Headaches

Question 1

Migraines

Answer 1

Chronic
12% of population report

Question 2

Precipitating migraine factors

Answer 2

Chocolate
Cheese
Noise/light
PMS

Question 3

Migraine with aura

Answer 3

Usually accompanied by visual symptoms and tingling
May also have mild weakness
Nausea inc + vom follows
Several –> many hours migraine settles and deep sleep often occurs

Question 4

Drugs used in acute attacks of migraines

Answer 4

NSAIDs- inhibit prostaglandins synthesis centrally, no withdrawal symptoms
Antimetics- usually added to NSAIDs to inc absorption, given at onset of attack
Ergot alkaloids
Triptan class

Question 5

Prophylaxis of migraine

Answer 5

Pizotefin- 0.5mg at night for several days, inc to 1.5mg. SE- weight gain, drowsiness
Propanolol- 10mg 3 times daily
Amitriptyline- 10mg nightly

Question 6

Tension/muscle contraction headaches

Answer 6

Non-vascular aetiology
More common in F
Bilateral
Frontal temporal occipital distribution
Band-like non pulsatile ache or tightness assoc with neck P
No aura
Significant sleep disturbance
Link w cervical spondylosis and TMJ dysfunction
Treatment- analgesics, antidepressants, cerebral nerve block, biofeedback, OMT

Question 7

Cluster

Answer 7

M:F 5:1
Appear in clusters, focal excruciating P over eye