Primary Headaches Flashcards
Reaches peak intensity with 1-2 hours
Migraine
Headache lasts 4-72 hours
Migraine
Sensory, motor and visual disturbances arising 15-30 minutes (or days) before and/or during headache
Aura
How many people experience auras with migrainous headaches?
~25/30%
Classical symptoms that arise in migraines (5)
POUND:
- Pounding, pulsatile, photo/phonophobia
- One day onset (peak intensity over 1-2 hours)
- Unilateral
- Nausea and Vomiting
- Debilitating
Main symptoms that arise with aura (3)
- visual disturbance (flashing lights)
- motor symptoms
- sensory symptoms (numbness, paraesthesia)
Triggers of migraine (8)
CHOCOLATES - CHeese - Oral contraceptives - Caffeine - alcohOL - Anxiety - Travel - Exercise Sleep Deprived
Diagnosis of migraines
Clinical: >2 migraines with aura OR
>5 migraines without aura plus classical symptoms
Acute management of Migraines (2)
- Paracetamol or NSAIDS and/or Triptans
- Antiemetic (e.g. metochloperamide, prochlorperazine
Caution of COCP in which types of patients?
Migraine with aura (or without but risk factors for stroke)
Lasts about 15 mins - 2 hours
Cluster
Peak onset within 1-2 hours
Migraine
Unilateral, pounding headache, usually accompanied by N&V.
Migraine
Bilateral headache at the back of the head/neck or frontotemperal
Tension
Can be triggered by sustained eye strain
Tension
Triggers of tension headaches
- eye strain
- stress
- dehydration
- sleep deprivation
Treated with analgesia (NSAIDs, paracetamol, triptans) and antiemetics
Migraine
Treatment of tension headaches
simple analgesia
Why should opiates typically be avoided in headaches?
Risk of medication overuse headaches
Unilateral headache, occurs behind/around the eye or temple
Cluster headaches
Which headache is described as a “pressure”
Tension headache
Headaches that come on as 1-3 month episodes of daily headaches
Cluster
ANS symptoms in Cluster headaches (7)
- lacrimation
- rhinorrhoea
- pstosis
- miosis
- conjunctiva infection
- pupil changes
- red ear
Alcohol is a trigger for which headaches? (2)
Migraine and Cluster
Treated with subcut Sumatriptan in acute presentation
Cluster
Which of the headaches require 100% oxygen in the acute presentation
Cluster
Used in the prophylaxis of migraine headaches
Propranolol, Amitryptilin, Topiramate
Used in the prophylaxis of cluster headaches
Verapamil (CCB), Prednisolone
