Скачать или смотреть FMGE, NCLEX CLINICAL CASE HISTORY #96 [MEDICAL ENTRANCE EXAM TRICKS] MIGRAINE PROPHYLACTIC THERAPY

96) Prophylactic therapy of migraine:

A. Is recommended in all cases

B. Benefits up to 70% patients of moderate to severe migraine

C. Needs to be continued lifelong without interruption

D. Reduces the severity but increases the frequency of migraine attacks. Explain with Mnemonic

Correct answer: B. Benefits up to 70% patients of moderate to severe migraine

Explanation:

Prophylactic therapy for migraine is used to reduce the frequency, severity, and duration of migraine attacks, especially in patients with moderate to severe, frequent, or debilitating migraines.

Option A:* *"Is recommended in all cases" — Incorrect because prophylaxis is not indicated for infrequent or mild migraines; it's reserved for recurrent, severe, or disabling attacks.

Option B:* *"Benefits up to 70% patients of moderate to severe migraine" — Correct. Studies show that prophylactic medications can reduce attack frequency by about 50-70% in many patients with frequent or severe migraines.

Option C:* *"Needs to be continued lifelong without interruption" — Incorrect. While some patients may require long-term therapy, in many cases, prophylaxis can be tapered or discontinued if migraines improve.

Option D:* *"Reduces the severity but increases the frequency of migraine attacks" — Incorrect. Successful prophylaxis reduces both severity and frequency.

Mnemonic to Remember Key Points about Migraine Prophylaxis:

"MIGRAINE"

M* - Medication* (use appropriate prophylactics like beta-blockers, antiepileptics, antidepressants)
I* - Indicated in Moderate to severe or frequent* attacks
G* - *Goals: Reduce **frequency, severity, and improve quality of life
R* - *Reassess regularly**; therapy isn't necessarily lifelong
A* - Avoid triggers* (stress, certain foods)
I* - Intermittent discontinuation* possible if attacks decrease
N* - *Note: Up to **70% benefit in reducing attacks

References:

Goadsby PJ, et al. Migraine: current understanding and management. BMJ. 2017; 357: j2010.
Linde M, et al. Preventive pharmacological treatment for episodic migraine in adults. Cochrane Database Syst Rev. 2013;6:CD003218.
American Headache Society. Guidelines for migraine prophylaxis. Headache. 2012.

Summary:

Prophylactic therapy benefits up to 70% of patients with moderate to severe migraine by reducing attack frequency and severity, and should be tailored to individual patient needs, with ongoing assessment.

Let me know if you'd like detailed drug options, dosing, or patient counseling tips!