Headache

Question 1

most common type of primary headache?

Answer 1

tension-type headaches

mild, bilateral headache which is often pressing or tightening in quality

Question 2

migraine symptoms (5)

Answer 2

headache
nausea
photophobia
functional disability
anticipatory anxiety

Question 3

what can trigger migraines?

Answer 3

normal life events

sleep disturbance, stress, hunger, environmental

Question 4

what is Aura?

Answer 4

A warning sign that a migraine is going to occur

flashing lights/lines or blind spots

Question 5

what classifies chronic migraine?

Answer 5

headache on more than 15days per month with more than 8 days migrainous for 3 months

Question 6

what is medication overuse headache?

Answer 6

headache presenting more than 15 days per month which has developed or worsened whilst taking medication

Question 7

what is the treatment for migraine?

Answer 7

abortive - aspirin/NSAIDs, tryptans (limit 10 days p/m)

prophylactic - propranolol, anti epileptics (gabapentin), tricyclic antidepressants

Question 8

4 types of trigeminal autonomic cephalgias?

Answer 8

cluster headaches
paroxysmal hemicrania
Short-lasting unilateral neuralgiform headache (SUNCT)
SUNA

Question 9

cluster headache main symptoms?

Answer 9

short, severe & restless
pain mainly orbital/temporal
unilateral 15m to 3hr
rapid cessation
episodic and occurs in groups (2 a day for 2 weeks)
circadian rhythmicicity

Question 10

Best evidence for treatment in cluster headaches?

Answer 10

verapamil

Question 11

what are paroxysmal hemicranial headaches?

Answer 11

same as cluster but more frequent and briefer (2-30mins)

less restless

Question 12

what does paroxysmal hemicranial best respond to?

Answer 12

indometacin

Question 13

SUNCT symptoms?

Answer 13

unilateral orbital, supraorbital or temporal pain
10-240secs
cutaneous triggers
3-200 days

Question 14

what is SUNCT pain accompanied with?

Answer 14

conjunctival injection and lacrimation

Question 15

Trigeminal neuralgia main feature and duration?

Answer 15

stabbing pain

5-10secs

Question 16

what is a thunderclap headache?

Answer 16

a high intensity headache reaching max intensity in less than 1 minute

Question 17

meningism symptoms?

Answer 17

nausea
photophobia
phonophobia
stiff neck

Question 18

encephalitis symptoms?

Answer 18

altered mental state
consciousness impaired
focal symptoms

Question 19

Warning features of raised intracranial pressure? (4)

Answer 19

pain worse in morning/wakening
lying flat
seizures
focal/non-focal signs

Question 20

Giant cell arteritis symptoms? (6)

Answer 20

diffuse or persistent headache
may be systemically unwell
scalp tenderness
jaw claudication
visual disturbance
prominent beaded TA

Question 21

checks in giant cell arteritis?

Answer 21

ESR count

CRP and platelet count

Question 22

management of giant cell arteritis?

Answer 22

high dose prednisolone

TA biopsy