User-agent: Google Allow: A Simple Guide to Medical Conditions: clusters

Search This Blog

Showing posts with label clusters. Show all posts
Showing posts with label clusters. Show all posts

Saturday, November 3, 2007

A Simple Guide to Headache

A Simple Guide to Headache

---------------------------------

What is Headache?

----------------------

Headache is a very common complaint, not an illness.

It literally means pain in the head.

What are the Common Types of Headaches?

--------------------------------------------------

Tension headache:

-----------------

as defined by the International Headache Society is characterised by:

1.bilateral location

2.pressing/tightening (non-pulsating) quality

3. mild to moderate in intensity

4. not aggravated by routine physical activity like walking or climbing stairs.

It is the most common headache and may be associated with contractions of head and neck muscles due to physical or mental stress. The headache is made worse by changes in the environment, drugs, or factors unique to the individual.

It can also be classified into 2 side types:

episodic (<>

chronic (> 14 days a month on average and <>

Treatment can be divided into:

pharmaceutical

non pharmaceutical

Pharmaceutial:

can be divided into acute and prophylactic.

In acute treament simple painkillers is usually effective.

In prophylactive treatment,antidepressants like amitriptyline usually help in the prevention of tension headache.

Medicines should always be given at low doses and titrated up to therapeutic doses to minimise side effects.

Non-pharmaceutical:
1. rest

2. removal of aggravating factors.

3. relaxation exercises

Migraine:

-----------

is defined as a heavy throbbing pain usually over one side of the scalp, forehead and about the eye, caused by abnormally dilated blood vessels.

Migraine may be accompanied by nausea, vomiting or sensitivity to loud noises or bright lights.

It is also triggered by certain factors unique to the individual such as:

1.menstruation,

2.alcohol,

3.anxiety,

4.loud noises,

5.bright lights

A validated 3 items questionaire covering

1. disability

2. nausea

3. sensitivity to lights

should given to every patient to screen the severity of the migraine.

Treatment again is divided into:

phamaceutical

non-pharmaceutical.

Pharmacetical:

can be divided into acute and prophylactic.

In acute treament simple painkillers like paracetamol is usually effective in mild cases.

Non-steroidal anti-inflamatory drugs should be tried if paracetamol fails.

If NSAIDs are ineffective then migraine-specific drugs like triptans or ergotamine which act to constrict blood vessel should be tried.

In some cases anti-emetic drugs like stemetil to prevent vomiting is given together with the migraine medication.

In prophylactic treatment, the goals are to:

1. reduce frequency,severity and duration

2.improve function and reduce disability

3.improve responsiveness to treatment of acute attacks

Medicines used include:

betablockers

Calcium channel blockers

Serotonin receptor antagonists

Antidressants

Anticonvulsants

Angiotensin blockers

NSAIDs

Non-pharmaceuticals:

1.resting in a cool, dark and quiet room.

2.relaxation exercises

3.Solving the triggering factors also help.

4.Oestogen containing oral cotraceptives should avoided in menstrual migraine.

During pregnancy or lactation treatment should be non-pharmaceutical when possible. If necessary paracetamol is the safest drug for women during pregnancy or lactation.

Cluster headaches

----------------------

is defined as pain which occurs in runs with tearing pain over the forehead or behind the eye(s) with flushing of the face.

There are aura of stars,flashing lights etc associated with this headache.

The cause is beleived to be due to histamine release from ingestion of certain foods like cheese, seafood,alcohol etc.

It is more common in males.

Treatment is by

1.strong painkillers

2.avoidance of food triggers

3.rest.

What are Secondary headaches?

---------------------------------------


Secondary headaches refer to headaches associated with a known medical illness.

It is diagnosed by its close relation to a disorder that is known to cause headache.

The headache improves or disappear after successful treatment or spontaneous resolution of the causative illness.
1.Sinus headaches:

----------------------

are due to acute sinus inflammation attacks.

