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Medication Causes of Headache

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21. Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Headache

349 headache, acute onset headache, acute primary headache, sudden acute headache, sudden onset headache, non- 350 traumatic headache, migraine, opiate, opioids, analgesic, narcotic analgesic agent, drug therapy, emergency, 351 emergency health service, hospital emergency service, emergency ward, emergency medicine, emergency care, 352 emergency treatment, emergency department, emergency room, emergency service, and variations and 353 combinations of the key words/phrases. Searches included (...) the following clinical questions: (1) In the adult emergency department patient presenting with acute headache, are 60 there risk-stratification strategies that reliably identify the need for emergent neuroimaging? (2) In the adult 61 emergency department patient treated for acute primary headache, are nonopioids preferred to opioid medications? 62 (3) In the adult emergency department patient presenting with acute headache, does a normal noncontrast head 63 computed tomography scan performed within 6 hours

2019 American College of Emergency Physicians

22. gammaCore for cluster headache

to treat cluster headaches. Existing medications for cluster headaches are often only partially effective and may cause serious side effects. Clinical evidence shows that, for some people, using gammaCore as well as standard care reduces the frequency and intensity of cluster headache attacks and reduces the need for medication. This is likely to lead to significant quality of life benefits for people living with this condition. Cost analysis suggests that using gammaCore may lead to cost savings (...) gammaCore for cluster headache gammaCore for cluster headache Medical technologies guidance Published: 3 December 2019 www.nice.org.uk/guidance/mtg46 © NICE 2019. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-of- rights).Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected

2019 National Institute for Health and Clinical Excellence - Medical technologies

23. 34m with fever, headache and myalgias

pain in his bilateral lower extremities, particularly in his calves, without any weakness or parasthesias. He also experiences a bi-frontal, throbbing headache over this time period, without any photophobia, nausea, or vomiting. He feels generally fatigued with a poor appetite and decreased PO intake. He takes ibuprofen 600mg every six hours and gabapentin 300mg nightly, but these don’t bring him any relief. Three days after his symptoms begin, he presents to an outside ER where he is diagnosed (...) because the doxy wasn’t appropriate, or was it not quite strong enough for what he had? Or, I did wonder perhaps the medication itself did help, but his underlying condition flared in the setting of systemic therapy. And the particular thing to watch out for would be the systemic inflammatory response from antibiotics in spirochete-induced diseases, the Jarisch-Herxheimer reaction. So his lack of response to the antibiotic I think could be interpreted in a lot of different ways. It still keeps our

2019 Clinical Correlations

24. Headache

Appropriateness Criteria ® 13 Headache Paroxysmal hemicranias are more frequent, and individual attacks are shorter in duration when compared with cluster headache. MRI of the brain with and without contrast should be performed in all patients with paroxysmal hemicranias. Trigeminal neuralgia is diagnosed by history, clinical evaluation, and the presence of paroxysmal and shock-like pain with a trigger zone in the distribution of the fifth cranial nerve. For trigeminal neuralgia refractory to medical therapy (...) are relatively similar with 83%–99% sensitivity and specificity [62]. MRA of the neck is most commonly performed with gadolinium contrast, whereas MRA of the head is most commonly performed without contrast. MRA of the brain with contrast is generally indicated if embolization coils or intracranial stents have been placed [63]. Headache of Trigeminal Autonomic Origin Trigeminal autonomic cephalgia is a group of primary headache disorders characterized by pain in unilateral trigeminal distribution

2019 American College of Radiology

25. Effectiveness of Manual Therapy vs Exercises With Foam Rolling for Tension Headache

month after treatment. The investigators will evaluate aspects such as the average pain of headaches, the impact, disability, quality of life, self-satisfaction and pain at the pressure of painful points of the trapezius and suboccipital muscles. Condition or disease Intervention/treatment Phase Tension-type Headache Other: Manual Therapy protocol Other: Foam Rolling protocol Other: Placebo control Not Applicable Detailed Description: Introduction Primary headaches occupy an important field (...) with headache less than 15 days per month and other types of primary headache, as well as those associated with drug abuse and those who do not meet the criteria established by the IHS, will be excluded from the study. Experimental treatment The patients will be randomly assigned to 3 different groups (one group of treatment with manual therapy, one group that will receive massage and another group of placebo control). The treatment will last for 8 weeks (4 weeks of treatment and 4 weeks of follow-up

