Discover and read the best of Twitter Threads about #headache

Most recents (24)

Migraine attacks can get triggered by sleeping less as well as oversleeping

1. 29-yr old presented with features of chronic #Migraine for 8 years. Among the triggers for headache, he mentioned lack of sleep as well as oversleeping (>9 hours/night).
#MedTwitter #Headache #sleep
2. Lack of sleep is a well-known trigger for migraine attacks.
People with migraine have a higher risk of insomnia and people with insomnia have a higher risk of developing migraine. Those with insomnia also have a higher migraine frequency & severity.
3. Oversleeping too can trigger migraine attacks. This is often referred to as "weekend migraine". The person wakes up in morning (after sleeping >9 hours) with headaches.…
Read 4 tweets
Woman in whom #migraine #headaches were triggered by financial dependence on husband

1. 35-year old Mahima- "Dr, my husband locks entire cash in a safe and takes the keys to office. I have no back account, so can't use UPI on mobile. I can't even buy a chocolate for my son."
2. Mahima had been consulting me for three months for frequent headaches, which were suggestive of migraine.
She was properly following my prescription, however, she still used to get 2-3 episodes of #headache every week.
I enquired with her about possible #stressors.
3. She had no interpersonal issues with in-laws or other family members and had no problems in marital life.
She was a housewife and had no source of income. She was dependent on husband for every expense, including buying small gifts for her son and even for emergency expenses.
Read 9 tweets
A woman in whom "pain-reliever" became "pain-giver"

1. 35-year old woman, known case of #migraine for 12 years, presented with increased frequency & severity of headaches for past 6 months (#headache occurred every single day in the past 3 months).
#MedTwitter #neurotwitter
2. Headache started early in the morning on awakening, after which she would take pain-relievers (sumatriptan, naproxen or ergotamine), which would relieve her headache for 4-6 hours, only to return by early evening. She would consume 30-40 tablets of pain-relievers every month.
3. She had disturbed sleep and also had features of #anxiety and #depression.
Headache, taking "pain-reliever" tablets, short duration pain relief followed by rebound headaches after 4-6 hours, occurring on daily basis had become a vicious cycle for her.
Read 9 tweets
Case of a woman in whom “Runny Nose” was caused by a Brain Disease

1. 35-year-old woman presented with intermittent #runny #nose and #headache of one month duration.
Local physician suspected #sinus infection, treated her with a course of antibiotics, with which she improved.
2. Symptoms recurred one week back after which she consulted me for a “permanent cure of her sinus infection”.
I decided to delve deeper into the history.
#MedTwitter #neurotwitter
3. Runny nose occurred only from left nostril. It occurred 4-5 times per week.
Discharge from nose was watery and it increased on bending the head downwards.
Read 12 tweets
Regular #exercise effectively reduces #headache days in patients with #migraine

1. Migraine is a disabling disease that causes repeated episodes of headaches.
Exercise is very effective, however, it is uncommonly prescribed in migraine.
#MedTwitter #neurotwitter
2. In a recent research, strength/resistance training reduced monthly migraine days (MMD) by 3.5 days, followed by high-intensity aerobic exercise (3.1 days) and moderate intensity aerobic exercise (2.2 days).
3. All exercise modalities showed higher efficacy compared to placebo.
The reason for strength/resistance training to rank top could be because of targeted muscular strengthening and reconditioning, particularly involving major muscles in the neck, shoulders and upper limbs.
Read 12 tweets
A teenager who continued enjoying the pleasurable #emotions induced by hot water bath until he became unconscious during one such bath

