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S3 Case 1 - Neurology > Pain Associated with the Head > Flashcards

Pain Associated with the Head Flashcards

1
Q

Describe the process of a migraine

A

When trigeminal system activated
Peptides are released
Promoting inflammation reaction
= increases flow of sensory traffic through the brain stem

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2
Q

What is the trigeminal nerve?

A

5th cranial nerve

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3
Q

What are the 6 causes of headaches?

A

Traction/dilation of intra/extracranial arteries
Traction of large extracranial veins
Compression, traction or inflammation of cranial + spinal nerves
Spasm + trauma to cranial + cervical muscles
Meningeal irritation + raised intracranial pressure
Disturbance of intracerebral serotonergic projections

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4
Q

Describe role of serotonin

A

Neurotransmitter
Mediator of migraines

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5
Q

What are the 4 types of headaches?

A

Sinus
Cluster
Tension
Migraine

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6
Q

What is a sinus headache?

A

Pain is usually behind the forehead + cheekbones

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7
Q

What is a cluster headache?

A

Pain is in + around one eye

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8
Q

What is a tension headache?

A

Pain is like a band squeezing the head

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8
Q

What is a migraine?

A

Pain, nausea + visual changes are classic form

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9
Q

What is the frequency for a tension headache?

A

Chronic
Often daily

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10
Q

What is the duration of a tension headache?

A

30mins-7 days

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11
Q

Where are tension headaches located?

A

Both sides
Whole head + neck

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12
Q

What is the pain of a tension headache?

A

Mild-moderate
Pressure
Tightness

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13
Q

What symptoms will not be present with tension headache?

A

Nausea + vomiting
Photophobia
Phonophobia

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14
Q

What is the frequency for a migraine?

A

1-2/year
2-3/week

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15
Q

What is the pain of a migraine?

A

Moderate-severe
Pulsating
Throbbing

16
Q

What is the duration of a migraine?

A

4hrs-3days

17
Q

What is the location of a migraine?

A

Usually one sided
(BUT can swap between attacks)

18
Q

What are the symptoms of migraines?

A

Aura
Nausea, vomiting
Sensitive to light, sound + smell

19
Q

How many stages is there of a migraine?

A

4
Prodrome
Aura
Headache
Postdrome

20
Q

What happens in Prodrome (stage 1)?

A

Days before actual pain
Light + sound sensitivity, depression, irritability + lack of appetite

21
Q

What happens in Aura (stage 2)?

A

One hour prior
Changes in visual perception
Seeing flashing lights + geometric patterns
Temporary loss of half of visual range

22
Q

What happens in Headache (stage 3)?

A

Moderate-severe pain
Up to 3 days
Also intolerance to light + noise, nausea + vomiting, sensitivity to movement + speech difficulties

23
Q

What happens in Postdrome (stage 4)?

A

Last for several days after
Irritable + fatigued
Scalp tender

24
Q

What can be some migraine triggers?

A

Foods - spices, wine
Food additives
Sleep
Stress
Female hormones
Family history
Medication
Noise, light

25
Q

What is the main difference between a tension headache + migraine?

A

Aura
Vomiting
Aggravated by activity

26
Q

What type of symptoms can be experienced in the migraine Aura?

A

Positive neurological - additional - eg. visual flashes
Negative neurological - loss - eg. blind spots, numbness

27
Q

What is the pain of cluster headaches?

A

Excruciating
Penetrating, boring, non-throbbing

28
Q

What is the duration of cluster headaches?

A

15mins-3hrs
Same time each day

29
Q

What is the location of cluster headaches?

A

Always the same side

30
Q

What are the symptoms of cluster headaches?

A

Watering eyes
Nasal stuffiness, runny nose
Red eye, swollen eyelids
Sweating

31
Q

What is trigeminal neuralgia?

A

Intense, sharp, burning pain
On one or both sides of face

32
Q

Where is trigeminal neuralgia normally distributed?

A

Along one or more of somatic sensory branches

33
Q

What are the causes of trigeminal neuralgia?

A

Pressure from blood vessel
Demyelination of nerve
Pressure from tumour
Pressure damage to nerve

34
Q

What are the branches of the trigeminal nerve?

A

Ophthalmic nerve (CN V1)
Maxillary nerve (CN V2)
Mandibular nerve (CN V3)

35
Q

What is the mechanism of action of triptans?

A

Serotonin 5HT 1B/1D receptor agonists

36
Q

Describe triptans anti-migraine action

A
  1. vasoconstriction
  2. trigeminal inhibition
  3. decreased pain transmission
37
Q

What are the mechanisms included in the triptans for migraines?

A

Intracranial vasoconstriction
Inhibition of neurotransmission in trigeminocervical complex
Inhibition of release of pro-inflammatory + vasoactive mediators

38
Q
A

S3 Case 1 - Neurology (16 decks)

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