Pain is over the frontal forehead and the upper cheeks.

It may be associated with fever and heavy mucus production.

Treatment is by

1.antibiotics for the sinus infection,

2.antihistamines to reduce mucus production

3.painkillers

4.rest.

2.Referred headaches:

---------------------------

these are caused by by referred pain from disorders of structures around the head. Common ones are

1. earaches,

2. toothache causing pain over an entire part of the face and

3. temporomandibular joint dysfunction from mechanical pain from the jaw joint.

4. temporal arteritis, a rare inflammatory blood vessel condition causing persistent headache at the temporal artery. There is possible complication of blindness secondary to anterior ischemic optic neuropathy. The headache usually resolves or improves with 3 days of high dose steroid treatment.

3.Meningitis / Encephalitis headaches:

---------------------------------------------

caused by infection of the brain tissue (encephalitis) or the membranes surrounding the brain (meningitis).

Headache is the most common symptom. The pain is diffuse and progressive with fever, a painful stiff neck and other symptoms such as drowsiness, seizures and neurological problems including weakness and numbness.

This type of headache needs immediate hospital treatment.

4.Cerebrovascular Accidents (haemorrhagic stroke):

-------------------------------------------------------------

a stroke happens when a blood vessel in the brain is blocked or bursts.

Bleeding in the brain causes a sudden severe headache.

There is also associated loss of consciousness and other neurological signs such as weakness, numbness and seizures.

This type of headache needs immediate hospital treatment.

5.Brain Tumour:

------------------

is rare and causes a gradual headache lasting for weeks.

It is localised and associated with nausea, vomiting, loss of appetite and loss of weight.

It is worse in the morning and aggravated by coughing or leaning forward.

By the time neurological symptoms appear such as seizures, numbness, weakness or blindness, the brain tumour has already grown to an advanced stage.

Treatment includes surgery, chemotherapy or radiotherapy.

6. Other causes of secondary headaches are:

a.post traumatic headache following a head injury

b.whiplash injury

c.cerebral venous thrombosis

d. idiopathic intracranial hypertension

e. hydrocephalus

f. sleep apnea

g.cardiac cephalgia

h.acute glaucoma

Simple Treatment of Headache

-------------------------------------

Consume a painkiller.

Lie down in a dark, quiet room.

Use muscle relaxation techniques or a gentle massage.

For tension headaches, try a warm bath.

For migraines, put an ice bag or cold towel on your temple.

If the headache do not improve, go for a complete investigation of the headache.

What are the investigations done in Headache?

-------------------------------------------------------

You should be investigated for your headache if the headache has:

1. associated fever and and change in mental state.

2. numbness of part of the body or with paralysis.

3. associated fits.

4. sudden onset of severe headache

5. lasted for more than a day even after taking painkillers.

6. increased headache frequency.

7. appeared different from your usual type

8. been precipitated by coughing,sneezing,bending

9. associated with stiff neck and vomiting

10.appeared for the first time in middle age

Common tests:

Blood tests - for infections,raised ESR, bleeding disease

MRI of brain- to exclude brain tumours, bleeding in the brain

Lumbar puncture - used only if there is suspected infection of brain or meninges

Saturday, September 15, 2007

A Simple Guide to Mouth Ulcers


A Simple Guide to Mouth Ulcers
--------------------------------------

What are Mouth Ulcers?
------------------------------

Mouth ulcers are painful open sores or lesions in the mouth. They may appear white or yellow surrouded by red inflamed tissue.

Mouth ulcers occur either singly or in clusters, causing a lot of discomfort or pain.
They usually heal within 7 to 10 days.

What are the Causes of Mouth Ulcers?
--------------------------------------

There are many disorders which can cause mouth ulcers:
1. canker sore (aphthous),
2.leukoplakia,
3.gingivostomatitis,
4.oral cancer,
5.oral lichen planus and
5.oral thrush.

