Headache and Migraine Biology and Management

 
 
Academic Press
  • 1. Auflage
  • |
  • erschienen am 13. März 2015
  • |
  • 334 Seiten
 
E-Book | ePUB mit Adobe DRM | Systemvoraussetzungen
E-Book | PDF mit Adobe DRM | Systemvoraussetzungen
978-0-12-801162-1 (ISBN)
 

There are two crucial issues in the treatment and management of headache patients: More than 50% of individuals experiencing headache have only been treated symptomatically, with no appropriate diagnosis established; and history and neurologic examination are essential to establishing a diagnosis, and thus selecting appropriate therapy.

Headache and Migraine Biology and Management is a practical text that addresses these issues, featuring contributions from expert clinical authors. The book covers in detail topics including chronic and episodic migraine, post-traumatic headache, sinus headache, cluster headache, tension headache, and others. Chapters are also dedicated to treatment subjects, including psychiatric and psychological approaches, medication overuse, inpatient treatment, and pediatric issues.

This book is an ideal resource for researchers and clinicians, uniting practical discussion of headache biology, current ideas on etiology, future research, and genetic significance and breakthroughs. This resource is useful to those who want to understand headache biology, treat and manage symptoms, and for those performing research in the headache field.


  • A practical discussion of headache biology, current ideas on etiology, future research, and genetic significance and breakthroughs
  • Features chapters from leading physicians and researchers in headache medicine
  • Full-color text that includes both an overview of multiple disciplines and discusses the measures that can be used to treat headaches
  • Englisch
  • Saint Louis
  • |
  • USA
Elsevier Science
  • 16,25 MB
978-0-12-801162-1 (9780128011621)
0128011629 (0128011629)
weitere Ausgaben werden ermittelt
1 - Front Cover [Seite 1]
2 - Headache and Migraine Biology and Management [Seite 4]
3 - Copyright Page [Seite 5]
4 - Dedication [Seite 6]
5 - Contents [Seite 8]
6 - Preface [Seite 12]
7 - About the Editor [Seite 14]
8 - List of Contributors [Seite 16]
9 - Acknowledgments [Seite 18]
10 - 1 Introduction - The History of Headache [Seite 20]
10.1 - Introduction [Seite 20]
10.2 - The Ancients [Seite 20]
10.3 - The Middle Ages [Seite 21]
10.4 - The 16th To 19th Centuries [Seite 23]
10.5 - The 20th Century Onwards [Seite 25]
10.5.1 - United States of America [Seite 25]
10.5.2 - United Kingdom [Seite 27]
10.5.3 - Australia [Seite 28]
10.5.4 - Italy [Seite 28]
10.5.5 - Scandinavia [Seite 29]
10.5.6 - Recent Advances [Seite 29]
10.6 - Conclusion [Seite 30]
10.7 - References [Seite 30]
11 - 2 Classification, Mechanism, Biochemistry, and Genetics of Headache [Seite 32]
11.1 - Classification [Seite 32]
11.2 - Mechanisms of Migraine-Associated Symptoms [Seite 33]
11.3 - Mechanisms of Migraine Triggers and Risk Factors [Seite 35]
11.4 - Genetics and Hypothalamic Regulation of Sleep [Seite 37]
11.5 - References [Seite 37]
12 - 3 Evaluation of the Headache Patient in the Computer Age [Seite 40]
12.1 - Evaluation of the Headache Patient [Seite 40]
12.2 - The Headache History [Seite 40]
12.2.1 - Structured Interview Versus Open Questioning [Seite 40]
12.2.2 - The Special Challenge of Talking to the Headache Patient . What Patients Tell Us [Seite 42]
12.2.2.1 - "Sinus" Headaches [Seite 42]
12.2.2.2 - "I Have a Pinched Nerve in My Neck" [Seite 42]
12.2.2.3 - "I can't Stay Asleep" [Seite 42]
12.2.3 - Migraine Aura Versus Other Conditions [Seite 42]
12.2.3.1 - "Blurred Vision" [Seite 42]
12.2.3.2 - "Numbness" or "Heaviness" [Seite 42]
12.2.3.3 - "Trouble Talking" [Seite 43]
12.2.3.4 - "Dizziness" [Seite 43]
12.2.4 - Screening for Secondary Headaches [Seite 43]
12.2.5 - Clinical History - What We Need to Ask the Patient with Primary Headaches [Seite 43]
12.2.5.1 - Headache Diary [Seite 43]
12.2.5.2 - What Type of Headache is it? [Seite 44]
12.2.5.3 - How Often are Your Headaches Occurring? [Seite 45]
12.2.5.4 - When Did These Headaches Begin? [Seite 45]
12.2.5.5 - What Do You Do When You Get a Headache? [Seite 45]
12.2.5.6 - How are you Treating your Headaches? [Seite 45]
12.2.5.7 - What Precedes your Headaches? [Seite 45]
12.2.5.8 - What Triggers the Headaches? [Seite 45]
12.2.5.9 - What are the Accompaniments? [Seite 45]
12.2.6 - Inquire About Migraine Comorbidities [Seite 46]
12.2.7 - Asking About the Common Migraine Comorbidities [Seite 46]
12.2.7.1 - Depression and Anxiety [Seite 46]
