Spot Diagnosis

Question 1

What is the most common presentation of multiple sclerosis?

Answer 1

Optic Neuritis

Question 2

Recurrent, severe headache which is usually unilateral and throbbing in nature

May be be associated with prodrome

Aggravated by, or causes avoidance of, routine activities of daily living.

In women may be associated with menstruation

What condition am I?

Answer 2

Migraine

Question 3

PC: Recurrent, bilateral headache, often described as a ‘tight-band’

HxPC: Not aggravated by routine activities of daily living

Answer 3

Tension headache

Question 4

More common in men and smokers

PC: Bad Headache

HxPC:
• Pain typical occurs once or twice a day, each episode lasting 15 mins - 2 hours with clusters typically lasting 4-12 weeks
• Intense pain around one eye accompanied by redness, tears, lid swelling.

Answer 4

Cluster Headache

Question 5

Typically patient > 60 years old

PC: Unilateral headache around Temples

HxPC: Usually rapid onset
Jaw claudication (65%)
Tender, palpable temporal artery

Igx: Raised ESR

Answer 5

Temporal Arteritis