Etiology

  • Genetic predisposition

  • Triggers: stress, sleep deprivation, certain foods, hormones

Pathogenesis

  • Cortical spreading depression

  • Trigeminal nerve activation → CGRP release → vasodilation & pain

Clinical Features

  • Unilateral throbbing headache

  • Photophobia, phonophobia

  • Nausea, vomiting

  • Aura in some patients

Treatment

  • Acute: NSAIDs, triptans, antiemetics

  • Preventive: propranolol, topiramate, amitriptyline, CGRP inhibitors

  • Lifestyle modification