Flashcards in headache Deck (37)
which headache involves the eye ? intense pain around one eye? lacrimal swelling. recurrent attack which 'always attacks one side?
how many times a day do you get cluster headaches?
once or twice a day (clusters)
how long do the clusters last ?
typically 4-12 weeks
what is raised in temporal arteritis?
Recurrent, severe headache which is usually unilateral and throbbing in nature
May be be associated with aura, nausea and photosensitivity
Aggravated by, or causes avoidance of, routine activities of daily living. Patients often describe 'going to bed'.
In women may be associated with menstruation
Recurrent, non-disabling, bilateral headache, often described as a 'tight-band'
Not aggravated by routine activities of daily living?
who is typical patient to have a migraine ?
how often typically would people have migraines
once a month
pain in migraine?
unilateral throbbing pain
autonomic features of a migraine?
what kind of aura can you get in migraine?
visual, seonsory, motor or language
triggers for migraine ?
• Physical exertion
management of migraine?
offer combination therapy with an oral triptan and an NSAID, or an oral triptan and paracetamol
prophylaxis for migraine?
offer either topiramate or propranolol (TOTP)
what are triptans?
example of triptan?
which NSAID would you give?
when would you consider prophylaxis?
more than 3 attacks per month or if very severe
Consider non-pharmacological methods such as?
accupuncture, relaxation exercises
which patients would you need to be careful giving propranolol to?
what kind of drug is topiramate?
carbonic anhydrase inhibitor
side effects of amytryptilline?
dry mouth, postural hypotension, sedation.
amytryptline is a TCA
common unilateral headache of the young?
when would you consider imaging ?
if late onset (>55)
Ipsilateral cranial autonomic features. what are they?
Nasal Stuffiness Nausea/ vomiting Tearing
Eye lid oedema
Severe unilateral headache, Duration: 45- 90mins (20 mins-3 hours)?
frequency per day cluster headache?
1-8 per day
Treatment of a cluster headache?
high flow oxygen
Sub cut sumatriptan 6mg
Steroids- reducing course over 2 weeks
Verapamil for prophylaxis
prophylaxis of cluster headache?