Migraine, Cluster headache, Tension headache Flashcards
What is a migraine? Uni/bi-lateral? How long does it last for?
A neurological condition often characterised by recurrent, intense, debilitating headaches.
Unilateral, throbbing headache
Often preceded by an aura -visual or sensory symptoms.
Can last between 4-72 hours
Presentation of migraine?
Aura (visual or sensory symptoms preceding the headache)
Unilateral throbbing headache
Photophobia and phonophobia
Nausea and/or vomiting
Causes of migraine?
The triggering factors are variable and can include:
- certain foods
- changes in weather
- stress
- hormonal changes
- medications such as COCP
Diagnosis/IVx for migraine?
Clinical diagnosis
Secondary causes:
- MRI or CT
- Blood tests (ESR, CRP -giant cell arteritis)
Management of migraine? Acute vs prophylaxis?
Avoid triggers
Acute:
- triptan (e.g. Sumatriptan -can’t given IHD)
- analgesia (paracetamol or NSAID)
Female pts should avoid COCP due to risk of ischaemic stroke.
Prophylaxis:
- propranolol
- topiramate
- amitriptyline
What is cluster headache?
A type of headache that is primarily unilateral and typically more severe around the eye region.
How long do cluster headaches last?
Pts experience multiple episodes over a short span of time.
Causes of cluster headache?
Associated with the activation of the trigeminal nerve:
→ leads to inflammation and pain.
Triggers:
- alcohol
- smoking
Presentation of cluster headache?
Unilateral, severe headache, often around the eye
A bloodshot or teary eye on the affected side
Vomiting
Diagnosis/IVx of cluster headache?
Clinical diagnosis
Neurological evaluation
Management of cluster headache? Acute vs prophylaxis?
Acute:
- 100% oxygen
- sumatriptan
Prophylaxis:
- verapamil
- steroids
Presentation of tension headache?
Bilateral, non-pulsatile headaches
Tightness sensation, feels like a band around the head
Scalp muscle tenderness
Management of tension headache?
Analgesia
Addressing stress factors
