Headaches

Question 1

What are some causes of rapid-onset headaches?

Answer 1

Subarachnoid haemorrhage
Meningitis
Encephalitis

Question 2

How do migraines present?

Answer 2

Unilateral
Throbbing
Photo/phonophobia
Aura

Question 3

How are migraines managed?

Answer 3

Prophylaxis - propanolol, topiramate, amitriptyline

Attack - triptan, NSAIDs, paracetamol, anti-emetics

Question 4

When a headache is accompanied by eye pain and reduced vision, what is the liekly cause?

Answer 4

Acute glaucoma

Question 5

How do cluster headaches present?

Answer 5

Pain around one eye (always UL)
Watery and bloodshot eye
Lid swelling, crying, flushing, rhinorrhoea, miosis, ptosis

Clustered: 1-2/day for 4-12 weeks then remission for up to 2 years

Question 6

How are cluster headaches managed?

Answer 6

Oxygen, sumatriptan

Question 7

What are the symptoms of trigeminal neuralgia?

Answer 7

Intense stabbing UL pain in trigeminal nerve distribution

Question 8

How is trigeminal neuralgia managed?

Answer 8

Carbamezapine, lamotrigine, phenytoin, gabapentin

Surgical nerve decompression

Question 9

What contraception can be used in patients with migraine with aura?

Answer 9

Progesteribe-only pill

COCP -> stroke risk increased