pain associated with the head Flashcards

1
Q

what is orofacial pain?

A

pain arising in the mouth, jaw and face

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2
Q

what are the painful conditions of the trigeminal system?

A
  1. Trigeminal Neuralgia
  2. Headache
  3. Migraine
  4. Temporomandibular disorders
  5. Myofascial pain
  6. Dental pain
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3
Q

what is the effect of injury to the brain?

A

-causes an altered brain function rather than pain itself

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4
Q

what do the 1st order neurones in the trigeminal system do?

A

-they travel from the face to the pars interpolaris and pars caudalis of the medulla/upper cervical cord

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5
Q

what do the 2nd order neurones in the trigeminal system do?

A

ascend contralaterally to the thalamus via the trigemino-thalamic tract

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6
Q

what do the 3rd order neurones in the trigeminal system do?

A

project to the cortex

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7
Q

what do 1st 2nd and 3rd order neurones (aka the 5th cranial nerves) innervate?

A

specialised structures i.e.

-tooth pulp

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8
Q

what are the 6 causes of headaches?

A
  1. Traction or dilatation of intracranial or extracranial arteries.
  2. Traction of large extracranial veins
  3. Compression, traction or inflammation of cranial and spinal nerves
  4. Spasm and trauma to cranial and cervical muscles.
  5. Meningeal irritation and raised intracranial pressure
  6. Disturbance of intracerebral serotonergic projection
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9
Q

what is the role of serotonin?

A
  • it is a neurotransmitter for transmitting pain signals.

- unstable transmission lowers the threshold of the migraine

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10
Q

there are 7 classes of serotonin (5-HT) receptors. How many of these are involved in migraine pain?

A

2

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11
Q

during a migraine are serotonin levels high or low in the blood?

A

low due to low blood pH

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12
Q

what is sinus pain?

A

pain behind the forehead and cheekbones

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13
Q

what is cluster pain?

A

pain in and around one eye

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14
Q

what is tension pain?

A

pain like a band squeezing the top of the head

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15
Q

what is migraine pain?

A

pain, nausea and visual changes

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16
Q

how long does acute tension pain last?

A

less than 15days per month

17
Q

what part of the head do migraines affect?

A

half of the head

18
Q

how long do migraines last

A

4hrs-3 days

19
Q

symtpoms of migraine

A

aura
nausea
vomiting light sound and smell sensitivity

20
Q

what triggers a migraine

A
food 
food additives 
sleep 
stress 
female hormones 
family hsitory 
medications 
noise light 
exertion
21
Q

what is an aura

A

events that hapen before actual migraine pain develops

22
Q

examples of auras

A
sctoma 
fortification 
scintilla 
unilateral paresthesia 
hallucinations 
hemianopsia
23
Q

positive neurological symptoms of a migraine

A

visual flashes, spots or zig zag lines

travelling tingling sensations

24
Q

what are the negative neurological synmptoms of migraine

A

visual blind spots
numbness
speech or words finding problems
trouble thinking

25
Q

what is allodynia?

A

when a painful stimulus hurts more than it usually would

26
Q

how long do cluster headaches last?

A

15mins-3hrs and happens at around the same time each day on the same sidw

27
Q

what are symptoms of cluster headaches?

A
watering eyes 
nasal stiffniness 
runny nose 
red eye 
swollen eyelids 
sweating
28
Q

what group of people are migraines more common in?

A

young females

29
Q

what group of people are cluster headaches more common in?

A

male middle- aged smokers

30
Q

what does a cluster headache feel like?

A

stabbing pain

31
Q

what group of people typically experience trigeminal neuralgia?

A

middle aged/ elderly women

32
Q

what is the characteristics of trigeminal neuralgia?

A

electric shock like pain on one or both sides of the face

sharp stabbing or burning sensation

33
Q

what effect does MS have on trigeminal neuralgia?

A

MS destorys the myelin sheath protecting the nerve fibres making them less responsive aka dead

34
Q

what are the branches of the trigeminal nerve?

A

opthalmic nerve
maxillary nerve
mandibular nerve

35
Q

what drugs work solely for the prophylactic therapy of migraines?

A

antiepileptic drugs e.g. gabapentin
alpha 1 and beta 1 receptor antagonists
amitriptyline

36
Q

what drugs work solely for the acute therapy of migraines?

A

triptains (Serotonin reuptake inhbiitors i.e. 5ht receptor agonists)
gepants

37
Q

what drugs work for both the prophylactic and acute therapy of migraines?

A

NSAIDS- naproxen for prophylactic, ibuprofen and diclofenac

ergot serivatives- methysergide for prophylactic and ergotamine

38
Q

how do triptans work?

A
  1. intracranial vasoconstriction
  2. inhibition of neurotransmssion in the trigemnocervical complex
  3. inhibtion of release of pro-inflammatory and vasoactive mediators therefore decrease pain transmission
  4. potentially cross BBB
  5. relieve from pain and nausea associated with migraine