Migraine Diagnosis and Management Cases
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Questions and Answers

What is a possible diagnosis for a 40-year-old male with transient dysphagia and left-sided weakness?

  • Retinal migraine
  • Intracranial hypertension (correct)
  • Temporal arteritis
  • Cluster headache

    • Which diagnosis is characterized by a constant headache that worsens in the morning and improves throughout the day?

  • Intracranial hypertension
  • Temporal arteritis (correct)
  • Tension-type headache
  • Migraine

    • Which treatment options are commonly prescribed for a 24-year-old female with recurrent headaches previously diagnosed as migraine without aura?

  • Amitriptyline and Propranolol (correct)
  • Ibuprofen and Codeine
  • Acetaminophen and Caffeine
  • Oxycodone and Sumatriptan

    • What is a key characteristic of a diagnosis of migraine in a 28-year-old female with unilateral headaches?

    <p>Sensitivity to light and sound (D)</p> Signup and view all the answers

    A severe sudden onset headache with nausea and a stiff neck indicates which critical condition?

    <p>Subarachnoid hemorrhage (D)</p> Signup and view all the answers

    Which condition is an example of an upper motor neuron lesion?

    <p>Multiple sclerosis (D)</p> Signup and view all the answers

    What type of movement disorder is characterized by rapid, involuntary muscle contractions primarily in the neck and shoulders?

    <p>Dystonia (D)</p> Signup and view all the answers

    What condition is associated with involuntary jerky movements and a family history of similar symptoms?

    <p>Huntington's disease (B)</p> Signup and view all the answers

    Which of the following symptoms is NOT associated with amyotrophic lateral sclerosis (ALS)?

    <p>Resting tremor (A)</p> Signup and view all the answers

    A patient with sharp stabbing left-sided facial pain is most likely suffering from which condition?

    <p>Trigeminal neuralgia (B)</p> Signup and view all the answers

    Flashcards

    Cluster Headache

    A type of headache characterized by sudden severe pain, usually on one side of the head, behind the eye, and accompanied by teary eyes, runny nose, and facial sweating.

    Migraine

    A type of headache that is often described as a throbbing pain, usually on one side of the head, and can be accompanied by nausea, vomiting, and sensitivity to light and sound. It can also be preceded by an aura.

    Dystonia

    A neurological disorder characterized by involuntary, repetitive, and often twisting movements, usually in the neck, shoulders, and other muscle groups.

    Amyotrophic Lateral Sclerosis (ALS)

    A neurological disorder characterized by a progressive degeneration of motor neurons, leading to muscle weakness, atrophy, and eventually paralysis. It affects both upper and lower motor neurons.

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    Tension-Type Headache

    A type of headache characterized by a dull, aching pain, usually felt all over the head, and often caused by stress or muscle tension.

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    Intracranial Hypertension

    A condition that occurs when pressure within the skull increases, causing symptoms such as headache, nausea, and vomiting, blurred vision, and dizziness.

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    Sinus Headache

    A type of headache characterized by pain around the eyes, forehead, and cheek, often accompanied by nasal congestion, facial pain, and a sense of pressure.

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    Trigeminal Neuralgia

    A disorder characterized by recurrent episodes of intense, sharp, stabbing pain in the face, typically involving the trigeminal nerve.

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    Huntington's Disease

    A neurological disorder characterized by involuntary, jerky movements of the limbs, face, and other parts of the body, often accompanied by cognitive decline and behavioral changes.

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    Parkinson's Disease

    A neurological disorder characterized by slowness of movement, stiffness, tremors, and difficulty initiating movement, caused by the loss of dopamine-producing cells in the brain.

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    Study Notes

    Migraine Diagnosis and Management

    • Case 1: 40-year-old male with transient dysphagia, episodic headache, increased light sensitivity, and left-sided weakness
    • Diagnosis: Potential retinal migraine

    Migraine Prophylaxis

    • Case 2: 60-year-old woman with morning headache improving throughout the day and elevated ESR
    • Diagnosis: Possible temporal arteritis

    Migraine in a 24-Year-Old

    • Case 3: 24-year-old female with recurrent headaches, originally diagnosed as migraine without aura 12 months prior
    • Diagnosis: Migraine, potential drug therapy options

    Cluster Headache

    • Case 4: 28-year-old female with throbbing, unilateral headaches accompanied by nausea, vomiting, and light/sound sensitivity. Episodes last 4-72 hours, possibly preceded by visual disturbances.
    • Diagnosis: Cluster headache

    Recurrent Headaches

    • Case 5: 35-year-old woman with unilateral, throbbing headaches lasting 4-72 hours, often accompanied by nausea, vomiting, and photophobia. Headaches preceded by visual disturbances (aura)
    • Diagnosis: Migraine

    Severe Headache

    • Case 6: 40-year-old man with sudden, severe headache, described as the worst of his life, located around neck/back of head, with nausea and photophobia
    • Diagnosis: Possible subarachnoid hemorrhage

    Neurological System Disorders

    • Case 7: Upper motor neuron lesions can cause autonomic nervous system dysfunction
    • Causes: Possibly peripheral or central nervous system disorders

    Upper Motor Neuron Lesions

    • Examples: Temporal arteritis, anterior horn cell disease, multiple sclerosis, and prion disease
    • Exceptions: Disorders excluding the anterior horn cell

    Involuntary Muscle Movements

    • Case 8: 30-year-old male with rapid, involuntary movements (twisting and repetitive movements) in the neck and shoulders
    • Diagnosis: Dystonia, possibly worsened by stress.

    Vitamin Toxicity and Pseudotumor Cerebri

    • Case 9: Pseudotumor cerebri may be linked to vitamin deficiencies
    • Vitamin deficiency/toxicity as cause of pseudotumor cerebri

    Upper Motor Neuron Lesion Symptoms

    • Case 10: 45-year-old female with difficulty initiating movement, a shuffling gait, stiffness in limbs, mask-like facial expression, resting tremor in hands, rigidity
    • Diagnosis: Parkinson's disease

    Genetic Condition

    • Case 11: 55-year-old male with involuntary, jerky movements (often worse with stress), family history, positive genetic test
    • Diagnosis: Huntington's disease

    Progressive Neurological Weakness

    • Case 12: 60-year-old woman with dysphagia, slurred speech, progressive muscle weakness, atrophy, and fasciculations in limbs.
    • Diagnosis: Possible amyotrophic lateral sclerosis (ALS)

    Facial Pain with Red Eye

    • Case 13: 72-year-old female with headaches, nausea, vomiting, one-sided head pain, red eye, worse at night, blurred vision
    • Diagnosis: Possible SUNCT syndrome, giant cell arteritis

    Facial Pain Episodes

    • Case 14: 61-year-old with recurring episodes of stabbing, left-sided facial pain (9/10 scale)
    • Diagnosis: Trigeminal neuralgia

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    Description

    Test your knowledge on various case studies involving migraine diagnoses and management strategies. Each case presents unique headache symptoms and potential diagnoses, ranging from retinal migraines to cluster headaches. Analyze the clinical information to understand how to approach each scenario effectively.

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