1. Here I am sharing the case of a 18-year old boy who used to experience extremely pleasurable emotions every time he poured water on his head
2. He loved taking #bath with #hot water. This was not just for the comfort of warm water sensation over his body, but also for the pleasurable sensations & emotions that used to start in his body & mind soon after he poured hot water on his head.
#MedTwitter #NeuroTwitter
3. He described the feeling as if he got transcended to another world, with feelings of extreme elation and happiness. These feelings increased as he continued pouring more hot water on his head. These had started about a year back. He hadn't shared this with his family members.
Read 7 tweets
Reasons I love #neurology
1. 2022 is my 25th year in Neurology. I enjoy this subject many times more than 1998, when I entered this branch as a #resident at @OffCMCVellore I was dissuaded by many of my teachers to take up DM in another specialty but I stuck to Neurology
2. Neurology is vast: If you love reading, there are several topics you can read. There are about 600 common #diseases in Neurology to read about. Newer diseases are being discovered, so there is no dearth of new topics to learn about.
3. History & physical examination are still the most important to arrive at a diagnosis. Whether it is epilepsy, migraine, stroke, Parkinson's disease or Alzheimer's disease, history & physical are more valuable than any investigations. MRI, EEG & EMG contribute but are not final
Read 11 tweets
Amy Offutt, MD: Rickettsial & Related Diseases
#RMSF Rocky Mountain Spotted Fever
#ILADS2022 ImageImage
2/Offutt Ticks are the primary vectors for spotted fevers; some species may be spread by fleas and mites #ILADS2022 #RMSF #Richettsia
3/Offutt: #RMSF is the most severe rickettsial illness in the US with risk of death. Early treatment with #doxycycline is critical, regardless of age #ILADS2022 Image
Read 10 tweets
1/”You want me to put my needle where??” my fellow asked incredulously. It’s daunting, but it works—image-guided sphenopalatine ganglion blocks
Here’s a #tweetorial about this underutilized but effective procedure! #medtwitter #neurology #headache #migraine #neurotwitter #FOAMed
2/Sphenopalatine ganglion (SPG) is the largest collection of neurons outside the brain—like a mini brain just for your face. It contains sensory, sympathetic, & parasympathetic nerve fibers. Given this, it’s not surprising that it’s felt to contribute to facial pain syndromes
3/SPG is a meeting point for the sensory nerves from V2 (thus related to trigeminal neuralgia) & the sympathetics and parasympathetics from the greater superficial and deep petrosal nerves, which have been implicated in cluster headache, migraine, & other facial pain syndromes.
Read 10 tweets
What is a spontaneous spinal CSF leak?

It’s so much more than a headache. It’s extremely debilitating.

When I experienced a CSF leak in 2014, I had to lie down all day every day for several months.

#leakweek2022 #csfleak #spinalCSFleak #SIH #headache…
Sometimes people are wrongly diagnosed with postural orthostatic tachycardia syndrome #POTS when it’s actually a spinal CSF leak.

I gave a short talk at the PoTS UK London Masterclass in December 2019

#leakweek2022 #CSFleak #spinalCSFleak #SIH #headache

I was interviewed for the National Migraine Centre HeadsUp Podcast about my experiences with a spontaneous spinal CSF leak (Series 2, Ep 6) to help educate healthcare professionals & patients

Sometimes a #CSFleak is misdiagnosed as chronic #migraine

#headache #SIH #leakweek2022
Read 4 tweets
1/Kids now out of school? Headache already?? Usually neuroimaging doesn’t add much in headaches, but in occipital neuralgia MR neurography can add a lot.

