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Migraine Headache Management

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1. Management of Childhood Migraine by Headache Specialist vs Non-Headache Specialists. (Abstract)

Management of Childhood Migraine by Headache Specialist vs Non-Headache Specialists. This study aims to compare the management practices of a headache specialist with non-headache specialists in the treatment of children with migraine. The use of appropriate rescue medications and prophylactic agents, application of neuroimaging, and short-term outcomes are compared in children treated by the two groups of physicians.A retrospective cohort study was conducted by utilizing the electronic medical (...) records of children 3-18 years of age with migraine, who were evaluated at a tertiary care children's hospital from 2016 to 2018.Of the 849 patients who met the study criteria, 469 children were classified as having chronic migraine or high-frequency episodic migraine and were followed-up on at least 1 occasion by the neurologists. Imaging was obtained in 66.5% of all children with migraine. The headache specialist used 5-HT agonists ("triptans") for migraine management in 56.7% (76/135) of cases

2019 Headache

2. Acupuncture for migraine headaches

Acupuncture for migraine headaches Acupuncture for migraine headaches Toggle navigation Shared more. Cited more. Safe forever. Toggle navigation View Item JavaScript is disabled for your browser. Some features of this site may not work without it. Search MOspace This Collection Browse Statistics Acupuncture for migraine headaches View/ Open Date 2010-04 Format Metadata Abstract Acupuncture reduces the frequency of migraine headaches when used as an adjunct to, or in place of, medical management

2019 Clinical Inquiries

3. Acupuncture for migraine headaches

Acupuncture for migraine headaches Acupuncture for migraine headaches Toggle navigation Shared more. Cited more. Safe forever. Toggle navigation View Item JavaScript is disabled for your browser. Some features of this site may not work without it. Search MOspace This Collection Browse Statistics Acupuncture for migraine headaches View/ Open Date 2010-04 Format Metadata Abstract Acupuncture reduces the frequency of migraine headaches when used as an adjunct to, or in place of, medical management

2019 Clinical Inquiries

4. Migraine and Tension Headache

with sumatriptan 85/naproxen sodium 500 in (truly) episodic migraine: what's neck pain got to do with it? Postgrad Med. 2014 Mar;126(2):86-90. Créac'h C, Frappe P, Cancade M, et al. In-patient versus out-patient withdrawal programmes for medication overuse headache: a 2- year randomized trial. Cephalalgia. 2011 Aug;31(11):1189-1198. Cull RE. Investigation of late-onset migraine. Scott Med J. 1995 Apr;40(2):50-52. Deitch K, Kuhfahl K, Kinzler D, et al. A Randomized, Double-blind Comparison of Single Dose (...) , Freitag FG. Ibuprofen plus caffeine in the treatment of tension-type headache. Cephalalgia. 2000 Jul;20(6):597-602. Facco E, Liguori A, Petti F, Fauci AJ, Cavallin F, Zanette G. Acupuncture versus valproic acid in the prophylaxis of migraine without aura: a prospective controlled study. Minerva Anestesiol. 2013 Jun;79(6):634-642. Fan W, Lv Y, Ying G, Li W, Zhou J. Pilot study of amitriptyline in the prophylactic treatment of medication-overuse headache: a 1-year follow-up. Pain Med. 2014 Oct;15(10

2018 Kaiser Permanente Clinical Guidelines

5. The Traffic Light of Headache: Simplifying Acute Migraine Management for Physicians and Patients Using the Canadian Headache Society Guidelines. (Abstract)

The Traffic Light of Headache: Simplifying Acute Migraine Management for Physicians and Patients Using the Canadian Headache Society Guidelines. Migraine is a disabling neurological condition and it is well described that early treatment is more effective and less likely to lead to headache recurrence. While it would seem intuitive for a migraine sufferer to treat early, despite well-established guidelines by the Canadian Headache Society, many sufferers continue to treat late. As a result (...) , acute therapy is less effective, resulting in higher associated disability and a longer lasting attack. Pain scales can help patients determine how to treat; however, we propose a simple, easily recalled traffic light system to help patients determine which drug to use based upon how they feel. The traffic light system is based on the associated disability of the migraine attack, with green being a "I can still go" headache, a yellow being a "I have to slow down" headache, and a red being a "I have

