Headache - Hon

Question 1

How does common migraine usually present? rate them in intensity, age of onset, gender prevalence.

Answer 1

Intensity: moderate to severe
Disability: inhibits or prohibits daily activities; pain aggrevated by activity
Age of onset: late teens to early 20s prevalence peaks between 34-40 years
Gender: F:M = 3:1

Question 2

How frequently does common migraine present? how long does it last? What part of brain does it localize to? describe the pain

Answer 2

1-4 attacks p er month
lasts 4-72 hrs, usually 12-24
location: uni or bilateral
throbbing/sharp/pressure

Question 3

What common symptoms are associated with common migraine?

Answer 3

Most common: nausea, vomiting, photophobia, phonophobia

Question 4

What kind of migraine usually presents with an aura?

Answer 4

Classic migraine

Question 5

Aura, as seen in classic migraine, usually lasts _ and commonly presents with what kind of symptoms?

Answer 5

Lasts 15-30 mins. Presents with visual symptoms (scintillations, scotoma - often hemianopic),

Question 6

What characteristics makes a headache chronic migraine?

Answer 6

h/o headaches consistent with migraine, now with headache 15 or more days per month, lasting 4 hours or longer, for a period of at least 3 months, not attributed to another disorder.

Question 7

Describe tension headaches in terms of intensity, affect on daily activities, age of onset, and gender prevalence

Answer 7

Intensity: mild to moderate
may inhibit, but does not prohibit daily activities
generally peak incidence 20-40 years
F:M = 3:2

Question 8

what is the frequency and duration of tension HA

Answer 8

Frequency: episodic 15 days/months

Duration: episodic: several hours; chronic: all day, waxing and waning

Question 9

When a pt presents comining of bifrontal, bifrontal, bioccipital, neck, shoulder, band like headache described as dull, aching, squeezing, pressure with no prodrome or aura. What kind of headache is that?

Answer 9

Tension headache.

Question 10

Are cluster type headaches more common in man or woman?

Answer 10

man. F:M ratio is 1:6

Question 11

Describe cluster headache.

Answer 11

Severe, excruciating that prohibits daily activities. it may be associated with obstructive sleep apnea. presents episodic or chronic, duration is 30mins to 2hr. 100% unilateral; general orbitaltemporal. Nonthrobbing, excruciating, sharp, boring, penetrating. these pts appear frenetic, pacing, or rocking.

Question 12

What are some acute treatment for migraine?

Answer 12

• OTC analgesics
• NSAIDS like naproxen, ketorolac
• Isomethoptene
• butalbital
• opioids (meperidine, morphine, codeine, eoxycodone, hydrocodene)
• DHE nasal spray
• Triptans

Question 13

what is the only FDA approved treatment for chronic migraine?

Answer 13

BOTOX injections