Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Headache Disorders”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 145 records · Page 8Linked to original sources
PubMed1993

Migraine and tension-type headache in a general population: precipitating factors, female hormones, sleep pattern and relation to lifestyle.

In a cross-sectional epidemiological study of headache disorders information on precipitating factors, age at onset, influence of menstruation and pregnancy and use of oral contraceptives was collected. The presence of migraine and tension-type headache was ascertained by a clinical interview and examination using the operational diagnostic criteria of the International Headache Society. The prevalence of migraine and tension-type headache was also analysed in relation to variables of lifestyle: physical activity, smoking, consumption of coffee, alcohol intake and sleep pattern. In both migraine and tension-type headache, the most conspicuous precipitating factor was stress and mental tension. Other common precipitants were alcohol, weather changes and menstruation. Disappearance or substantial improvement of the headache during pregnancy was more frequent in migraineurs than in tension-type headache sufferers. The age at onset of both migraine and tension-type headache differs between men and women. Female hormones may be an important factor responsible for the sex difference of headache disorders. The level of physical activity showed no association with migraine, but a significantly higher prevalence of tension-type headache in men with exclusively sedentary activity emerged. Smoking, coffee and alcohol consumption showed no significant associations with the headache disorders. Sleep pattern was significantly associated with migraine and tension-type headache in both univariate and multivariate analyses. In conclusion, migraine and tension-type headache seem to be different with regard to a number of endogenous and exogenous factors.

Adult↗
PubMed2007

Temporomandibular disorders and headache.

Headache is a common symptom, but when severe, it may be extremely disabling. It is assumed that patients who present to dentists with headache often are diagnosed with a temporomandibular disorder (TMD), although many may have migraine. TMD as a collective term may include several clinical entities, including myogenous and arthrogenous components. Because headache and TMD are so common they may be integrated or separate entities. Nevertheless, the temporomandibular joint (TMJ) and associated orofacial structures should be considered as triggering or perpetuating factors for migraine. This article discusses the relationship between the TMJ, muscles, or other orofacial structures and headache.

Facial Pain↗
PubMed2004

Evaluation and management of headache in primary care.

Headache disorders are ubiquitous, common, disabling and to a very large extent treatable in primary care. In this review, the important headache disorders are described together with their impact on public health. Suggestions are set out for their optimal management, although many of these are necessarily based more on expert opinion than on formal evidence, since clinical trials have covered only narrow areas of headache treatment. Most people whose lives are adversely affected by headache disorders benefit from drug interventions, either acute or preventative, but other forms of treatment are always important and should never be overlooked. An important disorder is entirely iatrogenic: its recognition is crucial to its effective management, which requires medication withdrawal. Future research is needed not only into the mechanisms of headache causation, as a prerequisite for the development of better treatments, but also into public health aspects seeking an explanation of (and remedy for) the low priority given worldwide to headache-related healthcare despite the severe human and socioeconomic consequences.

Disease Management↗
PubMed2003

Divalproex in the treatment of migraine.

Valproic acid has been used in the treatment of migraine headache for nearly 20 years. During this period of use several additional delivery modes have been developed to either improve tolerability or patient compliance with the divalproex sodium formulation and the extended-release formulation of divalproex sodium. Additionally, an intravenous formulation has become available which permits rapid achievement of therapeutic levels of the drug. There have been a number of reports on the use of valproic acid in migraine and other headache disorders, suggesting it to be an efficacious treatment. This paper reviews the results of the published reports of valproic acid in migraine and other headache disorders, including open-label studies, comparator trials, and double-blind, placebo-controlled trials. These studies have been conducted with the various formulations of valproic acid that have been on the market. The papers utilized in this study were obtained though Medline searches on valproic acid and divalproex sodium coupled with the various headache disorders. Additionally, the CD-ROM of past issues of Headache and Cephalalgia was reviewed for similar keywords. Lastly, the indices of the journal Headache Quarterly were reviewed for additional articles on valproic acid and divalproex sodium. Valproic acid in its various formulations has been demonstrated to be an efficacious and well-tolerated agent for the preventive treatment of migraine, chronic daily headache, and cluster headache. Additionally, it has been demonstrated to be efficacious and well tolerated in treating acute migraine attacks when given as an intravenous solution.

