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headache

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Verified User Primary Care Comments Off on CLUSTER HEADACHE 1785 views

Cluster headaches are more common in middle aged men, with a ratio of 2:1 In women, it is usually seen earlier in life (in their 20s) ASSOCIATED WITH 1. Depression 2. Asthma 3. History of migraines 4. Sleep apnea CLINICAL PRESENTATION The diagnosis is clinical 1. Unilateral, recurrent periorbital pain that lasts from 15 min upto 3 hours 2. Usually at night time 3. Ipsilateral injection, lacrimation and nasal congestion 4. Neurological exam is normal PATHOPHYSIOLOGY Posterior hypothalamus activation > increased parasympathetic outflow The lacrimation, redness and congestion is due to parasympathetic hyperactivity The ptosis and ...

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Evidence based approach to diagnosing Migraines

Verified User Primary Care Comments Off on Evidence based approach to diagnosing Migraines 3209 views

The pretest probability of a patient presenting to a PCP with a complain of headache to be migraine is 6-15%. A meta analysis identified nausea, photophobia, phonophobia and exacerbation with physical activity to be best individual symptoms for ruling in or out migraine. The best predictor was nausea. Headache with nausea = increases likelihood of headache being migraine to 90% 5 Item ...

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