12.2.7.2 - Sleep Disorders [Seite 46]
12.2.7.3 - Fibromyalgia [Seite 47]
12.2.7.4 - Restless Legs Syndrome [Seite 47]
12.2.7.5 - Other Somatic Complaints [Seite 47]
12.2.7.6 - Other Systemic Complaints [Seite 47]
12.2.7.7 - Substance Abuse [Seite 47]
12.2.7.8 - Cardiovascular Comorbidity [Seite 47]
12.2.8 - Quality of Life [Seite 47]
12.2.9 - Previous Treatment Attempts [Seite 47]
12.3 - Examination of a Headache Patient [Seite 48]
12.4 - Testing [Seite 48]
12.5 - Computer-Assisted History Taking [Seite 48]
12.6 - Telemedicine [Seite 49]
12.7 - Summary [Seite 50]
12.8 - References [Seite 50]
13 - 4 Screening and Testing of the Headache Patient [Seite 52]
13.1 - Introduction [Seite 52]
13.2 - Neuroimaging [Seite 52]
13.2.1 - Subarachnoid Hemorrhage [Seite 53]
13.2.2 - Cerebral Venous Thrombosis [Seite 53]
13.2.3 - White Matter Abnormalities [Seite 53]
13.3 - Lumbar Puncture [Seite 54]
13.3.1 - Subarachnoid Hemorrhage [Seite 54]
13.3.2 - Bacterial and Aseptic Meningitis [Seite 54]
13.3.3 - Encephalitis [Seite 55]
13.3.4 - Idiopathic Intracranial Hypertension (Pseudotumor Cerebri) [Seite 55]
13.4 - Electroencephalography [Seite 55]
13.5 - Laboratory Studies [Seite 56]
13.5.1 - Thyroid Function Studies [Seite 56]
13.5.2 - Other Laboratory Studies [Seite 56]
13.5.3 - Medication Compliance Monitoring [Seite 56]
13.5.4 - Genetic Testing [Seite 57]
13.6 - Conclusion [Seite 57]
13.7 - References [Seite 57]
14 - 5 Overview of Migraine: Recognition, Diagnosis, and Pathophysiology [Seite 60]
14.1 - Recognition of Migraine [Seite 60]
14.2 - History of Migraine [Seite 60]
14.3 - Epidemiology of Migraine [Seite 61]
14.4 - Acephalgic Attacks [Seite 63]
14.5 - The Spectrum of Migraine Attacks [Seite 63]
14.6 - The Diagnosis of Migraine [Seite 64]
14.7 - Precipitating Factors [Seite 64]
14.8 - Secondary Headaches [Seite 65]
14.9 - Pathophysiology [Seite 65]
14.10 - Comorbidities of Migraine [Seite 67]
14.11 - The Inheritance of Migraine [Seite 67]
14.12 - Progression of Migraine [Seite 67]
14.13 - Complications of Migraine [Seite 67]
14.14 - References [Seite 67]
15 - 6 Complicated Migraine [Seite 70]
15.1 - Introduction [Seite 70]
15.2 - Types of Migraine Auras and "Complicated Migraine" [Seite 70]
15.2.1 - Hemiplegic Migraine [Seite 71]
15.2.2 - Familial Hemiplegic Migraine [Seite 71]
15.2.2.1 - FHM1 [Seite 71]
15.2.2.2 - FHM2 & FHM3 and Other Familial Variants [Seite 71]
15.2.2.3 - Treatment [Seite 73]
15.2.3 - Basilar Migraine [Seite 73]
15.2.4 - Retinal Migraine [Seite 74]
15.2.5 - Migraine with Prolonged Aura [Seite 75]
15.2.6 - Ophthalmoplegic Migraine [Seite 75]
15.3 - Visual Disturbances in Migraine [Seite 75]
15.4 - Transient Global Amnesia [Seite 76]
15.5 - CADASIL [Seite 76]
15.6 - HaNDL Syndrome [Seite 76]
15.7 - Migralepsy and Occipital Seizures [Seite 77]
15.8 - Unusual Sensory Complications of Migraine [Seite 77]
15.9 - Is Angiography Safe in Migraine? [Seite 77]
15.10 - Treatment of Complicated Migraine [Seite 77]
15.11 - References [Seite 78]
16 - 7 Cerebrovascular Disease and Migraine [Seite 80]
16.1 - Introduction [Seite 80]
16.2 - The Biology Behind the Relationship [Seite 80]
16.3 - Neuroimaging [Seite 81]
16.4 - The Relationship Between Migraines and Secondary Causes of Stroke [Seite 81]
16.5 - The Diagnostic Challenge [Seite 83]
16.6 - Summary [Seite 84]
16.7 - References [Seite 85]
17 - 8 Acute and Preventative Treatment of Episodic Migraine [Seite 88]
17.1 - Part 1 [Seite 88]
17.1.1 - Introduction [Seite 88]
17.1.2 - Acute Medications for Migraine [Seite 89]
17.1.3 - Clinical Factors [Seite 89]
17.1.3.1 - Pattern [Seite 89]
17.1.3.2 - Phenotype [Seite 89]
17.1.3.3 - Patient [Seite 90]
17.1.3.4 - Pharmacology [Seite 90]
17.1.3.5 - Precipitants [Seite 90]
17.1.4 - Attack-Based Acute Treatment of Migraine [Seite 91]
17.1.5 - Phase-Based Acute Treatment of Migraine Attacks [Seite 91]
17.1.5.1 - The Therapeutic Phases of Migraine [Seite 92]
17.1.5.1.1 - 1. Vulnerability Phase [Seite 92]
17.1.5.1.2 - 2. Premonitory Phase [Seite 92]
17.1.5.1.3 - 3. Aura [Seite 93]
17.1.5.1.4 - 4. Headache [Seite 93]
17.1.5.1.4.1 - Treatment of Migraine when the Headache is Mild [Seite 93]
17.1.5.1.4.2 - Treatment of Migraine during Moderate to Severe Headache [Seite 94]
17.1.5.1.5 - 5. Resolution, Recovery, and the Postdrome Phase of Migraine [Seite 94]
17.1.5.1.6 - 6. Rescue Phase [Seite 95]
17.1.6 - Acute Medications for Episodic Migraine [Seite 95]
17.1.6.1 - Goals [Seite 95]
17.1.6.2 - Medications Indicated for Treatment of Acute Migraine (Table 8.2) [Seite 96]
17.1.6.2.1 - Triptans [Seite 96]
