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40 Cards in this Set
- Front
- Back
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Name the three primary headaches
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Cluster Headaches
Migraines Tension Headaches |
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What is the most common type of primary headache?
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Tension Headaches
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Name a few causes of secondary headaches
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Sinuses
Tumor Meningitis Toxins Hemorrhage |
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Define Migraine
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It is a primary headache that is usually pulsatile with pain that is typically (but not always) unilateral. There is an accompaniment of symptoms that may include nausea, vomiting, photophobia, and phonophobia.
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Pathophysiology of a Migraine
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Neurologic Dysfunction
Abnormal Dilation of blood vessels innervated by the trigeminal nerve. Failure of normal sensory processing in the brainstem |
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Risk factors that may indicate a tendency to get Migraines
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Genetic
Adolescent or young adult Women |
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Is neck pain common in migraines?
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Yes, most report neck pain.
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Migraines:
Must have 2 of... Must have at least 1 of... |
2: unilateral pain, throbbing/pulsitile, worsened with movements
1: nausea, vomiting, photophobia, phonophobia |
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Treatment for Migraines
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Manage Triggers!
Sumatriptan or almotriptan (not for pregnant women) |
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Prophylactics for Migraines
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Calcium Channel blockers --- verapamil
Beta Blockers --- propranolol Seizure preventatives --- topiramate |
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Define Cluster Headache
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A cyclic primary headache that is a deep headache on one side that comes on at about the same time every day.
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Risk factors for Cluster Headaches
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More common in men
Usually due to a trigger: alcohol, stress, glare, foods |
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Pathology of Cluster Headaches
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Activation of cells in ipsilateral hypothalamus triggering trigeminal autonomic vascular system
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Presentation/sign and symptoms of a Cluster headache
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Severe, excrutiating headache
Lasts 15 minutes to 3 hours Cyclic (occurs for several weeks and then stops) One sided May have: redness of eyes, tearing, ptosis, ipsilateral stuffiness |
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Treatment of Cluster headaches
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Sumotriptan or Zoltriptan
Inhalation of Oxygen |
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Prophylactics for Cluster headaches
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Beta Blockers
Steroids Calcium Channel Blockers |
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Most common trigger for Tension Headaches
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Stress
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Signs/symptoms of Tension Headaches
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Neck pain and tenderness
Not pulsatile Episodic lasting 30 min to 7 days Usually temporal or frontal Rubberband around the head sensation |
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Tension Headaches
Must have 2 of... Must have ABSENCE of 1 of... |
2: not throbbing, not severe, not worse with movement, not unilateral
1: nausea, vomiting, photophobia, phonophobia |
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Treatment for Tension Headaches
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Triptans are NOT indicated
Relaxation techniques NSAIDs Treat anxiety/depression |
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Define Epilepsy
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Recurrent, chronic, unprovoked seizures
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Define Seizure
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Transient disturbance of cerebral function due to an abnormal paroxysmal neuronal discharge of the brain
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Three classifications of epilepsy
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Genetic
Structural/Metabolic Epilepsy Unknown |
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Discuss Genetic Epilepsy
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Onset ranges from neonatal period to adult life.
Autosomal Dominant pattern of inheritance. |
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Name the 7 discussed structural/metabolic causes of epilepsy
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Pediatric Age Group
Metabolic Disorders Trauma Tumors Vascular Disease Degenerative Disorders Infectious Diseases |
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Discuss Unknown Epilepsy
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Most cases of epilepsy are due to an unknown cause.
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What are the two main classes of Seizures
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Generalized (4)
Focal (2) |
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What are the 4 types of generalized seizures
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Absence (petit mal)
Atypical Absensce Myoclonic Tonic-clonic *Diffuse involvement of the brain at onset* |
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What are the 2 types of focal seizures
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With impaired consciousness
Without impaired consciousness *Involvement of a restricted part of the brain* |
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What is an absence (petit mal) seizure?
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Consciousness impaired briefly with the patient unaware of the attack.
Usually very young age to age 20 |
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What is an Atypical Absensce seizure?
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May be more gradual in onset and termination then typical absence.
More marked changes in tone may occur |
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What is a myoclonic seizure?
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Single or multiple myoclonic jerks
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What is a tonic-clonic (grand-mal) seizure?
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Consists of two phases: tonic and clonic
Tonic phase: sudden loss of consciousness with rigidity and arrest of respiration (<1 min) Clonic phase: jerking occurs for <2-3 min Flaccid Coma: follows with variable duration |
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What is a focal seizure without impairment of consciousness?
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Observable focal motor or autonomic symptoms, or subjective sensory or psychic symptoms may occur
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What is a focal seizure with impairment of consciousness?
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Altered responsiveness may precede, accompany or follow the following syptoms:
Observable focal motor or autonomic symptoms, or subjective sensory or psychic symptoms may occur |
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What is status epilepticus?
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Repeated seizures without recovery between them; fixed and enduring epileptic condition lasting >30 min
MEDICAL EMERGENCY Most commonly due to poor compliance with anticonvulsant drugs |
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Treatment for Generalized and focal seizures
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Phenytoin (Dilantin)
Carbamazepine Valproic Acid |
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Treatment for Status Epilepticus
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Intubation (airway management)
Phenytoin (dilantin) Lorazepam and Diazepam (anti-anxiety) |
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What is a psychogenic nonepileptic seizure?
(PNES) |
Simulates an epileptic seizure
Tend to occur at times of stress Asynchronous thrashing of limb with consciousness normal or lost No finding on the EEG |
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Best ways to diagnose seizure
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EEG (electroencephalogram)
MRI |