Animals↗
PubMed2005

Noninvasive treatments for headache.

Primary headache disorders are often accompanied by neck pain or other symptoms referable to neck muscles. Therefore, physical therapy and other physical treatments are commonly prescribed for headache management. A medical literature review was completed in order to gather information regarding the efficacy of selected physical modalities in the treatment of primary and cervicogenic headache disorders. After analyzing the collected data, expert opinions were developed regarding the utility and efficacy of selected physical modalities in the management of primary and cervicogenic headaches. Based on this review, the following four expert opinions are presented: physical therapy is more effective than massage therapy or acupuncture for the treatment of tension-type headache and appears to be most beneficial for patients with a high frequency of headache attacks. Physical therapy is most effective for the treatment of migraine when combined with other treatments such as thermal biofeedback, relaxation training and exercise. Chiropractic manipulation demonstrated a trend towards benefit in the treatment of tension-type headache, but evidence is weak. Chiropractic manipulation is probably more effective in the treatment of tension-type headache than it is in the treatment of migraine. In general, strong evidence is lacking regarding the efficacy of these treatments in reducing headache frequency, intensity, duration and disability in many commonly encountered clinical situations. Many of the published case series and controlled studies are of low quality. Physical treatments are unlikely to pose a significant risk, with the exception of high velocity chiropractic manipulation of the neck. Consideration must be given to financial costs and lost treatment opportunity by prescribing potentially ineffective treatment. In the absence of clear evidence regarding their role in treatment, physicians and patients are advised to make cautious and individualized judgments about the utility of physical treatments for headache management. In most cases, the use of physical modalities should complement rather than replace better validated forms of therapy. The evidence base to determine the safety and efficacy of physical treatments in the management of headache disorders would be substantially improved by using standard scientific rigor in the development and conduct of future clinical studies.

Biofeedback, Psychology↗
PubMed2002

Hemicrania continua: recent treatment strategies and diagnostic evaluation.

Hemicrania continua (HC) is a primary headache disorder that is characterized by a continuous unilateral headache of moderate severity, exacerbations of severe pain, and complete responsiveness to indomethacin. HC was once thought to be a rare headache disorder, but now many cases have been reported. It is an underecognized headache syndrome. HC can be of continuous or remitting form. Variants such as hemicrania continua with aura have been described, and secondary cases may occur. Indomethacin is the best treatment, although HC could respond to other nonsteroidal anti-inflammatory drugs, such as the selective cyclo-oxygenase-2 inhibitors.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed2003

Management of trigeminal autonomic cephalgias and hemicrania continua.

The trigeminal autonomic cephalgias (TACs) are a group of primary headache disorders characterised by unilateral trigeminal distribution pain that occurs in association with ipsilateral cranial autonomic features. This group of headache disorders includes cluster headache, paroxysmal hemicrania and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT syndrome). Although hemicrania continua has previously been classified amongst the TACs, its nosological status remains unclear. Despite their similarities, these disorders differ in their clinical manifestations and response to therapy, thus underpinning the importance of recognising them. We have outlined the clinical manifestations, differential diagnoses, diagnostic workup and the treatment options for each of these syndromes.

Analgesics↗
PubMed2005

Diagnosing headache.

BACKGROUND: A systematic approach to the diagnosis of primary and secondary headache disorders requires the measurement of the frequency and the duration of headache. OBJECTIVE: This article presents thumbnail sketches of the most important headache subtypes and discusses some of the new revisions and headache types included in the International Classification of Headache Disorders (ICHD 2). DISCUSSION: The clinical features that distinguish secondary headaches requiring urgent investigation (red flags) from those that can be more safely monitored (blue flags) are discussed.