A🧵about the use of MR neurography in occipital neuralgia
#MedTwitter #MedEd #neurorad #FOAMed #Headache #occipitalneuralgia Image
2/ There are actually 3 occipital nerves:greater, lesser and least. They arise from the upper cervical nerves and innervate various areas of the dorsal scalp. The greater occipital nerve is the only one large enough to image and it arises from C2 Image
3/The greater occipital nerve is the largest cutaneous nerve in the body and can be traced from its origin at the dorsal ramus of C2 along the scalp in MR neurography Image
Read 6 tweets
1) Welcome to a #tweetorial on what every #ICU #nurse should know about #hypertensive crisis, or #hypertensive #emergency as it is now more properly termed. I’m Bryan Boling @bryanboling, ICU #NP, & co-host of the @icuscenarios podcast. Follow this 🧵for 🆓CE/#CME credit!
2) This accredited educational activity is intended for healthcare providers & is supported by grants from AstraZeneca, Bayer, & Chiesi. Faculty disclosures Like ❤️this topic? More CE/#CME on #hypertension mgt at….
3) So let's start with a case: 65yo ♂️, presents to the #ED with #headache, lethargy & confusion. PMH: #HTN, #hyperlipidemia, #DM2, COPD. Initial VS: HR 85, BP 205/120, T 37.2 RR 12, SpO2 92% on RA. Family reports that he has been more lethargic over the past 2 days.
Read 37 tweets
High levels of an #infection in #Massachusetts is causing both gastrointestinal (#diarrhoea, #vomiting) & respiratory (#cough, #sinus, #headache) symptoms WITHOUT typical fever or runny nose - School children & parents/guardians across #boston suburbs affected for last 3 weeks.
Note the CDC data suggests very little SARS-CoV-2 (Omicron) or influenza (flu) at this time in Massachusetts or Connecticut or New Hampshire. So diagnostic tests being used are not catching this circulating pathogen, or a seasonal coronavirus/norovirus/adenovirus is the culprit
According to the data on SARS-CoV-2-positive PCR tests there is very low levels of COVID-19 over last 3 weeks in Massachusetts, CT, NH, RI & VT. Yet there are several #school #children, #teachers and #parents with gastrointestinal & respiratory #infection symptoms in these states Image
Read 12 tweets
A lot of people mistakenly believe that to become a professional trader you need to have a degree in commerce, mathematics or economics.

This is due to a huge misconception that Forex/crypto trading is complicated. FALSE!

It’s not a prerequisite to have any fancy university degrees or other qualifications in any special fields to become a trader.

In fact, the ‘high school dropout’ has just as good of a chance of becoming a successful trader as any doctor, engineer, or physicist would.
Actually, the high school dropout probably has a better chance to succeed in the market over a seasoned mathematician.
The humble high school student is able to read things at the surface level and be content – not over complicating the issues by trying to understand...
Read 5 tweets
#Migraine is a neurological disorder, not a terrible, disabling #headache," expert @DavidDodick explains. #Pain is "just 1 clinical manifestation deriving from a sensory processing disturbance affecting the nervous system" (Morgan, Lancet 2020). /Thread…
Billie lost her insurance when #migraine disabled her: “There are days I don't see anything except for shapes." Visual warnings are the most commonly recognized auras, but these symptoms are highly variable, both in different patients & on different days for the same patient. 2/
Difficulty speaking or speaking clearly is another common #migraine symptom, either preceding or during an attack.

Poor St. Husband. He watched this clip & said, "Yup, that's you." I spent a lotta years in school to talk like this. 3/
Read 7 tweets
#Migraine is the most common & disabling brain disease, but @SocialSecurity still doesn't recognize it as potentially disabling, making it much harder for people to qualify for earned benefits.

🔵Bookmarkable Thread! Info about #SSDI & #disability for migraine.
Globally, #migraine is the #1 cause of disease-related #disability for people 10-24 & the 4th cause for people 25-49. Yet @SocialSecurity still doesn't treat it as a potentially disabling disease.… Image
Severe #migraine is profoundly disabling. The World Health Organization uses objective metrics to determine disease burden & ranks severe migraine in the highest category of disability alongside terminal-stage cancer.

Shame on @SocialSecurity. Image
Read 24 tweets
@ravensspirit68 @funchefchick @NitaGhei @StefanKertesz @AllysonVarley @PainPtFightBack @LelenaPeacock @tal7291 @urbanfatbiker I'm working on a big annotated bibliography of #cpp/rx #opioid research that I'll put online for activists to use. Here are studies I've got on #CPP-associated #suicide. Send me titles & authors for papers I'm missing & I'll add them. I'll link them below.
Tang et al 2006 review: Risk of death by #suicide at least doubled in #ChronicPain patients. Ideation is 3 times more common; lifetime prevalence of about 20%. 8 risks for suicidality in chronic pain were identified, half are physical.…
Tang et al: 8 risks for #suicide in #ChronicPain patients: 4 are physical, including type, intensity & duration of pain & sleep-onset insomnia co-occuring with #pain; 4 are psychological. CP is a neurological suicide risk AND a psychological risk.
Read 15 tweets
Med Schools offer almost no instruction in the world's #1 cause of working-age disability. It'd be like Dental Schools not covering cavities.