The most common mouth ulcer is Aphthous ulcer.
It is an open sore in the mouth, which appears as a painful white or yellow ulcer surrounded by a bright red area.

Who gets Mouth Ulcers?
---------------------------

Mouth ulcers may occur at any age, but usually first appear between the ages of 10 -40.
Women are more prone than men.

The cause is unknown.
There may be an inherited tendency or an immune system link.
Mouth injury such as dental procedures or aggressive tooth cleaning may cause mouth ulcers.
They may occur at the site of a bite when the tongue or cheek is bitten.
They can also triggered by stress, dietary deficiencies (especially iron, folic acid, or vitamin B12), menstrual periods, hormonal changes, food allergies, and similar situations.

What are the types of Mouth Ulcers?
-------------------------------------------

There are different types of mouth ulcers.

1.A single mouth ulcer is usually caused by damage to the mouth, like biting the cheek, or damage to the gum with a toothbrush or a sharp tooth or filling. They usually go away once the source of the problem is treated.
2.A recurrent ulcer is one that comes and goes, sometimes every few weeks.

Minor ulcers are the most common.
They usually appear inside the cheeks, on the lips, tongue, and gums.
Most of these ulcers are small, round and can sometimes come in clusters(four to six) at any one time.
Large ulcers are more severe, have an irregular border, and can last for 5-10 weeks. They usually appear near the tonsils and can be very painful, especially when swallowing. You usually only get one at a time.
Very rarely,some patients have up to 100 very small painful ulcers (herpetiform type), which last for one to two weeks.

Mouth Ulcers are very common.
About 20% of the population have recurrent mouth ulcers at some time in their lives.
Often they begin in childhood or adolescence.
Most people grow out of them by their late twenties.

What are the Symptoms of Mouth Ulcers?
-------------------------------------------------

Mouth ulcers usually appear on the inner surface of the cheeks and lips, tongue, soft palate, and the base of the gums.

They may begin with a tingling or burning sensation, followed by a red spot or bump that ulcerates.

Pain spontaneously decreases in 7 to 10 days, with complete healing in 1 to 3 weeks.

Occasionally, a severe occurrence may be accompanied by fever or lethargy.

Recurrence is common and may continue for years.
Most mouth ulcers are not infectious.

What is theTreatment of Mouth Ulcers?
-----------------------------------------------

The exact treatment will depend on the cause of the ulcer.
Sometimes all that is required is to remove the cause of the ulcer, such as a sharp tooth.

The following measures may help to reduce pain from mouth ulcers:
1.keep your mouth clean at all times,

2.avoid foods that are spicy, acidic, salty or particularly hot or cold, which can make the symptoms worse,

3.eat a healthy diet that includes fresh fruit and vegetables,

4.gargle with warm salt water,

5.use a diluted chlorhexidine mouthwash once a day to help reduce the length of time the ulcers last

6.sprays and rinses are also available for pain relief.

Medical treatment:
The main treatment of the mouth ulcer is application of topical corticosteroids (Kenalog in orabase or Oracorte E), or other soothing preparations.
Dry the area first with a cotton wool bud and then use a wet finger or the back of a spoon to put the cream on the sore area. You can use it up to four times a day after meals.
However, it is most effective to use this cream late at night as it stays there for longer.

What are the Prevention measures in Mouth Ulcers?
-------------------------------------------------------------

Good oral hygiene may help in the prevention of some types of mouth ulcers or complications from mouth ulcers. This includes brushing the teeth at least twice per day, flossing at least daily, and going for regular dental checkup and cleaning.

Healthy life style to avoid getting run down by making sure you eat a balanced diet, take regular exercise and learn to manage stress.

Subscribe Now: Feed Icon

Clicktale

Click and bookmark these Social Networking Bookmarks

Social Bookmarking bookmark at folkd

Labels

Is the medical Guide simple enough?

Ads by Adbrite