I have spent a little time introducing and reviewing New Daily Persistent Headache (NDPH), and what a miserable headache it is. We know that traditional headache medications and treatments are not particularly useful in alleviating NDPH. But there are some new initiatives available, some research initiatives and novel approaches to NDPH treatment which may bring … Continue reading What’s new with NDPH?
Let’s talk today about the story of NDPH, a primary headache not well understood or recognized, a zebra among headaches. The more we know about it, the more it is recognized. But that does not make it any easier to deal with as a provider or a patient. The first documented description of NDPH was … Continue reading More about NDPH
I have reviewed factors contributing to tension-type headaches, as well as some preventive strategies. In this post I will cover appropriate rescue medications, and talk about treatment for underlying anxiety, which often needs to be addressed for kids with tension-type headaches. Analgesia is a key part of a rescue strategy for TTH. Non-steroidal anti-inflammatory drugs … Continue reading Tension-type headache strategies
So you have diagnosed your teenaged patient with tension-type headaches, what are the next steps to prevent and treat them? The same questions apply to TTH as to migraine: Does this patient need a preventive or daily medication? What is the rescue plan? And even more importantly, what about the lifestyle factors that can trigger … Continue reading Tension-type headache treatments
In this case study we’ll look at a fairly straightforward patient, with some twists and turns and decision points along the way. Case Study: Patty is currently an 18 year-old teenage girl with a history of migraine headaches since age 9. You have been seeing her for years, and this is her story. At the … Continue reading Migraine case study, part 3
Here are the case studies with your possible interventions. Case Study #1: Sally is an 8 year-old little girl who you have known since birth. She’s happy and friendly, loves to play soccer and school, especially math. She met all of her developmental milestones, though you do remember that she did have colic as an infant. … Continue reading Migraine case studies, part 2
So your patient has developed chronic migraine, which is defined as 3-4 migraine per week, 15 migraine days per month, and is predictably miserable. Developing chronic migraine does happen in pediatrics, but it happens much more often in older teens and adults. You’ve done what you could to prevent it from happening: did a course … Continue reading Chronic migraine, what to do?
So when does episodic migraine transform into chronic migraine? Well, it’s a matter of frequency. The International Headache Society defines chronic migraine as more than 15 headache days per month over a three month period of which more than eight are migrainous, in the absence of medication over use (2-3+ times per week). Often your … Continue reading When migraine turns chronic
In this post, I am going to discuss the ins and outs of prescribing a daily medication for migraine prophylaxis. In the last post, I identified one migraine/week as a benchmark for considering a daily preventive medication. Here’s the run down on the basic daily meds that primary care providers could start for their patients … Continue reading Daily medications for migraines, part 2
So we have talked about lifestyle habits to prevent migraines, all the things your patient can do to prevent migraines. But your patient is still having frequent migraines or the migraines are significantly impacting the patient’s functioning. When do you consider adding a daily medication to prevent migraines? The mark I use for deciding when … Continue reading Daily medications for migraine, part 1