Migraines and Tension Headaches

Question 1

Causes of Primary headache in children (3)

Answer 1

migraine- most common
tension
cluster-rare

Question 2

Causes of secondary headache in children (4)

Answer 2

SOL-check signs of raised IOP

meningitis

coarctation-check BP-rare

refractive errors-check acuity

Question 3

Diagnostic criteria of migraine

Answer 3

bilateral/frontal headache w. nausea/vomitting and 2 of:

-photophobia, phonophobia, difficulty thinking, light-headedness, fatigue

Question 4

Features of migraine in children (3)

Answer 4

most have no aura

in children, more commonly assoc. w. GI upset

can be triggered by school pressure, diet, excess/not enough sleep, menstruation, OCP

Question 5

Acute Mx of migraine

Answer 5

paracetemol+sumitriptan

Question 6

Prophylaxis of migraine

Answer 6

pizotifen 1st

propranolol, topiramate, amytriptilline

Question 7

Headache, red flag Sx (6)

Answer 7

sudden onset/severe

long duration/progressively worsening

wt. loss

worse on straining e.g. coughing

morning headaches assoc. w. vomitting

seizures/focal neurology