scholarly journals Integrative East–West Medicine Intervention for Chronic Daily Headache: A Case Report and Care Perspective

2020 ◽  
Vol 9 ◽  
pp. 216495612090581
Author(s):  
Justin G Laube ◽  
Thais Salles Araujo ◽  
Lawrence B Taw
Keyword(s):  
Chronic Migraine ◽  
Chronic Daily Headache ◽  
Medication Overuse ◽  
Trigger Point ◽  
Tension Type Headache ◽  
Contributing Factors ◽  
Chronic Tension Type Headache ◽  
Daily Headache ◽  
Type Headache ◽  
East West

Chronic daily headache is a group of headache syndromes including most commonly chronic migraine and chronic tension-type headache, which often overlap, are complicated by medication overuse and are disabling, costly, and variable responsive to western pharmacotherapeutic interventions. There is growing research and awareness of integrative health approaches and therapies to address patients with chronic headache, yet limited examples of how to deliver this approach. This article reviews a commonly seen challenging case of a patient with overlapping chronic migraine and chronic tension-type headache complicated by medication overuse managed with an integrative east–west medicine intervention. This included person-centered biopsychosocial history taking, traditional Chinese medicine informed acupuncture, trigger point injections, and contributing factors modifications. A narrative review of the literature is presented to demonstrate an evidence-informed rationale for incorporating nonpharmacologic approaches to effectively help reduce the symptom burden of this patient population.

Evaluation of Chronic Daily Headache—Comparison to Criteria for Chronic Tension-Type Headache

Cephalalgia ◽  
1992 ◽  
Vol 12 (6) ◽  
pp. 365-368 ◽  
Author(s):  
Seymour Solomon ◽  
Richard B Lipton ◽  
Lawrence C Newman
Keyword(s):  
Chronic Daily Headache ◽  
Medication Overuse ◽  
International Headache Society ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Ihs Classification ◽  
Analgesic Medication ◽  
Daily Headache ◽  
Ihs Criteria ◽  
Type Headache

The purpose of this study was to evaluate the adequacy of the International Headache Society (IHS) criteria for chronic tension-type headache and, if appropriate, suggest modifications of the IHS classification. We evaluated 100 consecutive patients with chronic daily headache. Approximately two-thirds of our patients fulfilled the criteria for chronic tension-type headache. Most of the patients who failed to meet the criteria did so because they had more than one migrainous feature. Approximately 50% of patients took excessive amounts of analgesic medication. We conclude that the IHS criteria should be modified to include chronic daily headache evolving from migraine; subtypes with and without medication overuse should be distinguished.

Chronic Tension-Type Headache in Children and Adolescents

Cephalalgia ◽  
2001 ◽  
Vol 21 (8) ◽  
pp. 830-836 ◽  
Author(s):  
Ishaq Abu-Arafeh
Keyword(s):  
Children And Adolescents ◽  
Clinical Features ◽  
Chronic Daily Headache ◽  
Adult Population ◽  
Tension Type Headache ◽  
Stressful Events ◽  
Chronic Tension Type Headache ◽  
Daily Headache ◽  
Ihs Criteria ◽  
Type Headache

In this study, the causes, predisposing factors and clinical features of chronic daily headache in children and adolescents were studied within the population of patients attending a specialist headache. The International Headache Society's (IHS) criteria for the diagnosis of chronic tension type headache (CTTH) were assessed for their applicability in the paediatric age group. Over a period of three years, demographic and clinical data were collected prospectively on all children who attended the clinic and suffered from daily attacks of headache. One hundred and fifteen children and adolescents (32% of all clinic population) had chronic daily headache, of whom 93 patients (81%) fulfilled the IHS criteria for the diagnosis of CTTH. They were between 3-15 years of age (mean: 11.1, SD: 2.3) and their female to male ratio was 1.2: 1. Around one third of the patients also suffered from migraine (mainly migraine without aura). The headache was described as mild in 60.9%, moderate 36.5% and severe 2.6%. Headache was located at the forehead in 53% or over the whole of the head in 29.6%. Pain was described as ‘just sore’ or dull by 73.9%. During attacks of headache, at least half the patients reported light intolerance, noise intolerance, anorexia or nausea. Thirty-two percent of patients had at least one underlying chronic disease that may have contributed to the pathogenesis of the CTTH. Eleven percent had serious stressful events related to family illnesses and in four patients headaches were triggered by family bereavement. Fourteen percent were investigated with neuroimaging and 22% were referred for clinical psychology assessment and management. In conclusion, CTTH is a common cause of headache in children attending a specialist headache clinic. The clinical features closely match those of adult population and the IHS criteria for the diagnosis of CTTH can be adapted for use in children. Predisposing stressful risk factors, physical or emotional, are present in a large proportion.