17.1.6.2.1.1 - Formulations: the Key to Long-Term Successful Acute Intervention [Seite 98]
17.1.6.2.1.1.1 - Subcutaneous Sumatriptan [Seite 98]
17.1.6.2.1.1.2 - Nasal Formulations [Seite 98]
17.1.6.2.1.1.2.1 - Nasal Sprays [Seite 98]
17.1.6.2.1.1.2.2 - Dry Nasal Powder of Sumatriptan [Seite 98]
17.1.6.2.1.1.3 - Iontophoretic Transdermal Delivery of Sumatriptan [Seite 99]
17.1.6.2.1.1.4 - Oral Formulations [Seite 99]
17.1.6.2.1.1.4.1 - Sumatriptan 85mg/Naproxen 500mg Combination (Treximet®) [Seite 99]
17.1.6.2.2 - Non-steroidal Anti-inflammatory Drugs [Seite 99]
17.1.6.2.3 - Dihydroergotamine [Seite 100]
17.1.6.2.4 - Ergotamine [Seite 101]
17.1.6.2.5 - Neuroleptics and Anti-emetics [Seite 101]
17.1.6.2.6 - Opioids and Butalbital [Seite 101]
17.1.7 - Special Populations [Seite 102]
17.1.7.1 - Pregnancy and Nursing [Seite 102]
17.1.7.2 - Children and Adolescents [Seite 102]
17.1.7.3 - Elderly [Seite 102]
17.2 - Part 2 [Seite 102]
17.2.1 - Preventative Pharmacological and Non-Pharmacological Treatment of Migraine [Seite 102]
17.2.2 - Staging: Preventive Treatment Needs Based on the Evolution of Migraine [Seite 103]
17.2.2.1 - Migraine Stages to Chronification [Seite 104]
17.2.2.1.1 - Stage 1 - Infrequent Episodic Migraine [Seite 104]
17.2.2.1.2 - Stage 2 - Frequent Episodic Migraine [Seite 104]
17.2.2.1.3 - Stage 3 - Transforming Migraine [Seite 104]
17.2.2.1.4 - Stage 4 - Chronic Migraine [Seite 105]
17.2.3 - Preventive Medications for Migraine (Table 8.5) [Seite 105]
17.2.3.1 - Neuronal Stabilizers (Anti-epileptic Drugs) for Stages 2, 3, & 4 [Seite 106]
17.2.3.1.1 - Topiramate (Evidence Level A) [Seite 106]
17.2.3.1.2 - Sodium Valproate (Evidence Level A) [Seite 107]
17.2.3.1.3 - Other AEDs [Seite 107]
17.2.3.2 - Beta-blockers [Seite 108]
17.2.3.3 - Antidepressants [Seite 108]
17.2.3.3.1 - Tricyclic Antidepressants [Seite 108]
17.2.3.3.2 - Selective Serotonin/Norepinephrine Reuptake Inhibitors [Seite 109]
17.2.3.3.3 - Selective Serotonin Reuptake Inhibitors [Seite 109]
17.2.3.4 - Angiotensin Receptor Blockers and Angiotensin Converting-Enzyme Inhibitors [Seite 109]
17.2.3.5 - Calcium Channel Blockers (Evidence Level U) [Seite 109]
17.2.3.6 - Triptans (Table 8.8) [Seite 109]
17.2.3.7 - NSAIDs [Seite 109]
17.3 - Part 3 [Seite 110]
17.3.1 - Attack-Based Care: Clinical Approach and Medications Many Patients Find Most Useful and Effective [Seite 110]
17.3.1.1 - Summary [Seite 111]
17.3.2 - Preventative Medications [Seite 111]
17.4 - Conclusion [Seite 112]
17.5 - References [Seite 112]
18 - 9 Chronic Migraine: Diagnosis and Management [Seite 118]
18.1 - Introduction [Seite 118]
18.2 - Recognition of Chronic Migraine [Seite 118]
18.3 - Challenges and Implication of Defining a Diagnosis for Chronic Migraine [Seite 118]
18.4 - Epidemiology and Natural History of Chronic Migraine [Seite 119]
18.5 - Epigenetic Considerations in the Pathophysiology of Chronic Migraine [Seite 120]
18.6 - Diagnosis of Chronic Migraine [Seite 123]
18.7 - The Successful Management of Chronic Migraine [Seite 124]
18.7.1 - Steps to the Management of Chronic Migraine [Seite 124]
18.7.1.1 - Step 1: Confidently Provide a Diagnosis of CM to the Patient [Seite 124]
18.7.1.2 - Step 2: Define Management Roles for the Patient and the Provider [Seite 124]
18.7.1.3 - Step 3: Establish Agreed-upon Objective Goals and Boundaries [Seite 124]
18.7.1.4 - Step 4: Avoid Being Judgmental [Seite 125]
18.7.1.5 - Step 5: Establish Agreement on Management Decisions, Especially Medications [Seite 125]
18.8 - Non-Pharmacological Management of Chronic Migraine [Seite 125]
18.8.1 - Lifestyle Factors [Seite 125]
18.8.1.1 - Exercise [Seite 125]
18.8.1.2 - Diet [Seite 126]
18.8.1.3 - Sleep Hygiene [Seite 126]
18.8.1.4 - Smoking Cessation [Seite 126]
18.8.2 - Behavioral Therapies for Chronic Migraine [Seite 126]
18.8.2.1 - Biofeedback Training [Seite 126]
18.8.2.1.1 - Relaxation Training [Seite 126]
18.8.2.1.2 - Behavioral Retraining [Seite 126]
18.8.2.1.3 - Physiological Recalibration [Seite 127]
18.8.2.2 - Mindfulness [Seite 127]
18.8.2.3 - Cognitive Behavioral Therapy [Seite 127]
18.8.2.4 - Acupuncture [Seite 127]
18.8.3 - Complementary and Alternative Medicine [Seite 128]
18.8.3.1 - Osteopathic and Chiropractic Manipulative Therapy [Seite 128]
18.9 - Pharmacological Management of Chronic Migraine [Seite 128]
18.9.1 - Prophylaxis of Chronic Migraine [Seite 128]
18.9.1.1 - OnabotulinumtoxinA (Evidence Level A) [Seite 128]
18.9.1.2 - Topiramate [Seite 130]
18.9.1.3 - Repetitive Dihydroergotamine [Seite 130]
18.9.1.4 - Methysergide/Methergine [Seite 130]
18.9.1.5 - Phenelzine [Seite 130]
