Primary headache syndromes and epilepsy classification with first-line treatment, distinct from the lesion-localization focus of USMLE Neuro.
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- How long does a typical untreated migraine attack last?
- 4 to 72 hours
- What is the classic pain quality and laterality of migraine headache?
- Unilateral, throbbing (pulsating) pain
- Which gastrointestinal symptom commonly accompanies a migraine attack?
- Nausea and vomiting
- Which sensory symptoms commonly accompany a migraine attack?
- Photophobia and phonophobia
- What is the most common visual aura symptom in migraine with aura?
- Scintillating scotoma (a shimmering, expanding visual disturbance)
- What is the first-line abortive drug class for moderate to severe migraine attacks?
- Triptans
- What is the mechanism of action of triptans?
- Selective agonists at serotonin 5-HT1B and 5-HT1D receptors, causing vasoconstriction
- Triptans are contraindicated in patients with which condition?
- Coronary artery disease or other vasospastic/ischemic conditions
- Name a first-line beta-blocker used for migraine prophylaxis.
- Propranolol
- How is a tension-type headache classically described?
- Bilateral, band-like or pressing pain of mild to moderate intensity
- What is the first-line treatment for tension-type headache?
- NSAIDs or acetaminophen
- How is cluster headache pain classically described?
- Severe, unilateral periorbital or retro-orbital pain
- What ipsilateral autonomic symptoms accompany cluster headache?
- Lacrimation, rhinorrhea, ptosis, miosis, and conjunctival injection
- What is the first-line acute treatment for a cluster headache attack?
- 100% oxygen by mask
- Which triptan formulation is used for acute treatment of cluster headache?
- Subcutaneous sumatriptan