scholarly journals The management and clinical knowledge of headache disorders among general practitioners in Norway: a questionnaire survey

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Espen Saxhaug Kristoffersen ◽  
Kashif Waqar Faiz ◽  
Jakob Møller Hansen ◽  
Erling Andreas Tronvik ◽  
Jan C. Frich ◽  
...  
Keyword(s):  
General Practitioners ◽  
Questionnaire Survey ◽  
Medication Overuse Headache ◽  
Treatment Options ◽  
Episodic Migraine ◽  
Continuous Medical Education ◽  
Tension Type Headache ◽  
Headache Disorders ◽  
Type Headache ◽  
Headache Patients

Abstract Background General practitioners (GPs) diagnose and manage a majority of headache patients seeking health care. With the aim to understand the potential for clinical improvement and educational needs, we performed a study to investigate Norwegian GPs knowledge about headache and its clinical management. Methods We invited GPs from a random sample of 130 Norwegian continuous medical education (CME) groups to respond to an anonymous questionnaire survey. Results 367 GPs responded to the survey (73% of invited CME groups, 7.6% of all GPs in Norway). Mean age was 46 (SD 11) years, with an average of 18 (SD 10) years of clinical experience. In general the national treatment recommendations were followed, while the International Classification of Headache Disorders and other international guidelines were rarely used. Overall, 80% (n = 292) of the GPs suggested adequate prophylactic medication for frequent episodic migraine, while 28% (n = 101) suggested adequate prophylactic medication for chronic tension-type headache (CTTH). Half (52%, n = 191)) of the respondents were aware that different types of acute headache medication can lead to medication-overuse headache (MOH), and 59% (n = 217) knew that prophylactic headache medication does not lead to MOH. GPs often used MRI in the diagnostic work-up. GPs reported that lack of good treatment options was a main barrier to more optimized treatment of headache patients. Conclusion The knowledge of management of CTTH and MOH was moderate compared to migraine among Norwegian GPs.

Prevalence of primary headache disorders diagnosed according to ICHD-3 beta in three different social groups

Cephalalgia ◽  
2015 ◽  
Vol 36 (6) ◽  
pp. 579-588 ◽  
Author(s):  
Elena R Lebedeva ◽  
Natalia R Kobzeva ◽  
Denis Gilev ◽  
Jes Olesen
Keyword(s):  
Blood Donors ◽  
Medication Overuse Headache ◽  
Social Groups ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Headache Disorders ◽  
Primary Headache Disorders ◽  
Type Headache ◽  
One Year ◽  
Age Range

Background The aim of our study was to estimate the one-year prevalence of primary headache disorders in three different social groups using the third edition beta of the International Classification of Headache Disorders (ICHD-3 beta). Material and methods The study population included a total of 3124 participants: 1042 students (719 females, 323 males, mean age 20.6, age range 17–40), 1075 workers (146 females, 929 males, mean age 40.4, age range 21–67) and 1007 blood donors (484 females, 523 males, mean age 34.1, age range 18–64). We used a semi-structured, validated face-to-face interview. Results The age-adjusted one-year prevalence of migraine in females was significantly higher ( p < 0.001) in students (41.9%) than in workers (19.2%) and blood donors (18.7%). Age-adjusted prevalence of migraine among males did not differ among the three groups: 4.5% in students, 4.9% in workers and 4.5% in blood donors. Age-adjusted prevalence of tension-type headache (TTH) among females was almost the same in students and blood donors (68.8% and 66.7%) but female workers had a lower prevalence of TTH (57%). Age-adjusted prevalence of TTH among males did not differ significantly between students and blood donors (55.8% and 58.1%) but male workers had a significantly lower ( p < 0.001) prevalence of TTH (30.7%). The prevalence of chronic headache in students (TTH and/or migraine) was 3% and of probable medication-overuse headache 3%, significantly more than in workers and blood donors. Conclusion Headache prevalence was high and differed markedly among the three social groups. It is important that headache epidemiology also focus on socially defined groups in order to target future preventive efforts.