18.9.1.6 - Naproxen vs Sumatriptan/Naproxen [Seite 131]
18.9.1.7 - Neurostimulation [Seite 131]
18.9.1.8 - Repetitive Sphenopalatine Ganglia Blockade [Seite 131]
18.9.1.9 - Chronic Opioids [Seite 131]
18.9.1.10 - Co-Pharmacy [Seite 132]
18.9.2 - Acute Medication for Management of Chronic Migraine [Seite 132]
18.9.2.1 - Dihydroergotamine [Seite 132]
18.9.2.2 - Triptans [Seite 133]
18.9.2.2.1 - Adverse Events and Contraindications [Seite 133]
18.9.2.3 - Non-steroidal Anti-inflammatory Drugs [Seite 133]
18.9.2.4 - Intravenous Sodium Valproate [Seite 134]
18.9.2.5 - Phenothiazine/Metoclopramide [Seite 134]
18.9.2.6 - Addressing the 800-Pound Gorilla: Acute Medication Overuse and Misuse in Patients with Chronic Migraine [Seite 134]
18.9.2.7 - Medication Overuse and Medication Overuse Headache [Seite 134]
18.9.2.8 - Intravenous Magnesium [Seite 135]
18.10 - Continuity of Care [Seite 137]
18.11 - Consultation and Referral [Seite 137]
18.12 - Putting IT Together [Seite 137]
18.13 - Summary [Seite 137]
18.14 - Appendix [Seite 138]
18.15 - References [Seite 139]
19 - 10 Gender-Based Issues in Headache [Seite 142]
19.1 - Introduction [Seite 142]
19.2 - Menstrual Migraine [Seite 142]
19.2.1 - Treatment [Seite 144]
19.3 - Contraception and Migraine [Seite 146]
19.4 - Pregnancy and Migraine [Seite 147]
19.5 - Lactation [Seite 149]
19.6 - Menopause [Seite 149]
19.7 - Conclusion [Seite 150]
19.8 - References [Seite 150]
20 - 11 Cluster Headache [Seite 154]
20.1 - Introduction [Seite 154]
20.2 - Epidemiology [Seite 154]
20.3 - Diagnostic Classification and Clinical Description [Seite 154]
20.3.1 - Demographics [Seite 157]
20.4 - Circadian and Circannual Features [Seite 157]
20.5 - Other Trigeminal Autonomic Cephalalgias [Seite 158]
20.6 - Pathophysiology [Seite 159]
20.7 - Treatment [Seite 161]
20.7.1 - Acute Treatment [Seite 161]
20.7.2 - Preventative Treatment [Seite 162]
20.7.2.1 - Short-term Treatments or Bridges in Therapy [Seite 162]
20.7.2.2 - Lithium [Seite 163]
20.7.2.3 - Verapamil [Seite 163]
20.7.2.4 - Anti-epileptic Drugs [Seite 163]
20.7.2.5 - Miscellaneous Therapies [Seite 163]
20.7.3 - Intractable Cluster Headache Treatment [Seite 163]
20.7.3.1 - Occipital Nerve Blocks [Seite 163]
20.7.4 - Surgery [Seite 164]
20.7.4.1 - Hypothalamic Stimulation [Seite 164]
20.7.4.2 - Jannetta Procedure [Seite 164]
20.7.4.3 - Occipital Nerve Stimulation [Seite 164]
20.7.5 - Other Procedures [Seite 164]
20.7.5.1 - Gamma Knife Irradiation of the Trigeminal Root Outlet [Seite 164]
20.7.5.2 - Histamine Desensitization [Seite 164]
20.7.5.3 - Treatment of the Other Trigeminal Autonomic Cephalalgia [Seite 164]
20.8 - Conclusion [Seite 165]
20.9 - References [Seite 165]
21 - 12 Tension-Type Headache [Seite 168]
21.1 - Classification [Seite 168]
21.2 - Clinical Presentation [Seite 168]
21.3 - Diagnostic Testing [Seite 170]
21.4 - Epidemiology and Impact [Seite 171]
21.5 - Comorbid Conditions [Seite 172]
21.6 - Pathophysiology of Tension-Type Headache [Seite 172]
21.7 - Management of Tension-Type Headache [Seite 174]
21.7.1 - Non-Pharmacological Treatments [Seite 174]
21.7.2 - Acute Pharmacological Therapies [Seite 174]
21.7.3 - Preventive Pharmacological Therapies [Seite 175]
21.8 - Prognosis of Tension-Type Headache [Seite 176]
21.9 - Conclusions [Seite 177]
21.10 - References [Seite 177]
22 - 13 Post-Traumatic Headache [Seite 180]
22.1 - Introduction [Seite 180]
22.2 - Traumatic Brain Injury, Concussion, and Post-Concussive Syndrome [Seite 181]
22.3 - Epidemiology of Post-Traumatic Headache [Seite 182]
22.4 - Potential Risk Factors for Post-Traumatic Headache [Seite 184]
22.5 - The Phenotype of Post-Traumatic Headache [Seite 184]
22.6 - Post-Traumatic Headache in Military Settings [Seite 185]
22.7 - Physiology of Post-Traumatic Headache [Seite 186]
22.8 - Management of Post-Traumatic Headache [Seite 187]
22.9 - The Post-Traumatic Headache Ichd-III Criteria [Seite 188]
22.10 - Conclusions [Seite 190]
22.11 - References [Seite 190]
23 - 14 Headache and the Eye [Seite 194]
23.1 - Introduction [Seite 194]
23.2 - Basics of the Bedside Eye Examination [Seite 194]
23.2.1 - Visual Acuity [Seite 194]
23.2.2 - The Pupil [Seite 194]
23.2.3 - Visual Fields [Seite 194]
23.2.4 - Eye Movements [Seite 194]
23.2.5 - Funduscopic Examination [Seite 195]
23.2.6 - General Examination [Seite 195]
23.3 - Migraine-Related Visual and Eye Symptoms [Seite 195]
23.3.1 - Migraine-Related Visual Aura [Seite 195]
23.3.2 - Retinal Migraine [Seite 197]
23.4 - Photophobia and Eye Pain [Seite 197]
23.4.1 - Trochlear Headache [Seite 197]
23.4.2 - Photophobia [Seite 197]