An epidemiological approach to the nosography of chronic daily headache

Cephalalgia ◽  
1993 ◽  
Vol 13 (12_suppl) ◽  
pp. 72-77 ◽  
Author(s):  
Giorgio Sandrini ◽  
Gian Camillo Manzoni ◽  
Carla Zanferrari ◽  
Giuseppe Nappi
Keyword(s):  
Clinical Features ◽  
Chronic Daily Headache ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Transformed Migraine ◽  
Daily Headache ◽  
Ihs Criteria ◽  
Recent Classification ◽  
Type Headache ◽  
Epidemiological Approach

Chronic daily headache (CDH), a heterogeneous group of headaches, includes different forms that occur daily, or almost daily, over a prolonged period of time. The nosography of this group is still a matter of debate, and in the most recent classification of the IHS (1988) only a few types of CDH are included: chronic tension-type headache, coexisting migraine. This study is an epidemiological approach to identifying the clinical features of CDH and the possible factors involved in changing episodic headache in CDH. Ninety CDH outpatients were investigated using a computerized record chart. The main observed forms were: (a) chronic tension-type headache–migraine with interparoxysmal headache, an evolved form of migraine in which a constant low severity headache develops between attacks; (b) transformed migraine, an evolved form of migraine with progressive worsening of the disease which reaches the level of continuous pain with the disappearance of typical migraine attacks. Interval headaches in migraine with interparoxysmal headache partly fulfil the IHS criteria for chronic tension-type headache. Analgesic drug abuse plays a prominent role in inducing CDH and in determining its clinical features.

Transformed migraine

Cephalalgia ◽  
1993 ◽  
Vol 13 (12_suppl) ◽  
pp. 78-83 ◽  
Author(s):  
Ninan T Mathew
Keyword(s):  
Chronic Daily Headache ◽  
Tension Type Headache ◽  
Drug Induced ◽  
Chronic Tension Type Headache ◽  
Transformed Migraine ◽  
Mixed Features ◽  
History Of ◽  
Daily Headache ◽  
International Headache Classification ◽  
Type Headache

Chronic tension-type headache, which is included in the International Headache Classification, is present in only a minority of patients who present with chronic daily headache. The majority have what is termed transformed migraine, with a history of distinct episodes of migraine in the initial years which progresses into chronic daily headache. These patients with transformed migraine exhibit mixed features of migraine and chronic tension-type headache. Two distinct types of transformed migraine are identifiable, namely those related to excessive intake of medications (drug-induced transformed migraine) and those unrelated to excessive use of medications. The clinical features of transformed migraine and the drug-induced variety are described. The need for revision of the International Classification to include chronic daily headache and the subtypes of transformed migraine is pointed out.

scholarly journals Study of Sleep Disorders and Polysomnographic Evaluation among Primary Chronic Daily Headache Patients

2016 ◽  
Vol 07 (S 01) ◽  
pp. S072-S075 ◽  
Author(s):  
Rajesh Verma ◽  
Kamal Kumar Nagar ◽  
Ravindra Kumar Garg ◽  
Ravi Uniyal ◽  
Praveen Kumar Sharma ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Sleep Disorder ◽  
Chronic Daily Headache ◽  
Daytime Sleepiness ◽  
Structured Interview ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Daily Headache ◽  
Type Headache ◽  
Headache Patients

ABSTRACT Objective: Studies related to sleep disorders and polysomnography (PSG) among chronic daily headache patients are rare. We studied this and compared chronic migraine (CM) with chronic tension-type headache. Methods: Eighty-three patients were recruited. They were evaluated by semi-structured interview, headache, and sleep diaries along with Epworth Sleepiness Scale score and insomnia symptom score. Overnight PSG was performed and data compared. Results: Chronic tension-type headache was more common than CM, both having female preponderance. Insomnia followed by excessive daytime sleepiness was prevalent sleep disorder. Sleep efficiency and Stage 3 sleep were lower in CM compared to chronic tension-type. ESSS was significantly increased among chronic tension-type patients. No significant correlation was found among PSG parameters in patients with or without sleep disorders. Conclusion: Insomnia being most common sleep disorder among chronic headache population. Chronic tension-type headache had slightly better slow-wave sleep than CM and significantly increased daytime sleepiness.

