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
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
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
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
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 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
There are 3 groups of medications that are used to treat a migraine attack: migraine abortives, analgesia, and adjuncts. We have covered the migraine abortives (those medications specifically designed to stop the migraine attack) and analgesia (used to reduce pain) in the past 2 posts. There are several medications that are used either in combination … Continue reading Migraine medications to the rescue…..adjunct and combination therapies
So in the previous few posts I talked about the lifestyle factors important for migraine and headache patients. But even someone with excellent self-care, can still suffer from a migraine attack. After all, we have no control over weather changes, fire alarms, Aunt Betty’s strong perfume and other common triggers. So let’s talk about medications … Continue reading Migraine medications to the rescue
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
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