23.5 - Headache and the Red Eye [Seite 198]
23.5.1 - Glaucoma [Seite 198]
23.5.2 - Cavernous Sinus Fistula [Seite 198]
23.5.3 - Inflammation [Seite 199]
23.5.4 - Idiopathic Orbital Inflammatory Syndrome [Seite 199]
23.6 - Headache and Visual Loss [Seite 199]
23.6.1 - Vascular [Seite 200]
23.6.1.1 - Arterial Dissection [Seite 201]
23.6.1.2 - Cerebral Venous Sinus Thrombosis [Seite 201]
23.6.2 - Optic Neuritis [Seite 201]
23.6.3 - Giant Cell Arteritis [Seite 201]
23.6.4 - The Orbital Apex Syndrome [Seite 202]
23.7 - Headache and the Abnormal Pupil [Seite 202]
23.7.1 - Headache and the Small Pupil [Seite 202]
23.7.2 - Painful Horner's Syndrome [Seite 203]
23.7.3 - Headache and the Large Pupil [Seite 203]
23.7.3.1 - Third Nerve Palsy [Seite 203]
23.7.3.2 - Benign Pupillary Mydriasis [Seite 204]
23.7.3.3 - Acute Glaucoma [Seite 204]
23.7.3.4 - Adie's Pupil [Seite 204]
23.7.3.5 - Pharmacologic Pupil [Seite 204]
23.8 - Headache and Double Vision [Seite 204]
23.8.1 - Increased Intracranial Pressure [Seite 205]
23.8.2 - Intracranial Hypotension [Seite 206]
23.8.3 - Thyroid Eye Disease [Seite 206]
23.8.4 - Microvascular Cranial Neuropathy [Seite 206]
23.8.5 - Pituitary Apoplexy [Seite 206]
23.8.6 - Ophthalmoplegic Migraine [Seite 207]
23.9 - Conclusion [Seite 207]
23.10 - References [Seite 207]
24 - 15 Cranial Neuralgias, Sinus Headache, and Vestibular Migraine [Seite 210]
24.1 - Introduction [Seite 210]
24.2 - Anatomy of Facial Pain [Seite 210]
24.2.1 - Rhinogenic Headache [Seite 210]
24.3 - Cranial Neuralgias [Seite 211]
24.3.1 - Types of Cranial Neuralgias [Seite 212]
24.3.1.1 - Occipital Neuralgia [Seite 212]
24.3.1.2 - Glossopharyngeal Neuralgia [Seite 213]
24.3.1.3 - Trigeminal Neuralgia [Seite 213]
24.3.2 - Treatment of Cranial Neuralgias [Seite 213]
24.3.3 - Persistent Idiopathic Facial Pain (Previously Atypical Facial Pain) [Seite 214]
24.4 - Sinus Headache [Seite 214]
24.5 - Motion Sickness [Seite 216]
24.5.1 - Childhood Equivalents in Migraine [Seite 216]
24.5.2 - Role of Hormonal Factors [Seite 216]
24.5.3 - Migraine and Vertigo [Seite 216]
24.6 - Vestibular Migraine [Seite 218]
24.6.1 - Long-Term Follow-up of Clinical Symptoms [Seite 218]
24.6.2 - Examination [Seite 219]
24.6.3 - Treatment [Seite 219]
24.7 - References [Seite 219]
25 - 16 Cervicogenic Headache [Seite 222]
25.1 - The Relationship of Headache and Neck Pain as a Manifestation of Neck Disorders [Seite 222]
25.2 - Cervicogenic Headache Diagnosis [Seite 222]
25.2.1 - Anatomical Concepts [Seite 223]
25.3 - Clinical Characteristics [Seite 224]
25.4 - Evaluation of Cervicogenic Headache [Seite 225]
25.5 - Treatment of Cervicogenic Headache [Seite 226]
25.5.1 - Physical Modalities [Seite 226]
25.5.2 - Pharmacological Therapies [Seite 226]
25.5.2.1 - Anti-Epileptic Drugs [Seite 227]
25.5.2.2 - Antidepressant Medications [Seite 227]
25.5.3 - Greater Occipital Nerve Blockade [Seite 227]
25.5.4 - Cervical Medial Branch Neurotomy [Seite 228]
25.5.5 - Surgical Intervention [Seite 229]
25.5.6 - Other Modalities [Seite 229]
25.6 - Conclusion [Seite 229]
25.7 - References [Seite 230]
26 - 17 Headache in Children and Adolescents [Seite 232]
26.1 - Introduction [Seite 232]
26.2 - Historical Perspective [Seite 232]
26.3 - Epidemiology and Pathophysiology [Seite 233]
26.4 - Clinical Approach [Seite 233]
26.5 - Treatment [Seite 235]
26.6 - What Happens to our Patients as They Grow Up? [Seite 237]
26.7 - What the Future Holds for Pediatric Headache [Seite 237]
26.8 - References [Seite 238]
27 - 18 The Psychiatric Approach to Headache [Seite 242]
27.1 - Introduction [Seite 242]
27.2 - Migraine and Psychiatric Comorbidities, Beyond Coexistence [Seite 242]
27.3 - Beyond Coexistence: Complex Neurobiological Underpinnings of Mood Disorders and Pain [Seite 244]
27.4 - Prevalence of Psychiatric Comorbidities in Migraine Patients [Seite 245]
27.4.1 - Mood Disorders [Seite 245]
27.4.2 - Anxiety Disorders [Seite 245]
27.4.3 - Post-Traumatic Stress Disorder [Seite 245]
27.5 - Psychiatric Illness: Making the Correct Diagnosis [Seite 246]
27.6 - Choosing the Right Medication [Seite 247]
27.6.1 - The Antidepressants [Seite 247]
27.6.2 - The Anti-Epileptic Mood Stabilizers [Seite 247]
27.6.3 - The Antipsychotics [Seite 248]
27.7 - Migraine, Pain, and Suicide [Seite 248]
27.8 - Personality and Coping Styles in Migraine Headache [Seite 250]
27.8.1 - Cluster A Personality Disorders [Seite 251]
27.8.1.1 - Paranoid Personality Disorder [Seite 251]
27.8.1.2 - Schizoid Personality Disorder [Seite 251]
27.8.1.3 - Schizotypal Personality Disorder [Seite 251]
27.8.2 - Cluster B Personality Disorders [Seite 251]
