Neurology 4 Flashcards
when is migraine prophylaxis given
> 3 attacks a month or very severe attacks
what is topiramate
carbonic anhydrase inhibitor used in migraine prophylaxis
side effects of topiramate
weight loss
parasthesia
impaired concentration
features of cluster headache
rapid onset severe unilateral headache around one eye
worse around sleep + seasonal variation
men 30-40
Tx of cluster headache
high flow O2
SC sumatriptan
steroids
prophylaxis for cluster headache
verapamil
who gets paroxysmal hemicrania
elderly women in 50-60s
symptoms of paroxysmal hemicrania
severe unilateral headache + unilateral autonomic symptoms- ptosis/watery eye/miosis/odema
very frequent short attacks
Tx of paroxysmal hemicrania
Indomethicin
SUNCT
Short lived- 15-20s Unilateral Neuralgiaform headache Conjunctival injections (bloodshot eyes) Tearing
Tx of SUNCT
lamotrigine
gabapentin
Ix of new onset unilateral cranial autonomic features
MRI brain
MR angiogram
who gets trigeminal neuralgia
women >60
what is trigeminal neuralgia
severe unilateral stabbling pain in V2/V3 distribution
lasts 1-90 seconds
triggered by touch
1st line Tx for trigeminal neuralgia
carbamazepine
2nd line Tx for trigeminal neuralgia
gabapentin
phenytoin
lamotrigine
Tx if anticonvulsants don’t work in trigeminal neuralgia
baclofen
bilateral dull diffuse headache
tension headache
thunderclap headache- sudden severe headache
SAH
what is myasthenia gravis
most common disorder of neuromuscular junction
antibodies against post synaptic acetylcholine receptors
antibodies in myasthenia gravis
anti AchR antibodies