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Neurology > cluster headache > Flashcards

cluster headache Flashcards

1
Q

which nerve is responsible for cluster headaches?

A

trigeminal nerve

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2
Q

what is the 5th cranial nerve?

what are the three divisions of this nerve?

A

trigeminal nerve

ophthalmic
maxillary
mandibular

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3
Q

define cephalgia?

A

headache

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4
Q

what type of cephalgia is cluster headache?

A

trigeminal autonomic cephalgia

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5
Q

is PNS or CNS responsible for cluster headache?

A

PNS

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6
Q

in a cluster headache what happened to the sensitivity of the trigeminal nerve reflex arc?

A

increased sensitivity

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7
Q

is vascular dilation or vascular constriction responsible for this headache?

A

dilation

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8
Q

nociceptive info from the trigeminal nerve travels to what nucleus?

where is said nucleus located in brain?

A

trigeminocervical complex

brainstem

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9
Q

risk factors for cluster headache?

-5

A 
Male (3x)
Age: 20 – 40  
FHx
Smoker 
Alcohol excess
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10
Q

is male or female more likely to have cluster headache?

A

male

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11
Q

which age group is more likely to have cluster headache?

A

20-40

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12
Q

is obesity or smoking a risk factor?

A

smoking

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13
Q

are these headaches severe or mild?

A

severe

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14
Q

how long do cluster headaches last for?

A

15min-3hours

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15
Q

is pain unilateral or bilateral?

A

unilateral

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16
Q

which organ of the face is there a lot of pain?

A

eye

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17
Q

why is it called a cluster headache?

A

because headaches occur in cluster

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18
Q

how long might a cluster of these headaches last for?

  • give typical time range
A

2weeks to 3 months

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19
Q

pt is suffering from cluster headaches.

how many attacks will they have in one day?

  • give typical range
A

1-8 attacks/day

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20
Q

what is the least remission time between episodes of cluster headaches?

A

1 month

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21
Q

which ophthalmological condition must be a differential for a pt with a typical cluster headache Hx?

A

acute glaucoma

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22
Q

to which sensory stimulus does a person become agitated and restless?

what is this called?

A

light

photophobia

23
Q

non-autonomic symptoms of cluster headaches?

A

unilateral orbital pain/temporal pain
N&V
photophobia

24
Q

autonomic symptoms of cluster headache?

-5

A 
Lacrimation 
Rhinorrhoea 
Ptosis 
Miosis 
conjunctival injection
25
Q

are autonomic symptoms unilateral or bilateral?

A

unilateral

26
Q

are autonomic symptoms contralateral or ipsilateral?

A

ipsilateral

27
Q

simply put why do these autonomic symptoms occur?

A

↑↑↑ PNS activity

28
Q

medical word for flow of tears?

etymological root of above word?

A

lacrimation

lacrima (latin) = tear

29
Q

droopy eyelid is called what?

A

ptosis

30
Q

contraction of the pupil is called what?

etymological root of above word?

dilation of the pupil is called what?

A

miosis

muein (greek) = shut eyes

mydriasis

31
Q

cluster headache diagnosis is what type of diagnosis?

A

clinical diagnosis

32
Q

pt comes to GP with typical cluster headache Hx and signs.

what must GP do for all such patients?

A

refer everyone to neurologist

33
Q

Why might you do an ESR Ix?

A

rule out giant cell arthritis

34
Q

why might you do an MRI of brain?

A

rule out pituitary adenoma or any brain lesion

35
Q

prophylactic treatment of cluster headache?

-strength, route, frequency

A

verapamil
80mg
orally
tds

36
Q

what drug is given prophylactically to treat cluster headaches?

moa of this drug?

A

verapamil

Ca2+ channel blocker

37
Q

the prophylactic drug for cluster headache is more commonly used to treat what conditions?
-2

A

high blood pressure

angina

38
Q

the prophylactic drug for cluster headaches is taken via what route?

A

orally

39
Q

the prophylactic drug for cluster headaches is taken how many times a day?

A

3x/day

40
Q

the prophylactic drug for cluster headaches is of what strength?

A

80mg

41
Q

what is the acute Mx for cluster headaches?

-2

A

triptans + O2

42
Q

which triptan is likely given?

A

sumatriptan

43
Q

by what route should the triptan definitely not be given?

A

oral

44
Q

by what route can the triptan be given?

-2

A

subcutaneously

intra-nasally

45
Q

pt with acute cluster headache.

which drug should definitely not be given?
-4

A

paracetamol
NSAIDs
opioids
ergots

46
Q

pt with acute cluster headache in hospital.

O2 is given.

via what mask is it given?

A

non-rebreather mask

47
Q

pt with acute cluster headache in hospital.

O2 is given.

how long is it given for?

A

15 minutes

48
Q

pt with acute cluster headache in hospital.

O2 is given.

what is the strength of O2 given?

A

100% at 12-15L/minutes

49
Q

what side effect can occur from overusing triptans?

what should do if you get this side effect?

A

overuse headache

taper down triptans

50
Q

moa of triptans?

effect of this drug in the brain?
-2

A

5HT agonist

vasoconstricts cerebral blood vessels +
serotonin inhibits nerve firing

51
Q

which neurotransmitter is essentially being exploited to alleviate symptoms?

what does this neurotransmitter do at the synapse to help stop symptoms?

A

serotonin

inhibits neuropeptide release at synapse so less nerve firing

52
Q

what is prognosis for cluster headache?

A

variable

some better, some better with age, some do not improve

53
Q

is prognosis easy or hard to predict?

A

difficult to predict

Neurology (40 decks)

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