Diamond / Cady MD / Diamond MD Headache and Migraine Biology and Management

1. Auflage 2015
ISBN: 978-0-12-801162-1
Verlag: Elsevier Science & Techn.
Format: EPUB
Kopierschutz: 6 - ePub Watermark

E-Book, Englisch, 334 Seiten

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

Autoren/Hrsg.

Diamond, Seymour

Cady MD, Roger K.

Diamond MD, Facep

Green, Mark W.

Martin, Vincent T.

Inhaltsverzeichnis

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

Leseproben

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 The term “cephalea” referred to headaches which lasted longer. Because of migraine’s one-sided occurrence, Aretaeus named it , 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 .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 , 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, , 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 , 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, , 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...