2018 Headache

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

comparison studies, there is clear and overwhelming evidence to support the use of nonopioid management. Given 470 the well-documented complications associated with opioid management, including opioids’ addictive properties 471 with recurrent use for pain, nonopioids are strongly preferred in the management of acute primary headache, 472 including migraines, in the ED. As a result, the use of opioids should be discouraged, given the multiple 473 therapeutic options in this patient population. 474 (...) . 196 197 7 CRITICAL QUESTIONS 198 1. In the adult ED patient presenting with acute headache, are there risk-stratification strategies that 199 reliably identify the need for emergent neuroimaging? 200 201 Patient Management Recommendations 202 Level A recommendations. None specified. 203 Level B recommendations. Use the Ottawa Subarachnoid Hemorrhage Rule (>40 years, complaint of neck 204 pain or stiffness, witnessed loss of consciousness, onset with exertion, thunderclap headache, and limited neck

2019 American College of Emergency Physicians

7. Monoclonal antibodies to prevent migraine headaches

into specific head and neck sites. Other drugs are used in migraine prevention but patient adherence and efficacy are issues. Anti-calcitonin gene-related peptide (anti-CGRP) monoclonal antibodies belong to a novel class of drugs that target CGRP — a potent vasodilator — which plays a role in pain and migraines. Four anti-CGRP monoclonal antibodies are currently in development for use in the prevention of episodic and chronic migraines: eptinezumab, erenumab, fremanezumab, and galcanezumab. They have (...) not been determined, these drugs will potentially have a significant budget impact because of the high cost of biologics and the prevalence of episodic and chronic migraines. Background A migraine is characterized as a headache, with at least two of the following pain attributes: moderate or severe, throbbing, localized to one area, and avoidance of routine physical activity because of the pain. 1,2 The headache must be accompanied by at least one of the following symptoms: nausea or vomiting

2018 CADTH - Issues in Emerging Health Technologies

8. 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 (...) that are refractory to medical treatments. For patients with chronic cluster headache, these include deep brain stimulation to modulate central processing of pain signals. For patients with chronic migraine, these include treatments such as nerve blocks, botulinum toxin (see NICE's technology appraisal guidance on botulinum toxin type A for the prevention of headaches in adults with chronic migraine), acupuncture or nerve stimulation. 3 3 The procedure The procedure 3.1 Transcutaneous vagus nerve stimulation uses

2016 National Institute for Health and Clinical Excellence - Interventional Procedures

9. Chronic migraine and chronic tension-type headache

is not a covered benefit. HTCC reimbursement determination: Limitations of coverage: For treatment of chronic migraine (as defined by the International Headache Society), OnabotulinumtoxinA is covered when the following criteria are met: 1) Has not responded to at least three prior pharmacological prophylaxis therapies from two different classes of drugs AND 2) Condition is appropriately managed for medication overuse OnabotulinumtoxinA injections must be discontinued when the condition has shown inadequate (...) with chronic migraine (defined as headaches on =15 days per month of which =8 days are with migraine) if: 1) They have not responded to at least three prior pharmacological prophylaxis therapies from two different classes of drugs AND 2) Their condition is appropriately managed for medication overuse OnabotulinumtoxinA injections must be discontinued in people whose condition: 1) Has shown inadequate response to treatment (defined as <50% reduction in headache days per month after two treatment cycles

2017 Washington Health Care Authority

10. Pain Management Using Acupuncture Method in Migraine Headache Patients; A Single Blinded Randomized Clinical Trial. Full Text available with Trip Pro

Pain Management Using Acupuncture Method in Migraine Headache Patients; A Single Blinded Randomized Clinical Trial. There were numerous studies using acupuncture for pain relief and in most, the effect of this technique on preventing migraine attacks has been investigated. In those several studies that surveyed the effect of acupuncture on treatment of migraine headaches, the conclusion was not completely persuaded and they suggested further researches on this topic.The purpose of this study (...) is to examine the effect of acupuncture on controlling acute migraine attacks.This study was a single blinded randomized clinical trial that was conducted on patients with a diagnosis of acute migraine attacks. At the time of reference, the patient's pain intensity was measured and recorded in a written checklist. Acupuncture was done in the intervention group with thin metallic needles, which enter certain points in the ear's skin; including shen men, autonomic, thalamus, frontal, and temple

2018 Anesthesiology and pain medicine Controlled trial quality: uncertain

11. Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society Full Text available with Trip Pro

controlled trials studying the efficacy of preventive medications for pediatric migraine fail to demonstrate superiority to placebo. Recommendations for the prevention of migraine in children include counseling on lifestyle and behavioral factors that influence headache frequency and assessment and management of comorbid disorders associated with headache persistence. Clinicians should engage in shared decision-making with patients and caregivers regarding the use of preventive treatments for migraine (...) Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society To provide updated evidence-based recommendations for migraine prevention using pharmacologic treatment with or without cognitive behavioral therapy in the pediatric population.The authors systematically reviewed literature from January 2003

