRRT2
Familial hemiplegic migraine, a rare form of migraine, is associated with several genes, including PRRT2, which encodes an axonal protein involved in the exocytosis complex.
Which factor is commonly reported as a trigger for migraine attacks?
Answer: Certain foods like those containing MSG.
Common triggers for migraine attacks include various factors such as psychological stress, hunger, fatigue, certain foods (e.g., those containing MSG or tyramine), alcohol, weather changes, and sensory stimuli.
What is the relationship between migraine and sex hormones, particularly estrogen?
Answer: Estrogen fluctuations are thought to play a considerable role in provoking migraines, especially in women.
Estrogen fluctuations are believed to play a considerable role in provoking migraine pain, particularly in women, with episodes often correlating with menstrual cycles and other hormonal changes.
Which of the following is a common trigger for migraine attacks?
Answer: Weather changes (temperature and barometric pressure)
Common triggers for migraine attacks include various factors such as weather changes (specifically temperature and barometric pressure), stress, certain foods, and sensory stimuli.
Globally, migraine affects less than 5% of the population.
Answer: False
Globally, migraine affects approximately 15% of the population, not less than 5%.
Migraine prevalence is similar between boys and girls before puberty, but men experience migraines more frequently than women after puberty.
Answer: False
While migraine prevalence is similar between boys and girls before puberty, women experience migraines more frequently than men after puberty.
The World Health Organization ranks severe migraine as a condition causing minimal disability.
Answer: False
The World Health Organization ranks severe migraine as a condition causing significant disability, comparable to other severe chronic illnesses.
Migraine is considered the least costly neurological disorder in the European Community due to low direct medical costs.
Answer: False
Migraine is recognized as the most costly neurological disorder in the European Community due to substantial direct medical costs and indirect costs related to lost productivity.
Migraine with aura does not increase the risk of stroke.
Answer: False
Migraine with aura is identified as a risk factor for ischemic stroke, potentially doubling the risk.
What is the approximate global prevalence of migraine?
Answer: 15%
Globally, migraine affects approximately 15% of the population, translating to about one billion people worldwide.
How does migraine prevalence typically change after puberty?
Answer: It increases more significantly in women than in men.
While migraine prevalence is similar between boys and girls before puberty, it increases more significantly in women than in men after puberty.
Migraine is recognized by the WHO as a cause of:
Answer: Significant disability
The World Health Organization recognizes severe migraine as a condition causing significant disability, ranking it among the highest categories of disability comparable to other severe chronic illnesses.
What is a significant economic impact of migraine mentioned in the source?
Answer: It is the most costly neurological disorder in the European Community.
Migraine imposes a significant economic burden, being recognized as the most costly neurological disorder in the European Community due to substantial direct medical costs and indirect costs related to lost productivity.
Migraine with aura is identified as a risk factor for which condition?
Answer: Ischemic stroke
Migraine with aura is identified as a risk factor for ischemic stroke, potentially doubling the risk, especially when combined with other factors like hormonal birth control use or smoking.
Preventive migraine medications primarily work by increasing nerve cell excitability.
Answer: False
Preventive migraine medications work by inhibiting migraine pathophysiology through various mechanisms, rather than increasing nerve cell excitability.
Cortical spreading depression (CSD) is the accepted mechanism believed to cause the headache pain itself during a migraine.
Answer: False
Cortical spreading depression (CSD) is the accepted mechanism believed to cause the aura experienced during migraine attacks, not the headache pain itself.
Calcitonin gene-related peptide (CGRP) is a neuropeptide that contributes to pain transmission in migraines by causing vasoconstriction.
Answer: False
Calcitonin gene-related peptide (CGRP) contributes to pain transmission in migraines by causing vasodilation and releasing inflammatory mediators, not vasoconstriction.
CGRP targeting is a new therapeutic strategy for migraine, but it does not affect CGRP receptors.
Answer: False
CGRP targeting is a therapeutic strategy for migraine that involves affecting CGRP receptors or the peptide itself.
What is the widely believed cause of migraine aura?
Answer: Cortical spreading depression.
Cortical spreading depression (CSD) is the accepted mechanism believed to cause the aura experienced during migraine attacks. CSD involves a wave of neuronal excitation followed by a period of inactivity.
What is the proposed pathophysiological mechanism for migraine aura?
Answer: A wave of neuronal excitation followed by inactivity (CSD).
The proposed pathophysiological mechanism for migraine aura is cortical spreading depression (CSD), which involves a wave of neuronal excitation followed by a period of inactivity across the cerebral cortex.
What role does Calcitonin gene-related peptide (CGRP) play in migraine?
