Chronic Headache

This comprehensive, practical title invites all clinicians to take a fresh look at the evaluation and management of chronic daily headache (CDH). Developed by a distinguished international panel of experts, the book examines key social and economic issues around CDH and clarifies the diagnosis of CDH disorders, providing an understanding of the underlying biological substrates, offering guidance on the use of diagnostic testing and additional consultations, and outlining treatment strategies with the greatest potential to alleviate the burden of these patients and to provide the highest quality of care. The book fully examines the constellation of symptoms that constitute chronic daily headache, while also discussing the role of behavioral medicine and the important elements involved in taking a good history. The major forms and biology of chronic daily headache are covered, as is the role of diagnostic testing and treatment. The risk factors that lead patients to transform episodic primary headache disorders into the chronic form are examined. Invasive and neuromodulatory techniques are also discussed. A section on the classification of these disorders rounds out this important contribution to the literature. Chronic Headache – A Comprehensive Guide to Evaluation and Management will be of great interest to neurologists, primary care physicians, nurse practitioners, physician assistants, medical students, and other clinicians with an interest in chronic daily headache.

M. WILKINSON Patients with frequent or daily headaches pose a very difficult problem for the physician who has to treat them, particularly as many patients think that there should be a medicine or medicines which give them instant relief. In the search for the compound which would meet this very natural desire, many drugs have been manufactured and the temptation for the physician is either to increase the dose of a drug which seems to be, at any rate, partially effective, or to add one or more drugs to those which the patient is already taking. Although there have been some references to the dangers of overdosage of drugs for migraine in the past, it was not until relatively recently that it was recognized that drugs given for the relief of headache, if taken injudiciously, may themselves cause headache. The first drugs to be implicated in this way were ergotamine and phenazone. In the case of ergotamine tartrate, the dangers of ergotism were well known as this was a disorder which had been known and written about for many years. In the treatment of headache, fully blown ergotism is rare and in recent years has usually been due to self-medication in doses much greater than those prescribed although there are a few recorded cases where toxic amounts have been given.

The brain is the most complex organ in our body. Indeed, it is perhaps the most complex structure we have ever encountered in nature. Both structurally and functionally, there are many peculiarities that differentiate the brain from all other organs. The brain is our connection to the world around us and by governing nervous system and higher function, any disturbance induces severe neurological and psychiatric disorders that can have a devastating effect on quality of life. Our understanding of the physiology and biochemistry of the brain has improved dramatically in the last two decades. In particular, the critical role of cations, including magnesium, has become evident, even if incompletely understood at a mechanistic level. The exact role and regulation of magnesium, in particular, remains elusive, largely because intracellular levels are so difficult to routinely quantify. Nonetheless, the importance of magnesium to normal central nervous system activity is self-evident given the complicated homeostatic mechanisms that maintain the concentration of this cation within strict limits essential for normal physiology and metabolism. There is also considerable accumulating evidence to suggest alterations to some brain functions in both normal and pathological conditions may be linked to alterations in local magnesium concentration. This book, containing chapters written by some of the foremost experts in the field of magnesium research, brings together the latest in experimental and clinical magnesium research as it relates to the central nervous system. It offers a complete and updated view of magnesiums involvement in central nervous system function and in so doing, brings together two main pillars of contemporary neuroscience research, namely providing an explanation for the molecular mechanisms involved in brain function, and emphasizing the connections between the molecular changes and behavior. It is the untiring efforts of those magnesium researchers who have dedicated their lives to unraveling the mysteries of magnesiums role in biological systems that has inspired the collation of this volume of work.

As headache and facial pain are two of the most common medical complaints, it is essential that clinicians are well equipped to handle these issues. Clinician's Guide to Chronic Headache and Facial Pain is designed for all clinicians dealing with these syndromes in daily practice-whether in the outpatient, emergency, or ambulatory setting. Features

A significant number of individuals suffer from headaches intense enough to be physically debilitating, including migraines, tension-type, and combined or mixed headaches. Their severity resides not only in the pain they inflict but also in related problems such as anxiety, depression, and social withdrawal, as well as family difficulties resulting from coping with the sufferer's symptoms. This comprehensive volume reviews the psychological research literature and provides a detailed account of how to assess and manage these types of headaches. Taking into account the psychosocial and developmental context of each client, the book helps practitioners analyze the controlling factors that determine the changes in headache activity and develop an individualized plan for treatment, education, and relapse prevention. Case examples help illustrate the author's approach. Useful appendices include a Headache Classification System, Diagnostic Guidelines for Use with the Psychological Assessment of Headache Questionnaire, and a Preassessment Patient Information Sheet.

In its different presentations, headache is one of the most commonsymptoms seen by family practitioners. The difficulty is indiagnosing the cause of the headache so that the appropriatetreatment is provided, or if referral to a specialist is therecommended course of action. The ABC of Headache helps with this dilemma and guidesthe healthcare professional to look for the possible causes ofpresenting symptoms. Based on real case histories, each chapterguides the reader from symptoms through to diagnosis andmanagement. This new ABC is a highly illustrated, informative, andpractical source of knowledge. With links to further informationand resources, it is a valuable text for healthcare professionalsat all levels of practice and training.

The frequent headache syndromes are among the most challenging disorders that confront clinicians on a routine basis. The purpose of Chronic Daily Headache for Clinicians is to provide a practical guide for clinicians to both understand and manage patients with frequent headache. The foremost clinicians in each area will review in a very focused way the diagnostic and management issues for the most important and challenging disorders that present with frequent headache. Specific types of headaches examined include Chronic Migraine, Tension-Type, Chronic Cluster, Hypnic, Low-CSF Volume, and those headaches associated with Head Trauma, among others. Chronic Daily Headache for Clinicians will bring clinical clarity to these disorders in order to be appropriately studied in terms of their primary headache biology.

This book provides a detailed overview of the current state of knowledge regarding the pathophysiology of both primary headaches – migraine, tension-type headache (TTH), and cluster headache – and the very important and frequent type of secondary headache, medication overuse headache (MOH). After an introductory chapter describing relevant neuroanatomy and vascular anatomy, the evidence gained from animal models regarding the pathophysiology of migraine and the other primary headaches is reviewed. Knowledge of the genetic component in the different types of headache is then examined with reference to recent evidence, for example regarding the implication of the trigeminovascular system and cortical spreading depression in migraine. Detailed information is provided on insights into primary headaches from imaging studies, including functional magnetic resonance imaging and positron emission tomography and on their neurophysiology and biochemistry. A further series of important chapters describe present knowledge of the pathophysiology of each specific type of headache and consider future directions. Written by acknowledged experts in their fields from Europe and the United States, clinicians and students will find Pathophysiology of Headaches to be an excellent source of up-to-date information on why patients experience headaches. In addition, it will be of value for pain researchers investigating the underlying mechanisms of headache.