epileptic headache
Introduction
Introduction Epileptic headache, more severe pain, mostly deep pain, bursting pain, often accompanied by varying degrees of vomiting, signs of nervous system damage, convulsions, disturbance of consciousness, mental disorders and even changes in vital signs.
Cause
Cause
It may be caused by abnormal discharge of the brain part caused by various diseases. There are many causes of headache-type epilepsy. Some patients are related to genetics, trauma, birth injury and other factors. Active factors should be avoided, such as excessive mental stress, unpleasant mood, excessive fatigue, and impatience. In addition, diseases such as congenital diseases, infections, poisoning, intracranial tumors, cerebrovascular diseases, nutritional metabolic diseases, degenerative diseases, febrile seizures, etc. may also cause disease. Sufficient sleep has the potential to reduce seizures.
Examine
an examination
Related inspection
Cerebrospinal fluid pressure cerebrospinal fluid lactic acid
Found in adolescents and children, headaches are severe pulsating pain or bursting pain, seizures and terminations are more sudden, from a few seconds to tens of minutes, even up to one day, the frequency of attacks. May be associated with nausea, vomiting, dizziness, runny nose, tearing, abdominal pain, disturbance of consciousness or terror. EEG examinations often have epileptic waveforms in episodes, as well as other types of seizure history, family history of epilepsy, and related etiological history. Antiepileptic drugs can control seizures.
The examination should focus on the key points, that is, after considering the most likely one or several diseases according to the consultation materials, first check them to confirm or deny certain diagnoses as soon as possible. For example, patients with headache and vomiting should consider intracranial lesions if their medical history does not meet migraine, glaucoma, epilepsy, gastrointestinal lesions, etc., and a series of nervous systems and related laboratory tests should be performed as soon as possible until clarification diagnosis until.
Diagnosis
Differential diagnosis
First, migraine: As early as possible, one of the following methods can be used to relieve pain: oral ergotamine caffeine 0.1-0.2g, if it is invalid after half an hour, it can be taken 0.1g, the total amount per day does not exceed 0.6g. Intramuscular injection of ergometrine 0.2-0.5mg, can be repeated once after 1 hour. Intramuscular injection of sputum sputum 4-5mg or slow intravenous injection of 2-6mg (in 50% glucose 40ml). 0.5% novocaine is subcutaneously enclosed around the dilated brachial artery and so on. Arteriosclerosis, heart or brain vascular disease, and erotic preparations are avoided in pregnant women. Intermittent period To prevent seizures, oryzanol (20-30mg), propranolol (10-20mg), sputum (1-4mg) or phenylthiazine (0.5-1mg) can be used, three times/d. Can also take ergotamine butanolamide (the first dose of 0.5mg, gradually increased to 1-2mg, 2 times / d, no more than 6 months, contraindications with ergotamine), (1-4mg), phenylthiophene Pyridine (0.5-1 mg), three times / d. Gegen tablets, Chuanxiong injection, Chinese medicine for promoting blood circulation to remove blood stasis, intravenous injection of 0.5% novocaine (10ml each time, a total of 20-30 times), etc., also have a certain effect. For patients with severe disease duration, frequent seizures, ineffective drug treatment, and obvious dilatation of the radial artery, the superficial temporal artery ligation can also be performed as appropriate.
Second, cluster headache: ergot preparation can be used at the time of attack. In the intermittent period, the above drugs can also be tried, or 30 mg of prednisone can be used. After 3 days, it is changed to 5-20 mg, once a day or every other day, and the drug is stopped after 3 times.
Third, cervical migraine: cervical traction, while taking dilatation vasotherapy or activating blood circulation to remove phlegm Chinese medicine, and treatment of coexisting cervical thoracic radiculitis. You can also try to block the stellate ganglion. If the conservative treatment is ineffective and the symptoms are severe, it may be considered as a spondyloarthesis.
Fourth, muscle contraction headache: massage, hot compress, electric stimulation therapy and taking muscle relaxants and sedatives such as diazepam, tranquil tablets. It can also be blocked with 2% novocaine 1-2ml at the point of muscle tenderness. Acute cervical muscle strain caused by closure of cortisone acetate 1ml (plus 1% novocaine 1-2ml). Because of cervical vertebra hyperplasia or injury, cervical traction should be added, and the cervical collar should be added to consolidate the traction effect.
5. Neuroinflammatory headache: In addition to the treatment according to the principle of neuritis, you can use 2% slave ferry 0.5-1ml twice in the incision on the sputum, "wind pool", etc. (or add Vi.t B150mg or Vit. .B12 100 g) blocked, or once with 0.5 ml of absolute alcohol. Oral phenytoin or carbamazepine is also effective for analgesia. Cervical traction should be added to occipital neuralgia caused by cervical hyperplasia.
