Page: 7 (Migraines)

Question 1

COMMON MIGRAINE (“Sick” or “Vascular”)

1. ) Sex/Age?
2. ) Location?
3. ) Characteristics?
4. ) Provoked by?
5. ) Follow up?

Answer 1

1. ) Females (Pre-menstrual), Childhood and early adulthood
2. ) Unilateral/Bilateral
3. ) Photophobia, Worse behind 1 eye, Nausea, Vomiting
4. ) Hormone imbalance, Red wine, Hypoglycemia, Chocolate, Cheese, Bright lights
5. ) Dietary log, Adjust, Massage, Avoid provoking/triggering factors
   - Familial, Decrease prevalence with advancing age and pregnancy.

Question 2

CLASSIC MIGRAINE

1. ) Sex/Age?
2. ) Location?
3. ) Characteristics?
4. ) Provoked by?
5. ) Follow up?

Answer 2

1. ) Females, Pre-menstrual
2. ) Unilateral**
3. ) AURA/PRODROME** (Visual Disturbances), Photophobia, Worse behind 1 eye, Nausea, Vomiting
4. ) Hormone imbalance, Red wine, Hypoglycemia, Chocolate, Cheese, Bright lights
5. ) Dietary log, Adjust, Massage

Question 3

CLUSTER HEADACHE

1. ) Sex/Age?
2. ) Location?
3. ) Characteristics?
4. ) Provoked by?
5. ) Follow up?

Answer 3

1. ) Male, Adolescent (College Students) to Adult
2. ) Unilateral, Orbital, Temporal
3. ) Unilateral facial sweating (Hyperhidrosis), Unilateral eyelid ptosis, Unilateral constricted pupil (Miosis), Lasts 15-180 minutes ONLY**, Wake up at night with headache
4. ) Alcohol, Seasonal (Fall/Spring)
5. ) Allergy testing, CN evaluation, CN CT scan

Cluster Headache** = aka: ANS Disturbance, Vasomotor Disturbance

• NOT aggravated by exertion**

Question 4

HYPERTENSION HEADACHE

1. ) Sex/Age?
2. ) Location?
3. ) Characteristics?
4. ) Provoked by?
5. ) Follow up?

Answer 4

1. ) Adult
2. ) Suboccipital/Vertex
3. ) Throbbing, Wake up in the morning with headache
4. ) ————–
5. ) Blood pressure, Lipid profile

Question 5

TEMPORAL ARTERITIS (Giant Cell) 
aka: POLYMYALGIA RHEUMATICA

1. ) Sex/Age?
2. ) Location?
3. ) Characteristics?
4. ) Provoked by?
5. ) Follow up?

Answer 5

1. ) Adult, >50 years old
2. ) Unilateral, Temporal
3. ) Persistant burning, Aching, Throbbing
4. ) Scalp sensitive (Combing hair), Tender arteries
5. ) Biopsy, ESR elevated

**If patients has proximal neck/shoulder pain and stiffness as well = Polymalgia Rheumatica

Question 6

MUSCULAR/TENSION HEADACHE

1. ) Sex/Age?
2. ) Location?
3. ) Characteristics?
4. ) Provoked by?
5. ) Follow up?

Answer 6

1. ) Any sex/age
2. ) Band-like
3. ) Pressure, Muscle tightness
4. ) Fatigue, Tension, Stress, Work, Life
5. ) Adjust, Massage, Avoid provoking/triggering factors

Question 7

TQ: What is the MC effect of untreated Temporal Arteritis?

Answer 7

Blindness

Question 8

TQ: What are the “aka’s” for Cluster Headache?

Answer 8

ANS Disturbance

Vasomotor Disturbance

Question 9

TQ: Which type of headaches are seen most commonly with congenital anomalies?

Answer 9

Cervicogenic (aka: Vertebrogenic)

Question 10

TQ: What is the best test to evaluate meningeal irritation?

Answer 10

CSF tap

Question 11

TQ: Before you adjust a patient with a congenital anomaly what must you do first?

Answer 11

Take flexion and extension xray films to check stability of spine.

Question 12

TQ: Which type of headache is not aggravated by exertion?

Answer 12

Cluster headache