Chronic neuro

Question 1

what is a primary headache

Answer 1

caused by a primary disorder

Question 2

what is a secondary headache

Answer 2

side effect of another disorder

Question 3

what are the ss of a tension headache

Answer 3

bandlike; bilateral; episodic vs chronic; mild-moderate pain; constant dull pressure;

Question 4

what are some risk factors for tension headache

Answer 4

more common in femalesthen males; stress induced

Question 5

how is a tension headache diagnosed

Answer 5

History: Photophobia; phonophobia; Electromyography (EMG)
NO NAUSEA/VOMITING/PRODROME symptoms

Question 6

what are some meds used for tension headache

Answer 6

Symptom Treatment: NSAIDs, Acetaminophen, Flexeril
Prophylaxis: Antidepressants or Betablocker

Question 7

what are some non pharm methods for tension headache

Answer 7

Biofeedback; psychotherapy; muscle relaxation training

Question 8

what are the ss of migranes

Answer 8

Unilateral; throbbing; Nausea, Vomiting varies from mild to disabling can last 4-72 hours

Question 9

what are the risk factors for migraines

Answer 9

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

Question 10

how are migraines diagnosed

Answer 10

History!
NOT RECCOMMEDNED: Head CT Scan or MRI UNLESS abnormal neuro exam

Question 11

what are some meds used for migraines

Answer 11

Abortive Treatment: 1st line TRIPTINS: sumatriptin (Imitrex);NSAIDs, acetaminophen; Decadron
Preventative: Beta-BLOCKER: antidepressants; Anti-Seizure meds: valproic acid; topiramate (Topamax); BOTOX;

Question 12

what are some non pharm measures for migraines

Answer 12

avoid triggers: ETOH, Red wine, missed meals, fatigue, dehydration, menstruation; Food triggers: chocolate, MSG, tomatoes; things to help: acupuncture; massage, mediation, dimly lit rooms

Question 13

what are some ss of cluster headaches

Answer 13

unilateral, intense, sharp/stabbing pain, lasting minutes to hours around the eye, resulting in tearing (lacrimation), agitated

Question 14

what are some risk factors for cluster headaches

Answer 14

Alcohol, strong odors, weather changes, napping, flying

Question 15

how are cluster headaches diagnosed

Answer 15

History!
May use Head CT, MRI, MRAngiography to rule out aneurysm, tumor, infection.

Question 16

what are some meds used for cluster headaches

Answer 16

Symptom Treatment: 100% oxygen (vasoconstriction and serotonin release) and sumatriptin (Imitrex)
Prophylaxis: verapamil, lithium, prednisone, divalproex, melatonin, anti-seizure medications

Question 17

what are some non pharm methods for cluster headaches

Answer 17

nerve block, ablative procedure

Question 18

what is some teaching for headaches

Answer 18

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

Question 19

what is the blood brain barrier

Answer 19

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.

Question 20

what is multiple sclerosis

Answer 20

Autoimmune response from a trigger initiating the process in a genetically predisposed client. 3 processes: (1) Chronic inflammation, (2) demyelination, (3) gliosis (scarring).

Question 21

what are some motor ss of multiple sclerosis

Answer 21

weakness, falls, paralysis,diplopia, scanning speech, muscle spasticity

Question 22

what are some sensory ss of multiple sclerosis

Answer 22

numbness, tingling, scotomas (patchy blindness), blurred vision,vertigo, tinnitus, neuropathicpain

Question 23

what are some cerebral ss of multiple sclerosis

Answer 23

intentional tremors,nystagmus, dysarthria, dysphagia, fatigue, constipation,spastic bladder, erectile dysfunction, short term memory loss, wordfinding, +Babinski reflex

Question 24

what are some risk factors for multiple sclerosis

Answer 24

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

Question 25

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Answer 25

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