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Headaches-Primary Care Management PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "HEADACHES - PRIMARY CARE MANAGEMENT".
This medical PowerPoint presentation talks about primary care management of headaches.
Headaches are a common health problem that can affect people of all ages. There are several types of headaches, including tension headaches, migraines, and cluster headaches. Primary care providers play an important role in the management of headaches, including diagnosis, treatment, and referral as needed.

Tags : primary care management of headaches, headaches, tension headaches, migraines, cluster headaches, management of headaches, Child Neurology PowerPoint presentation, Neurology PowerPoint presentation

Published on : Mar 21, 2023 | Views : 689 | Downloads : 2

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Slide 1-

HEADACHES PRIMARY CARE MANAGEMENT
Slide 2-

Headaches-overview Primary headaches -Migraine -tension type -cluster headache/cephalgias -Others
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Headache classification Secondary headaches- Trauma Cranial/ cervical vascular disorder Substance or its withdrawl Infection Homeostasis related Neck , sinuses,eyes,nose, teeth Anxiety/somatisation
Slide 4-

Headache classification Neuralgias/other headaches Eg cranial neralgias, trigeminal neuralgia, atypical facial pain
Slide 5-

Headaches Affect 40% of UK population Migraine- 15% of population. Females:males 3:1 Tension headaches- 80% of population Cluster headache 1 in 200
Slide 6-

MIGRAINE
Slide 7-

Migraine management Look at predisposing factors -stress, fatigue,depression,anxiety,menstruation, menopause, head/neck trauma. -trigger factors-dietary (20%), relaxation, travel, missing meals/sleep, bright lights, noise, strenuous exercise, mensruation.
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Migraine Duration (hours3 days) Without aura in 2/3rd -unilateral, pulsating, moderate/severe intensity, aggravated by exercise, nausea/vomiting. Photophonophobia With aura in 1/3rd- spreading scintillating scotoma, unilateral paraesthesia, dysphasia
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Migraine-drug intervention Step one- simple analgesic+/- antiemetic Eg aspirin 600-900mg +buccastem 3-6mgbd Step two – rectal analgesic +/- antiemetic Eg diclofenac suppositaries+domperidone suppositaries Step three – triptans-use at onset of pain, not aura. Some rebound of symptoms in 20-50% of patients within 48 hours.
Slide 10-

Triptans Sumatriptan 50-100mg Zolmitriptan 2.5mg then rpt after 2 hours (not children) Rizatriptan 10mg (equiv sumatriptan 100mg) Almotritan 12.5mg-HIGH EFFICACY. COST EFFECTIVE
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Migraine prophylaxis Ineffective for medication overuse headaches Use for 4-6 months-taper off over 2-3 weeks. Agents: betablockers, TCAD, pizotifen, gabapentin, lisinopril Other agents-topiramate, sodium valproate, clonidine Non drug therapies
Slide 12-

Tension headache
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Tension headaches Chronic tension type headache:- -more than 15 days per month - often daily -often stress/lifestyle related
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Tension headaches Episodic tension-type headache- -may be unilateral but tend to be generalised - pressure/tightness - often spreads from neck -stress related or related to cervical/cranial musculoskeletal anomalies
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Tension headache management Lifestyle changes Regular exercise Drug treatments-acute-aspirin 600-900mg, ibuprofen 600mg, naproxen 250-500mg, paracetamol 500mg-1g Prophylaxis-amitriptyline, nortriptyline, propranolol, SSRIs
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Medication overuse headaches Affects 1 in 50 adults Females:males 5:1 First noted with phenacetin/ergotamine More common with aspirin/ NSAIDs/paracetamol/codeine/DF118 Can take several weeks to resolve after medication withdrawl Key feature-pre-emptive use of analgesia
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Medication overuse headaches-cont. Low doses daily carry larger risk than higher doses weekly Esp common if using simple analgesia more days than not per month Using triptans, codeine >10days per month Worse on awakening in the morning Worse after physical exertion
Slide 18-

Medication withdrawl headache-treatment Stage one-abrupt withdrawl most effective-Sx will worsen in days 3-7. Stage 2-recovery from MOH Stage 3- review and assess the underlying primary headache disorder Stage 4- prevent relapse Failure to withdraw- naproxen 250mgtds/500mg bd, tcad.
Slide 19-

References Mentor/GP notebook BASH (British Association for the Study of Headaches)-guidelines. www.bash.org.uk Neurological Differential diagnoses. Batten, J. 2nd edition.