1
Q
Evaluation:
A
chronology location, duration, quality associated activity: exertion, sleep, tension, relaxation timing r/t menstrual cycle presence of assoc symptoms 'triggers'
2
Q
Tension HA
A
vise like or tight in quality
no neuro
may be most intenses about neck or back of head
3
Q
Mgmt of tension HA
A
OTC analgesic
relaxation
4
Q
Classic migraine
A
with an aura
5
Q
common migraine
A
without an aura
6
Q
Migraine Lab/diagnostics (I/P with new onset)
A
blood chem, BMP CBC VDRL (r/o syphilis) ESR CT scan of head other studies ind. by Hx/PE
7
Q
initiate migraine prohylatic treatment, when?
A
occurs more than 2-3 X month Amitryptiline Verapamil Topiramate Gabapentin Magnesium Propanolol Clonidine Imipramine
8
Q
Mgmt of acute migraine
A
Rest in dark
ASA right away
Sumatriptan (Imitrex) 6mg SQ, may repeat 1 hour up to 3 X day
Sumatriptan 25 mg po at onset of HA
9
Q
Cluster HA
A
mostly middle aged men
10
Q
Character of Cluster HA
A
- severe, unilateral, PERIORBITAL pain occurring daily for several weeks
- usu. occur at night
- ipsilateral nasal congestion, rhinorrhea, and eye redness may occur
11
Q
Mgmt of cluster HA
A
inhalation of 100% O2
Sumatriptan 6mg SQ may be effective
Ergotamine tartrate aerosol inhalation (Ergostat) may be effective