7 words diagnose most #migraine: Recurrent #pain w/ hypersensitivity &/or nausea. 60% of patients go undiagnosed. #MedicalTwitter #PCP
#Migraine is PROGRESSIVE. A 40% diagnostic rate condemns some to lifelong #disability: Late diagnosis & ineffective treatment of acute #migraine are leading risks for continuous migraine. #PCP #MedicalTwitter…
🔴HOW DOES THIS CHILD GO 8 YEARS WITHOUT A DIAGNOSIS? She has textbook ICHD-3 #migraine! 1>sudden hypersensitivity (smell) 2>throbbing #pain 3>nausea 4>need for bedrest

She might've avoided #disability w/ early diagnosis & treatment. #PCP…
Read 10 tweets
1) Migraine Premonitory(Prodromal) Phase::
Presences of non-painful Symptoms, which can start hours to days before the onset of migraine pain and can be predictive of an impending headache.
2) Three Separate Groups of Symptoms::
1::Fatigue & Cognitive changes...
Concentration difficulty, Irritability, depression, fatigue, memory impairment.
2::Homeostatic Changes...
Food craving, Thirst, Yawning, Increased Urination, Sleep disturbance.
3) 3::Sensory Changes...
Photo, phono, osmo, Phobia, nause, neckstiffness.
Read 7 tweets
1) Migraine with AURA::
Recurrent attacks of unilateral fully reversible visual, sensory, or other CNS symptoms that develops gradually over minutes and usually followed by Headache and associated Migraine Symptoms.
2) Total 20-40% prevalent,Increased risk in 1st degree Relative + twins + Heritibility. Onset::
Gradual and progressive, unlike abrupt in Stroke.
AURA consists of Positive symptoms like flashing lights, and paresthesia while stroke dominates Negative symptoms like weakness.
3) Duration::
Typically 30 minutes but may be Prolong upto 4 hours. Symptoms::
Visual(90%,most common) > Sensory, language, motor.
Scintillating scotoma, Flashing lights, Blurry Visions.
Read 12 tweets
#PARENTS: If kids wet the bed over age 5, they might be at higher risk for the onset of #migraine. If they're over 5, peeing while sleeping AND have #migraine or #headache, the bedwetting is likely neurological, not behavioral. /thread…
The relationship bwn #migraine & #sleep disorders is well known: sleepwalking, sleep terrors, insomnia, and, in kids, betwetting over age 5.

The same abnormalities in brain structure & function that make migraine also make sleep disorders.
Migraine & sleep disorders share "common pathophysiological substrates. In particular, the increased prevalence of #migraine in patients with #sleep disorders is associated with the hypothalamus regulation of circadian rhythm" (Ferrara 2016).
Read 15 tweets
Study found that head pain (#migraine & #headache) has the "strongest association with suicidality" of all types of #pain. The risk is independent of depression & likely linked to altered functioning of serotonergic systems, not poor coping (Ilgen et al).…
"People with chronic #headache or #migraine were 4.3 times more likely to think about suicide, 4.6 times more likely to plan suicide, & 6.5 times more likely to have attempted suicide in the past 12-months than those without chronic headaches" (Ilgen).
Multiple studies report a particularly strong relationship between #migraine & #suicide. But "even after controlling for depression, anxiety disorders, & substance use disorders," most types of severe &/or #ChronicPain are "associated with suicidal thoughts and attempts" (Ilgen).
Read 6 tweets
The Vertebral Artery Test Part II:

Risk assessment of the cervical spine

4 clinical cases to try and make sense of risk assessment.

Of interest to ALL #Physiotherapy #PhysicalTherapy #FCP clinicians #Neck #Headache #Haemodynamics #Risk #VBI #CAD

A consideration of major or serious adverse events.

#Risk #LossOfVision #Stroke #Death #VBI #CarotidArtery #CAD Image
Into the 4th decade we go!

#Physio #PhysicalTherapy #VBI #CervicalSpine #Risk

How do we move forward from here? Image
Read 5 tweets

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