NYERI KEPALA

Zainuddin Arpandy
 EPIDEMIOLOGI
Termasuk dl 10 penyakit terbanyak
produktifitas
78% dan 64% pernah
merasakan paling sedikit 1x/th
35% & 19% menderita NK
rekuren
 ETIOLOGY
C = Circulation (ICH, SAH)
E = Encephalomeningitis
M = Migren
E = Eye
N = Neoplasma otak
T = Trauma kapitis
E = Ear & Nose (THT)
D = Dental (gigi dan gusi)

C = Cluster Headache
O = Otot (TTH)
A = Arteritis temporalis
T = Trigerminal neurologia
 DEVELOPMENT OF
HEADACHE HYPOTHESES

Unpleasant sensation
Gate control
perceived from the head, Theory (1960)
commonly produced by
processes which damage
or are capable of dama-
ging bodily tissues.

Somatic sensory
IMBALANCE component and
HYPOTHESIS aversive affective
component
Kandel et al, 2000
 IMBALANCE HYPOTHESIS

Excitatory Inhibitory
Transmision Transmision

NORMAL BALANCE

IMBALANCE HEADACHE
 PATOPHYISIOLOGY
1. Dilatasi /displacement pemb drh
intra-kranial
2. Dilatasi pemb drh ekstra-kranial
3. Iritasi Meningen
4. Kompresi Langsung N.V, IX dan X
5. Referred pain dari Mata, THT, gigi,
Tlg Leher (spondilosis cervicalis)
6. Kontraksi otot kepala (tension type
headache)
ORTHOMOLECULAR ECOLOGIC PATHOLOGY OF PAIN

Maladaptive symptoms
Micronutrients def
e.g pain

Food/chemical maladaptive Cell malnutrition

allergic reactions

Impoverished biochemical
environment

Leeney, Rinkel, Philpott

BERHUB.: TIK
DEF.
NEUROLOGIS
 TANDA BAHAYA
NK hebat, mendadak
NK memburuk secara progresif
Onset disertai batuk, kegiatan seksual
dan kegiatan fisik lainnya
Disertai ggn kesadaran, ggn memori,
malaise kronis, mialgia, arthralgia,
demam, ggn penglihatan progresif,
kelumpuhan, hilangnya keseimbangan
Onset pertama pada usia > 50 th
 N.K.Primer N.K.Sekunder

Migren Meningitis
TTH SAH/ICH
CH Tumor otak
TN Artritis servikal
AT
BIH (Benign
Intracranial
Hypertension)
MIGREN
-CLASSIC (dgn Aura)
-COMMON (tnp Aura)
= MIGREN MERAH
 BIH (Benign Intracranial
Hypertension)
TIK tanpa lesi / hidrosefalus
Mostly: wanita >45 th & obesitas
Etio: Intoxic Vit. A
Tetrasiklin
Kortikosteroid withdrawal
Gejala: sefalgia diffuse, diplopia, visus me, papil
edema tnp def. neurologis kec. N.VI
 MANAJEMEN
Simptomatis
Etiologis (CEMENTED COAT)
Diet
Preventif
Rehabilitatif
Psikoterapi

NK9
 Penatalaksanaan Migraine
Istirahat
Hindari pencetus
Kompres dingin
Diet & Mikronutrien
Medikamentosa :
a. Abortif /serangan
- Analgetik : ASA, Indomethacin, Ibuprofen
- Ergotamin
- Sumatriptan
- Tranquilizer
- Metoclopramid
b. Prevensi
Untuk frek serangan > 2x/bulan
- blokers
- Pizotifen
- Methysergid (anti serotonin)
- Flunarizin (Ca Ch Bloker)
- Amitriptilin

Mig11
 Penatalaksanaan TTH
Informasi & Edukasi
Mikronutrien
Analgesik
Tranquilizer
Muscle relaxant
Anti depresan
Latihan relaksasi
 Prinsip Manajemen TTH
.

stress kontraksi otot vasokonstriksi

nyeri zat vasoaktif

TTH2
Masase untuk NK
SENAM BAHU DAN KEPALA