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
In this post, I am going to introduce you to another primary headache, new daily persistent headache (NDPH). This primary headache is not often seen in primary care, but I think our clinic population has about 25% of teens with this diagnosis. There’s a good reason why a referral to a specialty headache program is … Continue reading Introducing……… New Daily Persistent Headache
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
Starting this month, I am going to move on from migraine and start to review another primary headache, tension-type headache (TTH), commonly seen in children and teens. In earlier blog posts I discussed lifestyle factors for good headache hygiene. All of those recommendations can be applied to any headache type, including TTH, and I refer … Continue reading Talking about Tension-type headaches
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 I feel like we have comprehensively covered pediatric migraine in my previous posts. Let’s look at a few case studies to see migraine management in action in primary care, looking at a variety of typical patients with migraine over the years, childhood to young adolescent to start. I will present 3 patients to consider … Continue reading Migraine case studies
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?