Headaches Flashcards
Migraine Tension headaches Cluster headaches Trigeminal neuralgia
What is a migraine?
A migraine is a recurrent headache disorder characterized by moderate to severe unilateral headaches often associated with nausea, vomiting, photophobia, and phonophobia.
True/False: Migraines are more common in males than females.
False. Migraines are more common in females.
Migraines often present with ______ headaches that may be pulsatile in nature.
Unilateral.
What is the pathophysiology of migraines?
Migraines are thought to involve cortical spreading depression, vascular dysfunction, and abnormal sensory processing.
What are the two main types of migraines?
Migraine with aura and migraine without aura.
True/False: An aura can include visual, sensory, or motor symptoms.
t
A ______ is a reversible focal neurological symptom that occurs before or during a migraine attack.
Aura
List common triggers for migraines.
Stress, hormonal changes (e.g., menstruation), certain foods (e.g., chocolate, cheese), alcohol, dehydration, and sleep disturbances.
True/False: Missing meals is not associated with triggering migraines.
False. Skipping meals is a common trigger.
What is a common hormonal trigger for migraines in women?
Fluctuations in estrogen levels, especially during menstruation.
What are the typical phases of a migraine?
Prodrome, aura (if present), headache, and postdrome.
Symptoms of the prodrome phase of a migraine include ______, ______, and ______.
Fatigue, mood changes, and food cravings.
What symptoms are typical during the postdrome phase?
Fatigue, confusion, and residual head discomfort.
How is a diagnosis of migraine made?
Through clinical history and meeting the International Headache Society (IHS) criteria.
True/False: Imaging is always required to diagnose migraines.
False. Imaging is only indicated if there are red flag symptoms.
What are some red flag symptoms in headaches that warrant further investigation?
Sudden onset (“thunderclap”), neurological deficits, seizures, fever, or new headaches in patients over 50.
A ______ headache is characterized by its rapid onset and may indicate a serious underlying condition.
Thunderclap.
True/False: Triptans are first-line treatment for acute migraine attacks.
t
______ is a commonly used antiemetic in migraine management.
Metoclopramide.
Name two prophylactic treatments for migraines.
Beta-blockers (e.g., propranolol) and topiramate.
What lifestyle modifications can help prevent migraines?
Regular sleep patterns, hydration, stress management, and avoiding known triggers.
True/False: Cognitive-behavioral therapy (CBT) has no role in migraine management.
False. CBT can be beneficial for managing stress-related triggers.
What is a tension headache?
A tension headache is the most common type of primary headache, often described as a bilateral, tight, band-like pain around the head
True/False: Tension headaches are typically associated with nausea and vomiting.
False. Tension headaches are not usually associated with nausea or vomiting.
Tension headaches are often ______ in location and can last from minutes to days.
Bilateral
What is the underlying mechanism thought to cause tension headaches?
Increased muscle tension and central sensitization of pain pathways.
True/False: Stress and anxiety are significant contributing factors to tension headaches.
t
What are the two main types of tension headaches?
Episodic and chronic tension headaches.
Chronic tension headaches occur on more than ______ days per month for at least 3 months
14
Describe the pain associated with tension headaches.
Dull, non-pulsating, and described as a tightness or pressure around the head.
True/False: Photophobia and phonophobia may occur in tension headaches but are mild compared to migraines.
t
Name common triggers for tension headaches.
Stress, fatigue, poor posture, dehydration, and lack of sleep.
Poor ______ posture can contribute to the development of tension headaches.
Cervical (neck)
How are tension headaches diagnosed?
Based on clinical history and excluding secondary causes of headaches.
True/False: Neuroimaging is typically required to diagnose tension headaches.
False. Imaging is not routinely required unless red flag symptoms are present.
What is the first-line treatment for acute tension headaches?
Simple analgesics such as paracetamol or NSAIDs.
For chronic tension headaches, ______ management and stress reduction strategies are key components of treatment.
Lifestyle
Name two non-pharmacological approaches to managing tension headaches.
Physiotherapy and cognitive-behavioral therapy (CBT).
What medication can be used prophylactically for chronic tension headaches?
Amyitriptyline
True/False: Caffeine overuse can lead to chronic tension headaches.
t
How can tension headaches be differentiated from migraines?
Tension headaches are bilateral, non-pulsating, and not aggravated by physical activity, unlike migraines.
Unlike cluster headaches, tension headaches are not associated with ______ symptoms.
Autonomic
What is a cluster headache?
A cluster headache is a severe, unilateral headache associated with autonomic symptoms, occurring in clusters over weeks to months
True/False: Cluster headaches are more common in women than in men.
False. Cluster headaches are more common in men.
Cluster headaches are part of the group of headaches known as ______ headaches.
Trigeminal autonomic cephalalgias.
What is the suspected mechanism behind cluster headaches?
Dysfunction in the hypothalamus and activation of the trigeminal-autonomic reflex.