Answer: It leads to vasodilation and release of inflammatory mediators contributing to pain.
Calcitonin gene-related peptide (CGRP) plays a significant role in migraine pathophysiology by promoting vasodilation of cerebral blood vessels and facilitating the release of inflammatory mediators, thereby contributing to pain transmission.
What is the primary mechanism proposed for the aura phase of a migraine?
Answer: A wave of neuronal excitation followed by inactivity (CSD).
The primary mechanism proposed for the aura phase of a migraine is cortical spreading depression (CSD), characterized by a wave of neuronal excitation followed by a period of inactivity.
Initial treatments for acute migraine attacks often include over-the-counter pain relievers and anti-nausea medications.
Answer: True
Initial treatments for acute migraine attacks typically involve over-the-counter pain relievers and anti-nausea medications.
Triptans and ergotamines are medications used for migraines that do not respond to over-the-counter treatments.
Answer: True
Triptans and ergotamines are specific medications prescribed for migraines that do not respond adequately to over-the-counter treatments.
Prophylactic medication is recommended only for individuals experiencing ten or more migraine attacks per month.
Answer: False
Preventive medication is generally recommended for individuals experiencing four or more migraine attacks per month, or for those whose attacks significantly impact their quality of life.
Commonly prescribed prophylactic migraine medications include beta-blockers, anticonvulsants, and antidepressants.
Answer: True
Commonly prescribed prophylactic medications for migraine include classes such as beta-blockers, anticonvulsants, and antidepressants.
Non-pharmacological preventive therapies for migraine include nutritional supplementation and improved sleep hygiene.
Answer: True
Non-pharmacological preventive therapies for migraine encompass strategies such as nutritional supplementation and improved sleep hygiene.
Migraine management focuses solely on acute medication for pain relief.
Answer: False
Migraine management involves multiple aspects, including trigger avoidance, acute treatment for attacks, and preventive control for frequent or severe migraines, not solely acute medication.
Ergotamine, derived from ergot fungus, was isolated in 1918 and first used for migraines in 1925.
Answer: True
Ergotamine, a medication derived from ergot fungus, was first used clinically for the treatment of migraines in 1925, following its isolation in 1918.
Emerging research suggests a ketogenic diet may help prevent migraine attacks.
Answer: True
Emerging research indicates that a ketogenic diet may offer benefits in preventing migraine attacks.
Transcranial magnetic stimulation (TMS) is an emerging research area for migraine prevention.
Answer: True
Transcranial magnetic stimulation (TMS) is an emerging area of research for migraine prevention.
Which of the following is considered an initial recommended treatment for an acute migraine attack?
Answer: Over-the-counter pain relievers and anti-nausea medications.
Initial treatments for acute migraine attacks typically involve over-the-counter pain relievers and anti-nausea medications, along with avoiding known triggers.
For migraines unresponsive to over-the-counter treatments, which specific medication class might be prescribed?
Answer: Triptans
For individuals whose migraines do not respond adequately to over-the-counter pain medications, specific treatments such as triptans, ergotamines, or calcitonin gene-related peptide (CGRP) inhibitors may be prescribed.
Preventive migraine medication is generally recommended for individuals experiencing how many attacks per month?
Answer: Four or more
Preventive medication is generally recommended for individuals experiencing four or more migraine attacks per month, or for those whose attacks significantly impact their quality of life.
Which of the following is an example of a commonly prescribed prophylactic migraine medication?
Answer: Amitriptyline
Commonly prescribed prophylactic medications for migraine include beta-blockers like propranolol, anticonvulsants such as sodium valproate, and antidepressants like amitriptyline.
How do prophylactic migraine medications primarily function according to the source?
Answer: By inhibiting migraine pathophysiology through various mechanisms.
Preventive medications work by inhibiting migraine pathophysiology through various mechanisms, such as blocking ion channels or interfering with cellular processes.
Which non-pharmacological therapy is mentioned for migraine prevention?
Answer: Regular aerobic exercise.
Non-pharmacological preventive therapies for migraine include dietary adjustments, nutritional supplementation, improving sleep hygiene, and engaging in regular aerobic exercise.
Ergotamine, an effective migraine treatment, was first used clinically in which year?
Answer: 1925
Ergotamine, a medication derived from ergot fungus, was first used clinically for the treatment of migraines in 1925, following its isolation in 1918.
Which of the following is a potential non-pharmacological preventive therapy for migraine?
Answer: Dietary adjustments.
Potential non-pharmacological preventive therapies for migraine include dietary adjustments, nutritional supplementation, improved sleep hygiene, and regular aerobic exercise.