Welcome to the New Year 2020! I have been missing-in-action for the past few months, just too much going on in life to be able to create any new posts. I am back and am committing to posting at least once per month from now on. I have been thinking a lot about resilience lately … Continue reading Resilience and the teen with headaches
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
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
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
There is much evidence and information in the literature about the general effect of concussion on kids and teens. Most pediatric practices and schools use specific protocols for concussion recovery and these plans generally work well. Unfortunately, for patients with headache, the story of recovery can be quite different. In this post, I would like … Continue reading The Impact of concussion on teens with headache
I have recently reviewed the basics of New Daily Persistent Headache (NDPH) so providers in the community can have a better understanding of this primary headache. It is often misdiagnosed, mainly due to unfamiliarity. And now that you have a better understanding, you will be able to recognize it more readily. One of the most … Continue reading The challenge of taking care of patients with NDPH
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 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
So you have identified one of your patients as having migraine. Now decisions have to be made about management. Important points to consider are: frequency of migraine, intensity of pain and/or associated symptoms, triggers, and lifestyle factors. Unless the patient is presenting with frequent or intractable migraine several times/week, the first things to review with … Continue reading All about the Migraine….part 2
The 3 most common subtypes of primary headaches commonly seen in pediatric patients are: migraine, tension-type, and new daily persistent headache. Children often have a combination of types, such as chronic mixed type headache, which generally combine migraine and tension-type headache. All primary headaches present differently and are often treated differently. Migraine is a well-known … Continue reading All about the Migraine…. part 1
HeadFirst PNP 