Primary headache and migraine in headache specialists – does personal history of doctors matter?

Cephalalgia ◽  
2019 ◽  
Vol 40 (1) ◽  
pp. 96-106 ◽  
Author(s):  
Stefan Evers ◽  
Nicole Brockmann ◽  
Oliver Summ ◽  
Ingo W Husstedt ◽  
Achim Frese
Keyword(s):  
Cluster Headache ◽  
General Practitioners ◽  
Primary Headache ◽  
Treatment Recommendations ◽  
Personal History ◽  
Self Report ◽  
Primary Headache Disorders ◽  
History Of ◽  
The Impact ◽  
Age And Sex

Objective Migraine is a common disorder affecting more than 10% of the population. The prevalence of migraine among physicians and, in particular, among headache specialists is widely unknown as is the impact of suffering from migraine on the attitudes towards migraine and on treatment recommendations of physicians. We designed a survey among headache specialists and neurologists and compared the results to general pain specialists and general practitioners. Methods A standardized interview in randomly selected samples of these four groups of physicians was performed. The interview included data on the prevalence of migraine and other primary headache disorders in the physician groups, self-report on their own treatment, attitudes towards migraine, and treatment recommendations for migraine. The prevalence rates were also compared to an age- and sex-matched German general population sample. Results The lifetime prevalence of migraine was higher in headache specialists (53.0%) than in general neurologists (43.0%), pain specialists (21.7%), general practitioners (19.3%), and in the general age- and sex-matched population (16.8%). Cluster headache prevalence was high in neurologists (1.9%) and in headache specialists (1.3%); episodic tension-type headache prevalence was significantly lower in general practitioners (19.5%). One reason, among others, was that being a migraine (or cluster headache) patient more often prompted the sufferers to become a specialist in neurology. Physicians with migraine rated the biopsychosocial concept of lower importance for migraine than did physicians without migraine. The self-treatment of migraine in physicians differs from the treatment recommendations to the patients. For example, only 36.4% of the headache specialists with migraine take triptans whereas 94.4% recommend triptans to their patients. Conclusions We conclude that being a headache specialist or a neurologist is associated with an increased migraine or cluster headache prevalence. This personal history of migraine leads to a more somatic view of migraine as a disorder and to different treatment recommendations as compared to self-treatment.

Posttraumatic Headache

2018 ◽  
Vol 38 (06) ◽  
pp. 619-626 ◽  
Author(s):  
Brigid Dwyer
Keyword(s):  
Tension Headache ◽  
Primary Headache ◽  
Secondary Headache ◽  
Postconcussion Syndrome ◽  
Posttraumatic Headache ◽  
Posttraumatic Epilepsy ◽  
Primary Headache Disorders ◽  
History Of ◽  
Military Populations ◽  
Patients Experience

AbstractPosttraumatic headaches are among the most challenging complaints after mild traumatic brain injury (mTBI). They are a debilitating problem experienced by patients after TBI of all severities. Up to 90% of mild TBI patients experience headache, particularly if female and with a premorbid history of primary headache. Tension headache has classically been the most common subtype, but in military populations migraine has dominated. Posttraumatic headache encompasses a spectrum of headache types that overlap heavily with common primary headache disorders, but also autonomic cephalgias as well as several secondary headache conditions. It is important to understand the evolution of postconcussion syndrome as a concept, and the challenges associated with diagnosing and treating multidomain drivers effectively. The first-line treatments for posttraumatic headache are typically the same as those used in nontraumatic headache, with additional considerations for cognitive side effects, posttraumatic epilepsy, and coexisting injuries resulting in neuropathic pain or medication overuse.

