Headache-focused neuro exam
Whenever I see a patient in my office, I spend most of the visit talking, getting to know the patient and family and getting a thorough history. Really, this is the most important part of the visit. But I always do a mostly a neurological focused physical exam. There are certain findings which are common … Continue reading Headache-focused neuro exam
Psychology and headaches, part 2
In this post, I will continue the conversation with Sarah Nelson, PhD, pain psychologist. Previously we talked about common psychological issues associated with headache, issues that affect coping and functioning for patients with chronic headache, dealing with resistance to accepting psychological help and barriers to care. What are the best screening measures to use in … Continue reading Psychology and headaches, part 2
Psychology and headaches, part 1
Psychological factors are known to play a role in pediatric headache. We know that stress is the #1 trigger for migraine for people of all ages. We also know that stress is a contributor/cause of tension-type headaches (stress headaches). And finally we know that patients with constant/chronic headache often have increased pain and decreased functioning … Continue reading Psychology and headaches, part 1
Gratitude
So it’s been just 1 year since I started this blog, posting regularly every 2 weeks. That was one of my intentions for 2018 and I am so glad I made it happen. I have learned a lot more about headache management in the process. I also learned that I do actually know a lot … Continue reading Gratitude
School and the patient with headache
Over the past year, I have covered many issues and situations in the care of kids and teens with a variety of headache diagnoses. What is the common denominator for all of them? SCHOOL! And your patient can find themselves either very supported or very challenged (or somewhere in between) in the school environment and … Continue reading School and the patient with headache
Migraine and concussion case study
So in the past few posts I have talked about the effect of a concussion can have on a patient with an existing headache diagnosis. Now let’s take a look at a classic headache clinic presentation as case study. I am using a composite of patients and situations, commonly seen in primary care. Background: Joe is … Continue reading Migraine and concussion case study
Concussion and the headache patient
In my last post I introduced the concept of concussion and the teenager with headaches. I would like to continue this topic by discussing what is helpful for these kids to help avoid disability and too much missed school. The first step we recommend is for them to see their PCP or even the ED … Continue reading Concussion and the headache patient
