12.10.30 Teaching notes
How long have you had headaches?
How often do you have headaches?
Are they becoming more frequent?
If daily, how long have they happened every day?
Where in the head are they?
What quality do they have?
e.g. pressing, throbbing, pounding etc.
How long do they last?
Are there any visual or sensory symptoms, if so how long do they last?
Is the headache associated with nausea or aversion to light (photophobia)?
Do you take medications for the headaches including painkillers?
c.f. medication overuse
How many attacks have you had?
When did they start?
What were you doing when the attack started?
Where you standing or seated/ lying when the attack started?
Was there any warning, or did the attack come on suddenly?
What was the warning like?
What happened next?
Was there a witness?
Establish if the patient actually collapsed to the floor / lost consciousness
Did you shake? For how long?
How long did it take to recover?
Spasticity affects the agonist, Rigidity is in both
=> Systematically check both directions at each joint
Upper limb extensors
Lower limb flexors
Types of spasm
Adductor (cross legs)
Flexor (bend legs)
Goes through the internal capsule
Crosses at the medulla
Drugs linked to myopathy
Myopathy tends to be proximal + symmetrical