{"id":381,"date":"2017-03-26T13:56:12","date_gmt":"2017-03-26T13:56:12","guid":{"rendered":"http:\/\/papergp.com\/index.php\/neurology\/headache\/"},"modified":"2023-01-24T11:25:26","modified_gmt":"2023-01-24T11:25:26","slug":"headache","status":"publish","type":"page","link":"https:\/\/papergp.com\/index.php\/neurology\/headache\/","title":{"rendered":"Headache"},"content":{"rendered":"<div class=\"content-box-blue\">\n<h4><strong>Differential diagnosis<\/strong><\/h4>\n<ul>\n<li>Meningism &#8211; fever, neck stiffness, rash<\/li>\n<li>Raised ICP \/ SOL &#8211; postural, vomiting, drowsiness, personality change<\/li>\n<li>SAH &#8211; sudden occipital<\/li>\n<li>Temporal arteritis &#8211; jaw claudication, temporal artery tenderness<\/li>\n<li>Tension &#8211; mild, frontal pressure<\/li>\n<li>Medication overuse &#8211; analgesics more than twice per week<\/li>\n<li>Migraine &#8211; unilateral, throbbing, aura, nausea, photophobia, triggers, FH<\/li>\n<li>Cluster &#8211; rare, severe unilateral periorbital pain, lasts up to 3 hours, cluster of episodes in 3 months<\/li>\n<li>Eye strain &#8211; optician review<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4><strong>Data gathering<\/strong><\/h4>\n<ul>\n<li>Red flags\n<ul>\n<li>See above<\/li>\n<\/ul>\n<\/li>\n<li>Others\n<ul>\n<li>Change from previous headache<\/li>\n<li>Analgesia use<\/li>\n<li>Stress<\/li>\n<li>Timings<\/li>\n<li>Optician<\/li>\n<\/ul>\n<\/li>\n<li>Examine\n<ul>\n<li>BP, temperature<\/li>\n<li>CN<\/li>\n<li>Fundoscopy<\/li>\n<li>Temporal arteries<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"content-box-blue\">\n<h4><strong>Clinical management<\/strong><\/h4>\n<ul>\n<li>Investigations\n<ul>\n<li>No specific investigations needed but consider baseline bloods<\/li>\n<\/ul>\n<\/li>\n<li>\u00a0Treatment\n<ul>\n<li>Tension headache\n<ul>\n<li>Lifestyle\n<ul>\n<li>Exercise, fluids, CBT<\/li>\n<\/ul>\n<\/li>\n<li>Medications\n<ul>\n<li>Aspirin\/paracetamol\/ibuprofen<\/li>\n<li>Amitriptyline 10-150mg\/day (if not tolerated, try Nortriptyline)\n<ul>\n<li>only use medications &lt; twice per week<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Medication overuse headache\n<ul>\n<li>Stop causative analgesia (esp opiates)\n<ul>\n<li>Headache may get worse for days-weeks before improvement<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Migraine\n<ul>\n<li>See\u00a0<a href=\"https:\/\/papergp.com\/index.php\/neurology\/migraine\/\">Migraine<\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li>Safety-net \/ Follow-up\n<ul>\n<li>Refer\n<ul>\n<li>If therapy fails or uncertain diagnosis<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Differential diagnosis Meningism &#8211; fever, neck stiffness, rash Raised ICP \/ SOL &#8211; postural, vomiting, drowsiness, personality change SAH &#8211; sudden occipital Temporal arteritis &#8211; jaw claudication, temporal artery tenderness Tension &#8211; mild, frontal pressure Medication overuse &#8211; analgesics more than twice per week Migraine &#8211; unilateral, throbbing, aura, nausea, photophobia, triggers, FH Cluster &#8211; &hellip; <a href=\"https:\/\/papergp.com\/index.php\/neurology\/headache\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Headache<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":378,"menu_order":147,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-381","page","type-page","status-publish","hentry"],"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/381","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/comments?post=381"}],"version-history":[{"count":12,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/381\/revisions"}],"predecessor-version":[{"id":677,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/381\/revisions\/677"}],"up":[{"embeddable":true,"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/pages\/378"}],"wp:attachment":[{"href":"https:\/\/papergp.com\/index.php\/wp-json\/wp\/v2\/media?parent=381"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}