Headaches

2021 ◽  
pp. 329-342
Author(s):  
Andrew D. Hershey
Keyword(s):  
Early Recognition ◽  
Primary Headache ◽  
Primary Care Providers ◽  
School Nurses ◽  
Primary Headaches ◽  
Care Providers ◽  
Primary Headache Disorders ◽  
Tension Type Headaches ◽  
The Impact

This chapter discusses recurrent headaches, especially when episodic, which are much more likely to represent primary headache disorders. Primary headaches are intrinsic to the nervous system and are the disease itself. Early recognition of the primary headaches in patients should result in improved response and outcome, minimizing the impact of the primary headaches and disability. Primary headaches can be grouped into migraine, tension-type headaches, and trigeminal autonomic cephalalgia, and an additional grouping of rarer headaches without a secondary cause. The primary headache that has the greatest impact on a child’s quality of life and disability is migraine, and subsequently is the most frequent primary headache brought to the attention of parents, primary care providers, and school nurses.

scholarly journals Baseline characteristics and comorbidities in the CAnadian REgistry for Pulmonary Fibrosis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
J. H. Fisher ◽  
M. Kolb ◽  
M. Algamdi ◽  
J. Morisset ◽  
K. A. Johannson ◽  
...  
Keyword(s):  
Pulmonary Fibrosis ◽  
Self Report ◽  
Full Cohort ◽  
Cross Sectional ◽  
Patient Reported ◽  
History Of ◽  
Baseline Characteristics ◽  
Clinical Measurements ◽  
Incident Cases ◽  
The Impact

Abstract Background The CAnadian REgistry for Pulmonary Fibrosis (CARE-PF) is a multi-center, prospective registry designed to study the natural history of fibrotic interstitial lung disease (ILD) in adults. The aim of this cross-sectional sub-study was to describe the baseline characteristics, risk factors, and comorbidities of patients enrolled in CARE-PF to date. Methods Patients completed study questionnaires and clinical measurements at enrollment and each follow-up visit. Environmental exposures were assessed by patient self-report and comorbidities by the Charlson Comorbidity Index (CCI). Baseline characteristics, exposures, and comorbidities were described for the overall study population and for incident cases, and were compared across ILD subtypes. Results The full cohort included 1285 patients with ILD (961 incident cases (74.8%)). Diagnoses included connective tissue disease-associated ILD (33.3%), idiopathic pulmonary fibrosis (IPF) (24.7%), unclassifiable ILD (22.3%), chronic hypersensitivity pneumonitis (HP) (7.5%), sarcoidosis (3.2%), non-IPF idiopathic interstitial pneumonias (3.0%, including idiopathic nonspecific interstitial pneumonia (NSIP) in 0.9%), and other ILDs (6.0%). Patient-reported exposures were most frequent amongst chronic HP, but common across all ILD subtypes. The CCI was ≤2 in 81% of patients, with a narrow distribution and range of values. Conclusions CTD-ILD, IPF, and unclassifiable ILD made up 80% of ILD diagnoses at ILD referral centers in Canada, while idiopathic NSIP was rare when adhering to recommended diagnostic criteria. CCI had a very narrow distribution across our cohort suggesting it may be a poor discriminator in assessing the impact of comorbidities on patients with ILD.

scholarly journals A-130 An Exploratory Analysis of the Impact PTSD Related Sleep Disturbance has on Language Generativity in Veterans with mTBI

2020 ◽  
Vol 35 (6) ◽  
pp. 923-923
Author(s):  
Walker N ◽  
Scott T ◽  
Spellman J ◽  
Rivera J ◽  
Waltzman D ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbance ◽  
Verbal Fluency ◽  
Sleep Disturbances ◽  
Self Report ◽  
Analysis Of Covariance ◽  
Ptsd Symptoms ◽  
History Of ◽  
The Impact ◽  
The Relationship