2018 Clinical Trials

26. Medical History in Art: A brief history of one of the most symbolic tools in medicine

Medical History in Art: A brief history of one of the most symbolic tools in medicine Medical History in Art: A brief history of one of the most symbolic tools in medicine - CanadiEM Medical History in Art: A brief history of one of the most symbolic tools in medicine In by Tetyana Maniuk March 31, 2018 Laennec – Unknown artist (Click for larger image) Yesterday (March 30th, 2018) was National Doctor’s Day in the United States, and we thought it would be fitting to do a feature on arguably one (...) was intently listening to the complaints of a young woman with chest pain. As any astute physician would do, Laennec needed to examine the heart. Unfortunately, the heart was rather inconveniently placed behind this patients ample chest. 3 He attempted to palpate and percuss the front of the chest, but found that the use of this was “ of little avail on account of the great degree of fatness “. With palpation and percussion of no use, he could only turn to immediate auscultation. However, placing his head

2018 CandiEM

27. Drug-Drug Interactions in Headache Medicine. Full Text available with Trip Pro

Drug-Drug Interactions in Headache Medicine. The main treatments in a majority of headache patients are pharmacologic therapies. As a result, it is imperative to have strong background in pharmacotherapy used to treat headaches in order to provide optimal therapy and avoid drug interactions. One of the main reasons for failure of pharmacologic treatment of headaches is drug-drug interactions (DDIs). While there are many distinct pathways and mechanisms in which DDIs can occur, most occur (...) through alterations within the cytochrome P450 pathways (CYP). Drugs that cause induction, inhibition, or are simply substrates for these pathways are responsible for many of the DDIs.We review and discuss the important and potential DDIs of commonly used headache medication often encountered in clinical practice. We divide the drugs into two classes, abortive and preventive. Within each group we select the most commonly used drugs and provide a detailed discussion of the mechanisms of interaction

2016 Headache

28. Headache

, birth control, corticosteroids, hormone replacement therapy, decongestants, SSRIs) Withdrawal from medications (e.g. opioids, caffeine, benzodiazepines, SSRIs, psychotropics) Uncontrolled hypertension Shingles and post-herpetic neuralgia – head and facial pain near area of herpetic eruption Sinusitis, otitis media or a dental abscess may cause headache symptoms; suspect if pain is localized to structures in the head and neck (e.g. eyes, ears, sinuses, temporomandibular joint, teeth or neck) : Can (...) hours prior to headache Aura (25%) - onset one hour before headache begins; visual, auditory and motor issues Headache phase Postdrome - feeling of exhaustion, and sudden head movement can cause transient pain Cluster headache Rarest form of headache Onset age 25-50 years old Will have several attacks over a period of time, and then goes into remission for months or years Severe unilateral, orbital or temporal pain Each attack lasts 15 minutes to three hours May also cause tearing, nasal congestion

2018 medSask

29. Guideline for concussion/mild traumatic brain injury & persistent symptoms - Post-Traumatic Headache

attacks when other first- and second-line therapies fail or are contraindicated. 6.11 B Prophylactic therapy should be considered if headaches are occurring too frequently, are too disabling, or if acute headache medications are contraindicated or poorly tolerated or are being used too frequently (see Appendix ). 6.12 C Post-traumatic headaches may be unresponsive to conventional treatments. If headaches remain inadequately controlled, referral to a neurologist, pain management specialist (...) of the environment. Pharmacologic interventions as appropriate both for acute pain and prevention of headache attacks. Taken from the VA/DoD Management of Concussion/Mild Traumatic Brain Injury Clinical Practice Guideline (VA/DoD, 2016). Pharmacological Treatment of Post-Traumatic Headache New Key Section Level of evidence A B C Updated Evidence 6.7 C All patients with frequent headaches should be strongly encouraged to maintain an accurate headache diary (see Appendix ), medication calendar and activity log