27.8.2.1 - Antisocial Personality Disorder [Seite 251]
27.8.2.2 - Borderline Personality Disorder [Seite 252]
27.8.2.3 - Histrionic Personality Disorder [Seite 252]
27.8.2.4 - Narcissistic Personality Disorder [Seite 252]
27.8.3 - Cluster C Personality Disorders [Seite 252]
27.8.3.1 - Avoidant Personality Disorder [Seite 252]
27.8.3.2 - Dependent Personality Disorder [Seite 253]
27.8.3.3 - Obsessive-Compulsive Personality Disorder [Seite 253]
27.8.4 - Influence of Axis II Personality Disorders in Headache [Seite 253]
27.8.5 - Understanding and Managing Personality Disorders in Headache Patients [Seite 254]
27.8.6 - Psychotherapy in Headache and Pain Disorders [Seite 255]
27.9 - Summary: What is the Psychiatric Approach to Headache? [Seite 256]
27.10 - References [Seite 256]
28 - 19 Psychological Approaches to Headache [Seite 258]
28.1 - Introduction [Seite 258]
28.2 - Trigger Factors [Seite 259]
28.2.1 - Stress [Seite 259]
28.2.2 - Sleep [Seite 260]
28.2.3 - Diet and Obesity [Seite 260]
28.3 - Personality Traits and Migraine [Seite 261]
28.4 - Psychiatric Comorbidity [Seite 261]
28.5 - Psychological Factors in Medical Treatment of Headache Disorders [Seite 263]
28.5.1 - Medication Adherence [Seite 263]
28.5.2 - Patient-Physician Communication [Seite 264]
28.6 - Psychological Approaches to Treating Headache Disorders [Seite 264]
28.6.1 - Biofeedback and Relaxation-Based Therapies [Seite 265]
28.6.2 - Cognitive Behavioral Approaches [Seite 265]
28.7 - Conclusion [Seite 266]
28.8 - References [Seite 266]
29 - 20 Too Much of a Good Thing: Medication Overuse Headache [Seite 272]
29.1 - Introduction [Seite 272]
29.2 - History/Background [Seite 273]
29.3 - Pathophysiology [Seite 274]
29.3.1 - Central Sensitization Pathway [Seite 274]
29.4 - Neuroimaging [Seite 275]
29.5 - Genetic Basis for Medication Overuse Headache [Seite 275]
29.6 - Psychological/Behavioral Aspects of Medication Overuse Headache [Seite 275]
29.7 - Clinical Presentation of Medication Overuse Headache [Seite 276]
29.8 - Detoxification from Medication Overuse Headache [Seite 277]
29.9 - Patient Education for Medication Overuse Headache [Seite 277]
29.10 - Treatment of Medication Overuse Headache [Seite 279]
29.10.1 - Infusion Center Withdrawal [Seite 280]
29.10.2 - Inpatient Treatment of Medication Overuse Headache [Seite 280]
29.10.3 - Appropriate Opiate Use in Chronic Migraine [Seite 281]
29.11 - Medication Overuse Pearls [Seite 283]
29.12 - References [Seite 283]
30 - 21 Presentation of Headache in the Emergency Department and its Triage [Seite 286]
30.1 - Introduction [Seite 286]
30.2 - The Role of the Emergency Department [Seite 286]
30.3 - Epidemiology of Headache in the Emergency Department [Seite 287]
30.4 - Diagnosis [Seite 287]
30.5 - Diagnostic Testing [Seite 291]
30.6 - Approach to Treatment [Seite 292]
30.7 - Difficult Emergency Department Populations [Seite 292]
30.8 - Discharge Care [Seite 293]
30.9 - Conclusion [Seite 293]
30.10 - References [Seite 294]
31 - 22 Headache Clinics [Seite 296]
31.1 - Introduction [Seite 296]
31.2 - Establishment of the Headache Clinic [Seite 297]
31.3 - Staffing of the Headache Clinic [Seite 298]
31.4 - Physical Plant of the Headache Clinic [Seite 300]
31.5 - Reimbursement Issues [Seite 300]
31.6 - Marketing the Headache Clinic [Seite 301]
31.7 - The Patient Attending the Headache Clinic [Seite 302]
31.8 - Conclusion [Seite 303]
31.9 - References [Seite 303]
32 - 23 Inpatient Treatment of Headaches [Seite 304]
32.1 - Introduction [Seite 304]
32.2 - Indications for Inpatient Headache Treatment [Seite 304]
32.3 - Admission Criteria [Seite 305]
32.4 - Advantages of Inpatient Treatment [Seite 305]
32.5 - Treatment [Seite 305]
32.5.1 - Detoxification [Seite 305]
32.5.2 - Pharmacological Treatment [Seite 306]
32.5.3 - Interventional Treatment Modalities [Seite 308]
32.5.4 - Non-Pharmacological Treatment [Seite 308]
32.6 - References [Seite 310]
33 - 24 Newer Research and its Significance [Seite 312]
33.1 - Introduction [Seite 312]
33.2 - Epidemiology [Seite 312]
33.3 - Neuroimaging [Seite 313]
33.4 - Genetics [Seite 314]
33.5 - Pharmacological Models [Seite 316]
33.5.1 - Nitric Oxide [Seite 316]
33.5.2 - CGRP [Seite 317]
33.5.3 - PACAP-38 [Seite 318]
33.6 - Treatment [Seite 319]
33.6.1 - Supraorbital Transcutaneous Electrical Stimulation [Seite 319]
33.6.2 - Occipital Nerve Stimulation [Seite 319]
33.6.3 - Transcranial Magnetic Stimulation [Seite 320]
33.6.4 - Vagal Nerve Stimulation [Seite 320]
33.7 - Conclusions [Seite 320]
33.8 - References [Seite 321]
34 - Index [Seite 326]
Chapter 1

