Headaches

Question 1

Characteristics of Tension-Type Headache (3)

Answer 1

● Bilateral
● Pressing, nonpulsatile pain
● Mild to moderate intensity

Question 2

Characteristics of Migraine with aura (5)

Answer 2

● Usually unilateral, occ. bilateral
● Pulsating, moderate to severe in intensity
● Made worse with activity
● N/V, photophobia, phonophobia
● Aura=anxiety, dread, fatigue, nervousness/excitement, GI upset, visual or olfactory alteration

Question 3

Cluster headache (4)

Answer 3

● Occurs at characteristics time of year
● Common to wake the person 1 hour after sleep
● Located behind one eye, severe pain
● Ipsilateral autonomic signs: Lacrimation, conjunctival injection, ptosis, nasal stuffiness

Question 4

Migraine abortive therapy? (4)

Answer 4

Triptans (sumatriptan), select ergot derivatives (dihydroergotamine), ditans, gepants.

Question 5

Prophylactic medications? (6)

Answer 5

● Beta blockers (metoprolol, prapranolol)
● TCAs (Amitriptyline, notriptyline)
● Antiepileptic drugs (Divalproex sodium, sodium valproate, topiramate)
● Calcitonin gene-related peptide (CGRP inhibitor)
● Nutrtional supplements
● Lithium (cluster headache)

Question 6

What labs are elevated with Giant Cell Arteritis (GCA)? How it it diagnosed? (2)

Answer 6

CSR and ESR

Diagnosed with superficial temporal artery biopsy

Question 7

Treatment for GCA? (1)

Answer 7

High dose corticosteroid therapy until disease stabilized