2018 Ontario Neurotrauma Foundation

30. Monoclonal antibodies to prevent migraine headaches

recurrent attacks may benefit from prophylactic therapy. 26 Botulinum toxin has received regulatory approval for the prevention of chronic migraine headaches. This medication requires multiple injections into specific head and neck sites. 1,6,24 Topiramate is used for the prophylaxis of migraine headaches in adults experiencing four or more migraine attacks per month. 27 Other drugs used for migraine prevention are anti-epileptics (divalproex sodium, lamotrigine, gabapentin), antidepressants (...) ]. In: ClinicalTrials.gov [Internet]. Bethesda (MD): U.S. National Library of Medicine; 2000 - . Available from: Identifier: NCT03107052. Schuster NM, Rapoport AM. Calcitonin gene-related peptide-targeted therapies for migraine and cluster headache: a review. Clin Neuropharmacol. 2017 Jul;40(4):169-74. Biohaven Pharmaceuticals [Internet]. New Haven (CT): Biohaven Pharmaceuticals. News release, Biohaven enrolls first patient in pivotal phase 3 clinical trial of oral rimegepant for the acute treatment of migraine; 2017

2018 CADTH - Issues in Emerging Health Technologies

31. Approach to Chronic Secondary Headache: A Case Report on Unusual Drug Side Effects Full Text available with Trip Pro

Approach to Chronic Secondary Headache: A Case Report on Unusual Drug Side Effects In this article, we present the case of a 12-year-old female child who complained of bilateral temporal and frontal headache for 2 to 3 months with nausea and vomiting. Physical examination revealed right-sided sixth cranial nerve palsy and papilledema in ophthalmoscopy. To find the cause of increased intracranial pressure, the patient underwent brain imaging and brain MRI showed no abnormality. Ultimately (...) , lumbar puncture (LP) was performed and cerebrospinal fluid (CSF) pressure was 280 mmH2O with normal chemistry. We considered pseudotumor cerebri as the first diagnosis. LP was carried out three times and 30cc of CSF was tapped each time. Finally, patient's headache and papilledema improved and physical examination after 6 months showed no sign of raised intracranial pressure (rICP). The most prominent point in her past medical history was the use of growth hormone (GH) for 2 years. No sign of symptom

2017 Iranian journal of medical sciences

32. Medication overuse headache: An entrenched idea in need of scrutiny. (Abstract)

Medication overuse headache: An entrenched idea in need of scrutiny. It is a widely accepted idea that medications taken to relieve acute headache pain can paradoxically worsen headache if used too often. This type of secondary headache is referred to as medication overuse headache (MOH); previously used terms include rebound headache and drug-induced headache. In the absence of consensus about the duration of use, amount, and type of medication needed to cause MOH, the default position (...) -relieving medications from people with frequent headaches solely to prevent or treat MOH. The benefits of doing so are smaller, and the harms larger, than currently recognized. The concept of MOH should be viewed with more skepticism. Until the evidence is better, we should avoid dogmatism about the use of symptomatic medication. Frequent use of symptom-relieving headache medications should be viewed more neutrally, as an indicator of poorly controlled headaches, and not invariably a cause.© 2017

2017 Neurology

33. Transcutaneous stimulation of the cervical branch of the vagus nerve for cluster headache and migraine

include changes in the number and severity of cluster headache or migraine episodes, medication use, quality of life in the short and long term, side effects, acceptability, and device durability. NICE may update this guidance on publication of further evidence. 2 2 Indications and current treatments Indications and current treatments 2.1 Cluster headaches are characterised by episodes of unilateral periorbital pain, conjunctival injection, lacrimation and rhinorrhoea. Attacks can last from a few (...) Disorders classifies migraine types. Transcutaneous stimulation of the cervical branch of the vagus nerve for cluster headache and migraine (IPG552) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 2 of 92.2 The usual treatment option for patients with cluster headache or migraine is medical therapy, either to stop or prevent attacks. Treatments for acute cluster headache attacks include oxygen inhalation and medications

