By Anne MacGregor, Alison Frith
In its assorted shows, headache is likely one of the commonest signs noticeable by means of kin practitioners. the trouble is in diagnosing the reason for the headache in order that the correct remedy is supplied, or if referral to a expert is the suggested plan of action. The ABC of Headache is helping with this predicament and courses the health practitioner to appear for the prospective motives of proposing indicators. in keeping with genuine case histories, every one bankruptcy publications the reader from indicators via to analysis and administration. This new ABC is a hugely illustrated, informative, and useful resource of data. With hyperlinks to additional info and assets, it's a priceless textual content for healthcare pros in any respect degrees of perform and coaching.
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Extra info for ABC of Headache
For migraine attacks occurring at or around period time, ET was commenced on sumatriptan 50 mg. Menstrual Headaches Non-pharmacological prevention ET was encouraged to eliminate non-hormonal triggers. This may improve migraine overall as hormonal and non-hormonal triggers may combine to cause migraines. Remaining hormonally triggered attacks may then respond better to hormonal treatment strategies. Pharmacological prevention Diary records showing migraines over three menstrual cycles should be reviewed before considering prophylaxis.
The headache lasts 2–3 days. Unlike her other headaches occurring once or twice at other times of the month, this headache does not respond to over-the-counter analgesia. ET dreads her period because she is ‘struck down’ each month. The menstrual headache is the reason for the consultation. History How many different headache types does the patient experience? ET describes two types of headaches: mild headaches at any time during her menstrual cycle, and severe menstrual headaches at the start of menses each month.
Final diagnosis Medication overuse headache. Management plan TR abruptly discontinued the combination analgesic and sumatriptan. Topiramate was initiated at a dose of 25 mg a day and increased to 50 mg bd over the course of four weeks. Intranasal dihydroergotamine 2 mg was used for acute symptomatic relief of moderate or severe headache with a limit of two treatment days (4 mg) a week. DHE was used in combination with metoclopramide 10 mg to prevent nausea and enhance the efficacy of DHE. TR was scheduled for a consultation with a neuropsychologist to provide behavioural and non-pharmacological strategies (biofeedback, relaxation therapy) to reduce pain and suffering and to enhance compliance with and effectiveness of the pharmacological strategies initiated.
ABC of Headache by Anne MacGregor, Alison Frith