Migraines Flashcards
Primary headaches = no known cause
Secondary headaches = have a known cause
Which of these is more common?
- primary
What is the most common type of primary headache?
1 - migraines
2 - thunderclap
3 - tension type
4 - cluster
3 - tension type
- migraine is the 2nd most common form of primary headache
- incidence of 0.5-5%
- difficult to identify exact incidence
What is the most common debilitating headache?
1 - tension headache
2 - thunderclap headache
3 - Migraine
4 - Cluster headaches
3 - Migraine
- also 2nd most common type of primary headaches
- 7th highest cause disability globally
- 2.9% of years of life lost to disability
- twice as likely in women
Can migraines be pulsatile in nature?
- yes
Pulsatile may suggest increases BP or increased intracranial pressure
What is the incidence of migraines?
1 - 50/100,000
2 - 500/100,000
3 - 5000/100,000
4 - 50,000/100,000
3 - 5000/100,000
At what time do migraines generally start and begin to decline?
1 - starts at puberty and declines around 20y/o
2 - starts at puberty and declines around 40y/o
3 - starts at puberty and declines around 60y/o
4 - starts at puberty and declines around 80y/o
2 - starts at puberty and declines around 40y/o
- 2% have chronic migraines, causing medication overuse
Are migraines more common in men or women?
- women
- 3x more likely
Menstrual migraines can occur in women. When would these generally occur?
1 - days 1-2
2 - days 2-3
3 - days 5-7
2 - days 2-3
- before the period of during the period
Are patients with comorbid psychiatric disorders such as anxiety & depression more or less likely to experience medication overuse headaches?
- more likely
The trigeminal nerve (CN5) is derived from the 1st pharyngeal arch and is the largest of all the cranial nerves. What functions does this cranial nerve have?
1 - sensory only of the face
2 - motor only of mastication muscles
3 - both of the above
4 - none of the above
3 - both of the above
What is the trigeminocervico complex?
1 - CN V (5) meets cervical vertebrae 1
2 - CN V (5) synapses in same nucleus as cervical vertebrae 1
3 - CN V (5) synapses in same nucleus as cervical vertebrae 1 and 2
4 - CN V (5) synapses in same nucleus as cervical vertebrae 1-3
4 - CN V (5) synapses in same nucleus as cervical vertebrae 1-3
- sensory only from CV V (5)
- this essentially means any sensory information from cervical vertebrae 1-3 can revert pain to the head causing a headache
- region of the brain receives nociceptive stimulus
The trigeminocervico complex is a nucleus where CN V (5) synapses in same nucleus as cervical vertebrae 1-3 for sensory receptors only. Where is this located?
1 - cerebellum
2 - brain stem
3 - pons
4 - medulla oblongata and upper cervical spine
4 - medulla oblongata and upper cervical spine
Which of the following is not part of the trigeminal nerve?
1 - ophthalmic
2 - maxillary
3 - accessory
4 - mandibular
3 - accessory
The spinal trigeminal nucleus is a nucleus in the medulla that receives information about deep/crude touch, pain, and temperature from the ipsilateral (same side) face. Which of the following is important for pain and temperature sensations?
1 - Pars oralis
2 - Pars interpolaris
3 - Pars caudalis
3 - Pars caudalis
Which of the following are typical triggers for developing a migraine?
1 - tiredness, stress, dehydration
2 - alcohol
3 - combined oral contraceptive pill
4 - cheese, chocolate, red wines, citrus fruits
5 - menstruation
6 - bright lights
7 - all of the above
7 - all of the above
Remember the mnemonic CHOCOLATE:
C = chocolate
H = hangovers
O = orgasms
C = cheese/caffeine
O = oral contraceptive
L = lie-ins
A = alcohol
T = travel
E = exercise
Migraines are a form of primary headaches, which essentially means the cause is unknown. Do migraines typically present unilaterally or bilaterally?
- unilaterally
Which of the following locations would the main symptom of a migraine be felt?
1 - on one side of the face
2 - around the eye on one side of the face
3 - across the top of the forehead
4 - all of the above
1 - on one side of the face
Migraines are a form of primary headaches, which essentially means the cause is unknown. Which of the following do migraines NOT typically present with?
1 - severe, bilateral, throbbing headache
2 - nausea, photophobia (sensitive to light) and phonophobia (fear of sound)
3 - can last up to 72h
4 - patients typically stay in dark and quiet rooms
5 - auras maybe present
6 - stiff neck
7 - vary 1-2/month or 1/year
1 - chronic, bilateral, throbbing headache
- typically migraines are unilateral
A migraine aura is something that you experience when having a migraine. which of the following is true?
1 - can be visual only
2 - can be auditory only
3 - can be motor or sensory
4 - all of the above
4 - all of the above
- most common is visual, and it is completely reversible
- builds up over time and can last up to 60 minutes
- more common in older patients, but no headaches
An aura is when there are visual changes that are associated with migraines. What visual symptoms can be experienced in an aura?
1 - Sparks in vision
2 - Blurring vision
3 - Lines across vision
4 - Loss of different visual fields
5 - all of the above
5 - all of the above