Headache

Question 1

What are the primary headache syndromes?

Answer 1

Migraine with aura and without
Tension type H
Trigeminal autonomic cephalgias
- Cluster headache
- paroxysmal hemicrania
other -

Question 2

Migraine treatment

Answer 2

non pharmacological
- avoid trigger/ life style / yoga

Pharmacological - 3 types
1- NSAIDs: acetaminophen+aspirin+caffeine
Aspirin+metoclopromide (SE: dyspepsia/ gastric irritation)
2- 5HT 1B/1D: Ergotamine & dihydroergotamine
non selective: Triptans - Sumatriptan, amitriptan, Eletriptan. Fravotriptan. Naratriptan, Rizatriptan, Zolmetriptan
3. Dopamine R antagonist: Metoclopromide/ Domperidone

Question 3

Cluster headache

Answer 3

involving central pacemaker neurone in the posterior hypothalamic region. 0.1% in population
deep retro orbital pain
high flow O2 100% 10-15L 15-20 min
Sumatriptan to shorten attack
prevention-
prednisolone 60mg x 7 days and rapid taper
lithium
verapamil