Bloody TACS
CGRP monoclonal antibody approved for preventive treatment of cluster headache
Galcanezumab (Emgality) 300 mg monthly
what imaging studies should be ordered in a patient presenting with suspected idiopathic intracranial hypertension?
MRI Brain + MRV Brain to rule out space occupying lesion, structural lesion, or venous sinus thrombosis
thought to be a migraine precursor; characterized by micropsia, macropsia, metamorphopsia, teleopsia, pelopsia
Alice in Wonderland Syndrome
first line treatment for Trigeminal Neuralgia
bonus: 3 lab abnormalities to monitor for
Carbamazepine and Oxcarbazepine
hyponatremia, leukopenia, transaminitis
triptan mechanism of action
bonus: name the 2 long acting triptans
5HT 1B/D receptor agonist
nratriptan and frovatriptan
Name the two TACs that respond absolutely to therapeutic doses of Indomethacin. Bonus: what is considered therapeutic dose of indomethacin
Paroxysmal Hemicrania
Hemicrania Continua
75 mg TID
MRI Brain finding in patient with suspected CSF hypotension
pachymeningeal enhancement
pain confined to a small circumscribed area of the scalp with no underlying structural lesion
nummular headache
elongated styloid process causing compression of nearby structures resulting in throat pain, dysphagia, odynophagia, globus
Eagle Syndrome
atogepant mechanism of action
small molecule CGRP receptor antagonist
lamotrigine
drugs associated with development of IIH (name 2)
tetracycline antibiotics
vitamin A derivatives (isotretinoin)
severe unilateral periorbital headache with painful and restricted eye movements
Tolosa Hunt Syndrome (inflammation in region of cavernous sinus or superior orbital fissure)
paroxysmal deep, boring pain felt within the ear canal. Provoked by touching trigger zones in the ear canal
nervus intermedius neuralgia
selective 5HT 1F receptor agonist
Lasmiditan (Reyvow)
Duration of cluster headache attack
15-180 minutes
first step in management of suspected CSF leak
nontargeted autologous high-volume epidural blood patch
CACNA1A gene mutation on chromosome c19q13
familial hemiplegic migraine 1 - cerebellar involvement (gaze evoked nystagmus, ataxia), prolonged hemiplegia
3 procedural options for patients with TN that have failed medical therapy
microvascular decompression
radiosurgery
balloon compression
acetazolamide mechanism of action
carbonic anhydrase inhibitor results in decreased CSF production
parasympathetic outflow from the superior salivatory nucleus
diagnostic test to identify leak site
CT myelography
Migraine with aura + stroke + dementia and other neurodegenerative symptoms
Diagnosis?
Gene mutation / chromosome?
diagnostic test?
CADASIL
NOTCH3 on c19q13.1
skin biopsy --> look for microangiopathy
Syncope associated with this syndrome results from activation of the carotid sinus, resulting in bradycardia and hypotension due to peripheral arterial vasodilation
glossopharyngeal neuralgia
side effects associated with erenumab (3)
injection site reaction, constipation (can be serious), new onset or worsening of existing hypertension