Cluster headaches are linked to activation of the ______ nerve and hypothalamus.
Trigeminal.
What is the characteristic presentation of a cluster headache?
Excruciating unilateral orbital, supraorbital, or temporal pain lasting 15–180 minutes.
True/False: Cluster headache attacks are often accompanied by restlessness or agitation.
t
Autonomic symptoms of cluster headaches include ______, nasal congestion, and eyelid edema.
Lacrimation (tearing).
When do cluster headaches typically occur?
Frequently at night, often waking the patient from sleep
What are the two types of cluster headaches?
Episodic (more common) and chronic.
True/False: Chronic cluster headaches occur without remission periods or with remissions lasting less than three months.
t
Name three common triggers for cluster headaches.
Alcohol, strong smells (e.g., solvents), and bright lights.
Exposure to ______ during a cluster headache cycle can often trigger an attack.
Alcohol
How are cluster headaches diagnosed?
Based on clinical history and criteria outlined by the International Classification of Headache Disorders (ICHD).
True/False: MRI is often used in cluster headache diagnosis to rule out secondary causes.
t
What is the first-line treatment for acute cluster headache attacks?
100% oxygen therapy (via non-rebreather mask) and subcutaneous or intranasal sumatriptan.
The recommended oxygen flow rate for acute cluster headache management is ______ L/min.
37240
What is the first-line prophylactic treatment for cluster headaches?
Verapamil.
True/False: Corticosteroids may be used for short-term prevention during a cluster headache cycle.
t
_____ is a non-invasive option sometimes used for prophylaxis in cluster headaches, involving stimulation of the vagus nerve.
Vagus nerve stimulation.
How can cluster headaches be differentiated from migraines?
Cluster headaches are unilateral, shorter in duration, and associated with autonomic symptoms, whereas migraines often involve aura and nausea.
True/False: Cluster headaches can be mistaken for sinus headaches due to overlapping symptoms like nasal congestion.
t
Do cluster headaches resolve spontaneously?
Episodic cluster headaches may have remission periods lasting months to years, while chronic forms may persist without significant remission.
Patients with cluster headaches often describe the pain as one of the most ______ experiences.
Excruciating.
What is Trigeminal Neuralgia?
A chronic condition characterized by recurrent episodes of severe, unilateral facial pain in the distribution of the trigeminal nerve.
True/False: Trigeminal Neuralgia is more common in women than men.
t
Trigeminal Neuralgia is often described as causing ______-like or stabbing facial pain.
Electric Shock
In which age group is Trigeminal Neuralgia most commonly diagnosed?
Typically in individuals over 50 years old.
rigeminal Neuralgia affects the ______ nerve, which has three branches: ophthalmic, maxillary, and mandibular.
Trigeminal
What is the primary cause of Trigeminal Neuralgia?
Compression of the trigeminal nerve root, often by a vascular loop.
True/False: Multiple sclerosis can also cause Trigeminal Neuralgia.
t
Demyelination of the trigeminal nerve, commonly seen in ______, can lead to Trigeminal Neuralgia.
Multiple Sclerosis
What are the characteristic symptoms of Trigeminal Neuralgia?
Sudden, severe, sharp, or stabbing unilateral facial pain lasting seconds to minutes, triggered by stimuli like chewing, talking, or cold wind.
True/False: Trigeminal Neuralgia pain can occur bilaterally in some cases.
False. It is typically unilateral.
Triggers for Trigeminal Neuralgia pain include ______, ______, and exposure to cold air.
Chewing; Talking.
How is Trigeminal Neuralgia diagnosed?
Through clinical history and examination, often supported by imaging (MRI) to exclude secondary causes.
True/False: MRI is used to rule out structural causes of trigeminal nerve compression.
t
A typical feature of Trigeminal Neuralgia is the absence of ______ symptoms.
Neurological
What is the first-line pharmacological treatment for Trigeminal Neuralgia?
Carbamazepine.
True/False: Gabapentin and pregabalin are commonly used for Trigeminal Neuralgia when carbamazepine is ineffective.
t
______ surgery can be performed if pharmacological treatments fail in Trigeminal Neuralgia.
Microvascular decompression.
What is the role of stereotactic radiosurgery in managing Trigeminal Neuralgia?
It uses focused radiation to target and relieve nerve pain.
Name two differential diagnoses for Trigeminal Neuralgia.
Migraine and temporomandibular joint (TMJ) dysfunction.
True/False: Postherpetic neuralgia can mimic Trigeminal Neuralgia.
t
Secondary Trigeminal Neuralgia can occur due to conditions such as ______ or brainstem tumors.
Multiple sclerosis.
What is the prognosis for Trigeminal Neuralgia?
Symptoms can be controlled with medication or surgery, though recurrence is possible.
True/False: Untreated Trigeminal Neuralgia can lead to significant impairment in quality of life.
t
