headache Flashcards
are most headaches primary or secondary?
primary
what would be types of secondary headaches?
Tumour Meningitis Vascular disorders Systemic infection Head injury Drug-induced
what would be types of primary headaches?
Tension Type Headache
Migraine
Cluster Headache
what is tension type headache?
Mild, bilateral headache which is often pressing or tightening in quality, has no significant associated features and is not aggravated by routine physical activity
what are tension type headache treatments?
Aspirin or paracetamol
NSAIDs
Limit to 10 days per month (~2 days per week) to avoid the development of medication overuse headache
Preventative treatment
Rarely required
Tricyclic antidepressants
amitriptyline, dothiepin, nortriptyline
what is the most frequent dsiabling primary headache?
migraine
what is a migraine?
A chronic disorder with episodic attacks
Complex changes in the brain
what happens during migraine attacks?
Headache
Nausea, photophobia, phonophobia
Functional disability
what happens in between migraine attacks?
Enduring predisposition to future attacks
Anticipatory anxiety
what are migraine triggers?
dehydration diet environmental stimuli changes in oestrogen level in women sleep disturbance hunger stress
what percentage of people does aura affect?
33%
what is aura?
Transient neurological symptoms resulting from cortical or brainstem dysfunction
May involve visual, sensory, motor or speech systems
how long does aura occur for?
15-60 minutes
how would you define a chronic migraine?
Headache on ≥ 15 days per month, of which ≥ 8 days have to be migraine, for more than 3 months
how does medication overuse in headaches occur?
Headache present on ≥15 days / month which has developed or worsened whilst taking regular symptomatic medication
what is the treatment for migraines?
Abortive treatment
Aspirin or NSAIDs
Triptans
Limit to 10 days per month (~2 days per week) to avoid the development of medication overuse headache
Prophylactic treatment Propranolol, Candesartan Anti-epileptics Topiramate, Valproate, Gabapentin Tricyclic antidepressants amitriptyline, dothiepin, nortriptyline Venlafaxine
when are you likely to get your first migraine as a woman?
during pregnancy
what treatment would you use for someone that is haveing an acute attack of migraines but is pregnant?
paraceamol