2016 National Institute for Health and Clinical Excellence - Interventional Procedures

34. Therapeutic and Analgesic Efficacy of Laser in Conjunction With Pharmaceutical Therapy for Trigeminal Neuralgia Full Text available with Trip Pro

Therapeutic and Analgesic Efficacy of Laser in Conjunction With Pharmaceutical Therapy for Trigeminal Neuralgia Introduction: Trigeminal neuralgia (TN) is the most common neuralgia in the head and neck region and a common cause of orofacial pain. It is routinely treated with carbamazepine. Laser, acupuncture and radiofrequency are among other treatment modalities for this condition. This study sought to assess the efficacy of laser therapy in conjunction with carbamazepine for treatment of TN (...) groups either (P=0.003). At the end of treatment pain intensity dropped in the intervention group from 6/8 to 1/2 and control group from 6/6 to 2/7. Conclusion: Laser therapy did add to the value of pharmaceutical therapy for treatment of TN. Both groups experienced significant improvement over time. So it is better to used laser complementary therapy to reduce side effects and the medicine dosage.

2017 Journal of lasers in medical sciences Controlled trial quality: uncertain

35. Acceptance and Commitment Therapy vs Medical Treatment as Usual Wait-list Control for Primary Headache Sufferers

exists as to its effectiveness for head pain problems. The current study will examine the effects of an ACT-based intervention when added to medical treatment as usual (MTAU) vs. a wait list control group comprised only of MTAU, on improving quality of life and decreasing disability among headache sufferers. Condition or disease Intervention/treatment Phase Headache Behavioral: ACT+ MTAU Behavioral: Waitlist Control +MTAU Not Applicable Detailed Description: Research to date suggests that individuals (...) pain perception. New treatment approaches, such as Acceptance and Commitment Therapy, emphasize acceptance and valued-living as alternatives to avoidance, have demonstrated to reduce headache-related disability and improve quality of life. Though APA has recently included ACT as an empirically supported treatment for chronic pain, very little evidence exists as to its effectiveness for head pain. The purpose of the present study is twofold. First, it examines, in a Randomized control study (RCT

2016 Clinical Trials

36. Developing New Pharmaceutical Treatments for Obstetric Conditions

. Securing orphan disease designation for medicines for rare diseases is one method to reduce the costs of commercialisation of a new therapeutic. The scheme is further described in Appendix I. As the standards of care increasingly differ across countries, it is more difficult for pharmaceutical companies to design a clinical trial programme that meets the needs of all major markets. The Food and Drug Administration (FDA) in the USA has approved only a dozen medications for use during pregnancy. 35 (...) pregnancy is increasingly common, with over 80% of pregnant women having at least one prescribed drug 8 either as a continuation of pre-existing therapy or as treatment for pregnancy- associated problems. Women may also access healthcare information from sources other than their physicians, such as internet sites, which may provide incorrect information. 9 Very few drugs are licensed for use in pregnancy. For many women the potential harm of taking a drug that may cause teratogenesis needs to be weighed