Introduction - The History of Headache


Seymour Diamond1,2 and Mary A. Franklin2,    1Diamond Fellowship and Educational Foundation, and Diamond Headache Clinic, Chicago, Illinois,    2National Headache Foundation, Chicago, Illinois, USA

The history of headache, starting with the earliest records from Mesopotamia, and continuing through Hippocrates, Aerateus, and Galen, provides a glimpse into a malady that has endured through several millenia. In this chapter, we also explore the history of headache treatment from the ancients, through the Middle Ages, and to the end of the 19th century. Finally, we explore the development of the remarkable innovations in pharmaceutical therapies during the late 20th and early 21st centuries.

Keywords


discarded therapies; major discoveries; headache pioneers; ancient remedies

Introduction


In a previous monograph with my editorial collaborator, Mary Franklin, we reviewed the history of headache through the ages - in the arts and literature.1 In this comprehensive work on headache, I would be remiss to not update the history of the advances in headache medicine during the 20th and early 21st centuries.

The history of headache treatment did not start with the discovery of the triptans. The approval of propranolol for the indication of migraine prophylaxis was not the nascent event for migraine prevention; neither was the introduction of dihydroergotamine into the migraine armamentarium. When Bayer started manufacturing acetylsalycilic acid for pain prevention, that was just one step in the long struggle for effective migraine and headache treatment, which has blossomed in recent years.

The Ancients


The earliest mention of headache can be found in Mesopotamia (modern-day Iraq), dating from 4000 BC. When the Ancients experienced headache, they blamed their affliction on Tiu, the evil spirit of headache. Our knowledge of the ancient Egyptians' headache management is found in the Ebers Papyrus, a collection of medical texts, named for the German Egyptologist George Ebers (1837-1898) who had acquired it. This papyrus contains the earliest written reference to the central nervous system and brain. For headache, the recommended treatment includes a combination of frankincense, cumin, ulan berry, and goose grease, to be boiled together and applied externally to the head.

