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Are There Pharmacologic Agents That Safely and Effectively Treat Post-lumbar Puncture Headache? DEFINE_ME_WA This site requires Cookies to be enabled to function. Please ensure Cookies are turned on and then re-visit the desired page.
Primary Care Management of Headache in Adults PRIMARY CARE MANAGEMENT OF HEADACHE IN ADULTS Clinical Practice Guideline | September 2016 2 nd Edition These recommendations are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. They should be used as an adjunct to sound clinical decision making. OBJECTIVES ? To increase the use of evidence-informed approaches for the prevention, assessment, diagnosis (...) , and treatment of headache for patients in primary care. ? To promote appropriate specialist referrals and use of diagnostic tests in patients with headache. ? To provide guidance on the parenteral pharmacological treatment of refractory migraine attacks for use in appropriate settings where parenteral medications can be safely administered. ? To encourage patients to engage in appropriate self-management. TARGET POPULATION Adult patients 18 years or older in primary care settings EXCLUSIONS ? Some guidance
Headache - tension-type Headache - tension-type - NICE CKS Clinical Knowledge Summaries Share Headache - tension-type - Summary Tension-type headache (TTH) is defined by the following diagnostic criteria: Episodes of headache lasting for 30 minutes to 7 days. Headache with at least two of the following characteristics: bilateral; pressing or tightening quality; mild-to-moderate intensity; not aggravated by routine physical activity. Episodes of headache are not associated with nausea (...) or vomiting. Photophobia or phonophobia, but not both, may be present. Headache that is not caused by other conditions, such as a pyrexial illness or medication overuse. The cause of TTH is not fully understood. It has been shown to be associated with the presence of myofascial trigger points, and abnormal central processing of pain (causing increased pain sensitivity). It may be triggered by stress or other factors, such as sleep disruption. For adults with infrequent TTH (on average for less than 1 day
Headache - medication overuse Headache - medication overuse - NICE CKS Clinical Knowledge Summaries Share Headache - medication overuse - Summary Medication-overuse headache (MOH) is a chronic headache (occurring on more than 15 days each month) that develops or worsens with frequent use of any drug treatment for pain in people with tension-type headache (TTH) or migraine. Typically, it develops with drug treatment of episodic migraine or TTH, but may occur in people with migraine or TTH who (...) take analgesics for other painful conditions. The symptoms of MOH resemble chronic TTH or chronic migraine; people overusing triptans are more likely to have migraine-like symptoms. MOH resolves following withdrawal of symptomatic treatment. It is thought that in people predisposed to migraine or TTH, frequent symptomatic treatment of any type of pain, including headache disorders, causes progressive down-regulation of receptors inhibiting pain. This increases sensitivity to pain, increasing
Headache - cluster Headache - cluster - NICE CKS Clinical Knowledge Summaries Share Headache - cluster - Summary Cluster headache is the most common of a group of conditions called trigeminal autonomic cephalalgias. Cluster headache is characterized by recurrent attacks of one-sided pain, in or around the eye or temporal region, and associated with signs of autonomic dysfunction on the same side. Attacks of pain usually last for 45–90 minutes and are almost always described as the most severe (...) pain known. They tend to recur at the same time each day, often waking the person shortly after falling asleep. Symptoms and signs of autonomic dysfunction include: rhinorrhoea; lacrimation; facial sweating or flushing; constriction of the pupil; swelling of periorbital tissue and conjunctiva with apparent drooping of the eyelid; and a sense of fullness in the ear. Most people have episodic cluster headache when recurrent attacks of pain occur in cluster periods lasting between 1 week and 1 year
Injection of botulinum toxin (Botox) for prophylaxis of headaches in adults with chronic migraine Injection of botulinum toxin (Botox) for prophylaxis of headaches in adults with chronic migraine Injection of botulinum toxin (Botox) for prophylaxis of headaches in adults with chronic migraine Medical Services Advisory Committee Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA (...) database. Citation Medical Services Advisory Committee. Injection of botulinum toxin (Botox) for prophylaxis of headaches in adults with chronic migraine. Canberra: Medical Services Advisory Committee (MSAC). MSAC application 1168. 2012 Authors' conclusions After considering the strength of the available evidence in relation to the safety, clinical effectiveness and cost-effectiveness of injecting botulinum toxin type A (Botox®) in refractory chronic migraine, MSAC supports its public funding via a new
