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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic daily headaches (CDH) affect between 3 and 4% of the Western population and is one of the most common problems seen in the neurology clinic. It is often difficult to delineate where CDH began and medication overuse headache (MOH) supervenes. The current study analyses the development of MOH in people taking regular analgesia for reasons other than headache, namely patients attending rheumatology clinics. The aim of this study was to assess, for the first time in an Irish population of patients, whether CDH was more common in such patients as previously reported. We also wanted to see how often rheumatology patients were taking non-prescribed analgesics. The results show that, in a cohort of 114 rheumatology patients, 32% reported that they suffer from headaches regularly. Of these, 38% fulfilled criteria for CDH (or 12% of the whole cohort). Of the 14 patients with CDH, 11 also fulfilled the International Classification of Headache Disorders criteria for MOH. Seventy per cent of the patients fell under the category of medication overuse (>15 days a month for > 3 months) but only 9% fulfil criteria for MOH. Contrary to the previous work in this area, we found a very low (< 2 %) incidence of previous migraine in our patients with CDH. We conclude that headaches (both CDH and MOH) are common in this patient population. We suggest that here should be greater awareness amongst all doctors caring for these patients of the potential for creating a second chronic problem when using excessive analgesia to treat the first.
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PMID:Headaches in a rheumatology clinic: when one pain leads to another. 1829 Aug 47

Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) is included among trigeminal autonomic cephalalgias in the International Classification of Headache Disorders-2. Available literature suggests that it responds to anticonvulsants, particularly lamotrigine. However, management of partial responders is difficult and antiepileptic duo-therapy may be an answer to it. Nonetheless, to our knowledge, anticonvulsant combination has never been tried in partial responders to monotherapy. We are presenting a case of SUNCT that had overlapping symptoms with Short-lasting Unilateral Neuralgiform headache attacks with cranial Autonomic features and responded well only to the combination of lamotrigine with carbamazepine. However, lamotrigine had to be stopped as patient developed leucopenia and it resulted in partial recurrence of symptoms.
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PMID:Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing: response to antiepileptic dual therapy. 1831 Aug 43

In 2004, the revised International Classification of Headache Disorders (ICHD-II) was published. This study evaluates: (1) the results obtained from applying ICHD-II to children with primary headaches to distinguish between migraine without aura (MO) and tension-type headache (TTH); and (2) the results obtained from introducing modifications of the classification criteria for MO as suggested by various authors. There were 200 participants (93 males, 107 females; age range 3-17 y, mean 9 y 8 mo [SD 2 y 7 mo]). According to the ICHD-II, MO compared with TTH was characterized by: higher intensity of pain; higher frequency of associated symptoms; and higher number of precipitating factors. The significant difference found between patients with MO/probable MO and those with TTH/probable TTH for the variables used in the ICHD-II shows that these variables describe the two forms well. However, 15.5% of children proved to be unclassifiable, mainly because they could not give information for some criteria; other reasons for this were too short a duration of episodes and the possible overlap of criteria describing probable MO and probable TTH. The frequency of one variable, pulsating pain, significantly increased with age. Reduction of duration to 1 hour for MO produced a statistically non-significant increase in the number of children with MO. Behaviour during attacks was found to be simple to apply in evaluating intensity and therefore was introduced as a new criterion. Severe intensity was related to MO, whereas moderate or low-intensity was related to TTH.
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PMID:Analysis of the International Classification of Headache Disorders for diagnosis of migraine and tension-type headache in children. 1835 94

The aim of this study was to determine the features and prevalence of primary stabbing headache, primary exertional headache, primary headache associated with sexual activity, and primary cough headache in a Turkish population of headache patients. The data for this study were obtained from 245 patients with headache. Of these patients, 55 fulfilled the International Classification of Headache Disorders (second edition) diagnostic criteria for 'other primary headaches' such as primary stabbing headache (n=31), primary cough headache (n=1), primary exertional headache (n=13), primary headache associated with sexual activity (n=4), and both primary cough headache and primary exertional headache (n=6). Primary stabbing headache was found in 12.6% of patients, primary cough headache in 0.4%, primary exertional headache in 5.3% and primary headache associated with sexual activity in 1.6%.
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PMID:Features of stabbing, cough, exertional and sexual headaches in a Turkish population of headache patients. 1834 15

A bibliographical search was conducted for papers published between 1999 and 2007 to verify the validity of International Classification of Headache Disorders (ICHD)-II criteria for the Tolosa-Hunt syndrome (THS) in terms of (i) the role of magnetic resonance imaging (MRI); (ii) which steroid treatment should be considered as adequate; and (iii) the response to treatment. Of 536 articles, 48, reporting on 62 patients, met the inclusion criteria. MRI was positive in 92.1% of the cases and it normalized after clinical resolution. There was no evidence of which steroid schedule should be considered as adequate; high-dose steroids are likely to be more effective both to induce resolution and to avoid recurrences. Pain subsided within the time limit required by the ICHD-II criteria, but signs did not. We conclude that THS diagnostic criteria can be improved on the basis of currently available data. MRI should play a pivotal role both to diagnose and to follow-up THS.
Cephalalgia 2008 Jun
PMID:ICHD-II diagnostic criteria for Tolosa-Hunt syndrome in idiopathic inflammatory syndromes of the orbit and/or the cavernous sinus. 1838 13

