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9 Cards in this Set
- Front
- Back
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What are the 3 types of primary headaches? |
1. Migraine 2. Tension 3. Cluster |
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Migraine without aura diagnostic criteria |
- at least 5 attacks lasting 4-72 hours - Headache has at least 2 of the following: a) unilateral b) pulsating c) moderate to severe pain during headache, more than 1 of the following: - nausea/vomit - photophobia/phonophobia |
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Migraine with aura diagnostic criteria |
A) at least 2 attacks with more than 3 of the following: 1. more than 1 fully reversible aura (visual/sensory/dysphasic) 2. more than 1 aura develop over 4 mins, or 2 aura in succession 3. no aura last >1 hour 4. headache follows aura with free interval of >1 hour B) more than 1 of following aura features establish a diagnosis of migraine with typical aura - homonymous visual symptoms - unilateral parasthesias - unliateral weakness - aphasia/speech difficulty - diplopia/vertigo/ataxia |
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Tension headache diagnostic criteria |
- headaches lasting 30 mins to a week - headache has more than 2 of following: a) bilateral headache b) pressing/tightening pain c) mild/moderate d) not aggravated by activity - NO nausea/vomiting and - NO more than 1 of photophobia/phonophobia |
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cluster headache diagnostic criteria |
- more than 5 attacks of severe, unilateral headache lasting from 15-180 mins untreated, with more than 1 autonomic symptom: (lacrimation, rhinorrhea, sweating, miosis, ptosis, eyelid edema, conjunctival injection) - Attacks have frequency of 1 every other day to 8 per day |
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What is the management for tension headache? |
Acute: Paracetamol, or NSAIDs Prophylaxis: amitryptilline |
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What is the management for cluster headache? |
- avoid alcohol/smoke - Acute: sumatriptan and high flow O2 - Prophylaxis: Verapamil/Lithium/Prednisolone/topiramate |
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What is the management for migraine? |
acute: - paracetamol - then NSAIDs - then Ergotamine 1-2mg 1 hrly - then Zolmig 2.5 mg 4 hrly Prophylaxis: (if more than twice a month, severe attacks, refractory, prolonged aura) - administer for at least a month to see effects, 6 months to take full effect - can try beta-blockers/CCB/anti-depressants/anti-convulsants/angiotensin blockers |
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scoring system for migraine? |
1. Migraine Disability Assessment Questionnaire (MIDAS) 2. Headache Impact Test-6 (HIT-6) |
