16.3 Headaches in Children Flashcards

1
Q

headaches in younger affect boys or girls?

A

boys

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2
Q

headaches in older kids girls or boys?

A

girls

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3
Q

what headache patterns are most sinister

A

Acute

chronic progressive

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4
Q

most likely cause of acute recurrent headaches?

A

migraines

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5
Q

most likely cause of chronic non-progressive headache?

A

tension-type

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6
Q

what is the Prensky migraine criteria?

A

3 of:

  • abdo pain, N+V
  • unilateral headache
  • pounding/throbbing pain
  • complete relief after sleep
  • aura
  • FHx
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7
Q

kids normally don’t have what with migraines?

A

normally don’t have aura

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8
Q

how to differentiate a migraine aura from a seizure aura?

A

migraine take longer onset of aura

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9
Q

Chronic progressive headache ddx?

A
  • space occupying lesion

- idiopathic intracranial HTN

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10
Q

other causes of chronic headaches?

A
Trauma
ocular
sinusitis
venous sinus thrombosus
post seizure
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11
Q

red flag symptoms history/exam

A
  • night time awakening/early morning headache
  • progressive worsening
  • occipital headaches
  • exetion/coughing
  • diplopia/seizures
  • behavioural
  • abnormal neurological exam/HTN/papilledema/growth
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12
Q

which symptoms in migraine are unusual?

  • vomiting
  • double vision
  • vertigo
  • no Fx
  • reversible focal neuro
  • persistent headache?
A
  • diplopia
  • lack of fx
  • persisten headache
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13
Q

Mx of migraine meds wise?

A

avoid meds if possible

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14
Q

Acute mx of migraine meds?

A
  • ibuprofen: acute onset
  • panadol
  • sumatriptan 5mg to 20mg oral and nasal
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15
Q

antiemetics for migraine?

A

ondansetron wafers

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16
Q

migraine resting place?

A

rest in dark room

17
Q

max analgesia for migraine in kids?

A

analgesia <2-3x/week

triptans <6/month

18
Q

5-HT1 agonists?

A

sumatriptan oral/nasal
rhizotriptan
zolmitriptan

19
Q

migraine preventive Rx? when? what?

A
  • if day-to-day impairment
  • takes 4-6 weeks to work
  • low dose:
  • propranolol
  • amitryptyline
  • sodium valproate
  • topiramate
  • flunarizine
  • pizotifen
  • cyproheptadine
  • riboflavin/magnesium