Headache And Fascial Pain Flashcards
What are the causes of headaches
Trigeminal autonomic cephalgias
Migraine
Tension type headache
Which causes of headache lasts minutes but is in high severtiy of pain
Trigeminal autonomic cephalgias
What type of headache lasts from hours to days and can be disabling
Migraine
What type of headache can lasts weeks to months and is manageable
Tension type headache
What are the causes of tension type headache
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
What is the treatment for tension type headache
Detox medication overuse
Physiotherapy
Tricyclic anti depressants
SSRI
What are the features of migraine
Episodic: come and go Better when lying down Stiff neck Photophobia Nausea Aura Prodrome
During the migraine what can you have
Photophobia (brigh light hurt)
Phomophobia (loud noise hurt)
Osmophobia (smells make you sick)
In between the migraine what can you have
Speech problems Dizziness Reflex syncope Restless legs Sensory disturbance Alice in wonderland syndrome Chronic fatigue IBS
What is the treatment for migraine
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
What are the types of trigeminal autonomic cephalgias
SUNCT
Paraoxysomal hemicrania
Cluster headache
Hemicrania continua
What are cluster headache
Headaches are in cluster e.g in the right side of head
What happens in cluster headaches
You get autonomic activation:
- runny nose
- runny eyes
- meiosis
- ptosis
- agitation
What is the treatment for cluster headaches
Fast actin tristan Break the cluster- prednisolone 60mg, reduce by 10mg every 3 days Prophylaxis Indometacin MRI
What is anothet condition that can resemble cluster headache
Caveat (acute close angle glaucoma)
What is acute close angle claucoma (caveat)
Raise intra ocular pressure
What are the symptoms of acute close angle glaucoma
Intense eye pain Nausea and vomiting Red eye Headache Tenderness around the eye Seeing rings around lights
What is trigeminal neuralgia
Damage to one of the trigeminal nerves so pain is limited to one distribution of the nerve
What are the rules for trigeminal neuralgia
One branch of the trigeminal nerve
Stabbing pain
Triggered by cold, wind, eating and drinking, touch sensitive
What is the treatment for trigeminal neuralgia
Carbamazepine Maximum carbamazepine Oxycarbamazepine Another AED MRI
What are the causes of a secondary headache
Raised icp
Thunderclap headache
Vascular problem
Sinusitis
What can a raised ICP be caused by
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
Hwo can you tell if someone has a raised ICP what are the signs
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
What is a thunderclap headache
When you have no headache then a severe headache within a few seconds appears
What does a thunderclap headache imply
Subarachnoid haemorrhage
Meningitis
CSF leak
CVST
What will happen if there is a carotid artery dissection
Neck pain
Fascial pain
Horners syndrome
