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BB 2 > Headaches and migraines > Flashcards

Headaches and migraines Flashcards

1
Q

What is the difference between primary and secondary headaches

A 
Primary= diagnosis made in the absence of physical signs
Secondary= diagnosis is made in the presence of physical signs
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2
Q

3 main types of headaches

A

Tension headache
Migraine
Cluster headache

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3
Q

What % of all headaches are tension headaches

A

80

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4
Q

What % of headaches are migraines

A

15

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5
Q

What % of headaches are cluster headaches

A

0.2-0.3%

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6
Q

Which headache affects men more than women

A

Cluster

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7
Q

When is a headache described as normal

A

When symptoms disappear once stimulus ire removed

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8
Q

Symptoms of a cluster headache

A

Pain comes in clusters lasting 6-8 weeks
Severe pain behind eyes
Unilateral rhinorrhoea

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9
Q

3 treatment options for cluster headaches

A

High flow oxygen for vasoconstriction
Triptans used to vasoconstrict
Verapamil

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10
Q

How many attacks must a person have for it to count as migraine? How long must they last for?

A

5 in a lifetime

4-72 hours

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11
Q

2 of which 4 characteristics must be seen to be categorised as an migraine

A

Unilateral pain
Pulsating
Moderate- severe pain
Aggravated by walking

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12
Q

1 of 2 symptoms must be seen to be categorised as a migraine

A

NIV

Photophobia and phonophobia

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13
Q

What is meant by the threshold of a headache

A

What stimulia can a person withstand before getting a migrain

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14
Q

What molecule is released in the early stages of a migraine

A

5-HT

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15
Q

What is the impact of releasing 5-HT in early stages

A

Constriction of dilated blood vessels

Dilations of constricted blood vessels

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16
Q

What are triptans

A

5-HT1D/B agonist

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17
Q

Name a prophylactic drug used to treat migraine

A

Methysergide

5-HT2b antagonist

18
Q

What are the 5 stages of a migraine

A

1) Premonitory phase
2) Aura
3) Headaches
4) Resolution
5) Recovery

19
Q

What happens in the premonitory phase of a migraine?

A

Cravings
Yawning
Fluid retention
Neck pain

20
Q

Which part of the brain is affected in the premonitory phase of a migraine

A

Hippocampus

21
Q

In what % of migraines is there aura

A

20-30%

22
Q

What happens in the resolution phase of migraine

A

Vomiting
Deep sleep
Medication

23
Q

What happens in the recovery phase of migraine

A

Tired
Diuresis
Limited food tolerance

24
Q

What is aura

A

A transient and local suppression of spontaneous electrical activity in the cortex which moves slowly across the brain

25
Q

What is the first stage of a headache

A

Dilated meningeal artery

26
Q

What happens as a result of dilation of the mesangial artery

A

Inflammatory release of peptides

CGRP

27
Q

What CGRP stand for

A

Calcitonin gene related peptide

28
Q

What is the function of CGRP

A

Potent vasodilator

29
Q

How do CGRP levels change during migraine attack

A

They rise spontaneously

30
Q

What is the effect of neuropeptide release after dilation

A

Activates nerve pathways which send pain pathways to trigeminal pathway

31
Q

What does the peripheral sensitisation mediate?

A

Throbbing pain

32
Q

Where does the trigeminal nerve transmit the pain to

A

Spinal trigeminal nucleus in the brainstem

33
Q

What is meant by allodynia

A

Over-sensitivity to a stimulus

34
Q

What does central sensitisation mediate

A

Allodynia

35
Q

When do these signals become a headache

A

Pain impulses move to thalamus for decoding

36
Q

Where does preventative medicine for migraine work

A

Centrally

37
Q

How do acute medications work

A

Via vasoconstriction

38
Q

Do acute medications cross the BBB

A

Nah

39
Q

Are triptans used preventitively or as treatment

A

Acute treatment

40
Q

Name 6 triptans

A 
Sumatriptan (some)
Zolmitriptan (zoos)
Naratriptan (never)
Electriptan (elect)
Almotriptan (altruistic)
Frovatriptan (friends)
41
Q

Name 4 CGRP monoclonal antibodies

A

Erenumab
Fremanezumab
Eptinezumab
Galcanezumab

BB 2 (28 decks)

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