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Neurology for Psychiatrists > Headaches > Flashcards

Flashcards in Headaches Deck (22):
1

Migraine

Greater than 5 attacks lasting at least 4 hours
At least 2 of the following:
Unilateral
Pulsating
Moderate severity
aggravated by physical activity

Can be associated with nausea, vomiting, photophobia, phonophobia

2

Migraine Aura

Lasts 5-20 minutes. Disappears with onset of headache

3

Treatment for migraines with psych comorbidities

Sleep hygiene, exercise, avoiding EtOH, CBT, Biofeedback, TCAs (more than SNRIs)

4

Childhood Migraines

Shorter, bilateral often, more severe, responds to Tylenol and NSAIDs (unlike in adults)

5

Basilar Type Migraine

Ataxia, vertigo, dysarthria, or diplopia

6

Hemiplegic Migraine

Hemiparesis of various grades

7

Familial Hemiplegic Migraine

Autosomally dominant migraine

8

Food-induced Headaches

Migraine sufferers should avoid 4 Cs: Chocolate, cheese, ....
But there is an intense craving for these foods.

9

Med-induced HA

Nitroglycerine, Isosorbide, others

10

Sex or exertion related HAs

Propranolol or Indomethacin prophylactically can help

11

Acute Tx of Migraine

CBT relaxation techniques, opiates (but risk rebound), Triptans, Ergotamine, DHE, Reglan (for nausea), parenteral meds if can't take PO

12

Preventative Treatment of Migraines

Antidepressants, antihypertensives, and _________. TCAs; Topiramate, Valproate,

13

Chronic Daily Headaches

Most likely due to Medication overuse (triptans and opiates). Commonly Fiorinal, NSAIDs, Benzos.

14

Cluster HA

45-90 min. Intense searing pain behind one eye. Eye tearing. Nasal congestion. Partial Horner Syndrome. Severe. 1-8 attacks per day for month then remits (they come in clusters)

15

Cluster HA Treatment

Most meds don't work. Sumatriptan + OXYGEN, + DHE injection can abort it. Especially O2.

16

Temporal Arteritis

Autoimmune. Dull and constant pain in temporal region. Can cause sudden blindness

17

Intracranial masses

Subdural hematomas, etc

18

Chronic Meningitis

Can cause facial palsy, hearing loss, extra ocular palsies.

19

Pseutotumor Cerebir

Papilledema and blind spots; Compressed/small ventricles on MRI

20

Subarachnoid Hemorrage

Worst HA of your life; Sudden; CT can reveal. Do CT before Lumbar tap so you don't cause herniation;

21

MAOIs and hypertensive crisis

MAOIs can react with tyramine rich foods or other medications to cause this. Phentolamine can reverse it. Chlorpromazine and Propranolol can help.

22

Trigeminal Neuralgia

Impingement of the nerve. Stabbing pains. Tx is Carbamazepine; Surgical interventions now.