2019 EvidenceUpdates

12. American Headache Society Survey About Urgent and Emergency Management of Headache Patients. Full Text available with Trip Pro

American Headache Society Survey About Urgent and Emergency Management of Headache Patients. Emergency department (ED) visits for migraine are burdensome to patients and to the larger healthcare system and society. Thus, it is important to determine strategies used to prevent ED visits and the common communication patterns between headache specialists and the ED team.We sought to understand: (1) Whether headache specialists use headache management protocols. (2) The strategies they use to try (...) or most of the time for headache management. Thirty-six percent reported prescribing a new medicine and 30% reported providing telephone counseling some/most/all of the time. Sixty percent reported that their ED has a protocol for migraine management. Overall, 38% were usually or very satisfied with the headache care in the ED.A substantial number of headache specialists are dissatisfied with the care their patients receive in the ED. More standardized protocols for ED visits by patients with known

2018 Headache

13. Headaches in over 12s: diagnosis and management

-type headache, migraine or cluster headache according to the headache features in the table. [2012] [2012] Headache Headache feature feature T T ension-type headache ension-type headache Migr Migraine (with or aine (with or without aur without aura) a) Cluster headache Cluster headache Pain location 1 Bilateral Unilateral or bilateral Unilateral (around the eye, above the eye and along the side of the head/face) Headaches in over 12s: diagnosis and management (CG150) © NICE 2019. All rights (...) Chronic migr migraine aine 6 6 (with or (with or without without aur aura) a) Episodic Episodic cluster cluster headache headache Chronic Chronic cluster cluster headache headache 1 Headache pain can be felt in the head, face or neck. 2 See recommendations 1.2.2, 1.2.3 and 1.2.4 for further information on diagnosis of migraine with aura. 3 The frequency of recurrent headaches during a cluster headache bout. 4 The pain-free period between cluster headache bouts. 5 Chronic migraine and chronic tension

2012 National Institute for Health and Clinical Excellence - Clinical Guidelines

14. gammaCore for cluster headache

gammaCore for cluster headache gammaCore for cluster headache gammaCore for cluster headache Medtech innovation briefing Published: 22 October 2018 nice.org.uk/guidance/mib162 pathways Summary Summary The technology technology described in this briefing is gammaCore. It is used as a daily preventative measure for cluster headache and can be used to treat pain during a headache. The inno innovativ vative aspects e aspects compared with other vagus nerve stimulators is that gammaCore is applied (...) care pathway NICE interventional procedures guidance on transcutaneous stimulation of the cervical branch of the vagus nerve for cluster headache and migraine recommends that the procedure should only be used with special arrangements for clinical governance, consent and audit or research. Current evidence on the safety of the procedure raised no concerns but the evidence on efficacy was limited in quantity and quality. NICE's clinical guideline on headache states that oxygen or triptans should

2018 National Institute for Health and Clinical Excellence - Advice

15. Lifting the burden of headache in China: managing migraine in a SMART way Full Text available with Trip Pro

Lifting the burden of headache in China: managing migraine in a SMART way With support from Lifting The Burden , a UK-registered charitable organization, a nationwide survey of headache disorders in the Chinese adult population was conducted in 2008-2009. This project, which was within the Global Campaign against Headache, showed that headache disorders have a major adverse impact on public health in China. Subsequently, as essential support for implementing headache services around the country (...) , an enactment of stage 3 (intervention) of the Global Campaign against Headache - the continuing medical education (CME) program Headache Schools - was established. 'SMART' (Screen, Migraine, Aura, Red flag and Treatment), a systematic and operational disease management model, was introduced with the aims of enhancing neurologists' knowledge of migraine, standardizing their diagnostic and treatment approaches, and improving their practices and outcomes. To date, 615 neurologists have been trained and 135

2017 The journal of headache and pain

16. Ketorolac versus Magnesium Sulfate in Migraine Headache Pain Management; a Preliminary Study Full Text available with Trip Pro