Cluster Headache↗
PubMed1995

Occlusal adjustment in patients with craniomandibular disorders including headaches. A 3- and 6-month follow-up.

The aim of this study was to evaluate the therapeutic effect of occlusal adjustment on symptoms and signs of craniomandibular disorders (CMD), including headaches, after 3 and 6 months. Fifty patients were selected and randomly assigned to a treatment (T) or a control (C) group. All patients in the treatment group were subjected to occlusal adjustment, whereas the controls were comforted only. Pre- and post-treatment assessment of subjective symptoms and clinical signs was made by a dentist not performing the occlusal adjustment. There was significant improvement in overall subjective symptoms within the T group at the 3- and 6-month follow-up visits, but a statistically significant difference between groups was found at the 3-month follow-up only. With regard to changes in frequency of facial pain a significant deterioration was reported within the C group, which resulted in a significant difference between groups at the 6-month follow-up. No other significant differences were found within or between groups at the follow-ups with regard to the variables investigated. In conclusion, the results from this study that occlusal adjustment is a treatment modality with a statistically significant short-term effect on symptoms of CMD of muscular origin and superior to counseling.

Chi-Square Distribution↗
PubMed2004

Medication-overuse headache: a worldwide problem.

Medication overuse and subsequent medication-overuse headache (MOH) is a growing problem worldwide. Epidemiological data suggest that up to 4% of the population overuse analgesics and other drugs for the treatment of pain conditions such as migraine and that about 1% of the general population in Europe, North America, and Asia have MOH. Recent clinical studies gave further insights in clinical and pharmacological features, such as critical monthly doses and frequencies. These features seem to vary significantly and depend on the primary headache disorder and the type of drug that is overused. Along with these findings the new international classification of headache disorders has now incorporated additional criteria and new headache entities that will facilitate the diagnosis of MOH. Withdrawal therapy is the only treatment for this disorder and clear restriction of monthly doses is the central requirement for successful prevention.

Diagnosis, Differential↗
PubMed2001

Symptoms and therapies: exertional and sexual headaches.

This article discusses the headache disorders associated with physical and sexual activity, highlighting their differences and similarities. The place of exertional and sexual headaches in the classification of the International Headache Society and in the proposed classification of Indomethacin-Responsive Headache Disorders is addressed here. The Valsalva's maneuver as a shared pathophysiologic mechanism is mentioned as well. Exertional headaches are divided into two subtypes, according to the pattern of physical exercises. Sexual headaches are divided into three subtypes, based on the onset time, related to orgasm. The clinical characteristics of each type are presented, and their etiologies pointed out. The diagnostic approach is discussed, as well as the nonpharmacologic and pharmacologic treatment options.

Coitus↗
PubMed1997

Migraine and pregnancy.

Migraine and tension-type headache are primary headache disorders that occur during pregnancy. Migraine sometimes occurs for the first time with pregnancy. Most migraineurs improve while pregnant; however, migraine often recurs postpartum. Some disorders that produce headache, such as stroke, cerebral venous thrombosis, eclampsia, and SAH, occur more frequently during pregnancy. Diagnostic testing serves to exclude organic causes of headache, to confirm the diagnosis, and to establish a baseline before treatment. If neurodiagnostic testing is indicated, the study that provides the most information with the least fetal risk is the study of choice. Although drugs are used commonly during pregnancy, there is insufficient knowledge about their effects on the growing fetus. Most drugs are not teratogenic. Adverse effects, such as spontaneous abortion, development defects, and various postnatal effects, depend on the dose and route of administration and the timing of the exposure relative to the period of fetal development. Although medication use should be limited, it is not absolutely contraindicated in pregnancy. In migraine, the risk of status migrainosus may be greater than the potential risk of the medication use to treat the pregnant patient. Nonpharmacologic treatment is the ideal solution; however, analgesics, such as acetaminophen and narcotics, can be used on a limited basis. Preventive therapy is a last resort.

Diagnosis, Differential↗
PubMed2004

Functional neuroimaging of headaches.

