CNS - Migraine Flashcards

1
Q

What are the 2 types of migraines?

A

1) Unliteral pulsating (severe enough to affect day to day activities)

2) with aura

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2
Q

With aura migraine symptoms?

A

Visual ( lights, flickering, lines, spots)

Sensory (pins + needles, numbness)

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3
Q

Unilateral migraine symptoms

A

Pulsating
Nausea vomiting
Photophobia

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4
Q

Migraine lifestyle advice?

A

AVOID Chocolate & Wine

Relax after stress

Hydrate, sleep, exercise

Headache diary to identify triggers

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5
Q

Acute treatment of migraines?

A

Aspirin, ibuprofen or Triptans (5HT1 agonist)

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6
Q

Migraines with aura when to take triptans?

A

Take triptan start of headache

NOT the AURA

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7
Q

How to take triptans?

A

Take 1 then repeat 2hrs after only if:
Inadequate response but a response from first dose was seen

**IF NOT HELPED AT ALL DO NOT TAKE 2nd DOSE

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8
Q

Which triptan second dose interval differs and how much by?

A

Naratriptan - 4hrs

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9
Q

If pt unable to taken aspirin, ibuprofen or triptan, what shall they take?

A

Soluble paracetamol - faster onset

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10
Q

Anti emetic used for migraines?

A

Metoclopramide/ Prochloroperazine

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11
Q

First line Migraine prophylaxis?

A

Propranolol

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12
Q

If pt is unable to use propranolol in migraine prophylaxis, what should they use?

A

Metoprolol or Nadalol

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13
Q

Alternative migraine prophylaxis med?

A

Amitriptyline also effective

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14
Q

If amitriptyline is not tolerated in migraine prophylaxis, what should they use?

A

Less sedating TCA

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15
Q

Specialist used drugs for migraine prophylaxis?

A

Sodium valproate
Pizotifen
Botox

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16
Q

Why should uncontrolled hypertension pt’s not use Triptans?

A

MOA of triptans constricts blood vessels

17
Q

What newly added drug can now be used for migraine prophylaxis

A

Topiramate

18
Q

What would be a sign for cluster headaches?

A

Unilateral intense pain in or around one eye

19
Q

Cluster headache acute treatment?

A

Nasal Sumatriptan/Zolmitriptan
Or
Sc sumatriptan

20
Q

Prophylaxis treatment in cluster headaches?

A

Verapamil
Lithium,
Prednisolone
or Ergotamine tartrate

21
Q

Important signs to recognise symptoms of Trigeminal Neuralgia?

A

Severe Head pain, JAWS AND TEETH

ELECTRIC SHOCK

22
Q

Trigeminal Neuralgia Treatment?

A

Carbamazepine

23
Q

Tension Headache

A

Tight band around head = Bilateral thrombin pain

24
Q

Tension headache treatment?

A

Paracetamol or ibuprofen

25
Q

Subarachnoid Haemorrhage signs?

A

PAIN IN BACK OF NECK
KICKED IN BACK OF HEAD feeling

26
Q

Subrachnoid Haemorrhage Treatment?

A

REFER TO A&E