The Egyptians also attributed the cause of headache as the work of an evil spirit. For those experiencing a "warmth in the head," the application of moistened mortar to the head was suggested. Another therapy was derived from Egyptian mythology - a combination of coriander, wormwood, juniper, honey, and opium. For joint pain, the Egyptians recommended a mixture of myrtle and willow leaves. The use of willow leaves is cited in treatment for an inflammatory condition: ". you must make cooling substances for him to draw the heat out . leaves of the willow." Salicylic acid is derived from willow bark, and its use led to the discovery of aspirin. Later, the Assyrians, using stone tablets, recommended the use of willow leaves for treating inflammatory rheumatoid disorders, such as arthritis.2

The Greeks were the next to espouse willow bark as a treatment for pain. Hippocrates (4th or 5th century BC) recommended the extract of willow bark for headache pain. As we know, the teachings of Hippocrates formed the basis of medicine for centuries in the Greek and then the Roman Empires.

At Alexandria, Egypt, the Greeks established a center for medical education and practice. Once the Romans conquered this area, they maintained the center. Aretaeus of Cappodocia (AD 81-138) was probably educated at Alexandria and practiced medicine in Rome. He was the first to distinguish migraine from general headache, noting migraine's unilaterality, periodicity, and the associated symptom of nausea.3 Aretaeus divided all diseases into acute and chronic. For headache, he described headaches of short duration, lasting a few days, as cephalalgia. The term "cephalea" referred to headaches which lasted longer. Because of migraine's one-sided occurrence, Aretaeus named it Heterocrania, meaning "half-a-head." The recommended treatment for headache by this ancient physician was counter-irritation in the form of application of blisters to the affected area, which had been shaved. In Aretaeus' repertoire of blister agents were pitch, peilitory, euphorbium, lemnestis, or the juice of the thapsia.

During the 2nd century AD, Galen (131-201) gained prominence in Rome. Like Aretaeus, he was trained in Hippocratic medicine and became the court physician to Commodus, the heir of Marcus Aurelius. He is credited with describing migraine as Hemicrania.4 Galen further advanced counter-irritation as a treatment for headache when he proposed the use of the electric torpedo fish applied to the forehead. This form of therapy foreshadowed the use of electrotherapy by Duchenne (1806-1875) and the transcutaneous electric stimulator (TENS) introduced in the late 20th century for all types of chronic pain.

The Middle Ages


The use of trephination for headache treatment was described by Paul of Aegina (625-690), who practiced in ancient Alexandria. The procedure, removing a circular portion of the skull, was believed to disturb the evil spirits which were causing the headache pain and allow them to escape through the wound (Figures 1.1, 1.2).


Figure 1.1 Electrotherapy.
Guillaume-Benjamin Duchenne demonstrates electric stimulation therapy on a patient by holding an electric apparatus to the patient's head. ©CORBIS.
Figure 1.2 Trephination, 1593.
Use of an elevator to remove a piece of bone from the skull. Reproduced from the Veldt Boeck van den Chirugia Scheel-Hans, by Hans von Gersdorf (Amsterdam, 1593). Oxford Science Archive.

The fall of the Roman Empire did not mean the end of ancient Greek and Roman medicine. Those early texts on medicine influenced Arab physicians throughout the Islamic world from the 7th century and beyond. One of the most prominent of these physicians was Avicenna (980-1037). A native of Persia (modern day Iran), his textbook, The Book of Healing, was used by his contemporary Islamic physicians but was also available as a Latin translation for the scientists in Europe. Avicenna noted that headache location could vary between frontal, occipital, or generalized, and that one-sided headaches could be provoked by smells. He used cashews as a remedy for headache as well as other neurological and psychiatric disorders. Other Arab physicians wrote of treating headache, epilepsy, and syncope with anomum nelegueta, an African ginger.

In Cordoba, Spain, Abulcasis (935-1013) was physician to the Spanish caliph and was considered the greatest of Islamic medieval surgeons. His book, Kitab al-Tasrif, remained the leading textbook on surgery for the next five centuries in Europe and the Middle East. Abulcasis recognized the importance of the physician-patient relationship. Also, he advised his students to observe individuals closely in order to establish the appropriate diagnosis and select the most effective therapy. His recommended therapy for headache was extreme - applying a hot iron to the head of the individual with headaches. Another headache intervention that he suggested was an incision made to the temple, and application of garlic to the wound.

In addition to its prominence in the Islamic world, Cordoba was also known as the birthplace of the medieval Jewish scholar and physician Maimonides (1135-1204). He studied medicine at Fez, Morocco, and later settled in Egypt, serving as court physician to the Sultan, Saladin, during the first crusade.5 Maimonides' works on medicine continue to be studied, and it is apparent that he was influenced by Hippocrates and Galen. In his work on headache, Maimonides recognized various triggers of headache, including extremes of cold and heat, caused by changes in barometric pressure.

For headache treatment, Maimonides recommended that those suffering from a "strong midline headache, secondary to thick blood or internal coldness" could benefit from consumption of undiluted wine either during or after a meal. The warming effect of the wine would help, and also would thin the blood. Maimonides also instructed individuals with headache to refrain from physical exertion and other activities until their headache resolved. He cautioned that certain foods which were "rich in moisture" should be avoided, including melons, peaches, apricots, mulberries, fresh dates, etc.6 For milder headache, Maimonides did not believe medication was appropriate, believing nature could relieve this pain without assistance.

During the same period, in what is now modern Germany, a remarkably intelligent and creative nun, the Abbess Hildegard of Bingen (1098-1179), became prominent in the Church because of her preaching. She is also remembered for her religious music and several texts that she wrote on a variety of subjects. In the world of headache medicine, she is known for the illuminated manuscripts that she created from her "visions," but which have been described as excellent depictions of migraine auras.7 Hildegard lived in a area of Germany near the Rhine...

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