Ketorolac versus Magnesium Sulfate in Migraine Headache Pain Management; a Preliminary Study Migraine is a common cause of emergency department (ED) visits. To date, there is no recommended drug of choice for pain management of these patients. In the present study, we aimed to evaluate the effectiveness of ketorolac and magnesium sulfate in this regard.This is a cross-sectional study performed on all 18 - 60 year-old patients, visiting two different EDs with complaint of moderate to severe (...) migraine headache. Patients were treated with 30 mg ketorolac in one hospital and 1 gram magnesium sulfate in the other. Pain scores were assessed on arrival, 1 and 2 hours after drugs administration and quality of pain management was compared between two groups using SPSS 22.70 patients with the mean age of 36.4 ± 11.4 years were enrolled (51.4% male). The two groups were similar regarding baseline characteristics (p > 0.05). The improvement in pain score in magnesium sulfate group was greater than

2017 Emergency

17. Onabotulinumtoxin A for the management of chronic migraine in current clinical practice: results of a survey of sixty-three Italian headache centers Full Text available with Trip Pro

Onabotulinumtoxin A for the management of chronic migraine in current clinical practice: results of a survey of sixty-three Italian headache centers Chronic migraine is a complex clinical condition often undertreated. Onabotulinumtoxin A (OBT-A) was approved in Italy in 2013 for symptom relief in patients with chronic migraine who have failed, or do not tolerate, oral prophylactic treatments. However, the impact of OBT-A in clinical practice remains to be defined.To investigate the current (...) management of chronic migraine with OBT-A in clinical practice, a web-based survey was conducted among clinicians working in third-level headache centers across Italy. A 26-item questionnaire was designed and developed by a group of 10 Italian headache specialists to address the following issues: treatment paradigm and OBT-A injection intervals, frequency of treatment and retreatment, definition of responders/non-responders, satisfaction with treatment potential impact of early treatment with OBT

2017 The journal of headache and pain

18. Comparing Zonisamide With Sodium Valproate in the Management of Migraine Headaches: Double-Blind Randomized Clinical Trial of Efficacy and Safety. Full Text available with Trip Pro

Comparing Zonisamide With Sodium Valproate in the Management of Migraine Headaches: Double-Blind Randomized Clinical Trial of Efficacy and Safety. Migraine is one of the most debilitating medical conditions and has a high socioeconomic burden. As conventional therapeutic methods do not entirely alleviate the symptoms, new alternatives are being considered.This study evaluates the efficacy and safety of zonisamide compared with sodium valproate in the management of migraine headaches.In (...) the current double-blind, parallel, randomized, controlled trial, 96 patients with a migraine diagnosis based on the international headache society (HIS) criteria were selected. They were divided randomly into two groups; the case group was given zonisamide, and sodium valproate was given to a control group. In addition to the side effects of the drugs, the severity, duration, and frequency of migraine attacks were evaluated at baseline and at three months.The 96 selected patients were divided randomly

2017 Iranian Red Crescent medical journal Controlled trial quality: uncertain

19. Botulinum toxin type A for the prevention of headaches in adults with chronic migraine

Botulinum toxin type A for the prevention of headaches in adults with chronic migraine Overview | Botulinum toxin type A for the prevention of headaches in adults with chronic migraine | Guidance | NICE Botulinum toxin type A for the prevention of headaches in adults with chronic migraine Technology appraisal guidance [TA260] Published date: 27 June 2012 Share Guidance on botulinum toxin type A (Botox) for preventing headaches in adults with chronic migraine. Guidance development process (...) Is this guidance up to date? . We found nothing new that affects the recommendations in this guidance. Next review : This guidance will be reviewed if there is new evidence that is likely to change the recommendations. Your responsibility The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs

2012 National Institute for Health and Clinical Excellence - Technology Appraisals

20. Covid-19: Headache

citizen may be familiar with, in particular, e.g. Skype, WhatsApp, Facetime. Vision contact matters significantly. TIP THREE Encourage patients with primary headaches to adhere with the suggested treatment and to control dietary triggers, particularly alcohol consumption that may be increased under isolation. Maintaining regular sleep and eating habits and managing stress are important as they are common migraine triggers. In the conditions of social isolation, anxiety and depression disorder may (...) of COVID-19. In medical practice, treatment guidelines are based on clinical studies. NSAIDS, especially ibuprofen, naproxen, diclofenac and tolfenamic acid, have proven efficacy and safety in clinical trials of symptomatic treatment of migraine and therefore are recommended for acute treatment. Furthermore, indomethacin, is the only available treatment for some Trigeminal Autonomic Cephalalgias. In general, NSAIDs are of great therapeutic value in headaches. The FDA recently released advice

2020 European Academy of Neurology

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