Headaches are the most common disorders of the central nervous system affecting 46% of the adult population worldwide. Headaches may be lifelong illnesses, often associated with substantial disability for the individual and the population as a whole. The International Classification of Headache Disorders (ICHD-II) codifies headache disorders into fourteen categories, predominantly primary headaches and secondary headache disorders. Primary headache disorders, mainly migraine and trigeminal autonomic cephalgias (TACs), are frequently associated with neuro-ophthalmologic manifestations. Ophthalmologists are often the first physicians to be involved in the deciphering of headache-related visual disturbances. This article reviews two major primary headache disorders, migraine and trigeminal autonomic cephalgias, and discusses their neuro-ophthalmic complications, clinical presentation, and treatment.
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PMID:Neuro-ophthalmologic manifestations of primary headache disorders. 1843 43

Tension-type headache (TTH) is the most prevalent of all headaches and also represents one of the most expensive clinical conditions for the health system. Despite the high impact of this disorder and the existence of well-established diagnostic criteria, knowledge about TTH is still quite limited. In most cases in which crises are quite sporadic, the patients call this normal headache. However, there is a group of patients with the chronic subtype of this headache whose quality of life is greatly compromised. According to the second edition of the International Classification of Headache Disorders, TTH is a bilateral headache of the tight band of pressure type of mild-to-moderate intensity that does not worsen with routine physical activities and whose associated symptoms are less intense than those observed in migraine. Its physiopathology still awaits better elucidation but the existence of central and peripheral mechanisms is already recognized. From a therapeutic viewpoint, simple analgesics are used for the acute treatment of the condition, and tricyclic antidepressants are the most effective class of drugs for its prevention. Follow-up of these patients over the years has demonstrated that the course of TTH is quite favorable in most cases.
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PMID:Tension-type headache. 1845 40

A set of related medical disorders that lack a proper classification system and diagnostic criteria is like a society without laws. The result is incoherence at best, chaos at worst. For this reason, the International Classification of Headache Disorders (ICHD) is arguably the single most important breakthrough in headache medicine over the last 50 years. The ICHD identifies and categorizes more than a hundred different kinds of headache in a logical, hierarchal system. Even more important, it has provided explicit diagnostic criteria for all of the headache disorders listed. The ICHD quickly became universally accepted, and criticism of the classification has been minor relative to that directed at other disease classification systems. Over the 20 years following publication of the first edition of the ICHD, headache research has rapidly accelerated despite sparse allocation of resources to that effort. In summary, the ICHD has attained widespread acceptance at the international level and has substantially facilitated both clinical research and clinical care in the field of headache medicine.
Headache 2008 May
PMID:The International Classification of Headache Disorders. 1847 Nov 12

The study of migraine has yielded many benefits for headache patients. Little research, however, has been performed on refractory migraine (RM) headache, a term often used interchangeably with intractable migraine. This may be a consequence of a lack of a well-accepted definition. In a survey performed by the Refractory Headache Special Interest Section (RHSIS) on the American Headache Society (AHS) in 2006, 58% of the members agreed that a definition for refractory headache should be added to the International Classification of Headache Disorders-2. A PubMed search identified 21 articles that defined refractory or intractable headache/migraine. Sixteen (76%) defined the term "refractory" and 5 (24%) defined the term "intractable." Many of these definitions did not address the need for an adequate trial of a preventive medicine, disability, and medication overuse. An operational definition will allow us to better characterize the disorder, address unmet medical needs, and identify the most effective treatments. RHSIS of the AHS has proposed a definition of RM. It is our hope that this definition will spur interest in this entity and will lead to further research in the area.
Headache 2008 Jun
PMID:Refractory headache: historical perspective, need, and purposes for an operational definition. 1847 19

The proposed definitions for refractory migraine (RM) and refractory chronic migraine (R-CM) comprise 5 key components that must be operationalized for epidemiologic research. Persons with RM or R-CM must meet the second edition of the International Classification of Headache Disorders criteria for migraine or chronic migraine. They must experience significant interference with function or quality of life due to headaches. This interference must be present despite adequate treatment in 3 domains: modification of triggers and lifestyle factors, acute medication, and preventive medicines. The epidemiologic data which address these 5 components will be reviewed herein though specifically designed studies will be required to fully explore RM and R-CM. In addition, 2 "modifiers" of RM and R-CM have been proposed; one addresses medication overuse and the other considers disability based on a Migraine Disability Assessment score of 11 or greater. The epidemiology of these modifiers is discussed.
Headache 2008 Jun
PMID:Toward an epidemiology of refractory migraine: current knowledge and issues for future research. 1847 22


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