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Neurology and Neuroscience > Headache - Migraine, Cluster, Tension > Flashcards

Headache - Migraine, Cluster, Tension Flashcards

1
Q

overview of migraine

A 
disorder
tendency to repeated attacks
triggers
easily hungover
visual vertigo
motion sickness
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2
Q

list the three forms of migraine attacks

A

pain
focal symptoms
pain + focal symptoms

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3
Q

list phases of migraine

A 
prodrome
aura
headache
resolution
recovery
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4
Q

outline the prodrome phase

A

changes in mood, urination, fluid retention, food craving, yawning

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5
Q

outline the aura phase

A

visual, sensory (numbness/paraesthesia), weakness, speech arrest

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6
Q

outline the headache phase

A

head and body pain, nausea, photophobia

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7
Q

outline the resolution phase

A

rest and sleep

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8
Q

outline the recovery phase

A

mood disturbed, food intolerance, feeling hungover

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9
Q

what positive and negative symptoms are present in aura?

A

scintillations and blindspot
expanding C’s
elemental visual disturbance

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10
Q

what are scintillations?

A

spot of flickering light that eventually expands

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11
Q

treatment for an acute migraine attack

A

aspirin/ibuprofen, paracetamol and metoclopramide (anti-emetic), soluble preparations for absorption, triptans (vasoconstrictors) opiates, short nap, TMS

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12
Q

what should you be aware of when prescribing opiates?

A

analgesic abuse potential

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13
Q

how does TMS work to treat migraine?

A

interrupts complex networks that trigger and perpetuate migraine, which is caused by spreading electrical depression across the cerebral cortex

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14
Q

lifestyle issues for those who suffer with migraines

A

sensitive heads even in between attacks
over-react to any sort of stimulation
can’t ignore the world around them, it overstimulates their brains

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15
Q

what are lifestyle triggers? things to avoid?

A

dietary, environmental, hormonal, weather, dehydration, stress
drink 2 litres water/day
avoid caffeinated drinks, don’t skip meals, eat fresh food
no oversleeping / late nights / electronics
analgesic abuse

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16
Q

list prophylactic medications for migraines

A

over the counter: feverfew, coenzyme Q10, EPO, Mg. TCAs, beta blockers, serotonin antagonists, calcium channel blockers, anti-convulsants, greater occipital nerve blocks, botox, suppress ovulation

17
Q

erenumab is used to treat what types of migraine?

A

episodic
chronic
cluster

18
Q

what drug class is erenumab?

A

calcitonin gene-related peptide receptor (CGRP-R) antagonist

19
Q

describe how tension type headache presents

A

tight muscles around head and neck bilaterally, as though head is in a vice

20
Q

treatment for tension type headache

A

NSAIDs
paracetamol
tricyclic anti-depressants
SSRI

21
Q

describe how cluster headache presents

A

severe unilateral pain lasting 15-180 minutes untreated
forehead and facial sweating
miosis and/or ptosis
sense of restlessness or agitation

22
Q

cluster headache is classified as?

A

classified as a trigeminal autonomic cephalgia.

23
Q

trigeminal autonomic cephalgia presents with at least one of the following ipsilaterally?

A

Conjunctival redness and/or lacrimation
Nasal congestion and/or rhinorrhoea
Eyelid oedema

24
Q

frequency of cluster headache

A

between one on alternate days to 8 per day

25
Q

is cluster headache associated with a brain lesion on MRI?

A

no

26
Q

list sites of pain of cluster headache

A

eye, forehead, temple, cheek, nostril, upper gum, palate, lower jaw, ear, occiput, neck , half head

27
Q

treatment of acute cluster headache

A

inhaled oxygen

S/C or Nasal Sumatriptan

28
Q

how does oxygen treat acute cluster headache?

A

inhibits neuronal activation in the trigeminocervical complex

29
Q

prevention of cluster headache

A

verapamil, prednisolone, lithium, valproate, gabapentin, topiramate, pizotifen

30
Q

compare distribution between men and women of migraine and cluster headache

A

migraine: 1/3 men, 2/3 women

cluster headache: 90% men, 10% women

31
Q

compare duration of migraine and cluster headache

A

migraine: 3-12 hours

cluster headache: 45 min - 3 hours

32
Q

compare frequency of migraine and cluster headache

A

migraine: 1-8 attacks monthly

cluster headache: 1-3 attacks daily (often at night)

33
Q

compare remission of migraine and cluster headache

A

migraine: long remission unusual

cluster headache: long remission common

34
Q

compare nausea with migraine and cluster headache

A

migraine: nausea and vomiting frequent

cluster headache: rare

35
Q

compare pain with migraine and cluster headache

A

migraine: pulsating hemicranial pain
cluster: steady, exceptionally severe, well localised, unilateral in each cluster

36
Q

compare symptoms of migraine and cluster headache

A

migraine: visual or sensory auras
cluster: eye waters, nose blocked, ptosis

37
Q

compare activity with migraine and cluster headache

A

migraine: patients lie in the dark
cluster: patients pace about

Neurology and Neuroscience (15 decks)

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