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Neurological lectures...Headaches

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Professor Yasser Metwally
Professor Yasser Metwally

Neurological lectures...Headaches http://yassermetwally.com http://yassermetwally.net

FormationSanté & Médecine
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Classification of headaches Professor Yasser Metwally ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
HISTORY AND EXAMINATIONS SHOULD CLARIFY IF ,[object Object],[object Object],[object Object]
SECONDARY, SYMPTOMATIC HEADACHES ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Primary, idiopathic headaches ,[object Object],[object Object],[object Object],[object Object]
Treatment of tension type of headache ,[object Object],[object Object]
Prophylactic treatment of the chronic tension type of headache ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Prophylactic treatment of the chronic tension type of headache
Common side effects of tricyclic antidepressants ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
If the patient does not tolerate the TCA drugs, or cannot be administared because of danger of interaction ,[object Object],[object Object],[object Object],[object Object]
Migraine: epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Migraine: pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object]
Migraine classification 1.1 migraine without aura 1.2 migraine with aura 1.3 periodic syndromes in childhood 1.4 retinal migraine 1.5 migraine complications 1.6 probable migraine
Migraine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MIGRAINE WITH AURA ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],BUT: AURA SYMPTOM IS NOT CONSEQUENCE OF VASOCONSTRICTION INDUCED HYPOPERFUSION CUASE OF THE AURA: SPREADING DEPRESSION. THE VASOCONSTRICTION AND HYPOPERFUSION ARE CONSEQUENCES OF THE SPREADIND DEPRESSION SPREADING DEPRESSION AURA VASOCONSTRICTION, HYPOPERFUSION
IMPORTANT TO KNOW! MIGRAINE WITH AURA ,[object Object],[object Object],[object Object],[object Object],[object Object]
Is there a relationship between aura and patent foramen ovale ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment of migraine attack ,[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment of migraine attack I. Antiemetics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment of migraine attack II. Analgetics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],Treatment of migraine attack III. Ergot derivatives
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Treatment of migraine attack IV. Combinations in Hungary
Treatment of migraine attack V. Triptans
The ideal triptan ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Very severe migraine attack / status migrainosus: ,[object Object],[object Object],[object Object],[object Object],[object Object],Attack treatment in emergency
Strategy of treatment of migraine attacks ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prophylactic treatment of migraine attacks ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Aims of prophylactic treatment of migraine ,[object Object],[object Object],[object Object]
Prophylactic treatment of migraine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Beta-receptor-blockers (propranolol 2x20-40 mg) Calcium channel blockers (flunarizine, 10 mg every evening) Side effects: provokes depression, increases appetite, cause sleepiness Tricyclic antidepressants (amitryptiline, 10-75 mg every evening) Antiepileptics (valproic acid, 2x300-500 mg) Use: hypertension, tachycardia Do not use: hypotension, bradicardia, heart conduction disturbances Do not use: obesity, maior depression in the history Use: if tension type of headache is present besides migraine Do not use: see above Few side effects, but Pregnancy should be avoided
Other prophylactic treatment of migraine ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Migraine and pregnancy ,[object Object],[object Object],[object Object],[object Object],[object Object]
Migraine in childhood I ,[object Object],[object Object],[object Object],[object Object],[object Object]
Migraine in childhood II ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment of cluster attack ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prophylactic treatment of the episodic form of cluster headache ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],Prophylactic treatment of the chronic form of cluster headache
3. Cluster headache and trigemino-autonomic cephalgias ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Headache of cervical origin ,[object Object],[object Object],[object Object],[object Object]
Arteriitis temporalis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Facial pains ,[object Object],[object Object]
Carotid dissection ,[object Object],[object Object],[object Object],[object Object]

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Neurological lectures...Headaches

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  • 13. Migraine classification 1.1 migraine without aura 1.2 migraine with aura 1.3 periodic syndromes in childhood 1.4 retinal migraine 1.5 migraine complications 1.6 probable migraine
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  • 23. Treatment of migraine attack V. Triptans
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  • 30. Beta-receptor-blockers (propranolol 2x20-40 mg) Calcium channel blockers (flunarizine, 10 mg every evening) Side effects: provokes depression, increases appetite, cause sleepiness Tricyclic antidepressants (amitryptiline, 10-75 mg every evening) Antiepileptics (valproic acid, 2x300-500 mg) Use: hypertension, tachycardia Do not use: hypotension, bradicardia, heart conduction disturbances Do not use: obesity, maior depression in the history Use: if tension type of headache is present besides migraine Do not use: see above Few side effects, but Pregnancy should be avoided
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