Migraines

Question 1

What is a tension headache?

Answer 1

bilateral throbbing pain like a tight band around head lasting around 30 mins

Question 2

cluster headache

Answer 2

extreme and sharp unilateral pain in or around 1 eye lasting 15 mins-3 hours

Question 3

trigeminal neuralgia

Answer 3

shooting sharp pain like an electric shock in the jaw, teeth or gums, lasting up to 2 mins

Question 4

What is a migraine

Answer 4

unilateral, pulsating pain severe enough to impact daily activities
- often accompanied with photophobia, N&V, and phonophobia, lasting up to 72 hours

Question 5

tension headache treatment

Answer 5

paracetamol and ibuprofen

Question 6

cluster headache treatment

Answer 6

triptan +/- oxygen (acute)
verapamil (prophylaxis)

Question 7

trigeminal neuralgia treatment

Answer 7

carbamazepine

Question 8

What is a subarachnoid haemorrhage

Answer 8

pain described as being kicked in the back of the head or neck
- cause a stiff neck
- refer to A&E

Question 9

migraine acute treatment

Answer 9

• triptan with high dose aspirin, paracetamol or ibuprofen
• antiemetics: metoclopramide or prochlorperazine

Question 10

Migraine prophylaxis

Answer 10

• propranolol, topiramate or amitriptyline
• can use candesartan and sodium valproate
• do not offer gabapentin

Question 11

triptan counselling

Answer 11

• take as soon as pain starts (not aura)
• onset 30-60 mins
• if migraine improves but comes back, take another dose after 2 hours (4 hours for naratriptan)
• if first dose does not help, don’t take another one

Question 12

What classes as a good response to migraine treatment?

Answer 12

50% reduction in severity and frequency of migraine attacks