Abstract Objective Reviewed literature suggests that individuals with Posttraumatic Stress Disorder (PTSD) demonstrate cognitive deficits in attention, learning/memory, and executive functions. Less is known regarding the relationship between sleep disturbance and language abilities among individuals with PTSD. We hypothesized that subjective perceptions of PTSD-related sleep disturbance would impact language generativity in Veterans with PTSD. Methods 38 individuals (mean age = 46.58, SD = 13.55; 10% female) were administered a brief neurocognitive battery including measures of verbal generativity [i.e., Delis-Kaplan Executive Function System: Verbal fluency subtest], PTSD symptoms (i.e., clinically significant PTSD = > 35 on the PTSD Checklist for DSM-IV), self-report measures of sleep quality (Pittsburgh Sleep Quality Inventory; PSQI), and PTSD-related sleep disturbances (PSQI – Addendum for PTSD). All participants had a history of mild traumatic brain injury (mTBI). An analysis of covariance was used to assess the contribution of PTSD-related sleep disturbance on verbal fluency in Veterans with PTSD. Post-hoc analyses were conducted. Results Those without PTSD performed better on letter fluency than those with PTSD (p=.019). There was no significant effect of PTSD (presence or absence) on letter fluency performance after controlling for subjective sleep quality, F(1, 35) = 1.43, p = .239. Follow up analyses failed to show any associations between PTSD and other cognitive measures. Conclusions PTSD related sleep disturbance accounts for a significant portion of the variance in the relationship between PTSD and verbal generativity. Individuals with a history of mTBI and current PTSD symptoms, may have worse verbal generativity but is partially accounted for by PTSD related sleep disturbance.

Neuromodulatory Approaches to the Management of Medically Refractory Cluster Headache

2010 ◽  
Vol 5 (1) ◽  
pp. 97
Author(s):  
Arne May ◽  
Peter J Goadsby ◽  
◽  
Keyword(s):  
Cluster Headache ◽  
Treatment Options ◽  
Primary Headache ◽  
Chronic Cluster Headache ◽  
Primary Headache Disorders ◽  
Greater Occipital Nerve ◽  
Term Data ◽  
Deep Brain ◽  
Stimulation Of

The trigeminal autonomic cephalalgias are a group of primary headache disorders characterised by unilateral trigeminal distribution of pain that occurs in association with ipsilateral cranial autonomic features. The most prominent one is cluster headache, a dreadful disease with excrutiating pain attacks. These attacks last no longer than two hours but may occur several times per day. It is mandatory to find an efficient therapy for these patients, but some are unresponsive to all treatments. In these intractable cases invasive procedures are introduced, but the available evidence (while conflicting) illustrates that trigeminal denervation may not be effective in preventing the headache attacks or autonomic symptoms of chronic cluster headache. Modern neurostimulating approaches, such as stimulation of the greater occipital nerve and hypothalamic deep brain stimulation, supersede neurodestructive procedures. Both stimulation methods are exquisite and potentially lifesaving treatment options in otherwise intractable patients, but they need to be better characterised and further long-term data are needed.

scholarly journals Phenotypic and treatment outcome data on SUNCT and SUNA, including a randomised placebo-controlled trial

Cephalalgia ◽  
2017 ◽  
Vol 38 (9) ◽  
pp. 1554-1563 ◽  
Author(s):  
Hsing-Yu Weng ◽  
Anna S Cohen ◽  
Christoph Schankin ◽  
Peter J Goadsby
Keyword(s):  
Controlled Trial ◽  
Clinical Manifestations ◽  
Primary Headache ◽  
Outcome Data ◽  
Short Term ◽  
Autonomic Symptoms ◽  
Primary Headache Disorders ◽  
Cranial Autonomic Symptoms ◽  
History Of

