scholarly journals Behavioural Management of Headache Triggers: Three Case Examples Illustrating a New Effective Approach (Learning to Cope with Triggers)

2015 ◽  
Vol 32 (3) ◽  
pp. 202-208 ◽  
Author(s):  
Paul R. Martin ◽  
Moira Callan ◽  
Archana Kaur ◽  
Karen Gregg
Keyword(s):  
Traditional Approach ◽  
Tension Type Headache ◽  
Post Treatment ◽  
Case Examples ◽  
Medication Consumption ◽  
Alternative Approach ◽  
Treatment Changes ◽  
Type Headache ◽  
Behavioural Management

The traditional approach to headache trigger management is to advise avoidance of all triggers, but we have advocated an alternative approach called ‘Learning to Cope with Triggers’ (LCT), in which the objective is to desensitise headache sufferers to some triggers or to build up tolerance for the triggers, using exposure techniques. A recent publication established the efficacy of this approach to trigger management. Reported here are three cases to illustrate how LCT is used in practice. Two cases were male and one was female, with ages ranging from 32 to 67 years. The headache diagnoses were frequent episodic tension-type headache, migraine without aura, and chronic tension-type headache; all had had headaches since childhood/adolescence. The headache triggers that were the focus of the intervention were heat, tiredness, and stress/anger. Post-treatment, changes in the capacity of the triggers to elicit headaches were reported in all three cases. Reductions in headaches from pre- to post-treatment, and from pre- to 4-month follow-up, were: case 1, 69% and 60% respectively; case 2, 76% and 80% respectively; and case 3, 73% and 61% respectively. Decreases in medication consumption, and enhanced self-efficacy were also recorded.

Efficacy of Physiotherapy Including a Craniocervical Training Programme for Tension-Type Headache; A Randomized Clinical Trial

Cephalalgia ◽  
2006 ◽  
Vol 26 (8) ◽  
pp. 983-991 ◽  
Author(s):  
H van Ettekoven ◽  
C Lucas
Keyword(s):  
Controlled Trial ◽  
Training Group ◽  
Training Programme ◽  
Time Frame ◽  
Primary Outcome Measure ◽  
Tension Type Headache ◽  
Control Group ◽  
Headache Frequency ◽  
Type Headache

We conducted a multicentre, randomized controlled trial with blinded outcome assessment. The treatment period was 6 weeks with follow-up assessment immediately thereafter and after 6 months. The objective was to determine the effectiveness of a craniocervical training programme combined with physiotherapy for tension-type headache. Eighty-one participants meeting the diagnostic criteria for tension-type headache were randomly assigned to an exercise group (physiotherapy and an additional craniocervical training programme) and a control group (physiotherapy alone). The primary outcome measure was headache frequency. Secondary outcomes included headache intensity and duration, Quality of Life (SF-36) and the Multidimensional Headache Locus of Control scale (MHLC). At 6 months' follow-up, the craniocervical training group showed significantly reduced headache frequency, intensity and duration ( P < 0.001 for all). Effect sizes were large and clinically relevant. Loss to follow-up amounted to 3.7±. Physiotherapy including craniocervical training reduces symptoms of tension-type headache significantly over a prolonged time frame.

Changing Headache from Preschool Age to Puberty. A Controlled Study

Cephalalgia ◽  
2007 ◽  
Vol 27 (4) ◽  
pp. 294-303 ◽  
Author(s):  
R Virtanen ◽  
M Aromaa ◽  
P Rautava ◽  
L Metsähonkala ◽  
P Anttila ◽  
...  
Keyword(s):  
Primary Headache ◽  
Tension Type Headache ◽  
Preschool Age ◽  
Controlled Study ◽  
Abdominal Symptoms ◽  
Common Location ◽  
Headache Type ◽  
Type Headache ◽  
Pain Localization

The characteristics of disturbing primary headache and the occurrence of headache types were studied by sending a questionnaire to 1132 Finnish families of 6-year-old children. Children with headache in the preceding 6 months and their controls were clinically examined at the ages of 6 and 13. During the follow-up, half of the headaches, classified as migraine at age 6 years, were unchanged and 32% turned into tension-type headache. In children with tension-type headache, the situation was unchanged in 35%, and in 38% of children the headache type had changed to migraine. At preschool age the most common location of headache was bilateral and supraorbital, and at puberty bilateral and temporal. During the follow-up, symptoms concurrent with headache, such as odour phobia, dizziness and balance disturbances became more typical, whereas restlessness, flushing and abdominal symptoms became less marked. The early manifestation of both migraine and tension-type headache predict equally often migraine in puberty with marked changes in concurrent symptoms and pain localization.

