Head and face pain Flashcards
What nerves give sensory supply to the face?
What is SNOOP?
S= systemic symptoms: Fever, stiff neck, photophobia, vomiting
N= neuro Signs: Altered conscious state, focal neuro deficit, change in memory/ behaviour
O= onset: sudden or abrupt
O = old: +50
P = past HA history: change in pattern, frequency
What is the difference between a primary and secondary headache?
Primary headache: the headache cause is known
Secondary headache: Due to a unkwon cause: a headache atributed to other malignancy or illness
What are the primary headaches?
- cluster
- tension
- migraine
what are the more likely acute headaches?
upper respiratory tract infection
sinusitis: asthma/ allergic / infection
what are the most common chronic headaches?
- tension
- migraine
- cervicogenic
- combination headache: tension/ depression. cervical dysfunction, drugs
what are the serious cardiovascular disorders related to HA?
- CAD
- intracranial haemorrhage
- myocardial ischaemia
- hypertensive crisis
Other conditions related to HA?
- neoplasia (brain tumour)
- Severe infection (meningitis): rash, Cx stiffness, photophobia,
- TMJ dysfunction: sore jaw, grinding, clicking, bruxism, tenderness
- dental disorder: caries, gingivitis, bath breath, infection, under/over bite
- Eye disorder: refractive error, glaucoma
- trigeminal neuralgia: pain with temperature, icescream
- depression:
- anemia: pallor, fatigue
- metabolic disorder (thyroid)
- Drugs: meds, alcohol, caffeine
- exertional: sex, excercise
what drugs cause headaches?
alcohol
nicotine
caffeine
analgesic
antibiotics
vasodilators
What are the features of tension headache ?
Diagnosed after 10 episodes
Lasts from 30min to 7 days
band pattern
Must have two
Bilateral location
- Pressing or tightening quality (non-pulsatile)
- Mild to moderate intensity
- No aggravation with routine physical activity
NOT
nausea
vomiting
more than one sensory deficit (photo / phonophobia)
What are the features of cervicogenic HA
- unilateral
- occipital region
- dysfunction of Cx
- Arise from a convergence of trigeminal sensory fibres
What are the features of migraine
- diagnosed after 5 attacks
- last 4 – 72 hours
two of the following characteristics:
- •Unilateral location
- •Pulsating quality
- •Moderate or severe intensity
- •Aggravation by routine physical activity
•AND if I’m associated with at least one of nausea, vomiting, photophobia and phobia
What causes migraines and auras?
- Vascular desregulation
- spreding cortical depression: self propagating wave causes depolarization
-
neural sensitisation:
- increased nociceptive actiovation
- reduced supraspinal modulaiton
What are the features of cluster HA
- I can be diagnosed after 5 attacks if I fulfil the following criteria:
- I am unilateral in nature and cause severe to very severe pain in the orbital, supraorbital or temporal region
- If am accompanied by at least oneof the following:
- Lacrimation or rhinorrhea
- Eyelid, forehead or facial oedema
- Miosis &/or ptosis
- Restlessness or agitation
- I can last for 15 – 180 minutes
- My frequency can vary from once every second day to 8 times per day
What are the features of CAD
- I usually present with at least two of the following features:
- Sudden onset or “thunderclap” headache
- Unilateralpain: frontal, temporal, occipital or supraorbital region
- Unilateral neck or facial pain
- Constant and severe pain (ache/throbbing/sharp) – unlike anything ever experienced
- Neurological symptoms such as:
- Upper or lower limb deficits
- Horner’s syndrome
- Cranial nerve neuropathy
- Pulsating tinnitus