Background Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) are two rare headache syndromes classified broadly as Trigeminal Autonomic Cephalalgias (TACs). Methods Here, 65 SUNCT (37 males) and 37 SUNA (18 males) patients were studied to describe their clinical manifestations and responses to treatment. Results Pain was almost always unilateral and side-locked. There were three types of attack: Single stabs, stab groups, and a saw-tooth pattern, with some patients experiencing a mixture of two types. As to cranial autonomic symptoms, SUNA patients mainly had lacrimation (41%) and ptosis (40%). Most cases of the two syndromes had attack triggers, and the most common triggers were touching, chewing, or eating for SUNCT, and chewing/eating and touching for SUNA. More than half of each group had a personal or family history of migraine that resulted in more likely photophobia, phonophobia and persistent pain between attacks. For short-term prevention, both syndromes were highly responsive to intravenous lidocaine by infusion; for long-term prevention, lamotrigine and topiramate were effective for SUNCT, and lamotrigine and gabapentin were efficacious in preventing SUNA attacks. A randomized placebo-controlled cross-over trial of topiramate in SUNCT using an N-of-1 design demonstrated it to be an effective treatment in line with clinical experience. Conclusions SUNCT and SUNA are rare primary headache disorders that are distinct and very often tractable to medical therapy.

scholarly journals Gambaran nyeri kepala primer pada mahasiswa angkatan 2013 Fakultas Kedokteran Universitas Sam Ratulangi Manado

e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Yafet Tandaju ◽  
Theresia . Runtuwene ◽  
Mieke A.H.N. Kembuan
Keyword(s):  
Medical Students ◽  
Family History ◽  
Cluster Headache ◽  
Migraine With Aura ◽  
Migraine Without Aura ◽  
Primary Headache ◽  
Descriptive Study ◽  
Headache Type ◽  
History Of ◽  
Pain Questionnaires

Abstract: This study aimed to obtain the profile of primary headache among medical students batch 2013 in University of Sam Ratulangi Manado. This was a descriptive study. The headache description was assessed with questionnaires (Pain questionnaires PERDOSSI). There were 176 respondents consisted of 45 males and 131 females. The percentages of each headache type were as follows: tension-type 64%, migraine without aura 20%, migraine with aura 15%, and cluster headache 1%. The results showed that stress triggered 84% of headache cases. There were 73% of respondents who suffered from headache had family history of headache.Keywords: primary headache, types of headache Abstrak: Penelitian ini bertujuan untuk mendapatkan gambaran nyeri kepala primer pada mahasiswa kedokteran Universitas Negeri Sam Ratulangi angkatan 2013. Jenis penelitian ini deskriptif. Deskripsi nyeri kepala pada responden dinilai dengan kuesioner (kuesioner nyeri PERDOSSI ). Terdapat 176 responden, terdiri dari 45 responden laki-laki dan 131 responden perempuan. Persentase untuk setiap jenis sakit kepala ialah sebagai berikut: tipe tegang 64%, migraine tanpa aura 20%, migrain dengan aura 15%, dan nyeri kepala klaster 1%. Hasil penelitian menunjukkan bahwa stres memicu 84% dari kasus nyeri kepala. Pada penelitian ini didapatkan 73% dari responden yang menderita serangan nyeri kepala memiliki riwayat keluarga sakit kepala.Kata kunci: nyeri kepala primer, jenis sakit kepala

Cluster Headache and Other Trigeminal Autonomic Cephalalgias

2018 ◽  
Vol 38 (06) ◽  
pp. 603-607
Author(s):  
Brian McGeeney
Keyword(s):  
Cluster Headache ◽  
Health Care Providers ◽  
Treatment Options ◽  
Primary Headache ◽  
Trigeminal Autonomic Cephalalgias ◽  
Care Providers ◽  
Private Industry ◽  
Primary Headache Disorders ◽  
New Treatments ◽  
Delays In Diagnosis

AbstractThe trigeminal autonomic cephalalgias are a group of distinct primary headache disorders that share common characteristics of strict unilateral headache often accompanied by unilateral cranial autonomic features. Cluster headache is the most well-known example, but other than neurologists, practitioners often have limited familiarity with these disorders and treatment options. Delays in diagnosis are typical and treatment options remain suboptimal, associated with limited scientific research into these brain disorders. Improved familiarity with core clinical features by health care providers should lead to earlier referral to specialists, and this education is the responsibility of headache medicine specialists. Optimistically, the last few years have seen lobbying for more federal research support in headache medicine and there has been renewed interest by private industry in potential new treatments for trigeminal autonomic cephalalgias.