Psychophysical testing in chronic migraine and chronic tension type headache: An observational study

Cephalalgia ◽  
2021 ◽  
pp. 033310242110603
Author(s):  
Ignacio Elizagaray-García ◽  
Gabriela F Carvalho ◽  
Tibor M Szikszay ◽  
Waclaw M Adamczyk ◽  
Gonzalo Navarro-Fernández ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Tension Type Headache ◽  
Headache Frequency ◽  
Chronic Tension Type Headache ◽  
Psychophysical Testing ◽  
Pressure Pain Thresholds ◽  
Type Headache ◽  
Neck Disability ◽  
Painful Area

Background Clinical presentation is the key to the diagnosis of patients with migraine and tension-type headache, but features may overlap when both become chronic. Psychophysical parameters may distinguish both conditions. We aimed to compare psychophysical aspects of patients with chronic migraine, chronic tension-type headache and headache-free controls, and to determine whether these can predict headache frequency. Methods An examiner blinded to the diagnosis assessed 100 participants (chronic migraine (n = 38), chronic tension-type headache (n = 31) and controls (n = 31)). Assessed variables included painful area, pressure pain thresholds, temporal summation, cervical range of motion, neck posture, headache and neck impact, quality of life, and kinesiophobia. Comparison between groups was performed with one-way ANOVA and multiple linear regression was used to assess the headache frequency predictors. Results We found differences of both headache groups compared to controls ( p < 0.01), but not between headache groups. Neck disability was a significant predictor of headache frequency for chronic tension-type headache (adjusted R2 = 0.14; β = 0.43; p = 0.03) and chronic migraine (adjusted R2 = 0.18; β = 0.51; p < 0.01). Conclusions Chronic tension-type headache and chronic migraine showed similar psychophysical results, but were significantly worse when compared to controls. The psychophysical examination did not discriminate between headache types. The variable best explaining headache frequency for both headache types was neck disability.

Contingent Negative Variation in Patients with Chronic Daily Headache

Cephalalgia ◽  
1998 ◽  
Vol 18 (8) ◽  
pp. 565-569 ◽  
Author(s):  
M Siniatchkin ◽  
W-D Gerber ◽  
P Kropp ◽  
A Vein
Keyword(s):  
Chronic Daily Headache ◽  
Contingent Negative Variation ◽  
Migraine Without Aura ◽  
Tension Type Headache ◽  
Transformed Migraine ◽  
Early Component ◽  
Predictive Variables ◽  
Environment Control ◽  
Daily Headache ◽  
Type Headache

The aim of this study was the investigation of amplitude and habituation of contingent negative variation (CNV) in migraine and chronic daily headache (CDH) patients in order to describe possible neurophysiological features responsible for the clinical transformation and worsening of the headache. Fifteen females suffering from migraine without aura and 15 females diagnosed with CDH evolved from migraine without aura with interparoxysmal chronic tension-type headache (transformed migraine), underwent CNV recording. Fifteen healthy females matched for age served as controls. CNV was obtained from C3 and C4 using the standard reaction time paradigm and 3 sec ISI. The amplitudes and habituation of total CNV, early and late components, and of post-imperative negative variation (PINV) were calculated. The migraine patients were characterized by significantly more pronounced negativity of the early component and total CNV, compared to CDH sufferers and controls. CDH patients demonstrated significantly reduced negativity of the late component and pronounced PINV compared to the other groups. The early component of CNV did not habituate in migraine or CDH patients. However, the impaired habituation in CDH was related to significantly lower amplitudes. These results support the diagnostic and scientific value of habituation in migraine research and therapy. Late components of CNV and PINV can be considered as predictive variables for transformation of migraine. The results are discussed in terms of the relationship between late CNV, PINV, environment control abilities and susceptibility for development of depression.

Sign in / Sign up

Export Citation Format

Share Document