Headaches Flashcards

1
Q

Diagnostic criteria for migraine without aura

A

5 or more attacks lasting 4-72 hours
1 of: autonomic features, photo/phonophobia
2 of: moderate/severe, unilateral, throbbing pain, worse on movement

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2
Q

Nature of migraine aura

A

Fully reversible
VISUAL, sensory or motor
Lasts 20-60 mins
Headaches usually follows but can occur simultaneously

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3
Q

What is the medical treatment for a migraine?

A

NSAIDs +/- anti-emetic

Triptans (taken at start of headache)

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4
Q

What are the prophylactic treatments for migraine?

A

Propranolol, topiramate or amitriptyline

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5
Q

When should migraine prophylaxis be considered?

A

> 3 attacks per month, or if very severe

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6
Q

For how long should each migraine prophylactic medication be trialled?

A

4 months

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7
Q

What are the features of tension type headache?

A

Mild/moderate
Pressing tingling quality - non pulsatile
Bilateral
? scalp muscle tenderness

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8
Q

What are the subtypes of trigeminal autonomic cephalgia?

A

Cluster headache
Paroxysmal hemicrania
Hemicrania continua
SUNCT

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9
Q

What are the features of cluster headache?

A

Severe unilateral headache

Ipsilateral cranial autonomic features (ptosis, nasal stuffiness, N+V, miosis, eye lid oedema, tearing)

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10
Q

What is the treatment for cluster headache?

A

High flow O2
s/c sumatriptan
Verapamil prophylaxis

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11
Q

What are the features of paroxysmal hemicrania?

A

Similar to cluster headache, but shorter more frequent headaches

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12
Q

What are the features of SUNCT?

A
Short lived 
Unilateral 
Neuralgiaform headache 
Conjunctival injections 
Tearing
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13
Q

What are the features of trigeminal neuralgia?

A

Triggered by touch to v2/3
Severe stabbing unilateral pain
Very short duration

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14
Q

What is the treatment for trigeminal neuralgia?

A

MRI brain to exclude secondary causes
Carbamazepine, gabapentin, phenytoin, baclofen
May consider surgery

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15
Q

What are the features of idiopathic intracranial hypertension?

A

More common in females, obesity
Pulsatile tinnitus
Exacerbated on valsalva

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16
Q

What is the appropriate management approach towards idiopathic intracranial hypertension?

A
Opthalmascope and visual fields 
MRI brain to rule out SOL 
LP 
Advise weight loss
Acetazolamide