Quality of life in primary headache disorders: A review

Cephalalgia ◽  
2015 ◽  
Vol 36 (1) ◽  
pp. 67-91 ◽  
Author(s):  
Norazah Abu Bakar ◽  
Surat Tanprawate ◽  
Giorgio Lambru ◽  
Mariam Torkamani ◽  
Marjan Jahanshahi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Headache ◽  
Well Being ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Headache Type ◽  
Related Quality ◽  
Psychological Comorbidities ◽  
The Impact

Background Health-related quality of life (HRQoL) is emerging as an important element of clinical research in primary headache disorders, allowing a measure of the impact of headache on patients’ well-being and daily life. A better understanding of this may contribute to improved resource allocations and treatment approaches. Objective The objective of this study is to review available data on HRQoL in primary headache disorders and identify any influencing factors. Methods Database searches including MEDLINE, PsycINFO and EMBASE were performed. Studies that investigated HRQoL in patients with primary headache disorders were included and reviewed. Trials that evaluated the efficacy of medications or interventions were excluded. Results A total of 80 articles were included in the review. Both physical and emotional/mental aspects of HRQoL were impaired across headache subtypes, although the extent varied depending on headache type. A number of factors influencing HRQoL were also identified. Conclusion This narrative review suggests that headache, particularly in its chronic form, has a great impact on HRQoL. Clinical practice should not solely focus on pain alleviation but rather adopt routine assessment of HRQoL. Furthermore, identification and management of associated psychological comorbidities, which can significantly influence HRQoL in headache sufferers, are essential for optimal clinical management.

scholarly journals The Canadian Registry for Pulmonary Fibrosis: Design and Rationale of a National Pulmonary Fibrosis Registry

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Christopher J. Ryerson ◽  
Benjamin Tan ◽  
Charlene D. Fell ◽  
Hélène Manganas ◽  
Shane Shapera ◽  
...  
Keyword(s):  
Natural History ◽  
Pulmonary Fibrosis ◽  
Health Services ◽  
Self Report ◽  
Administrative Databases ◽  
Health Services Use ◽  
Acute Exacerbations ◽  
History Of ◽  
The Impact ◽  
Services Use

Background. The relative rarity and diversity of fibrotic interstitial lung disease (ILD) have made it challenging to study these diseases in single-centre cohorts. Here we describe formation of a multicentre Canadian registry that is needed to describe the outcomes of fibrotic ILD and to enable detailed healthcare utilization analyses that will be the cornerstone for future healthcare planning.Methods. The Canadian Registry for Pulmonary Fibrosis (CARE-PF) is a prospective cohort anticipated to consist of at least 2,800 patients with fibrotic ILD. CARE-PF will be used to (1) describe the natural history of fibrotic ILD, specifically determining the incidence and outcomes of acute exacerbations of ILD subtypes and (2) determine the impact of ILD and acute exacerbations of ILD on health services use and healthcare costs in the Canadian population. Consecutive patients with fibrotic ILD will be recruited from five Canadian ILD centres over a period of five years. Patients will be followed up as clinically indicated and will complete standardized questionnaires at each clinic visit. Prespecified outcomes and health services use will be measured based on self-report and linkage to provincial health administrative databases.Conclusion. CARE-PF will be among the largest prospective multicentre ILD registries in the world, providing detailed data on the natural history of fibrotic ILD and the healthcare resources used by these patients. As the largest and most comprehensive cohort of Canadian ILD patients, CARE-PF establishes a network for future clinical research and early phase clinical trials and provides a platform for translational and basic science research.

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