2: Neurology- Headaches Flashcards
What % of chronic headaches in childhood have no identifiable cause
90
How can aetiology of headaches be divided
Primary and Secondary
What are the 3 types of primary headaches
- Tension-type headache
- Cluster headache
- Migraine
What are 4 causes of secondary headache
- Raised ICP
- Medication over-use
- Sinusitis
- Infection
What are features of chronic tension headache
Frontal, Regular
No other features: vomiting, visual disturbance
What red-flags of headache mean a child should receive an urgent referral
- Fever
- Vomiting
- Recent head trauma
- LOC
- Focal neurological signs
- Peak intensity in 5-minutes
- History malignancy
- Immunocompromised
- Neurological deficit
- Cognitive deficit
- Orthostatic
What is first-line for paediatric headaches
If no red-flags get family to keep a headache diary for 8W
what % children suffer from migraines
10
what is the criteria for migraines in children
A. At least 5 attacks fulfilling B-D
B. 1-48h duration
C. Features headache:
- Unilateral or bilateral
- Pulsating
- moderate-severe
- aggregated by physical activity
D. During headache:
- N+V
- Photophobia
- Phonophobia
What is first-line for management of migraines
Trigger-avoidance:
- Diet
- Exercise
- Stress
- Sleep
- Dehydration
What is first-line pharmacological management for paediatric migraines
Paracetamol and domperidone
When is migraine prophylaxis indicated
If headaches disrupting school
What is given as migraine prophylaxis first-line in children under age 12
Pizotifen
If ineffective. what is given as an alternative to pizotifen
Propanolol
What is given to prevent headaches in over-12’s
Sumatriptan
