Headache & Migraine

Question 1

Primary Headache (3)

Answer 1

1. migraine
2. tension type
3. cluster type

Question 2

secondary headache (4)

Answer 2

1. tumor
2. meningitis
3. sinus
4. alcohol

Question 3

Sinus Headache

Answer 3

constant pain in cheekbones

occurs with nasal discharge or fullness

Question 4

Tension Headache

Answer 4

mild to moderate pain
begins gradually usually around mid day
last 30 mins to several days
-difficulty falling asleep

Question 5

Migraine prevalence

Answer 5

10% americans
women to men 3:1
1 of 19 disabling diseases
highest in white -> AA -> Asian

Question 6

what is a migraine

Answer 6

biological disorder of CNS

-nerve cells in and brain and the blood vessels surrounding

Question 7

Pathogenesis of Migraines

Answer 7

response of brain and BV to challenge

disordered control of intrinsic and extrinsic circulation

Question 8

premonitory/prodrome phase

Answer 8

-elated, irritable, depressed, stiff neck, food craving, thirsty, drowsy

Question 9

aura phase

Answer 9

sensory disturbance - flashing lights, etc

Question 10

Mild to mod/severe headache phase

Answer 10

unilateral throbbing pain 
nausea
photo/phonophobia
resolved by sleep
* early intervention point

Question 11

postdrome phase

Answer 11

mood changes
weakness
reduced appetite

Question 12

How do you know when you have a migraine?

Answer 12

• mod-severe pain 1 sided
• nausea/vomiting
• aversion to lights or sound
• pain aggravated by activity
• throbbing pain

Question 13

transformation of migraine

Answer 13

episodic —> tension type —> mixed —> daily

Question 14

treatment options

Answer 14

Acute
-take when migraine
-treats after attack has begun
Preventative
-taken daily
-reduces frequency and intensity

Question 15

Non pharmacological strategies

Answer 15

• biofeedback
• relaxation training
• cog behavioral therapy
• cold compress
• cool dark quiet environment
• diary

Question 16

Acetaminophen warnings

Answer 16

• severe skin reactions
• rash
• blisters
• stevens johnson syndrome

Question 17

Aspirin mechanism

Answer 17

inhibits inflammatory response

Question 18

Aspirin side effects

Answer 18

• GI & stomach upset

- tinnitus

Question 19

Reye’s syndrome

Answer 19

develops after taking ASA during a viral infection

Question 20

Stages of Reye’s syndrome

Answer 20

Stage 1
-vomiting
-signs of brain dysfunction
-lethargic
Stage 2
-personality changes
-irritability 
-aggressive behavior
-disorientation
-confusion
-irrational behavior
-combative
-coma

Question 21

Caffeine and Migraine

Answer 21

caffeine blocks adenosine receptors

enhance absorption of other anti headache meds (?)

Question 22

tips for recognizing medication overuse

Answer 22

• part of daily routine
• meds seem less effective
• stopping meds worsens headache