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3A > Neurology - Headaches > Flashcards

Neurology - Headaches Flashcards

1
Q

Migraine causes

A

CHOCOLATE - M

Chocolate 
Hangovers 
OCP
Cheese/caffeine 
Orgasm
Lack of sleep 
Alcohol 
Travel 
Exercise

Menstruation

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2
Q

What is a migraine aura

A 
Visual disturbance 
Nausea 
"Feeling in tummy"
Dysarthria 
Sensory disturbance
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3
Q

Migraine presentation

A 
Aura
Acute onset 
Last up to 72 hours
Unilateral 
Throbbing pain
Paraesthesia 
FND 
Photophobia 
Phonophobia 
N/V
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4
Q

Migraine investigations

A

Clinical diagnosis unless suspicious symptoms

Ophthalmoscopy
BP
Neuro assessment

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5
Q

Acute migraine management

A

Sumatriptan
NSAIDs
Ergotamine
Metoclopramide

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6
Q

Migraine prevention

A 
Amitriptyline 
Propranolol
Topiramate - Teratogenic
Acupuncture 
Riboflavin
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7
Q

Tension headache causes

A

Stress
Lack of sleep
Dehydration
Anxiety

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8
Q

Tension headache presentation

A 
Mild/moderate pain
Bilateral
Frontal and neck
< 1 week  
Pressing nature
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9
Q

Tension headache investigations

A

Clinical diagnosis

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10
Q

Tension headache management

A

Avoid triggers
Aspirin
Sleep hygiene
Meditation

Chronic - TCA, acupuncture

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11
Q

Cluster headache causes

A 
Alcohol 
Smoking 
Exercise 
Heat 
Histamine
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12
Q

Cluster headache presentation

A 
Males 
Severe orbital pain
"Worst pain ever"
Unilateral 
Stabbing nature 
Relieved by movement 
15-180 minutes 
Bouts lasting 6-12 weeks
Worse at night
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13
Q

Cluster headache investigations

A

Optic assessment

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14
Q

Acute cluster headache management

A

Sumatriptan

O2

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15
Q

Cluster headache prevention

A

Verapamil
Topiramate
Prednisolone

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16
Q

Trigeminal neuralgia associations

A

Triggered by skin contact

Associated with MS

17
Q

Trigeminal neuralgia presentation

A 
Shock-like sensations in the trigeminal nerve - Maxillary branch 
Severe 
Unilateral 
Worse on touching face 
Up 10 100 attacks per day
1-180 seconds
18
Q

Trigeminal neuralgia investigations

A

History
Neuro assessment
CT/MRI - Rule out MS
Rule out SOL

19
Q

Trigeminal neuralgia red flags

A 
Sensory changes 
Deafness 
Optic neuritis 
FHx - MS 
Onset < 40
20
Q

Trigeminal neuralgia management

A

Carbamazepine

Lamotrigine 
Phenytoin 
Gabapentin
Surgery - Microvascular decompression
Radiotherapy
21
Q

Giant cell arteritis causes

A

Vasculitis
Females
Associated with polymyalgia rheumatica
(Muscle and joint pain)

22
Q

Giant cell arteritis presentation

A 
Jaw claudication 
Severe 
Scalp pain 
Worse on chewing, talking, brushing hair
Amaurosis fugax
B symptoms

+ Proximal muscle and joint pain!

23
Q

Giant cell arteritis investigations

A

Bloods

  • ESR ^
  • Platelets ^
  • ALP ^
  • Anaemia

Colour duplex USS + temporal artery biopsy
= Granulomatous inflammation

24
Q

Giant cell arteritis management

A

Prednisolone + bisphosphonate
Low dose aspirin + PPI

Visual symptoms - Urgent ophthalmology review

3A (31 decks)

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