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neurology FA > Headache - vertigo > Flashcards

Headache - vertigo Flashcards

1
Q

headache - definition / MC in (sex)

A
  • pain due to irritation of of structure such as dura, cranial nerves or extracranial structures
  • MC in women, except clusters
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2
Q

main types of headache

A
  1. cluster
  2. tension
  3. migraine
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3
Q

other causes of headache (10)

A
  1. subarachnoid hemorrhage
  2. meningitis/encephalitis
  3. hydrocephalus
  4. neoplasia
  5. arteritis
  6. trigeminal neuralgia
  7. head injury
  8. acute glaucoma
  9. sinusitis
  10. venous sinus thrombosis
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4
Q

main types of headache - localization

A
  1. cluster –> unilateral
  2. tension –> bilateral
  3. migraine –> unilateral
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5
Q

main types of headache - duration

A
  1. cluster –> 15min-3h repetitive
  2. tension –> more than 30 min (typically 4-6h)
    constant
  3. migraine –> 4-72h
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6
Q

tension headache - characteristic of pain and other symptoms

A
  • steady pain
  • No photophobia
  • No phonophobia
  • No aura
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7
Q

cluster headache - characteristic of pain and other symptoms

A
  • Repetitive brief headaches
  • Excruciating periorbital pain with lacrimation
  • Rhinorrhea
  • may present with HORNER syndrome
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8
Q

cluster headache may induce …

A

HORNER syndrome

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9
Q

cluster headache is more common in

A

males

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10
Q

Migraine - characteristic of pain and other symptoms

A
  • pulsating pain
  • nausea
  • photophobia or phonophobia
  • may have aura
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11
Q

Migraine mnemonic

A

POUND

Pulsatile, One-day duration, Unilateral, Nausea, Disabling

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12
Q

migraine is due to

A

irritation of: 1. CN V 2. Meninges 3. Blood vessels

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13
Q

migraine due to blood vessel irritation - mechanism

A

release of substance P, calcitonin gene-related peptide, vasoactive peptide

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14
Q

cluster headache - treatment

A

acute: 1. 100% 02 2. sumatriptan
prophylaxis: verapamil

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15
Q

tension headache - treatment

A
  1. Analgesics
  2. NSAID
  3. acetaminophen
  4. Amitryptyline for chronic pain
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16
Q

Migraine - treatment

A

Acute: triptans, NSAIN, dihydroergotamine
ProphylaxiS: lifestyle changes (sleep, exercisem diet eg,) propranolol, topiramate, Ca2+ channel blockers, amitriptyline, valproate

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17
Q

trigeminal neuralgia headache - duration / type of pain

A

typically less than 1 minute

repetitive shooting pain in distribution of CN V

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18
Q

Vertigo - definition

A

sensation of spinning while actually stationary. (subtype of dizziness but distinct from lightheadedness

19
Q

types of vertigo (MC?)

A
  1. peripheral vertigo (MC)

2. central vertigo

20
Q

peripheral vertigo - etiology

A

inner ear etiology

  1. semicircular canal debris (benign position vertigo)
  2. vestibular nerve infection
  3. Meniere disease
  4. ototoxic drugs
  5. Ramsay Hunt syndrome
21
Q

peripheral vertigo - diagnosis

A

positional testing –> delayed horizontal nystagmus

22
Q

causes of central vertigo

A

Brain stem or cerebellar lesion

eg. stroke affecting vestibular nuclei or posterior fossa tumor

23
Q

central vertigo findings

A
  1. directional change of nistagmus
  2. skew deviation
  3. diplopia (eyes)
  4. dysmetria
  5. focal neurological findings
24
Q

dysmetria

A

lack of coordination of movement typified by the undershoot or overshoot of intended position with the hand, arm, leg, or eye. It is a type of ataxia.

25
Q

central vertigo diagnosis

A
  1. positional testing –> immediate nystagmus in andy direction, may change direction
  2. Focal neurologic findings
26
Q

prophylaxis of migraine

A
  1. propranolol
  2. topiramate
  3. Ca2+ channel blockers
  4. amitriptyline
  5. life style modifications
  6. valproate
27
Q

triptans - clinical use

A
  1. acute migraine

2. cluster headache attacks

28
Q

triptans - mechanism of action

A

5-HT (1B/1D) agonists (seretonin) –>

a. inhibit trigeminal nerve activtion
b. prevent vasoactive peptide release
c. induce vasoconstriction

29
Q

triptans - toxicity

A
  1. coronary vasospasm

2. mild paresthesia

30
Q

triptans are contraindicated in

A

patients with CAD or Prinzmetal angina

31
Q

headache - pain due to irritation of structures such as

A
  1. dura
  2. cranial nerves
  3. extracranial nerves
32
Q

meningism signs

A
  • acute severe headache, felt over most of the head
  • nech stiffness
  • photophobia
33
Q

causes of headache with meningism

A

meningitis
encephalitis
subarachnoid hemorrhage

34
Q

encephalitis vs meningitis according ONE clinical sign

A

encephalitis –> strange behaviour

35
Q

sinusitis - pain worse when

A

bending over

36
Q

Horner syndrome - headache

A
  1. cluster

2. venous sinus thrombosis

37
Q

migraine due to blood vessel irritation - mechanism - release of

A
  1. substance P
  2. calcitonin gene-related peptide
  3. vasoactive peptides
38
Q

tension headache - treatment for chronic pain

A

amitriptyline

39
Q

vertigo is always worsened by

A

movement

40
Q

semicircular canal debris –>

A

benign position vertigo

41
Q

1st line for trigeminal neuralgia

A

Carbamazepine

42
Q

positional testing for nystagmus is also called

A

Hallpike manoeuvre

43
Q

Epley manoeuvre –>

A

clear the debris from the semicircular canalas (benign positional vertigo)

44
Q

Menierre disease - symptoms

A
  1. recurrent attacks of vertgio (>20 mins)
  2. tinnitus
  3. hearing loss
  4. fullness sensation

neurology FA (31 decks)

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