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Neurology > Headache And Fascial Pain > Flashcards

Headache And Fascial Pain Flashcards

1
Q

What are the causes of headaches

A

Trigeminal autonomic cephalgias
Migraine
Tension type headache

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2
Q

Which causes of headache lasts minutes but is in high severtiy of pain

A

Trigeminal autonomic cephalgias

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3
Q

What type of headache lasts from hours to days and can be disabling

A

Migraine

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4
Q

What type of headache can lasts weeks to months and is manageable

A

Tension type headache

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5
Q

What are the causes of tension type headache

A

Medication overuse- build up of high analgesics in blood
Cervicogenic headache- osteoarthritis in the spine causes the disc to wear out in the neck so the stiffness causes headache
Raised pressure

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6
Q

What is the treatment for tension type headache

A

Detox medication overuse
Physiotherapy
Tricyclic anti depressants
SSRI

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7
Q

What are the features of migraine

A 
Episodic: come and go
Better when lying down
Stiff neck
Photophobia
Nausea
Aura 
Prodrome
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8
Q

During the migraine what can you have

A

Photophobia (brigh light hurt)
Phomophobia (loud noise hurt)
Osmophobia (smells make you sick)

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9
Q

In between the migraine what can you have

A 
Speech problems
Dizziness
Reflex syncope
Restless legs
Sensory disturbance
Alice in wonderland syndrome 
Chronic fatigue 
IBS
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10
Q

What is the treatment for migraine

A

Lifestyle: detox, no caffeine, look for triggers
Rescue treatment: NSAIDs and anti emetic (no opiods) and triptan
Prophylaxis: beta blocker, topiramta, candesartan, valproate, tricylic, SS or SNRI
Botox arounf the scalp
CGRP blockade with antognoist or prophylaxis antibodies that block CGRP

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11
Q

What are the types of trigeminal autonomic cephalgias

A

SUNCT
Paraoxysomal hemicrania
Cluster headache
Hemicrania continua

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12
Q

What are cluster headache

A

Headaches are in cluster e.g in the right side of head

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13
Q

What happens in cluster headaches

A

You get autonomic activation:

  • runny nose
  • runny eyes
  • meiosis
  • ptosis
  • agitation
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14
Q

What is the treatment for cluster headaches

A 
Fast actin tristan
Break the cluster- prednisolone 60mg, reduce by 10mg every 3 days
Prophylaxis 
Indometacin
MRI
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15
Q

What is anothet condition that can resemble cluster headache

A

Caveat (acute close angle glaucoma)

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16
Q

What is acute close angle claucoma (caveat)

A

Raise intra ocular pressure

17
Q

What are the symptoms of acute close angle glaucoma

A 
Intense eye pain
Nausea and vomiting
Red eye
Headache
Tenderness around the eye
Seeing rings around lights
18
Q

What is trigeminal neuralgia

A

Damage to one of the trigeminal nerves so pain is limited to one distribution of the nerve

19
Q

What are the rules for trigeminal neuralgia

A

One branch of the trigeminal nerve
Stabbing pain
Triggered by cold, wind, eating and drinking, touch sensitive

20
Q

What is the treatment for trigeminal neuralgia

A 
Carbamazepine
Maximum carbamazepine
Oxycarbamazepine
Another AED
MRI
21
Q

What are the causes of a secondary headache

A

Raised icp
Thunderclap headache
Vascular problem
Sinusitis

22
Q

What can a raised ICP be caused by

A

Increase in arterial blood e.g hypercapnia, haematoma, abscess
Problem with venous drainge e.g clot
Problem with meninges e.g meningitis
Problem with CSF: producting too much are problem with drainage

23
Q

Hwo can you tell if someone has a raised ICP what are the signs

A 
Papilloedema 
Seizures
Visual disturbance
Postural change: headache worse on lying
Pregnancy 
Nausea and vomiting
History of vasculits
Diabetes- prone to infection 
Progressivelt worsening
Morning headache or waking from sleep
24
Q

What is a thunderclap headache

A

When you have no headache then a severe headache within a few seconds appears

25
Q

What does a thunderclap headache imply

A

Subarachnoid haemorrhage
Meningitis
CSF leak
CVST

26
Q

What will happen if there is a carotid artery dissection

A

Neck pain
Fascial pain
Horners syndrome

Neurology (9 decks)

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