Botulinum toxin treatment for migraine headache Botulinum toxin treatment for migraine headache Botulinum toxin treatment for migraine headache Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Botulinum toxin treatment for migraine headache. Lansdale: HAYES, Inc.. Directory Publication. 2011 Authors' objectives Botulinum toxin (BTX), a neurotoxin produced (...) by the bacterium Clostridium (C.) botulinum, is used as a prophylactic or acute treatment for chronic or recurrent headaches. The theoretical basis of its action is that BTX relieves muscle tension by blocking the release of the neurotransmitter acetylcholine at the neuromuscular junction, thereby interfering with nerve transmission and blocking subsequent muscle contraction. Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned by CRD MeSH Botulinum Toxinss
Magnitude, impact, and stability of primary headache subtypes: 30 year prospective Swiss cohort study. OBJECTIVE: To determine the prevalence, impact, and stability of different subtypes of headache in a 30 year prospective follow-up study of a general population sample. DESIGN: Prospective cohort study. SETTING: Canton of Zurich, Switzerland. PARTICIPANTS: 591 people aged 19-20 from a cohort of 4547 residents of Zurich, Switzerland, interviewed seven times across 30 years of follow-up. MAIN (...) OUTCOME MEASURES: Prevalence of headache; stability of the predominant subtype of headache over time; and age of onset, severity, impact, family history, use of healthcare services, and drugs for headache subtypes. RESULTS: The average one year prevalences of subtypes of headache were 0.9% (female:male ratio of 2.8) for migraine with aura, 10.9% (female:male ratio of 2.2) for migraine without aura, and 11.5% (female:male ratio of 1.2) for tension-type headache. Cumulative 30 year prevalences
Drug therapy for treating post-dural puncture headache. BACKGROUND: Post-dural puncture headache (PDPH) is the most common complication of lumbar puncture, an invasive procedure frequently performed in the emergency room. Numerous pharmaceutical drugs have been proposed to treat PDPH but there are still some uncertainties about their clinical effectiveness. OBJECTIVES: To assess the effectiveness and safety of drugs for treating PDPH in adults and children. SEARCH STRATEGY: The search strategy
Subjective well-being in patients with chronic tension-type headache: effect of acupuncture, physical training, and relaxation training 21317776 2011 05 10 2011 09 29 2011 05 10 1536-5409 27 5 2011 Jun The Clinical journal of pain Clin J Pain Subjective well-being in patients with chronic tension-type headache: effect of acupuncture, physical training, and relaxation training. 448-56 10.1097/AJP.0b013e318208c8fe Episodic tension-type headache is a common problem affecting approximately 2 of 3 (...) of the population. The origin of tension-type headache is multifactorial, but the pathogenesis is still unclear. In some individuals episodic tension-type headache transforms into chronic tension-type headache (CTTH). Subjective symptoms related to the central nervous system might affect patients subjective well-being and quality of life. This study compared 3 nonpharmacologic treatments; acupuncture, relaxation training, and physical training on subjective well-being in patients with CTTH. Ninety consecutive
Sensitivity of computed tomography performed within six hours of onset of headache for diagnosis of subarachnoid haemorrhage: prospective cohort study. OBJECTIVE: To measure the sensitivity of modern third generation computed tomography in emergency patients being evaluated for possible subarachnoid haemorrhage, especially when carried out within six hours of headache onset. DESIGN: Prospective cohort study. SETTING: 11 tertiary care emergency departments across Canada, 2000-9. PARTICIPANTS (...) : Neurologically intact adults with a new acute headache peaking in intensity within one hour of onset in whom a computed tomography was ordered by the treating physician to rule out subarachnoid haemorrhage. MAIN OUTCOME MEASURES: Subarachnoid haemorrhage was defined by any of subarachnoid blood on computed tomography, xanthochromia in cerebrospinal fluid, or any red blood cells in final tube of cerebrospinal fluid collected with positive results on cerebral angiography. RESULTS: Of the 3132 patients enrolled