The Usefulness and Applicability of a Basic Headache Diary Before First Consultation: Results of a Pilot Study Conducted In Two Centres

Cephalalgia ◽  
2008 ◽  
Vol 28 (10) ◽  
pp. 1023-1030 ◽  
Author(s):  
C Tassorelli ◽  
G Sances ◽  
M Allena ◽  
N Ghiotto ◽  
L Bendtsen ◽  
...  
Keyword(s):  
Medication Overuse Headache ◽  
Tension Type Headache ◽  
Clinical Interview ◽  
Diagnostic Purpose ◽  
Headache Centre ◽  
Combined Use ◽  
Headache Diary ◽  
Type Headache ◽  
Level Of Agreement ◽  
Headache Patients

We tested the usefulness and applicability of a simplified headache diary in the diagnosis of migraine (M), tension-type headache (TTH) and medication overuse headache (MOH). The diary was given to headache patients before their first consultation at the headache centre. Seventy-six naive headache patients completed the study. Their understanding of the diary proved highly satisfactory. The patients' level of compliance was also good, with 71± returning the diary completely filled in. The data entered in the diary were deemed complete for the diagnostic purpose in 93± of cases. The level of agreement between headache information gathered through clinical interview and the headache diary was satisfactory. When comparing the diary with the clinical interview, sensitivity was 92± for M, 75± for TTH and MOH. Specificity was 58± for M and TTH, 87± for MOH. Combined use of a diagnostic diary and clinical interview is recommended from the first consultation for headache.

Laboratory tests of headache disorders – dawn of a new era?

Cephalalgia ◽  
2016 ◽  
Vol 36 (13) ◽  
pp. 1268-1290 ◽  
Author(s):  
Henrik Winther Schytz ◽  
Jes Olesen
Keyword(s):  
Trigeminal Neuralgia ◽  
Cluster Headache ◽  
Laboratory Tests ◽  
Medication Overuse Headache ◽  
Blink Reflex ◽  
Tension Type Headache ◽  
Headache Disorders ◽  
Secondary Headaches ◽  
Nociceptive Blink Reflex ◽  
Type Headache

Context The classification of headache disorders has improved over the years, but further work is needed to develop and improve headache diagnosis within headache subtypes. The present review is a call for action to implement laboratory tests in the classification and management of primary and some secondary headaches. Background In this narrative review we present and discuss published tests that might be useful in phenotyping and/or diagnosis of long-lasting headache disorders such as migraine, tension-type headache, trigeminal autonomic cephalalgias, trigeminal neuralgia and persisting secondary headaches. Aim The palpometer test, quantitative sensory testing, nociceptive blink reflex and autonomic tests may be valuable to phenotype and/or diagnose subforms of migraine, tension-type headache, cluster headache, trigeminal neuralgia and medication-overuse headache. Provocation tests with glyceryl trinitrate (GTN) and calcitonin gene-related peptide (CGRP) may be valuable in subclassification of migraine and cluster headache. Lumbar pressure monitoring and optical coherence tomography may valuable tools to diagnose and follow patients with chronic headache and raised intracranial pressure. Finding A number of laboratory tests in headache research are presently available, but have primarily been performed in single research studies or a few studies that differ in methods and patient groups. At present, there is no evidence-based strategy for implementing diagnostic tests, but this could be achieved if well-reputed tertiary headache centers commence developing and implementing laboratory tests in order to improve the classification and treatment of headache patients.

The first prevalence study of primary headaches in adults in a post-conflict area of Serbia

Cephalalgia ◽  
2021 ◽  
pp. 033310242110060
Author(s):  
Nenad Milošević ◽  
Jasna Zidverc Trajković ◽  
Milija Mijajlović ◽  
Jovana Milošević ◽  
Ana Podgorac ◽  
...  
Keyword(s):  
Medication Overuse Headache ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Headache Disorders ◽  
Cross Sectional ◽  
Primary Headache Disorders ◽  
Conflict Area ◽  
Post Conflict ◽  
Type Headache

