Headache

Question 1

How can headache’s be classified and give examples?

Answer 1

Primary: Migraine, Tension, Cluster headaches. Primary malfunction of neurones.

Secondary: Due to an underlying condition: infection, raised ICP.

Question 2

What is the most common cause of headache in children?

Answer 2

Migraine

Question 3

What are the classical features of migraine?

Answer 3

Unilateral severe pulsating headache. (may be bilateral)

Aggravated by light and movement.

Nausea.

10% occur with an aura usually visual but may be olfactory.

Headaches last between 4 and 72 hours.

Note: There is the concept of abdominal migraines in which symptoms present as idiopathic nausea and abdominal pain.

Question 4

What are the classical features of a tension headache?

Answer 4

A symmetrical headache with gradual onset often described as a bilateral tight band-like pain.

Question 5

How can you manage migraines?

Answer 5

Avoid triggers: Cheese, chocolate, wine, stress, certain smells

Simple analgesia: 1st line

Triptans: 2nd line

Preventative: Beta blockers (if having 2 migraines per month, if using medication more than twice a week for migraine aka medication overuse)