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FINALS - NEURO > headache > Flashcards

headache Flashcards

1
Q

RF headache

A

immuno // history of mets // vomitting unknown cause // + fever // neuro or cognitive or personality or consiousness // trauma // triggered by cough or valsava

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2
Q

symptoms migraine

A

severe, unilateral, throbbing, nausea, photophobia, aura

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3
Q

triggers migraine

A

stress, tired, alcohol, COCP, dehydration, cheese, chocolate, red wine, menstruation, bright lights

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4
Q

migraine diagnostic criteria

A

5 attacks of: headache lasting 4-72 hours // 2 of - unilateral, pulsating, severe pain, aggregated by activity // N+V or photo+phonophobia // no secondary disorder

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5
Q

symptoms hemiplegic migraines

A

aura of motor weakness, strong FH history

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6
Q

1st line acute mx migraine

A

oral triptan + NSAID or paracetamol

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7
Q

2nd line mx acute migraine

A

metoclopramide or prochlorperazine

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8
Q

when should prophylactic migraine treatment be started

A

2 or more a month

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9
Q

1st line prophylaxis migraines

A

topirimate or propanolol // toperimate should be avoided in child bearing women

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10
Q

prophylaxis mx menstrual migraines

A

frovatriptan (2.5mg BD) // zolmitriptan (2.5mg TD) // mx with mefanfemic acid, paracetamol, triptan

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11
Q

1st line migraine mx during pregnancy

A

paracematol

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12
Q

2nd line migraine mx during pregnancy + when can it be used

A

NSAIDs = 2nd + 3rd trimester // avoid opioids

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13
Q

what contraception is contraindicated in migrane with aura and what UKMEC is it

A

COCP - UKMEC 4

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14
Q

can you prescribe HRT with migraines

A

yes - may make them worse

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15
Q

mechanism of triptans

A

spececifc serotonin (B+D) agonists

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16
Q

administration triptans

A

oral, oraldisersile, nasal spray, sub/cut

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17
Q

SE triptans

A

tingling, heat, tightness, heavy chest

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18
Q

containdications triptans

A

IHD or cerebrovascular disease

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19
Q

symptoms tension headache

A

tight band around head, bilatera // lower pain that migraine, no N+V, no photophobia or phonophobia

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20
Q

what is chronic tension headaches

A

headaches occur 15+ days a month

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21
Q

acute mx tension headaches

A

aspirin, paracetamol, NSAIDs

22
Q

2nd line mx migraines + tension headaches

A

acupuncture over 5-8 weeks

23
Q

what conditions are Trigeminal Autonomic Cephalgia’s (TACs) + what general symptoms

A

cluster headaches, paroxysmal hemicrania, SUNCT // unilateral pain + trigeminal nerve symptoms

24
Q

who gets cluster headaches + what can trigger them

A

men, smoking, alcohol

25
Q

symptoms (not frequency + length) cluster headache

A

intense pain around one eye // agitated and restless patient // redness and lacrimiation around lid // nasal congestion // common at night

26
Q

frequency and duration cluster headaches

A

need 5 attacks for diagnosis // usually 1-2 times a day // last 15mins - 2 hours // clusters last 4 - 12 weeks

27
Q

invx cluster headache

A

MRI + gadolium contrast

28
Q

acute mx cluster headache

A

100% O2, subcut triptan

29
Q

prophylaxis cluster

A

1 = verapamil (maybe some pred) 2 = topimerate

30
Q

symptoms, duration, frequency SUNCT

A

unilateral, stabbing heading with conjunctival injection + tearing // attacks last seconds, can occur 300 times a day

31
Q

mx SUNCT

A

gabapentin or lamotrigene

32
Q

symptoms paroxysmal hemicrania + who usually gets it

A

unilateral headache around orbital or temporal area, tears or conjunctival injection common, women in their 60s

33
Q

duration and frequency paroxysmal hemicrania

A

last 10-30 mins but happen lots in a day

34
Q

mx paroxysmal hemicrania

A

indomethacin

35
Q

what causes trigeminal neuralgia

A

vascular, demyelination, neoplasms

36
Q

symptoms trigeminal neuralgia

A

unilateral, sudden pain in trigeminal distribution // pain evoked by touch eg washing, shaving // nasolabial fold or chin v sore // lasts minutes

37
Q

RF trigeminal neuralgia

A

sensory change, deaf, skin legions, opthalamic division, optic neurits // onset <40

38
Q

what is trigem neuralgia assoc with

A

MS

39
Q

mx trigem neuralgia

A

carbamazepine (if does not response refer)

40
Q

what is the most common type of chronic headache

A

medication overuse

41
Q

how many days a month for medication overuse headache

A

15 days a month

42
Q

which medications cause overuse headaches

A

opioids and triptans

43
Q

mx for withdrawing meds in overuse headache

A

simple analgesia + triptans stop immediately // wean opioids

44
Q

causes secondary headaches

A

drugs, cough, exercise, post-coital

45
Q

how common is post LP headache and who gets them

A

1/3, young females, low BMI

46
Q

features post LP headache

A

develop 24-48 hours after, lasts a few days, worse upright

47
Q

mx LP headache

A

initally conservative, after 72 hours –> blood patch, epidural saline, IV caffeine

48
Q

what can post LP headaches lead too

A

subdural haematoma

49
Q

what causes spontaneous intracranial hypotension

A

CSF leak from thoracic nerve root sleeves

50
Q

RF spontaneous intracranial hypotension

A

marfans

51
Q

symptoms spontaneous intracranial hypotension

A

headache worse upright

52
Q

invx spontaneous intracranial hypotension

A

MRI + gadolium

FINALS - NEURO (16 decks)

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