2015 Royal College of Obstetricians and Gynaecologists

37. Responsible use of high-risk medical devices: the example of 3D printed medical devices

AIMDD Active Implantable medical device Directive ATMP BCIP BOIP BFM advanced therapy medicinal product Benelux Convention on Intellectual Property Benelux Office for intellectual property Budget of Financial Means CAD computer-aided design CBA cost-benefit analyses CC Civil Code CCA cost-consequence analyses CEA CI cost-effectiveness analyses confidence interval CMA cost-minimization analyses CPD CRD College physicians-directors Centre for Review and Dissemination CUA cost-utility analyses CPC (...) EUDAMED European Databank on Medical Devices EUIPO EUnetHTA European Union Intellectual Property Office European Network for Health Technology Assessment EUTM DD DMCA FAMHP European Union Trade Mark Directive on the legal protection of designs Digital Millennium Copyright Act Federal Agency for Medicines and Health Products (FAGG-AFMPS) FDA Food and Drug Administration GDPR General Data Protection Regulation HSR HTA Health Services Research Health Technology Assessment IC IDEAL INAHTA Insurance

2018 Belgian Health Care Knowledge Centre

38. CRACKCast E103 – Headache Disorders

on the IHSC (international headache society classification) Primary Secondary “Organic, identifiable, distinct pathologic process” Others: Migraine Cluster Tension H/A attributed to trauma or injury to the head or neck Cranial or cervical vascular disorder Nonvascular intracranial disorder A substance or its withdrawal Infection Disorder of homeostasis Headache or facial pain attributed to disorder of cranium, neck, Eyes, ears, nose, sinuses, teeth, mouth, or other facial or cranial structures PAINFUL (...) with antidopaminergic and NSAIDs, reserve blood pressure medications for people with evidence of end organ damage. 6) What is reversible cranial vasoconstriction syndrome? “A cerebral arteriopathy characterized by segmental areas of vasoconstriction within large- and medium-sized vessels. It is the same disease as postpartum angiopathy or migrainous vasospasm. RCVS causes recurrent thunderclap headache in susceptible patients and may cause ischemic or hemorrhagic stroke.” – Rosen’s 9th Ed. Diagnosed more frequently

2017 CandiEM

39. Headache ? Child

-Etessam J, Medrano V, et al. Neuroimaging in the evaluation of patients with non-acute headache. Cephalalgia. 2005;25(1):30-35. 7. Nallasamy K, Singhi SC, Singhi P. Approach to headache in emergency department. Indian J Pediatr. 2012;79(3):376-380. 8. Raieli V, Eliseo M, Pandolfi E, et al. Recurrent and chronic headaches in children below 6 years of age. J Headache Pain. 2005;6(3):135-142. 9. Alexiou GA, Argyropoulou MI. Neuroimaging in childhood headache: a systematic review. Pediatr Radiol. 2013;43 (...) . American College of Radiology. ACR Appropriateness Criteria ® : Head Trauma — Child. Available at: https://acsearch.acr.org/docs/3083021/Narrative/. Accessed December 4, 2017. 17. Dowling MM, Noetzel MJ, Rodeghier MJ, et al. Headache and migraine in children with sickle cell disease are associated with lower hemoglobin and higher pain event rates but not silent cerebral infarction. J Pediatr. 2014;164(5):1175-1180 e1171. 18. Ozge A, Termine C, Antonaci F, Natriashvili S, Guidetti V, Wober-Bingol C

2017 American College of Radiology

40. Cases of visual impairment caused by cerebral venous sinus occlusion-induced intracranial hypertension in the absence of headache. Full Text available with Trip Pro

Cases of visual impairment caused by cerebral venous sinus occlusion-induced intracranial hypertension in the absence of headache. Cerebral venous sinus thrombosis or stenosis (here collectively referred to as cerebral venous sinus occlusion, CVSO) can cause chronically-elevated intracranial pressure (ICP). Patients may have no neurological symptoms other than visual impairment, secondary to bilateral papilledema. Correctly recognizing these conditions, through proper ophthalmological (...) examination and brain imaging, is very important to avoid delayed diagnosis and treatment.We report a case series of 3 patients with chronic CVSO, who were admitted to an ophthalmological department in Chongqing, China, from 2015 March to 2017 February. All patients presented with decreased vision and bilateral papilledema, but had no headache or other neurological symptoms. The visual fields of all patients were impaired. Flash visual evoked potentials (VEPs) in two patients showed essentially normal

2018 BMC Neurology

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