Aim The aim of the present study was to establish annual prevalence of primary headaches, migraine, and tension-type headache among adults in a post-conflict area of Serbia. Methods The data for this cross-sectional study was obtained via face-to-face interviews using questionnaires specifically designed for this purpose, in line with the available guidelines. The study sample included adults aged 18–65 years whose native language is Serbian with residence in six predominantly Serbian communities in Kosovo and Metohija. Relevant diagnoses were established according to the diagnostic criteria of the International Classification of Headache Disorders, 3rd edition. Results The study included 1062 adults. Analyses indicated 47.7% prevalence of primary headaches. The 1-year prevalence of migraine (with aura and without aura) and tension-type headache was established at 15.2% (3.3% and 11.9%), and 32.2%, respectively. One-year prevalence of chronic headache was calculated at 3.5%, while the prevalence of medication overuse headache was slightly lower at 2.9%. Primary headaches were more prevalent among women, participants residing south of the river Ibar, married or cohabiting individuals, as well as among interviewees (persons) who reported feeling unsafe in Kosovo and Metohija. This is the first study of the prevalence of primary headache disorders in Serbia. The obtained data is comparable to the data available for other countries, especially those in the Balkan region.

scholarly journals Primary headache diagnosis among chronic daily headache patients

2003 ◽  
Vol 61 (2B) ◽  
pp. 364-367 ◽  
Author(s):  
Abouch Valenty Krymchantowski
Keyword(s):  
Chronic Daily Headache ◽  
Primary Headache ◽  
Episodic Migraine ◽  
Tension Type Headache ◽  
Hemicrania Continua ◽  
Headache Diagnosis ◽  
Daily Headache ◽  
Type Headache ◽  
Persistent Headache ◽  
Headache Patients

Chronic daily headache (CDH) refers to a group of non-paroxysmal daily or near-daily headaches with peculiar characteristics that are highly prevalent in populations of neurological clinics and not uncommon among non-patient populations. Most of the patients with CDH had, as primary diagnosis, episodic migraine, which, with the time, presented a progressive frequency, pattern modification and loss of specific migraine characteristics. Other CDH patients had chronic tension-type headache, new daily persistent headache and hemicrania continua, which evolved thru the time to the daily or near-daily presentation. The objective of this study was to determine the primary headache diagnosis among a population of chronic daily headache patients attending a tertiary center for headache treatment. During a 5-year period 651 consecutive chronic daily headache patients attending a private subspecialty center were studied prospectively. The criteria adopted were those proposed by Silberstein et al (1994, revised 1996). Five hundred seventy four patients (88.1%) had episodic migraine as primary headache before turning into daily presentation, 52 (8%) had chronic tension-type headache, 14 (2.2%) had hemicrania continua and 11 patients (1.7%) had new daily persistent headache. CDH is quite frequent in patients from clinic-based studies suggesting a high degree of disability. Emphasis on education of patients suffering from frequent primary headaches with regard to measures that are able to decrease suffering and disability as well as better medical education directed to more efficient ways to handle these patients are necessary to improve outcome of such a prevalent condition.

Headache

2016 ◽  
Author(s):  
Sathiji Nageshwaran ◽  
Heather C Wilson ◽  
Anthony Dickenson ◽  
David Ledingham
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Tension Type Headache ◽  
Secondary Headache ◽  
Trigeminal Autonomic Cephalalgias ◽  
Headache Disorders ◽  
Treatment Regimes ◽  
Type Headache

This chapter on headache discusses the classification, clinical features, treatment regimes, and evidence for treatment of primary (including migraine, tension-type headache, and trigeminal autonomic cephalalgias) and secondary headache (idiopathic intracranial hypertension and medication overuse headache) disorders.

Odorant substances that trigger headaches in migraine patients

Cephalalgia ◽  
2013 ◽  
Vol 34 (1) ◽  
pp. 14-21 ◽  
Author(s):  
RP Silva-Néto ◽  
MFP Peres ◽  
MM Valença
Keyword(s):  
High Specificity ◽  
Tension Type Headache ◽  
International Classification ◽  
Lifetime Prevalence ◽  
Headache Disorders ◽  
Type Headache ◽  
Low Sensitivity ◽  
Beauty Products ◽  
Headache Patients

Objectives Our objective was to determine odorants that trigger migraine attacks and the time of onset of headache after exposure. Methods Migraine or tension-type headache patients, diagnosed according to the criteria of the International Classification of Headache Disorders-II, were interviewed about lifetime prevalence of headaches triggered by odors and time of onset of pain, after exposure of the patient to the odor. Results We studied 200 migraine patients and 200 tension-type headache patients. There were odor-triggered headaches after 25.5 ± 1.9 minutes of exposure in 70.0% (140/200) of migraine patients and none with tension-type headache, which ran at low sensitivity (70.0%, 95% CI 63.1–76.2) and high specificity (100.0%, 95% CI 97.6–100.0). Odor-triggered headaches are distributed in the following order of frequency: perfumes (106/140, 75.7%), paints (59/140, 42.1%), gasoline (40/140, 28.6%) and bleach (38/140, 27.1%). There was significance in the association of odor-triggered migraine, especially among perfume with cleaning (phi = –0.459), cooking (phi = 0.238), beauty products (phi = –0.213) and foul odors (phi = –0.582). Conclusions Odorants, isolated or in association, especially perfume, may trigger migraine attacks after a few minutes of exposure.

