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Neuro/Psych Exam > Migraines > Flashcards

Migraines Flashcards

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1
Q

Are the scalp, sinuses, meninges, pail arteries or major vessels sensitive to pain?

A

Yes

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2
Q

Are the ventricles, choroid, parenchyma or small veins sensitive to pain?

A

No

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3
Q

What area of the midbrain can be stimulated to induce migraine type pain?

A

The Dorsal Raphe Nucleus

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4
Q

How does a Common Migraine (Migraine without Aura) present?

A
  1. Unilateral HA
  2. Deep ache, throbbing
  3. Phonophobia, photophobia, nausea and vomiting
  4. Worse with Activity
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5
Q

What disorder presents the same as a Common Migraine but has Auras?

A

Classic Migraine

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6
Q

Which disorder presents with dramatic auras that resemble a stroke?

A

Complicated Migraine

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7
Q

Which disorder presents with initial vertigo, ataxia, dysathria and diplopia followed by throbbing occipital pain?

A

Basilar Migraine

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8
Q

What is a Bickerstaff’s Migraine?

A

A dramatic basilar migraine that begins with total blindness, followed by ataxia, vertigo, dysarthria and tinnitus

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9
Q

What are common triggers for migraines?

A
  1. Wine
  2. Foods (Chocolare, cheese, MSG, Nitrates)
  3. Hunger
  4. Poor sleep hygiene
  5. Stress
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10
Q

What are abortive therapy options for migraine?

A
  1. NSAIDs
  2. Triptans and Ergots
  3. Dopamine Antagonists
  4. Combo drugs
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11
Q

Which Triptan is fast acting?

A

Sumatriptan

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12
Q

Which Triptan is long acting?

A

Frovatriptan

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13
Q

What are potential Prophylactic therapies for migraines?

A
  1. Beta Blockers
  2. Calcium Channel Blockers
  3. TCAs
  4. Anticonvulsants
  5. 5HT Drugs
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14
Q

Which migraine prophylactic would you use for a patient with HTN?

A

Beta Blocker

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15
Q

Which migraine prophylactic would you use for a patient having trouble sleeping?

A

TCA (Amitriptyline)

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16
Q

Which migraine prophylactic would you use for kids?

A

5HT Drug (Cyproheptadine)

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17
Q

What are the symptoms of a Cluster Headache?

A
  1. Severe Unilateral Stabbing Pain
  2. Lacrimation, Miosis, Ptosis and Eyelid Edema
  3. Rhinorrhea/congestion
  4. Circadian Rhythm
  5. Perspiration
18
Q

What is the acute treatment of a cluster headache?

A
  1. Oxygen

2. IV Sumatriptan

19
Q

What are the prophylactic options for Cluster Headaches?

A
  1. Prednisone

2. Calcium Channel Blockers (Verapamil is first line)

20
Q

What is the most prevalent HA disorder?

A

Tension Headaches

21
Q

Which disorder presents with squeezing around the head and light OR sound sensitivity without nausea/vomiting?

A

Tension Headaches

22
Q

What are non-pharmacological treatment options for tension HAs?

A
  1. Stress Reduction
  2. Biofeedback
  3. CBT
  4. Sleep Hygiene
23
Q

What are pharmacological options for tension HAs?

A
  1. Acetaminophen

2. NSAIDs

24
Q

What is the prophylactic treatment for tension HAs?

A
  1. TCAs

2. Antiepileptics

25
Q

Which patients usually get IIH?

A

Overweight young girls

26
Q

Which drugs cause IIH?

A
  1. Tetracyclines
  2. Contraceptives
  3. Hypervitaminosis A
27
Q

Which disorder is not worsened by physical activity?

A

Tension Headaches

28
Q

Which disorder is worse with coughing, sneezing and moving into a supine position?

A

IIH

29
Q

When is an MRI warrented?

A
  1. IIH

2. New, acute onset HA that have an ABNORMAL neuro PE

30
Q

Which disorder improves with an LP?

A

IIH

31
Q

What are the MRI findings of an IIH?

A
  1. Small Ventricles
  2. Large Optic Nerve Sheath
  3. Empty Sella
32
Q

What is the opening pressure of IIH?

A

Greater than 250mmH20

33
Q

What are the non-pharm treatment options for IIH?

A
  1. Weight loss

2. Stop causitive drugs

34
Q

Which drugs help IIH?

A
  1. CA Inhibitors (Acetazolamide and Topiramate)
35
Q

Shunt placement or optic nerve fenestration may be options for which condition?

A

IIH

36
Q

Which condition is caused by cell mediated immunity?

A

Giant Cell Arteritis

37
Q

Which conditions may lead to permanent vision loss?

A

IIH and GCA

38
Q

How does GCA present?

A
  1. Progressive unilateral temporal throbbing
  2. Jaw claudication
  3. Joint Pain
  4. Transient monocular vision loss
  5. Neck, shoulder or torso pain
39
Q

Which disorder is typically only seen in patients older than 50?

A

GCA

40
Q

What is the treatment for GCA?

A

High dose steroids

Neuro/Psych Exam (12 decks)

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