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Neurology Edited by Professor Emeritus Desire' Dubounet, IMUNE

Neurology Edited by Professor Emeritus Desire' Dubounet, IMUNE

Neurology Edited by Professor Emeritus Desire' Dubounet, IMUNE

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Headache: differential diagnosisDesignation Age at presentation and sex Timing of onset Localizationand type of pain Cocomitant symptoms Triggers Drug TreatmentMigraine Puberty, M < F, in childhood M > F Onset often in morning maylast24-72h, weekly recurrencesHemicrania or unilateral start, mainlyfrontotemporal, changing sides, boring, throbbing, patient retires to bed Nausea,vomiting, intolerance light and noise; possibly flickering scotoma, focal neurologicalsymptoms Some foods (cheese, chocolate), drinks (red wine), premenstrual,relaxation, alcohol, weather change Beta-blockers, calcium antagonists,sumatriptanCluster headache (migrainous neuralgia) Age 30-40 years, 80% malesNights, often same time, 20-120 min. Daily for weeks, free for monthsUnilateral periorbital, severe shooting pain, restless perambulationRedness of eye and forehead, ipsilateral tear and nasal secretion, Homer'ssyndrome None; occasionally alcohol, histamine, nitrateCorticosteroids, serotonin antagonists, lithium, sumatriptan oxygenChronic paroxysmal hemicrania Age 30-50 years, F > M Day andnight5-30min. No remissions Unilateral, shooting, boring Lacrimation, facial flushing andlid swelling None; rarely head movement IndomethacinTrigeminal neuralgia Older ages, more females Numerous daily attacks,lasting seconds. Free months to years Unilateral, mostly 2 nd and 3 rd divisionUnbearable, severe shooting, burning pain Anorexia, avoids speaking, shaving triggeringTouching trigger points, chewing, swallowing, cold airCarbamazepine, PhenytoinCranial arteritis Over age 50 years Day and night, continuous for

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