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
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
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
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
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
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
HeadFirst PNP 