Headache (migrain and tension) Flashcards
What are the symptoms of a tension headache?
- chronic dailu headache
- recurrent
- tight band
- pressure behind eyes
- throbbing
- bursting
What are the signs of a tension headache?
-tenderness and tension in neck and scalp muscles
What are the causes / risk factors for tension headache?
- worry / stress
- noise
- concentrated visual effort
- depression
What is the management for tension headache?
- avoid causes
- analgesia
What is a migraine?
Recurrent headache with visual or GI disturbance.
Attacks range from intermittent headaches similar to tension headache to episodes that mimic thromboembolic cerebral ischaemia
What is the progression of a migraine?
1) Well being before attack
2) Prodromal symptoms - irritability, photophobia, fatigue
2. 5) Can be with or without aura
3) Main attack - headache, nausea, vomiting
4) Sleep and tiredness after
What are the main symptoms of a classic migraine with aura?
1) Prodrome (mins-hours):
- visual symptoms
- aphasia
- tingling
- numbness
- nausea
2)Headache:
begins localised then becomes general.
nausea vomiting
photophobia
3) deep sleep
What are the main symptoms of a migraine without aura ?
NO prodrome (visual disturbance)
- headache
- nausea + vomiting
What are some of the precipitating factors of a migraine?
(use CHOCOLATE_
CHOCOLATE CH -cheese / chocolate O - OCP / pregnancy C - caffeine (or withdrawal) OL - alcohOL A - anxiety T - travel E - exercise
noise, lights, premenstrual
What is the prophylactic treatment for migraine?
If frequency of migraines is more than 2 a month try: 1) Pizotifen Or 2) Propanolol Or 3) Amitryptilline
2nd line treatment:
- sodium valproate
- methysergide
- SSRIs
- verapamil
What is the treatment for an immediate migraine?
1) paracetamol
2) antiemetic e.g. metoclopramide
3) Sumitriptan (constricts cranial arteries)
4) Ergotamine (constricts cranial arteries)
What are the differentials for migraine?
1) sudden migraine —> subarachnoid haemorrhage, meningitis
2) Hemiplegic, visual and hemisensory symptoms —-> TIA
3) unilateral tingling / numbness ——> focal epileptic siezure
4) Cluster or tension headache
5) Cervical spondylosis
6) Sinusitis / otitis media
