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Medicine C.N.S. dffc5533

A female has episodic, recurrent headache in left hemicranium with nausea and parasthesia on right upper and lower limbs is most probably suffering from

A
Migraine
B
Glossopharyngeal neuralgia
C
Herpes zoster infection of trigeminal Nerve
D
Brain tumour
High-Yield Explanation
Ans. is 'a' i.e Migraine A female giving above mentioned symptoms is most probably suffering from migraine (classical migraine with Aura)migraine headache has the following characteristicsUnilateral locationPulsating qualitiesModerate or severe intensityFrontotemporal in locationAggravation by walking, climbing stairs or similar routine physical activityDuring headache at least one of the followingNausea or VomitingPhotophobia and phonophobiaIf the headache occurs in association with Aura then it is a classical migraine with Aura.Aura usually consists of Homonymous visual disturbance, hemiparesis, Hemisensory symptoms, Dysphasias or any combination of these symptoms.visual aura is most common and usually consists of photopsia & scintillation.sometimes basilar migraine in which headache is accompanied by brainstem symptoms.Glossopharyngeal neuralgiaThe patient gets brief attack of lancinating pain in the side of the throat radiating down the side of the neck, the back of the lower jaw and deep towards the inner ear. The attacks are precipitated by protruding or swallowing the tongue.Post herpetic trigeminal pain - Usually distinguished by h/o of zoster & residual scars, constant quality of pain over the distribution of the trigeminal nerve and sometimes sensory impairment over involved area.Brain tumour - May present with prostrating pounding headache that is associated with nausea & Vomiting. It is usually difficult to distinguish headache of migraine from brain tumour.

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