Chronic neuro Flashcards
what is a primary headache
caused by a primary disorder
what is a secondary headache
side effect of another disorder
what are the ss of a tension headache
bandlike; bilateral; episodic vs chronic; mild-moderate pain; constant dull pressure;
what are some risk factors for tension headache
more common in femalesthen males; stress induced
how is a tension headache diagnosed
History: Photophobia; phonophobia; Electromyography (EMG)
NO NAUSEA/VOMITING/PRODROME symptoms
what are some meds used for tension headache
Symptom Treatment: NSAIDs, Acetaminophen, Flexeril
Prophylaxis: Antidepressants or Betablocker
what are some non pharm methods for tension headache
Biofeedback; psychotherapy; muscle relaxation training
what are the ss of migranes
Unilateral; throbbing; Nausea, Vomiting varies from mild to disabling can last 4-72 hours
what are the risk factors for migraines
Common in 20-30yr olds; more common in Females than Men; family history; stress; low socio-economic status (bc stress about food/bills/et); hx of frequent tension-type headaches
how are migraines diagnosed
History!
NOT RECCOMMEDNED: Head CT Scan or MRI UNLESS abnormal neuro exam
what are some meds used for migraines
Abortive Treatment: 1st line TRIPTINS: sumatriptin (Imitrex);NSAIDs, acetaminophen; Decadron
Preventative: Beta-BLOCKER: antidepressants; Anti-Seizure meds: valproic acid; topiramate (Topamax); BOTOX;
what are some non pharm measures for migraines
avoid triggers: ETOH, Red wine, missed meals, fatigue, dehydration, menstruation; Food triggers: chocolate, MSG, tomatoes; things to help: acupuncture; massage, mediation, dimly lit rooms
what are some ss of cluster headaches
unilateral, intense, sharp/stabbing pain, lasting minutes to hours around the eye, resulting in tearing (lacrimation), agitated
what are some risk factors for cluster headaches
Alcohol, strong odors, weather changes, napping, flying
how are cluster headaches diagnosed
History!
May use Head CT, MRI, MRAngiography to rule out aneurysm, tumor, infection.
what are some meds used for cluster headaches
Symptom Treatment: 100% oxygen (vasoconstriction and serotonin release) and sumatriptin (Imitrex)
Prophylaxis: verapamil, lithium, prednisone, divalproex, melatonin, anti-seizure medications
what are some non pharm methods for cluster headaches
nerve block, ablative procedure
what is some teaching for headaches
Diary of headaches; precipitating events; changes; stress coping skills; quiet-dimly lit environment; hot packs; massage; avoid alcohol; medication education; avoid high altitudes; relaxation techniques; meditation; yoga
what is the blood brain barrier
a highly selective semipermeable border of endothelial cells that prevents solutes in the circulatingbloodfrom non-selectively crossing into the extracellular fluid of the central nervous system where neurons reside.
what is multiple sclerosis
Autoimmune response from a trigger initiating the process in a genetically predisposed client. 3 processes: (1) Chronic inflammation, (2) demyelination, (3) gliosis (scarring).
what are some motor ss of multiple sclerosis
weakness, falls, paralysis,diplopia, scanning speech, muscle spasticity
what are some sensory ss of multiple sclerosis
numbness, tingling, scotomas (patchy blindness), blurred vision,vertigo, tinnitus, neuropathicpain
what are some cerebral ss of multiple sclerosis
intentional tremors,nystagmus, dysarthria, dysphagia, fatigue, constipation,spastic bladder, erectile dysfunction, short term memory loss, wordfinding, +Babinski reflex
what are some risk factors for multiple sclerosis
20-50yrs old; Female 2-3x at risk than Male; Temperate climates (Northern US; Canada; Europe), Genetic: 1st, 2nd, 3rd degree relatives; Triggers: Smoking, pregnancy; infection Eg: URI and UTI, injury, stress, unhealthy
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