Cluster of MMPI Personality Profiles in Chronic Tension-Type Headache and Predictable Response to Fluoxetine

Cephalalgia ◽  
2000 ◽  
Vol 20 (1) ◽  
pp. 51-56 ◽  
Author(s):  
J Aguirre ◽  
R Gallardo ◽  
Juan A Pareja ◽  
M Pérez-Miranda
Keyword(s):  
Minnesota Multiphasic Personality Inventory ◽  
Tension Type Headache ◽  
Control Group ◽  
Personality Profiles ◽  
Chronic Tension Type Headache ◽  
Fluoxetine Treatment ◽  
Chi Squared ◽  
Type Headache ◽  
Cluster 2

A study was made of the personality profiles of a sample of 51 patients with chronic tension-type headache (CTH) employing the Minnesota Multiphasic Personality Inventory (MMPI). Two clusters were obtained by applying multivariate classification techniques: cluster 1 (with elevations on scales Hy, D and Hs only) and cluster 2 (exhibiting elevations on most scales except Pd, Mf and Si). Fifty subjects without chronic pain or known psychiatric disorders, and extracted from the same social setting as the patients, completed the MMPI as a control group. Fluoxetine treatment was started in the CTH group, with follow-up over a 1-year period. Chi-squared analysis correlating the clusters obtained to different pain-related variables and epidemiological parameters revealed a significant association to sex only. There were no differences in therapeutic response between the two clusters. However, the patients belonging to the less perturbed cluster who exhibited profiles analogous to those of the control population showed significant improvement with respect to the global sample and their own cluster.

Prognosis of migraine and tension-type headache: A population-based follow-up study

Neurology ◽  
2005 ◽  
Vol 65 (4) ◽  
pp. 580-585 ◽  
Author(s):  
A. C. Lyngberg ◽  
B. K. Rasmussen ◽  
T. Jorgensen ◽  
R. Jensen
Keyword(s):  
Population Based ◽  
Tension Type Headache ◽  
Follow Up Study ◽  
Type Headache

A 3-Year Follow-Up of Headache Diagnoses and Symptoms in Swedish Schoolchildren

Cephalalgia ◽  
2006 ◽  
Vol 26 (7) ◽  
pp. 809-815 ◽  
Author(s):  
K Laurell ◽  
B Larsson ◽  
P Mattsson ◽  
O Eeg-Olofsson
Keyword(s):  
General Population ◽  
Female Gender ◽  
Tension Type Headache ◽  
Annual Incidence ◽  
Childhood Headache ◽  
Average Annual Incidence ◽  
Headache Diagnosis ◽  
Type Headache

Information is sparse concerning the incidence and prognosis of headache in children from the general population, especially of tension-type headache. In this study, headache diagnoses and symptoms were reassessed in 122 out of 130 schoolchildren after 3 years. Nearly 80± of those with headache at first evaluation still reported headache at follow-up. Although the likelihood of experiencing the same headache diagnosis and symptoms was high, about one-fifth of children with tension-type headache developed migraine and vice versa. Female gender predicted migraine and frequent headache episodes predicted overall headache at follow-up. The estimated average annual incidence was 81 and 65 per 1000 children, for tension-type headache and migraine, respectively. We conclude that there is a considerable risk of developing and maintaining headache during childhood. Headache diagnoses should be reassessed regularly and treatment adjusted. Girls and children with frequent headache have a poorer prognosis and therefore intervention is particularly important in these groups.

