Headaches Flashcards
what is the diagnostic criteria for a migraine headache?
presence of an aura is sufficient for diagnosis
if no aura; x5 headache lasting 4-72 hours with photophobia/photophobia and/or nausea/vomiting AND at least 2 of; - unilateral headache - pulsating character - impaired or worsening daily activities
what is the acute management of a migraine?
Triptans i.e. Sumatriptan
+ Paracetamol and/or NSAID
name 1 contraindication for triptans.
ischaemic heart disease
what is the prophylactic management for migraine?
what is a contraindication for this treatment?
Propanolol (BB)
- Contraindicated in asthma
or Topiramate
what is the presentation of trigeminal neuralgia?
shot
unilateral stabbing/sharp pain in the distribution of the trigeminal nerve
what is the 1st line treatment for trigeminal neuralgia?
Carbamazepine
how is medication resistant trigeminal neuralgia managed?
Microvascular decompressive surgery
or
Ablative surgery i.e. Stereotactic radio-surgery
what is the presentation of a cluster headache?
Unilateral periorbital pain lasting 15 mins to 3 hours
Associated with lacrimation, blood shot eye, rhinorrhoea, ptosis, lid swelling, facial flushing
Occur once/twice a day for 4-12 weeks then have a period of no headaches for a few months
what is the acute management for cluster headaches?
100% oxygen via non-rebreathable mask
subcutaneous or nasal triptan i.e. Sumatriptan
what is the prophylactic management for cluster headaches?
Verapamil (CCB)
what is the presentation of a tension type headache?
bilateral, non-pulsatile headache
feels tight, like a band around the head
what’s the difference in pain between a tension type headache and a migraine?
Migraine = unilateral throbbing Tension = bilateral, tight, non-pulsatile
