Neurology\Cluster Headaches Flashcards
1
Q
How common are cluster headaches ?
A
- < than 1% of the population.
- And effect mostly males.
2
Q
What are the international headache society diagnostic criteria for cluster headaches?
A
- Severe unilateral Obital, supraorbital and/or temporal pain lasting 15 - 180 minutes
- be associated with one of the following ipsilateral signs
- conjunctival injection.
- lacrimation
- nasal congestion
- rhinorrhea
- facial sweating
- Miosis
- ptosis
- eyelid edema
3
Q
Why are they called cluster headaches?
A
- This headaches present in clusters with up to eight episodes per day, followed by spontaneous periods of remission lasting days to months to years between attacks.
4
Q
How cluster headaches classified?
A
They can be classified as
- episodic, or chronic depending on the extent of pain free remissions between cycles
- the chronic state is defined as cluster headaches occuring every day for more than one year without a remission period lasting more than one month.
5
Q
In general, patients with cluster headaches, like migraine sufferers in that they prefer to be in a dark quiet room when they have a headache. True or False?
A
- False patients with cluster headaches are restless, and prefer to pace.
6
Q
What first line, acute treatments for cluster headaches?
A
- Oxygen typically administered using a non rebreather facial mask with a flow rate of at least 7L/min for 20 minutes
- triptan
- subcutaneous/intranasal sumatriptan or
- oral or intranasal Zolmitriptan.
7
Q
What’s our second line acute treatments for cluster headaches?
A
- ergotamine
- IV hydroergotamine
- intranasal lignocaine
- subcutaneous octreotide.
8
Q
When should preventive medication be started for cluster headaches?
A
- Start at the onset of a cluster episode and continue over the expected duration of the cluster, period.
9
Q
Which preventive medications can be used for cluster headaches?
A
- Verapamil
- glucocorticoids
- lithium
- Topiramate
- methysergide
10
Q
A
