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Major auras in migraine
Visual
Sensory
Language
Percentage of migraineurs with aura
33%
How long does the aura in migraine last
5 to 60 mins
Differential for a aura in migraine
Ischaemia related
Seizure
Differentiate aura of migraine from ischemia related aura
Migraine aura has
SLOW MIGRATORY and SPREADING quality
SEQUENTIAL
Least common aura in migraine
Motor
The body that defines headache
International Headache Society
What is the biphasic quality of the migraine aura
Positive phenomenon appears first followed within a few minutes by negatve phenomenon
What are the language auras in migraine
Paraphasic errors
Word retrieval errors
Name the motor aura in Migraine
Hemiplegic Migraine
How long can the weakness in hemiplegic Migraine last
Hours to Days
Is there a biphasic pattern to the aura in a seizure
Yes.
But the rate is much much faster
Name a positive sensory aura in migraine
Tingling
Name a negative aura in migraine
Numbness
List two negative visual auras in migraine
SCOTOMA
VISUAL LOS
What is the classic visual aura seen in Migraine
Fortification Spectra
Another name for Fortification Spectra
Teichopsia
How are the lines arranges in a fortification spectra
At Right Angles
What Aura is this
Scintillations
Name the characterisic visual phenomenon in Migraine aura
SPARKLES
MACROPSIA
MICROPSIA
CEREBRAL POLYOPIA
PALINOPSIA
METAMORPHOSIA
PROSOPAGNOSIA
DYSCHROMATOPSIA
Alice in Wonderland syndrome in MIgraine
Distortion of body images
What is Acephalgic Migraine
Migraine Aura with the absence of headache
Causes for Persistent Visual Loss in Migraine
Retinopathy
Chroidopathy
Ant. Ischaemic Optic Neuropathy
Post. Ischaemic Optic Neuropathy
Drusen in Optic Nerve
Stroke in Migraine
Retinal Migraine
Causes for Retinopathy in Migraine
Retinal Artery and Vein Occlusion
Retinal Haemorrhage
Ant. Ischaemic Optic Neuropathy affects which part of the Optic Nerve
Optic Nerve Head
Most common cause of Optic Neuropathy in patients above the age of 50
Ant. Ischaemic Optic Neuropathy
Clinical features of Ant. Ischaemic Optic Neuropathy
Painless Visual Loss over days
Afferent pupillary defects
Nerve Fibre bundle or Central visual field defect
What is more common, AION or PION
AION
Which part of the Optic Nerve is involved in PION
Intra-orbital
Intra-canalicular
Intra-cranial part of the Optic Nerve
How does Ergotamine derivatives cause Optic Neuropathy
Vasospasm of the optic nerve vessels
What is Drusen
Hyaline crystalline material
What is the likely pathophysiology for Drusen
Persistent accumulation of calcium due to abnormal axonal metabolism
Symptoms in Optic Nerve Drusen
Asymptomatic
Mild nerve fibre bundle visual field defect
Stroke due to migraine is known to cause what type of visual field defect
Homonymous Hemianopia
What is the progression of Sensory Aura in Migraine
Begins in the arm or hands
Jumps to the face before reaching the shoulder
Spreads over the face and goes to involve the inside of the mouth and half of the tongue
What are the two pathophysiologic explanations for a Migraine Aura
Vasogenic
Neurogenic
What does the Neurogenic theory in Migaine Aura postulate
Cortical Spreading Depression
MRI is better tha CT Head ihi type of lesions
Post. Fossa and Cervico-medullary lesions.
Pituitary Lesions.
Meningeal Disease.
Vascular Lesions.
What meningeal diseases are better visualised with MRI
Meningel Carcinomatosis
Sarcoid
Diffuse meningeal enhancement due to low CSF pressure syndromes.
Vascular lesions better visualised on MRI
Cerebral Venous Thrombosis
Epidural and Subdural Hematomas
Brain infections better visualised on MRI
Cerebritis.
Brain Abscess.
Common malignancies that are associated with Radiation exposure
Leukemia
Thyroid
Breast
Lung
Stomach
What is the latency period for solid tumours following radiation exposure
10 - 20 Years
What is the Latency period for Leukemia fllng radiation exposure
3 - 5 Years
Why is the Pediatric population at higher risk for radiation exposure complications
Increased radiosensitivity
What is the total radiation exposure in pregnany while using Lead Shielding
1 mRad
When is the fetus susceptible to the teratonic effects of radiation
2 wk - 20wks
Indications for MRI Brain study during pregnancy
Cerebral Venous Thrombosis
Pituitary Apoplexy
Metastatic Choriocarcinoma
Advise given to lactating mothers following IV Iodinated contrast or gadolinium
Dicard the breast milk for 24 hours
How can the headches following LP be reduced
Using atraumatic needles ( Whitacare/Sprotte)
Replace the stylet before withdrawing the needle.
What percentage of Migraneurs can have onset of headche at the age of 50
2%
Significance of Hb in headache
Anaemia can cause headache
What % of hypothyroidism can cause headaches
14%
Significance of platelets in Headaches
Thrombotic Thrombocytopenia Purpura
What is the duration of Chronic Headaches
3 months
What are the various blood tests that need to be one in headaches
Hb
Platelets
RFT
TSH
Calcium
A Pituitary hemorrhage mimics what condition
Migraine
Pituitary Infarction mimics what
Aseptic meningitis
Meningo-encephalitis
Which sinusitis can mimic migraine
Sphenoid Sinusitis
Headaches that can awaken one from sleep
Migraine
Cluster Headaches
What % of migraneurs have white matter abnormalities
12 - 46%
WMA are more common in which part of the brain
Frontal Lobe
What should I suspect when migraneurs have extensive WMA
CADASIL
Anti Phospholipid AB Syndrome
What are the 3 causes for side-locked headaches
AV Malformations (95%)
Migraine with aura
Migraine without headache
Parenchymal AVM's are more common in which lobe
Occipital Lobe
What is the character of headaches in AVM
Atypical Headaches
AVM's in which location is usually associated with Migraine like headaches
AVM's in the brainstem
What are the phenotypes of Trigeminal Autonomic Cephalgia's (TACS)
Cluster Headaches
Hemicrania Continua
SUNCT (short lasting unilateral neuralgiform headaches with conjunctival injection and tearing)
Five characteristics of Hemicrania Continua
Unilateral
Moderate intensity
Continuous
Exacerbations
Relieved with Indomethacin
Author
jproenca@rediffmail.com
ID
51991
Card Set
Neurology
Description
On Headaches
Updated
2010-12-03T15:18:49Z
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