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Headache Disorders
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Headache is one of the most common medical complaints. At present there are more than 300 recognized forms of headache in the recent iteration of the International Classification of Headache Disorders (ICHD-3) criteria.1 It is probably surprising to note that we understand more about the pathogenesis of primary headache disorders than we do about most other neurologic conditions. This knowledge is changing the landscape of headache therapy. The goal of this chapter is to discuss some of the better and lesser known primary headache disorders and their treatment.
Vestibular Migraine
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Migraine is defined by the International Headache Society International Classification of Headache Disorders (ICHD), most recently ICHD-3 beta (Box 76.1).1 Of note, there is no objective diagnostic test and the diagnosis rests with the patient’s subjective description of the symptoms, as well as the clinician’s assessment that no other disorder better accounts for the clinical presentation. This can be supported to some extent by behavioural observation, especially in those unable to provide a history, such as young children.
Sleep and headache disorders
Published in S.R. Pandi-Perumal, Meera Narasimhan, Milton Kramer, Sleep and Psychosomatic Medicine, 2017
C. Rains Jeanetta, J. Steven Poceta, B. Penzien Donald
Classification of headaches follows the International Classification of Headache Disorders—3rd Edition, Beta Version (ICHD-3).3 The subset of headaches comorbid with sleep disorders have also been addressed in a general manner in the most recent revision of the International Classification of Sleep Disorders—3rd Edition (ICSD-3).4 The ICSD-3 recently added a five-page appendix that describes the diagnosis and clinical course under a section entitled “Sleep-related medical and neurological disorders.” Finally, sleep-related headaches may be diagnosed from the Diagnostic and Statistical Manual of Mental Disorders—5th Edition (DSM-5).5 The DSM-5 includes diagnoses for 10 major sleep–wake disorders consistent with ICSD-3. Psychiatric disorders are comorbid with both sleep disorders and headache and the symptom constellation of sleep–headache–mood disorder is a common and clinically challenging case. Thus, familiarity with the DSM-5 may facilitate a differential diagnosis for cases in which psychological symptoms, distress, and impairment are prominent.
Clinical benefits and economic cost-savings of remote electrical neuromodulation (REN) for migraine prevention
Published in Journal of Medical Economics, 2023
Robert Cowan, Alit Stark-Inbar, Liron Rabany, Dagan Harris, Maya Vizel, Alon Ironi, Julio R. Vieira, Michelle Galen, Christina Treppendahl
The clinical trial (Clinicaltrials.gov NCT04828707; see29) was conducted at 15 US centers. Eligible patients were 18–75 years old with at least 6 months of diagnosed migraine meeting the International Classification of Headache Disorders, 3rd edition (ICHD-3) diagnostic criteria for migraine with or without aura, with either chronic or episodic migraine; 6-24 headache days and at least 4 migraine attacks per 28-days month, aka 4 weeks. Before and throughout the study, subjects either did not use preventive medications or were on a stable dose of a single migraine preventive medication. The study was approved by Western Institutional Review Board (WIRB; 20210751) and was conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from all participants prior to their enrollment (For further details see29).
Effectiveness of spinal mobilization and postural correction exercises in the management of cervicogenic headache: A randomized controlled trial
Published in Physiotherapy Theory and Practice, 2023
The International Classification of Headache Disorders (ICHD) criteria for CGH third version given by IHS was used for excluding secondary headaches except for CGH. We did not apply anesthetic blockade and headache resolution after treatment to diagnose CGH as per ICHD criteria as it was not feasible. Instead, CGH was assessed using SJAASTAD criteria, which includes four points: 1) major criteria (except diagnostic anesthetic blockades) includes signs and symptoms of neck involvement, unilaterality of the head pain without side-shift; 2) head pain characteristics include moderate to severe nonthrobbing pain usually starting in the neck; 3) other characteristics of some importance includes female sex; and 4) other features of lesser importance like nausea and phono-photophobia (Sjaastad, Fredriksen, and Pfaffenrath, 1998) (Appendix 1).
Annual indirect cost savings in patients with episodic or chronic migraine: post-hoc analyses from multiple galcanezumab clinical trials
Published in Journal of Medical Economics, 2022
Joshua Tobin, Janet H. Ford, Antje Tockhorn-Heidenreich, Russell M. Nichols, Wenyu Ye, Rohit Bhandari, Xiaojuan Mi, Karan Sharma, Richard B. Lipton
The analysis of the 4 clinical studies included patients who had received either 240 mg loading dose of GMB followed by 120 mg GMB monthly subcutaneously or PBO and also had baseline and at least one post-baseline measurement of MIDAS. MIDAS scores at baseline and at Month 3 (last observation carried forward [LOCF] applied if patients were early dropout) were used for calculation of indirect cost savings in the analysis. All the patients had migraine diagnosis defined by the International Headache Society (IHS) International Classification of Headache Disorders (ICHD), 3rd edition (beta version) (ICHD-3 2013)19, had a history of migraine headaches for ≥1 year prior to screening, and had migraine onset before 50 years of age. The primary results for all 4 clinical studies have been previously reported11–14.