The Efficacy of Hypnotic and Nonhypnotic Response-Based Imagery for Self-Managing Recurrent Headache

1995 ◽  
Vol 14 (3) ◽  
pp. 183-201 ◽  
Author(s):  
Robert P. Nolan ◽  
Nicholas P. Spanos ◽  
Amber A. Hayward ◽  
Heather A. Scott
Keyword(s):  
Group Treatment ◽  
Migraine Headache ◽  
Tension Headache ◽  
Post Treatment ◽  
Control Group ◽  
Recurrent Headache ◽  
Imagery Training ◽  
Imagery Group ◽  
Medication Consumption

Two experiments investigated the use of hypnotic and nonhypnotic response-based imagery training for recurrent headache. In Experiment 1, subjects with symptoms of chronic migraine headache (CMH), or chronic mixed migraine/tension headache (Mixed CMH/CTH) were assigned to a Hypnotic or Nonhypnotic Imagery group, or to a Monitoring Control group. Treatment efficacy was assessed over two-week intervals, at Baseline, Post-treatment, and three successive follow-up periods. In Experiment 2, subjects with symptoms of chronic tension headache (CTH) were assigned to four conditions (Hypnotic Imagery/Nonhypnotic Imagery/Placebo/Monitoring Control), and studied across two-week intervals at Baseline, Post-treatment, and eight-week Follow-up. Hypnotic and Nonhypnotic Imagery conditions did not differ in demonstrating efficacy in reducing headache activity in both experiments. Treatment outcome was not associated with medication consumption, or actual changes in physiologic processes (cardiovascular functioning and frontalis EMG). Headache reduction was not correlated with hypnotizability or the trait propensity to engage in vivid imagery. These results replicate and extend previous findings, and support the use of imagery strategies as a treatment component in pain management programs.

scholarly journals Clinical efficacy of Tailin formulation combined with continuous low-dose antimicrobial therapy for recurrent urinary tract infection: study protocol for a multicenter, double-blind, randomized, controlled clinical trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Tonglu Li ◽  
Yingru Xu ◽  
Xuezhong Gong
Keyword(s):  
Clinical Trial ◽  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Post Treatment ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Randomized Controlled ◽  
Treatment Changes

Abstract Background Given the increasing rates of antimicrobial resistance (AMR), recurrent urinary tract infection (rUTI) is becoming refractory more and more. Antibiotic prophylaxis including continuous low-dose antibiotic therapy (CLAT), is the common treatment for rUTI of the world. However, the presumably adverse reactions caused by CLAT alone should be paid more attention. Studies indicated that Chinese herbal medicine (CHM) might be an available treatment method for rUTI. Tailin formulation (TLF) is a herbal prescription developed for the treatment of rUTI in the 2000s in Shanghai Municipal Hospital of Traditional Chinese Medicine. Our previous studies have shown TLF could prevent urinary tract infection both in pyelonephritis (PN) rat model and in PN patients. Additionally, our published data demonstrated TLF is helpful to reduce the recurrence of rUTI and protect renal tubular function in clinic. In order to find a novel treating project for rUTI to increase the clinical curative effect, we thus try to combine TLF with CLAT to treat rUTI and design an optimized, pragmatically clinical trial to evaluate the efficacy and safety of this project. Methods/design This is a multicenter, double-blind, randomized, controlled clinical trial. We will enroll 200 eligible patients diagnosed with uncomplicated rUTI and then divide them randomly into two groups with a 1:1 ratio: TLF + CLAT group and placebo + CLAT group. This trial consists of two stages, a 12-week period of treatment and a 12-week period of post-treatment follow-up, respectively. The primary outcome will be the recurrence rate at the 12th week of the follow-up period; the second outcomes will be the post-treatment changes in renal and liver function; furthermore, traditional Chinese medicine (TCM) symptoms, non-infection-related physical signs, and subjective symptoms will be scored, and the number of episodes of each subject will be also recorded; meanwhile, vital signs indicators and serious adverse events (SAEs) will be monitored throughout the trial. Discussion This study will provide convictive research-derived data to evaluate clinical efficacy and safety of TLF combined with CLAT for rUTI, and provide an evidence-based recommendation for clinicians. Moreover, post-treatment changes in non-infection-related physical signs and subjective symptoms were included in the efficacy evaluation, which is important and more significant for assessing the clinical benefits for those rUTI patients. Trial registration Chinese Clinical Trial Registry ChiCTR2100041914. Registered on 10 January 2021. Protocol date and version: September 12, 2020; version 1.

scholarly journals Appearance of recurrent adult fibrosarcoma of the soft tissue and loco-regional post-treatment changes on MRI follow-up

2020 ◽  
Author(s):  
Sam Sedaghat ◽  
Frederick Schmitz ◽  
Anne Krieger ◽  
Maya Sedaghat ◽  
Benjamin Reichardt
Keyword(s):  
Soft Tissue ◽  
Post Treatment ◽  
Treatment Changes
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