Medication‐overuse headache in patients with secondary headache disorders: Need for revision?

2021 ◽  
Vol 61 (5) ◽  
pp. 790-791
Author(s):  
Håkan Ashina ◽  
David W. Dodick
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Secondary Headache Disorders

Headache

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

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

scholarly journals Medication-Overuse Headache: Results from a Pain Medicine Clinic Cohort

2022 ◽  
Author(s):  
Leon Moskatel
Keyword(s):  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Headache Disorder ◽  
Tension Type Headache ◽  
Pain Clinic ◽  
Secondary Headache ◽  
Pain Medicine ◽  
Medicine Clinic ◽  
Type Headache ◽  
Clinical Records

Background and Objective: Medication-overuse headache (MOH) is a common, disabling, and treatable cause of chronic daily headache. This study evaluates the characteristics of a cohort of patients with MOH seen in a pain medicine clinic. Methods: We conducted a retrospective study of consecutive patients seen by a neurologist in the pain medicine clinic at the University of California, San Diego. Demographics, headache diagnoses, and overused medications were extracted from clinical records from 83 patients ≥ 18 years of age where a diagnosis of MOH was entered into the electronic medical record September 12, 2017-March 30, 2020. Results: Opioids were the most overused medications (42/83, 50.6%) followed by caffeine-containing compounds (20/83, 24.1%), triptans (12/83, 14.5%) and non-steroidal anti-inflammatory drugs (10/83, 12.9%). Chronic migraine was the most common underlying headache syndrome (54/83, 65.1%), followed by secondary headache disorder (13/83, 15.7%) and tension-type headache (8/83, 9.6%). Men were more likely to be overusing opioids (OR 3.3, p = 0.026) while women were more likely to be overusing caffeine-containing compounds (OR 5.4, p = 0.041). Discussion and Conclusions: It is crucial for pain specialists to recognize MOH in the pain clinic setting. Opioid overuse headache is more common among men, likely in part due to migraine being underrecognized in men and therefore men not receiving migraine-specific medications. Caffeine-containing compound overuse is more common among women; these are over-the-counter (OTC) and often do not appear on patients’ medications lists. Pain specialists should specifically ask patients with headache whether they are using OTC caffeine-containing compounds.

scholarly journals International Classification of Headache Disorders - ICHD-4. Will medication-overuse headache survive?

2021 ◽  
pp. 72-74
Author(s):  
Mario Fernando Prieto Peres ◽  
Thaiza Agostini Córdoba de Lima ◽  
Marcelo Moraes Valença
Keyword(s):  
Clinical Practice ◽  
Diagnostic Criteria ◽  
Critical Analysis ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
International Classification ◽  
Headache Disorders ◽  
Critical View

The article is a critical analysis of the diagnostic criteria for medication-overuse headache. This is an important discussion to improve the criteria in the next update, as well as providing a critical view for neurologists when applying the criteria to their clinical practice.

scholarly journals De novo migraine with aura in the third trimester of pregnancy: a case report and literature review

2021 ◽  
Vol 28 (1) ◽  
pp. 19
Author(s):  
Elena Paškevičiūtė ◽  
Diana Bužinskienė ◽  
Kristina Ryliškienė
Keyword(s):  
Migraine With Aura ◽  
Rating Scale ◽  
De Novo ◽  
Large Body ◽  
Secondary Headache ◽  
Headache Disorders ◽  
Diagnostic Challenge ◽  
Safe Treatment ◽  
Secondary Headache Disorders ◽  
Adverse Pregnancy

Background: Among all headache disorders, migraine has the highest prevalence during gestation. The majority of migraineurs experience improvement during pregnancy, but a few may experience migraine for the first time. This poses a diagnostic challenge in the differential diagnosis between primary and life-threatening secondary headache disorders. Because pregnancy itself is an independent risk factor for secondary headache disorders, it is mandatory to exclude these conditions in order to diagnose migraine. There is a large body of literature about pre-existing migraine course during pregnancy and its link with adverse pregnancy outcomes, but there are no studies examining these aspects among women with new-onset migraine during pregnancy.Case report. A 31-year-old female at 33 weeks of gestation (gravida 2, para 2) was referred to the neurologist eds disturbances, which were followed by pressing severe headache, rated as 8 out of 10 on a numeric rating scale and accompanied by dizziness. The headache lasted for one day, and dizziness continued to the following day. The patient was investigated for a secondary headache disorder, but laboratory and neuroimaging results were unremarkable. A migraine with aura was diagnosed. The patient was advised to keep a consistent sleep schedule, maintain regular low physical activity, eat regularly and take magnesium supplementation. The patient was informed about a safe treatment approach in case of an acute attack. At 40 weeks of gestation the patient delivered female newborn, weighing 3750g, with Apgar scores of 8 and 9 (due to a nuchal cord). The postpartum period was uneventful. During the subsequent 4 years, the patient did not experience any recurrent migraine attacks and had no pregnancies.Conclusion. In order to diagnose a migraine during pregnancy, exclusion of secondary headache disorders is mandatory. Pregnant migraineur should be regularly monitored for adverse birth outcomes. It is essential to educate patients, provide information about the safe treatment of migraine attacks, and explain nonpharmacological prevention and supplementation benefits.

scholarly journals Bridging the gaps of headache care for underserved populations: A medication overuse headache survey among international headache society members from Latin America

2019 ◽  
Vol 2 ◽  
pp. 251581631882407
Author(s):  
Marco Lisicki ◽  
Juan Antonio Castro Flores ◽  
Carlos Alberto Bordini ◽  
María Teresa Goicochea ◽  
Mario Fernando Prieto Peres
Keyword(s):  
Latin America ◽  
Latin American ◽  
Western Europe ◽  
Medication Overuse ◽  
Underserved Populations ◽  
International Headache Society ◽  
Medication Overuse Headache ◽  
Health Concern ◽  
Health Providers ◽  
Headache Disorders

Introduction: Headache epidemiological studies in Latin America are scarce, and available data suggest that medication overuse headache is an existing health concern in the region. Materials and Methods: A survey empirically constructed to assess the management of medication overuse headache was sent to all the International Headache Society (IHS) members from Latin American countries. Results: We found no IHS members in 13 countries of Latin America. In countries with active members, the median number of IHS members per million inhabitants was significantly less when compared to Western Europe. Although the International Classification of Headache Disorders-3-beta (ICHD-3-beta) criterion was the most frequently used tool for medication overuse headache diagnosis, 41% of responders considered the diagnostic criterion ‘ambiguous’ and only 67% found them ‘very useful’. With respect to preferred treatment patterns, an important lack of uniformity, and a very limited usage of therapeutic approaches widely employed in other regions, characterized the responses. Conclusion: There is an urgent need to reach a consensus and establish region-specific strategies for the management of medication overuse headache as well as other headache disorders in this region. Development of headache specialized educational programmes, and participation of Latin American health providers in the IHS, should be incentivized.

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