headache

Question 1

cluster headaches risk factors

Answer 1

more common in men
smokers
triggered by alcohol
relation to nocturnal sleep

Question 2

presentation of cluster headaches

Answer 2

intense sharp, stabbing pain around one eye
- occurs once or twice a day lasting 15mins-2 hours
4-12 weeks
accompanied by redness, lacrimation, lid swelling
nasal stuffiness
miosis and ptosis

Question 3

investigations in cluster headaches

Answer 3

MRI with gadolinium contract

Question 4

management of cluster headaches

Answer 4

acute: oxygen, subcutaneous triptan
prophylaxis: verapamil (some evidence for prednisolone)

Question 5

red flag headaches symptoms

Answer 5

fever, photophobia or neck stiffness
visual disturbance
sudden onset occipital headache
worse on coughing or straining
postural, worse of standing, lying or bending over
vomiting

Question 6

what is trigeminal neuralgia

Answer 6

unilateral disorder characterised by brief electric shock like pains, abrupt in onset and termination, limited to one or more divisions of trigeminal nerve

Question 7

features of trigeminal neuralgia

Answer 7

sharp shooting pain
commonly evoked by light touch, washing, shaving, smoking, talking
small areas nasolabial fold or chin my be particularly susceptible

Question 8

management of trigeminal neuralgia

Answer 8

carbamazepine first line
refer to neuro