Headaches Flashcards
who is most likely to develop migraines
young women
obese people
what are the triggers for developing migraines
travel stress diet - caffeine, alcohol exercise pre-menstrual
describe the features of an aura before a migraine
visual - central scotoma, hemianopia, zigzags of colour
somatosensory - paraesthesia
motor - ataxia and ophthalmoplegia
speech - dysphasia
how long does an aura usually last before a migraine
20-60 minutes
which is more common, migraine with or without aura
without aura
describe the headache associated with migraine
unilateral, throbbing, pulsatile headache
lasts 4-72 hours can have multiple attacks within that time
made worse on movement
associated with photophobia, phonophobia
what drugs are used to manage migraines acutely
NSAIDs + paracetamol
aspirin or Triptan second line
what type of drug is a Triptan
serotonin agonist that reduces symptoms of migraines
shouldn’t use more than twice a week as can become dependent
what is the symptom classification to receive migraine prophylaxis
> 3 attacks in a month or very severe
what drugs are used as migraine prophylaxis
propanolol
amitriptyline
gabapentin
topiorimate
describe the features of a tension headache
bilateral pressure/tightness that is mild-moderate in severity and lasts up to 7 days
what are the risk factors for developing tension headaches
stress
tiredness
excessive concentration/looking at a screen for too long
how are chronic tension headaches managed
discourage regular use of analgesia
cluster headaches are more common in male or females
males
for a diagnosis of cluster headaches, how many must be present
more than 5 - multiple attacks happen over a period of 1-3 months
describe the clinical presentation of cluster headaches
severe unilateral headache around the orbit, supra-orbit and temporal areas lasting up to 3 hours
when do cluster headaches typically occur
occur at night
describe some of the ipsilateral autonomic features that are associated with cluster headaches
lacrimation miosis and ptosis conjunctival infection facial flushing and sweating nasal congestion and rhinorrhoea
how are cluster headaches managed acutely
high flow oxygen
triptan
prednisolone
what is given as prophylaxis for cluster headaches
verapamil
topiramate
gabapentin, pregabalin
what are the main differences between paroxysmal hemicrania and cluster headaches
hemicrania does not have autonomic features
hemicrania attacks are of shorter duration
paroxysmal hemicrania and hemicrania continua show good response to which drug
indomethacin