Functional neuroimaging, mainly PET and functional MRI, is the main tool that allows the capturing of neurovascular events during a headache attack. In migraine, functional imaging has clarified the underlying pathophysiology of the visual aura, whereas in migraine without aura, brainstem findings suggest a dysfunctional pain system. In cluster headache, the activation and morphological changes seen in a region posterior and inferior to the hypothalamus has provided a useful therapeutic target using deep-brain stimulation. We will discuss the main neuroimaging findings pertaining to the pathophysiology of these two common headache disorders, migraine and cluster headache.

Headache Disorders↗
PubMed1999

The three dimensions of headache impact: pain, disability and affective distress.

It is increasingly recognized that pain measures alone provide incomplete information about the impact of pain on functioning or quality-of-life. A wide range of measures that promise to provide additional information about the impact of pain on people's lives are thus coming into use. In order to clarify the construct of headache impact, we attempted to identify the dimensions assessed by a set of 22 headache-impact measures and to identify the specific measures that best assessed each of these headache-impact dimensions. Adults (n=329) with frequent benign headache disorders completed a comprehensive assessment battery that included 22 headache-impact measures. Factor analysis was then used to identify dimensions underlying the headache-impact measures. Three factors labeled Affective Distress, Pain Density and Disability best accounted for correlations among headache-impact measures. Interfactor correlations ranged between 0.37 and 0.20, suggesting three correlated but separable impact dimensions. These results suggest the construct of headache impact needs to be broadened beyond pain and disability to include affective distress. An adequate assessment of the impact of recurrent headache disorders in clinical trials and other research may require measures from all three of the headache-impact dimensions identified here.

Activities of Daily Living↗
PubMed1995

Benign indomethacin-responsive headaches presenting in the orofacial region: eight case reports.

Indomethacin-responsive headaches can present in the orofacial region. According to the classification of headache by the International Headache Society, indomethacin-responsive headaches include chronic paroxysmal hemicrania, hemicrania continue, benign cough headache, benign exertional headache, and sharp, short-lived headache pain syndrome. The mechanism by which indomethacin produces its therapeutic effects in these headache disorders remains speculative. A review of indomethacin-responsive headaches and eight cases in which the presenting symptom was orofacial pain are reported. Because these headache disorders are rare but may present as facial pain, they should be considered in the differential diagnosis of orofacial pain. A comprehensive evaluation prior to performing irreversible treatments is essential when an idiopathic facial pain presents to the dental clinician.

Adult↗
PubMed2005

[Tension-type headache].

Tension-type headache is the most common type of primary headache. Life time prevalence of tension-type headache in general population ranges from 30 to 78%. It is the least studied of the primary headache disorders, despite the fact that it has the highest socio-economic impact. In the new 'The International Classification of Headache Disorders', tension-type headache is divided into episodic and chronic subtypes. The exact mechanisms of tension -type headache are not known. Peripheral pain mechanisms are most likely to play a role in episodic headache, whereas central pain mechanisms play a more important role in chronic tension-type headache. Treatments of tension-type headache include not only medication but also the physical therapy. In many uncertain cases there is overuse of medication. Two months after medication overuse has ceased, chronic tension-type should be diagnosed.

Humans↗
PubMed2005

Advances in the understanding of headache.

Primary headache disorders account for a substantial part of the morbidity seen in medical practice and so advances in their understanding and management are of general importance. The classification of headache disorders has recently been revised, and the importance of frequent migraine, chronic (transformed) migraine and some important, albeit rarer, conditions that were previously not included has been recognized. Identification of the first genes for a migraine syndrome, namely familial hemiplegic migraine, and their classification as channelopathies opens up new understanding of these disorders and their possible pathophysiology. Functional brain imaging of migraine and cluster headache has placed the pathophysiology of these disorders firmly and clearly in the brain. As our understanding of migraine and related syndromes has increased, new therapies have been developed which reduce the significant disability associated with these important neurological disorders.

Acute Disease↗