Localization skills: headache or regional pain

Question 1

Are migraine HA’s more common in M or F?
What sx may accompany migraines?
What’s the dif b/w classic and common migraines?

Answer 1

• F
• N/V, photophobia, phonophobia
• Classic: has aura

Question 2

Are cluster HA’s more common in M or F?

Describe the pain.

Answer 2

• M

- Unilateral periorbital pain. Often, affected eye is red, tearing. Occasionally see Horner’s.

Question 3

Describe the pain of tension HA’s and differentiate it from migraine.
How long do they typically last?

Answer 3

• Steady pressure/band-like feeling around head, not as severe or incapacitating as migraine w/o significant n/v, photophobia, phonophobia.
• Lasting hours to all day.
• A/w psychosocial stresses

Question 4

What are some sx of increased ICP?

Answer 4

N/V, diplopia

Question 5

What’s another name for pseudotumor cerebri?

List the s/s of pseudotumor cerebri. What types of pts get this and what PE feature is characteristic?

Answer 5

Idiopathic intracranial hypertension

Throbbing HA, sometimes accompanied by N/V, similar to migraine. Can have diplopia. Patients are often obese and have papilledema on exam.

Question 6

What is seen on LP in pseudotumor cerebri?

Answer 6

LP will have normal CSF + high opening pressure

Question 7

Trigeminal neuralgia in younger pt, suspect ___________.

Trigeminal neuralgia in older pt, suspect ___________.

Answer 7

• MS

- Tortuous or kinked bv compressing CN V

Question 8

Tx for trigeminal neuralgia?

Answer 8

Carbamezapine (Tegretol)

Question 9

What is the name for the post-herpes pain in the area of the dermatome?

Answer 9

Zoster

Question 10

Define allodynia.

Allodynia is a subcategory of ____________.

Answer 10

Central pain sensitization (increased response of neurons) following normally non-painful, often repetitive, stimulation.

• Dysesthesia (other subtype is hyperalgesia)