Pain perception studies in tension-type headache 21029081 2011 02 02 2011 03 31 2013 11 21 1526-4610 51 2 2011 Feb HeadacheHeadache Pain perception studies in tension-type headache. 262-71 10.1111/j.1526-4610.2010.01768.x Tension-type headache (TTH) is a disorder with high prevalence and significant impact on society. Understanding of pathophysiology of TTH is paramount for development of effective treatments and prevention of chronification of TTH. Our aim was to review the findings from pain (...) induce central sensitization and thereby chronification of the headache. Measurements of pain tolerance thresholds and suprathreshold stimulation have shown presence of generalized hyperalgesia in chronic tension-type headache (CTTH) patients, while DNIC function has been shown to be reduced in CTTH. One imaging study showed loss of gray matter structures involved in pain processing in CTTH patients. Future studies should aim to integrate pain perception and imaging to confirm this finding
Headache, migraine, and structural brain lesions and function: population based Epidemiology of Vascular Ageing-MRI study. OBJECTIVE: To evaluate the association of overall and specific headaches with volume of white matter hyperintensities, brain infarcts, and cognition. DESIGN: Population based, cross sectional study. SETTING: Epidemiology of Vascular Ageing study, Nantes, France. PARTICIPANTS: 780 participants (mean age 69, 58.5% women) with detailed headache assessment. MAIN OUTCOME (...) MEASURES: Brain scans were evaluated for volume of white matter hyperintensities (by fully automated imaging processing) and for classification of infarcts (by visual reading with a standardised assessment grid). Cognitive function was assessed by a battery of tests including the mini-mental state examination. RESULTS: 163 (20.9%) participants reported a history of severe headache and 116 had migraine, of whom 17 (14.7%) reported aura symptoms. An association was found between any history of severe
Local injection therapy and neurosurgery for cervicogenic headache and occipital neuralgia Local injection therapy and neurosurgery for cervicogenic headache and occipital neuralgia Local injection therapy and neurosurgery for cervicogenic headache and occipital neuralgia Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Local injection therapy and neurosurgery (...) for cervicogenic headache and occipital neuralgia. Lansdale: HAYES, Inc.. Directory Publication. 2011 Authors' conclusions Both local injection therapies and neurosurgery are used in the treatment of cervicogenic headache and occipital neuralgia, which are typically unilateral headaches that may be symptomatic of pathology involving the greater or lesser occipital nerves, or the cervical spine. The goal of injection therapy is to deliver local anesthetic, steroids, or agents such as botulinum toxin
Botulinum toxin treatment for chronic tension-type headache Botulinum toxin treatment for chronic tension-type headache Botulinum toxin treatment for chronic tension-type headache Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Botulinum toxin treatment for chronic tension-type headache. Lansdale: HAYES, Inc.. Directory Publication. 2011 Authors' conclusions (...) Botulinum toxin (BTX), a neurotoxin produced by the bacterium Clostridium (C.) botulinum, inhibits the release of the neurotransmitter acetylcholine at the neuromuscular junction and causes muscle paralysis. BTX has been investigated as a treatment for chronic tension-type headache because of the potential for it to reduce muscle tension and modulate pain receptor activity in the central nervous system. Final publication URL The report may be purchased from: Indexing Status Subject indexing assigned
[Botulinum toxin for the treatment of headache] Uso de toxina botulínica en pacientes con cefalea [Botulinum toxin for the treatment of headache] Uso de toxina botulínica en pacientes con cefalea [Botulinum toxin for the treatment of headache] Pichon Riviere A, Augustovski F, Garcia Marti S, Glujovsky D, Alcaraz A, Lopez A, Bardach A, Ciapponi A, Romano M Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation (...) of the quality of this assessment has been made for the HTA database. Citation Pichon Riviere A, Augustovski F, Garcia Marti S, Glujovsky D, Alcaraz A, Lopez A, Bardach A, Ciapponi A, Romano M. Uso de toxina botulínica en pacientes con cefalea. [Botulinum toxin for the treatment of headache] Buenos Aires: Institute for Clinical Effectiveness and Health Policy (IECS). 2011 Authors' objectives Evaluate the available evidence about the effectiveness, safety and insurance policy related to the use of TBA