thompson 3

Question 1

Primary types of headaches

Answer 1

Tension

Migraine

Cluster

Question 2

Tension HA

Answer 2

• STRESS headache
• 90% in US; more common in women (in kids equal boys/girls)
• usually HAS A TRIGGER
• CONSTANT, BILATERAL, not associated with nausea or photophobia

Question 3

tx of Tension HA

Answer 3

• Avoiding triggers
• ibuprofen (any OTC NSAID)
• tylenol
• caffeine as ADJUNCT
• biofeedback/relaxing

Question 4

S/S of migraine

Answer 4

• throbbing
• movement makes worse
• moderate to severe
• photophobia
• sound sensitive
• fatigue
• nausea/vomiting
• visual issues
• unilateral (2/3) and often switches side
• triggers (hormone is biggie)

Question 5

Triptans

Answer 5

Tx of Migraine

zomig, imitrez, relpax, maxalt

• Spendy
• 80% effective
• increase risk of CV event
• Don’t use in people uncontrolled HTN or CV disease
• SIDE EFFECTS: dizzy, flushing, feel strange

Question 6

Prophylaxis against migraine

Answer 6

• meds to prevent –> consider when HA interfere with life
  
  • more than 2 a week for more than 2 months that dont respond, or cant take rescue meds
• Beta blockers
• BCP
• antidepressants
• antiseizure (neuontin)

Question 7

Cluster HA

Answer 7

• Clusters (weeks or months) of HA that can last from 3 mins to hours
  
  • pain so intense person can consider suicide
• MUCH MORE COMMON IN MALES
• Eye/nose on one side often affected
  
  • red/runny eye
  • runny nose

Question 8

TX of cluster headaches

Answer 8

• O2
• Triptans
• narcotics
• occipital nerve stimualtion

Question 9

When to worry…

Answer 9

• age extremes.. over 50 without clear history or cause
• neuro changes
• different HA
• worst of life
• trauma
• seizures (new)
• neck/fever/exposure
• PMH of cancer or HIV

Question 10

Temporal arteritis

Answer 10

• Inflammation of temporal artery
• Common in people over 50 and more likely in women than men
• New onset
• ESR > 50
• PAIN AT SITE Or decrease pulse
• Bx of temporal artery
• TX = Prednisone prior to BX (to prevent permanent visual loss)