Headache Facial Pain Headache l 3 Main Headache
- Slides: 20
Headache & Facial Pain
Headache l 3 Main Headache Syndromes l Migraine l Cluster headache l Tension headache
Sinogenic Headache Non sinogenic
Trigeminal Nerve
Sinogenic headache ( International Headache Society Criteria) l l Frontal headache accompanied by pain in one or more regions of the face, ears, or teeth Clinical, nasal endoscopic, or CT and/or MRI and/or laboratory evidence of acute or acute-onchronic rhinosinusitis Headache and facial pain that develop simultaneously with the onset or acute exacerbation of rhinosinusitis Headache, facial pain, or both that resolve within 7 days of remission or successful treatment of acute or acute-on-chronic rhinosinusitis
Localisation of Pain Frontal sinus - Frontal, vertex, and retroorbital pain l Maxillary sinus - Malar region and upper teeth pain l Ethmoid sinus - Nasion and retro-orbital pain and pain that radiates to the temporal area l Sphenoid sinus - Vertex, occipital, frontal, and retro-orbital pain l
Sinogenic headache l Co-existing symptoms l Endoscopic evidence l Radiographic l Treat evidence sinusitis
Mucosal Contact Points
Primary Headache Syndromes l Tension headache l Migraine l Cluster headache
Tension Headache l Triggered by stress l Bilateral, non pulsatile l Relaxation therapy l Stress management l Counselling l Psychotherapy
Cluster headache Severe unilateral temporal headache grouped attacks over weeks to months l Males> females l 30 -40 years l Subcutaneous sumatriptan l Ergotamine l Corticosteroids l
Migraine Typical throbbing unilateral pain l > women l Nausea, aura, photophobia l Triggers l Flunarizine l Ergotamine l Beta blockers l Tricyclic antidepressants l Anticonvulsants l
Secondary Headache subarachnoid hemorrhage l meningitis l ICP too high or low l cerebral sinus thrombosis l pituitary apoplexy l TIA l Carotid artery dissection l Pain of dental origin l TMJ pain l …. many more l
Clues to Secondary Headache fever, seizure, behavioral change, etc l age >55 l posterior location l neurological deficit l abrupt onset/severe intensity: “thunderclap” l
Facial Pain l typical” vs. “atypical” l “symptomatic” vs. “primary”
Trigeminal Neuralgia: Diagnosis Table 1 Trigeminal Neuralgia: IHS Diagnostic Criteria A. B. C. D. E. Paroxysmal attacks of facial or frontal pain which last a few seconds to less than two minutes Pain has at least 4 of the following characteristics: (1) distribution along one or more distributions of the trigeminal nerve. (2) sudden, intense, sharp, superficial, stabbing or burning in quality. No neurologic deficit Attacks are stereotyped in the individual patient. Exclusion of other causes of facial pain by history, physician examination and special investigations when necessary.
Trigeminal Neuralgia: Treatment l pharmacologic l “procedural” l anesthesia dolorosa
Glossopharyngeal Neuralgia Paroxysmal pain l Originates in tongue base or tonsillar fossa l Provoked by swallowing, chewing or yawning l Hypotension, bradycardia, syncope l Carbamazepine l Glossopharyngeal neurectomy l
- Headache pain chart
- Facial veins and arteries
- Martian pain
- Sore breasts before period
- Pms or pregnancy
- Right side headache
- Dix hallpike
- Headache chart
- Headache red flags
- New york headache center
- Meao mudra benefits
- Pumcture
- Red flag sign headache
- Headache
- Infosys sabbatical leave policy
- Headache
- Rasmussen's encephalitis
- Improved
- Headache
- What is postictal confusion
- Anxiety headache