University:
West Coast University
Course:
PHAR 835 | IPC Neurology/Psychiatry
Academic year:

2021
Views:

349

Pages:

4
Author:

rehinhea0c

Primary headaches > without underlying "neurological 1 and cause brain images are normal" Migraine headache < 2 most common seen in clinics Tension headache < 3 primary exam most common type Cluster headache & other TACs secondary most 4 painful Others: Primary cough headache, primary exercise headache, hypnic headache… 3 You have to full workup ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪ I 2 3 further investigate , , role outs see to the Red Flags Big hihtsthatthers ene First or worst headache. Abrupt onset headache. Progression or change in the pattern of headache. Younger than 5 older than 50 ofunilateral pulsatinginnaturea Cancer, Pregnancy or Immunosuppression. Syncope or seizure. Valsalva maneuver ,exertion & sex. Neurological symptom lasted more than one hour. Abnormal general or neurological exam. Subarachinoid Hemorrhage EX: Female simmunocompromised S immunosupressions G 7 < f - Hypercoguable status , t risk cerebral venous per known stabbing case of Migraine  The diagnosis is based solely on the history and examination. pain thrombosis Tension Headache Chronic subarchinoid hemorrhage > Aura) &  most common form of headache in the general population. Subarachinoid Hemorrhage > Y Tension Headache e cause If of . 2 neurological Symptoms Casts B-Infrequent - EX : Female pth and presented it's her 1st with unilateral headache and pulsating she is headache pregnant with , 2 phonal photo-phobia Red flags headache >15 days per month Episodic : A-frequent migraine * Any : Band or like , >12 days (12 days mild-moderate phonophobia not both) not Lif Both per least 3 consentative months per month year in chronic No nausea / vomiting aggrevated think : meningitis at per year but 15 days entr , I migrainechinoid 3 for with in episodic associated with photophobia physical activity cunlike migraine which is aggrevated by Activity hemorrhage * Each attackcasting from 30 min up to 7 clurations attack $ , sattacks days days ins o of Headache 11 EX "attacks each : > yattacks each lasting days lasting , 16 days 1 days ydays > if for 3 months chronic tension headache frequent episodic headache 12149 How many days ? 12 days but not 12 Attacks • Excessive contraction of pericranial & cervical muscles. • Myofacial factors & CNS components. Triggering factors > paracetamol or NSAIDS ▪ Mental or physical stress. ▪ Hunger. ▪ Caffeine withdrawal. or nicotine if chronic ▪ Dehydration. or frequent < ▪ Alteration in sleep pattern. daily and bases therapy severity at to least decrease 50 % to be the recurrance succefull TCA ▪ Female hormonal fluctuation. TCA SE : Dry eyse , dry mouth , weight gain , sedation , cardiac Arrythmia , Gl upset > / - Episodic 2 chronic 15 : days <15 per month per month for 3 months (at least days 8 days Headache days) , Migraine Headache * most common Migraine females in Types :  Disorder of brain excitability and sensory dysmodulation causing head pain plus associated features. Hereditary or post trauma. Episodic less than 15 days per month , chronic more than 15 days. 20% with aura , 80% without . 43% women , 18%in men , 4-5 % in children. I 2 * migraine if left untreated it may last if more days Xunilateral headache bilateral doesn't exclude migraine ! 1 migrainus Throbbing pulsating Migraine with aura * MRI - in unknown normal > you might see dots subcortical hyperinterity to physical Activity severe 80 % Acute Migraine Therapy * moderate , paracetamol NSAIDs A severe Migraine specific ↑ I > - vasoconstriction Acute therapy together (Clin IHD . stroke , VS Abportive peripheral vascular uncontrolled HTN , panadol Extra/migraine > Tolerance Rs , supression comprehensive Aphasia /receptive) : normal Fluency * Aura : Transient neurological deficits Ian alarm either Ill before either Headache or gradual & reaching peak within Smin Visual Aura (most common) : Black dots or Zigzag symptoms with the Casting lines or or signs visual , sensory , speech Mother headache * to diagnose Aura you need at least speech Aura : Aphasia , Dysarthric clear speech if the pth came with Aphasia do full workup -655-e Aura : zattacks CIH scintillating scotomain , Expressive Aphasia , &jajijo stutterd clear speech siSAJ FINAL ❖US Food and Drug Administration (FDA) approved recently: - Lasmiditan ( Ditan) A doesn't * can be vasocontriction cause * not available used in in Jordan elderly with + Expensive IHD , uncorolled HTN - --ere *selective 5-HT1F receptor agonists * does not cause vasoconstriction - Ubrogepant, and Rimegepant ( Gepant) • CGRP receptor antagonists • does not cause vasoconstriction Seisedation Noninvasive Neuromodulation Treatment of Acute Attacks: stimulation magnatic Migraine Electrical supress excitability > - Behavioral distraction < EX : when there is > - HRd pulsation , Relax the pth or to

Headache Disorder

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