neuro - headaches in kids Flashcards
features of tension type headache
symmetrical
gradual onset
tightness/band/pressure
usually no other symptoms
features of migraine without aura
90% migraines lasts 1-72hours unilateral (but can be bilateral) pulsing over frontal/temporal area nausea/vomiting abdominal pain photophobia phonophobia made worse by physical activity - better by sleep
migraine with aura
10% of migraines
the aura can be visual, sensory or motor
mostly visual - hemianopia (loss of half visual field), scotoma (small areas of visual loss)
seeing zigzag lines
possible to get unilateral sensory/motor symptoms (hemiplegia)
triggers of headaches
not enough sleep
stress
cheese, chocolate, caffeine
menstruation/contraceptive pill
what is cyclical vomiting
vomiting with intense nausea with pallor and lethargy
in recurrent episodes with the kid well inbetween
abdominal migraine
episodic midline abdominal pain lasting 1-72 hours
with nausea/vomiting
kid is well inbetween episodes
benign paroxysmal vertigo of childhood
recurrent brief vertigo in otherwise healthy kids coming and going
features of a space occupying lesion?
headache worse on lying down
morning vomiting
night time waking from pain
change in mood, personality, school
visual field defect/cranial nerve defect - new onset squint abnormal gait torticollis growth failure papilloedema
chronic daily headache from medication overuse - how to sort?
headache will go after 2 weeks of stopping the medication
treatments to stop headaches
analgesia - paracetamol, NSAIDs
antiemetics - prochlorperazine
triptans - sumatriptan (nasal)
cold compresses, warm pads
prophylactic treatments for frequent, intrusive headaches
topiramate/valproate (anti epileptics)
propanolol (b blocker)
pizotifen/amitriptyline (tricyclics)
acupuncture
