General neurology

Question 1

What are the clinical signs and symptoms of a cluster headache

Answer 1

excruciating unilateral pain over one eye lasting for a few minutes

ptosis, miosis, blocked/runny nose. vomiting

Question 2

What is the acute and long term management of cluster headaches

Answer 2

Acute:
triptans e.g. sumatriptan and high flow oxygen

Long term: beta blockers and avoidance of alcohol

Question 3

What are the clinical signs and symptoms of temporal arteritis

Answer 3

scalp pain, jaw and tongue claudication, rare in <50

Question 4

How is temporal arteritis diagnosed and managed

Answer 4

Dx: raise in ESR and temporal artery biopsy

Tx: prednisolone

Question 5

What are the clinical features of trigeminal neuralgia

Answer 5

3% bilateral, ophthalmic less likely affected. Electric shock type pain lasting up to 2 minutes, dull ache can be present afterwards. Can be trigger points on skin causing pain so shaving, brushing teeth, wind, draught, hot/spicy food can trigger.

Question 6

How is trigeminal neuralgia diagnosed

Answer 6

MRI

Question 7

How is trigeminal neuralgia managed

Answer 7

carbamezapine, surgical decompression, ablation, - Percutaneous procedures: glycerol injection, radiofrequency lesioning, balloon compression. Work by damaging Gasserian ganglion.