Complete detoxification is the most effective treatment of medication-overuse headache: A randomized controlled open-label trial

Cephalalgia ◽  
2017 ◽  
Vol 38 (2) ◽  
pp. 225-236 ◽  
Author(s):  
Louise Ninett Carlsen ◽  
Signe Bruun Munksgaard ◽  
Rigmor Højland Jensen ◽  
Lars Bendtsen
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Tension Type Headache ◽  
Acute Migraine ◽  
Open Label ◽  
Acute Medication ◽  
Headache Diagnosis ◽  
Type Headache ◽  
Migraine Medication ◽  
Headache Patients

Background There is lack of evidence on how to detoxify medication-overuse headache. Aim To compare the effect of complete stop of acute medication with restricted intake. Methods Medication-overuse headache patients were included in a prospective, outpatient study and randomized to two months’ detoxification with either a) no analgesics or acute migraine-medication (program A), or b) acute medication restricted to two days/week (program B). Detoxification was followed by preventives if indicated. Patients were followed up at 2, 6 and 12 months. Percentage reduction in headache days/month after 6 months was the primary outcome. Results We included 72 medication-overuse headache patients with a primary migraine and/or tension-type headache diagnosis. Fifty-nine completed detoxification, 58 (81%) were followed up at month 6 and 53 (74%) at month 12. At month 6, program A reduced headache days/month by 46% (95% CI 34–58) compared with 22% (95% CI 11–34) in program-B ( p = 0.005), and 70% in program A versus 42% in program B were reverted to episodic headache ( p = 0.04). Migraine-days/month were reduced by 7.2 in program A ( p < 0.001) and 3.6 in program B ( p = 0.002) after 6 months. Conclusion Both detoxification programs were very effective. Detoxification without analgesics or acute migraine-medication was the most effective program. Trial registration Clinicaltrials.gov (NCT02903329).

scholarly journals Demographics and Clinical Features of Patients Referred to Headache Specialists

2006 ◽  
Vol 33 (2) ◽  
pp. 228-234 ◽  
Author(s):  
Susan E. Jelinski ◽  
Werner J. Becker ◽  
Suzanne N. Christie ◽  
Rose Giammarco ◽  
Gordon F. Mackie ◽  
...  
Keyword(s):  
Clinical Features ◽  
Tension Type Headache ◽  
Full Time ◽  
Headache Disorders ◽  
Severe Intensity ◽  
Part Time ◽  
Productive Phase ◽  
Type Headache ◽  
Headache Impact ◽  
Headache Patients

ABSTRACT:Objective:To examine demographic characteristics and clinical features of headache patients referred to neurologists specializing in headache in Canada.Methods:Demographic and clinical data were collected at the time of consultation for 865 new headache patients referred to five headache-specialty clinics in Canada. The Headache Impact Test (HIT-6) and Migraine Disability Questionnaire (MIDAS) were used to measure headache impact and disability. Data were analyzed as part of the Canadian Headache Outpatient Registry and Database (CHORD) Project.Results:The average age of the patients was 40 years and the majority were female (78%). Most were employed either full time (49%) or part time (13%). The majority of patients were diagnosed with either migraine or tension-type headache (78%). Over a third of patients experienced headache every day, and half had experienced a headache in the previous month which was of severe intensity. Most (80%) scored in the “very severe” category of the HIT-6 and over half (55%) were severely disabled as measured by the MIDAS.Conclusion:Patients referred to headache specialists in Canada are severely disabled by their headache disorders. These patients are in the most productive phase of their lives in terms of age and employment. It is important to provide the best available treatment to headache patients in order to minimize the disability and impact of their headache disorders.

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