Cephalgia

Question 1

cephalgia

Answer 1

headache

Question 2

47% adults

Answer 2

suffer HA 1 time a year

Question 3

2nd most common complaint

Answer 3

cephalgia

Question 4

most common type

Answer 4

migraine

Question 5

tension headaches

Answer 5

three degrees severity

Question 6

infrequent

Answer 6

less than 1 per month

Question 7

frequent

Answer 7

HA episode 2-14 days

Question 8

chronic

Answer 8

HA 15 or more days per month

Question 9

pathology of tension headaches

Answer 9

dont know mechanism

• CNS - decreased threshold of neurons - leads to misinterpretation
• PNS - increased muscle tenderness, increased number of active trigger points, forward head posture, decreased neck mobility

Question 10

every one in US has episodic

Answer 10

3000 x 10~6 lost work days annually

Question 11

clinical features tension headaches

Answer 11

peripheral muscle tenderness

• head, neck, shoulders
• constant worsens with HA pain
• correlates with frequency of HA and intensity of HA pain

Question 12

palpation of muscles

Answer 12

can initiate HA

Question 13

diagnostic criteria of tension headaches

Answer 13

bilateral head pain
pain steady
intensity is mild to moderate pain
no aggravation of HA by normal daily activities
Pain lasts 30 minutes to 7 days
HA not attributed to other causes

Question 14

Tx of tension headache

Answer 14

earlier the treatment, the better

• start with max dose of chosen therapy
• triptans, muscle relaxants, OMT

Question 15

clenching teeth at night

Answer 15

TMJ - could cause tension headaches

Question 16

migraine headaches

Answer 16

mechanism unknown

• vascular - dilation of vessels in brain, pain
• cortical spreading depression theory - self propagating wave of neuronal and glial depolarization in the brain

Question 17

trigemino muscular theory

Answer 17

activation of trigeminal system, neuron that innervates the vessels of dura

Question 18

aura migraine

Answer 18

from vessel constriction

Question 19

sensitization

Answer 19

neurons increase response to nociceptive input

Question 20

genetics

Answer 20

role in development in migraine

Question 21

prodrome

Answer 21

phase before have headaches

Question 22

affective or vegetative symptoms 24-48 hours before

Answer 22

euphoria, depression, irritability, food craving, constipation, neck stiffness

Question 23

aura

Answer 23

in classic migraine

Question 24

types of aura

Answer 24

visual, auditory, olfactory, verbal

any sense

Question 25

most common aura

Answer 25

visual | -visual loss

Question 26

HA stage

Answer 26

unilateral, throbbing, pulsatile pain, intensity increase, nausea/vomiting, chills sweats, photo/phonobia

Question 27

postdrome pain

Answer 27

pain when move head - exhaustion - elation/euphoria

Question 28

mild to moderate migraine

Answer 28

no nausea/vomiting

Question 29

moderate to severe

Answer 29

have nausea/vomiting

Question 30

cluster headaches

Answer 30

episodic and chronic

Question 31

episodic

Answer 31

daily attacks for weeks with periods of remission

Question 32

chronic

Answer 32

daily attacks with no significant periods of remission

Question 33

pathogenesis of cluster headaches

Answer 33

unknown - theory 1 - hypothalamic activation with secondary activation of trigeminal autonomic reflex - 2 - neurogenic inflammation of wall of cavernous sinus obliterates venous drainage

Question 34

clinical features of cluster headaches

Answer 34

8 times a day unilateral attacks of severe orbital, supraorbital, temporal pain

Question 35

diagnosis of cluster headaches

Answer 35

at least 5 attacks lasting 15-180 mins one every other day for more than half time for an attack period one or more other symptoms of cluster HA

Question 36

medication overuse headaches

Answer 36

pathogenesis, not understood opiods, aspirin, tylenol, butalbital, triptans, ergotamine, NSAIDs

Question 37

clinical features of medication overuse HA

Answer 37

frequent treatment of HA pain with analgesic -

Question 38

diagnosis of medication overuse HA

Answer 38

more than 15 days / month - for at least 3 months - developed or worsened with continued use of medication

Question 39

Tx of medication overuse HA

Answer 39

stop medication intake | -withdrawal symptoms, make HA worse

Question 40

bridge therapy

Answer 40

treat the HA pain to get through withdrawal period, use the bridging agent not same class of drug

Question 41

HA is complaint

Answer 41

associated with many illnesses consider other potential causes

Question 42

indications for imaging

Answer 42

possible with bad enough headache

Question 43

CV4

Answer 43

cranial technique done to self for HA decrease