headaches Flashcards
Migraine, tension headache, cluster headache, medication overuse headache, and trigeminal neuralgia
risk factors for migraines
family history
hormones
pathology of migraines
primary headache, believed to involve blood vessels
how many migraines are preceded by an aura?
1/3
symptoms of migraines
unilateral pain phonophobia photophobia nausea aura motor weakness affected language made worse by activity
diagnosis of migraine
clinical diagnosis
5 attacks lasting 4-72 hours
must have 2 or more symptoms
treatment of migraine
simple painkillers - can advance to triptans
propanolol and amitriptyline for prevention
risk factors for tension headache
stress
tension
sleep deprivation
symptoms of tension headache
non-pulsating not made worse by activity either photophobia or phonophobia bilateral no nausea may have affected language lasts 30 minutes to 7 days
diagnosis of tension headaches
> 10 attacks a year
treatment of tension headaches
paracetamol and ibuprofen
tricyclic antidepressants
what is the incidence of cluster headaches?
1/1,000
risk factors for cluster headaches
tobacco smoke exposure
family history
how long do cluster headaches last?
15 minutes to 3 hours
episodic cluster headaches - >1 cluster headache in 7 days to 1 year separated by at least 1 month
chronic cluster headaches - attacks occur for more than a year with no remission
symptoms of cluster headaches
shadow pain prior to attack
recurrent unilateral pain particularly around the eye
diagnosis of cluster headaches
at least 5 headache attacks fulfilling criteria
treatment for acute attack of cluster headache
SC sumatriptan
nasal zolmitriptan
100% oxygen
risk factors for medication overuse headache
frequent use of analgesics
pathology of medication overuse headache
overuse of a medication often inappropriately prescribed for headache disorders, leading to chronic headaches and potentially dependence
symptoms of medication overuse headache
recurring headache
withdrawal symptoms if no analgesic
complications of medication overuse headache
sudden removal of drug can induce seizures and headaches of a greater intensity
diagnosis of medication overuse headache
information concerning drug use
headache on more than 15 days/month for more than 3 months
treatment of medication overuse headache
gradual decrease in use of specific drug
prophylactic pain relief such as naproxen
risk factors for trigeminal neuralgia
> 50
male
Asian
MS
pathology of primary trigeminal neuralgia
idiopathic demyelination of Vth nerve
symptoms of trigeminal neuralgia
paroxysms of intense stabbing pain lasting seconds
pain is unilateral
triggered by washing the area, shaving etc…
pain when talking
complications of trigeminal neuralgia
depression
diagnosis of trigeminal neuralgia
MRI to exclude secondary causes
treatment of trigeminal neuralgia
microvascular decompression (surgery) treat primary pathology if secondary
