Headache

Question 1

Migraine without aura diagnostic criteria:

Answer 1

A. At least five attacks fulfilling criteria B-D
B. Headache attacks lasting 4-72 hr (untreated or unsuccessfully treated)
C. Headache has at least two of the following four characteristics:
1. unilateral location
2. pulsating quality
3. moderate or severe pain intensity
4. aggravation by or causing avoidance of routine physical activity (eg, walking or climbing stairs)
D. During headache at least one of the following:
1. nausea and/or vomiting
2. photophobia and phonophobia

Question 2

migraine without aura often has a ___________ relationship

Answer 2

menstrual

Question 3

Aura:

Answer 3

Neurological symptoms that occur usually before the headache
may begin after the pain phase has commenced or continue into the headache phase

Question 4

migraine with aura diagnostic criteria:

Answer 4

A. At least two attacks fulfilling criteria B and C
B. One or more of the following fully reversible aura symptoms:
	1. visual
	2. sensory
	3. speech and/or language
	4. motor
	5. brainstem
	6. retinal

C. At least two of the following four characteristics:

1. at least one aura symptom spreads gradually over ≥5 min, and/or two or more symptoms occur in succession
2. each individual aura symptom lasts 5-60 min1
3. at least one aura symptom is unilateral2
4. the aura is accompanied, or followed within 60 min, by headache

Question 5

Infrequent episodic TTH

Answer 5

headache episodes less than one day a month

Question 6

Frequent episodic TTH

Answer 6

headache episodes 1 to 14 days a month

Question 7

chronic TTH

Answer 7

headaches 15 or more days a month

Question 8

tension headache clinical feat:

Answer 8

Mild to moderate intensity
Bilateral
Non- throbbing headache

Question 9

tension headache triggers:

Answer 9

• stress

- head and neck movements

Question 10

tension headache tx:

Answer 10

Acute
Nonpharmacological
Heat, ice, massage, rest
Analgesics
Aspirin
Acetaminophen
Ibuprofen
Naproxen

Preventative
Tricyclic antidepressants
Amitriptyline
Antidepressants 
Mirtazapine
Venlafaxine

Anticonvulsants
Topiramate
Gabapentin
Muscle relaxant
tizanidine

Question 11

Trigeminal Autonomic Cephalgias

Answer 11

disorders characterized by unilateral trigeminal distribution pain that occurs in association with prominent ipsilateral cranial autonomic features
cluster headache
paroxysmal hemicrania
short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)
short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA)
hemicrania continua

Question 12

cluster headache:

Answer 12

• longest attack duration (min to hours)

- low attack frequency, up to 8 a day

Question 13

paroxysmal hemicrania:

Answer 13

• intermediate duration (min)

- intermediate attack frequency (up to 40 a day)

Question 14

SUNCT/SUNA

Answer 14

• shortest attack duration (sec to min)

- highest attack frequency(up to 200 a day)

Question 15

hemicrania continua

Answer 15

continuous daily headache for weeks to several months and sometimes years

Question 16

cluster headache diagnosis:

Answer 16

A. At least five attacks fulfilling criteria B-D
B. Severe or very severe unilateral orbital, supraorbital and/or temporal pain lasting 15-180 min (when untreated)1
C. Either or both of the following:
1. at least one of the following symptoms or signs, ipsilateral to the headache:
a) conjunctival injection and/or lacrimation
b) nasal congestion and/or rhinorrhoea
c) eyelid oedema
d) forehead and facial sweating
e) forehead and facial flushing
f) sensation of fullness in the ear
g) miosis and/or ptosis
2. a sense of restlessness or agitation
D. Attacks have a frequency between one every other day and 8 per day for more than half of the time when the disorder is active

Question 17

cluster headache tx:

Answer 17

Oxygen
Triptans 
Sumatriptan
Zolmitriptan
Intranasal formulations
Intranasal lidocaine

Verapamil for prevention

Question 18

idiopathic intracranial hypertension (IIH) risk factors:

Answer 18

Tetracycline
Vitamin A
Growth hormone in children

Question 19

IIH clinical feat:

Answer 19

Positional headache
Visual symptoms
Blurred vision
Transient vision obscurations
Pulsating tinnitus

Question 20

absence sz

Answer 20

staring spell

Question 21

atonic:

Answer 21

sudden loss of tone, can cause falls and injury

Question 22

tonic-clonic:

Answer 22

whole body convulsions/shaking

Question 23

myoclonic:

Answer 23

quick, involuntary, twitching of muscles

Question 24

simple sz:

Answer 24

intact awareness

Question 25

complex sz:

Answer 25

loss of consciousness

Question 26

status epilepticus:

Answer 26

sz longer than 5 min

Question 27

sz aura:

Answer 27

warning sign right beforethe seizure occurs. Sometimes this can includechanges in vision, hearing noises, or smelling scents

Question 28

diagnosis of epilepsy:

Answer 28

At least two unprovoked seizures occurring >24 h apart
One unprovoked seizure and a probability of further seizures similar to the general recurrence risk (>60%) after two unprovoked seizures, occurring over the next 10 years
Diagnosis of epilepsy syndrome