Neurology key facts

Question 1

What are the options for management of acute migraine? What are the contraindications for each?

Answer 1

• NSAIDs
• Aspirin
• Triptans e.g. sumatriptan (contraindicated in CV disease/CV accident)

Question 2

What are the options for prophylactic management of migraine? What are the contraindications for each?

Answer 2

• Propanolol (contraindicated in asthma)
• Topiramate (contraindicated in women of childbearing age/pregnancy)
• Amitriptyline

Question 3

How does idiopathic intracranial hypertension present?

Answer 3

Headache
Pressure like sensation behind the eyes
Visual disturbance

Question 4

What is the key investigation used in idiopathic intracranial hypertension?

Answer 4

Fundoscopy - shows bilateral papilloedema.

Question 5

What are the key investigations for Idiopathic intracranial hypertension?

Answer 5

MRI/CT to exclude secondary causes

Lumbar puncture to assess CSF opening pressure - look for raised opening pressure with normal CSF.

Question 6

What is the management for idiopathic intracranial hypertension?

Answer 6

Weight loss.

Acetazolamide is the first line medication.

Can use a CSF shunt if resistant to acetazolamide.