migraine

Daily Preventative Therapies Can Reduce Migraine

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The American Academy of Neurology/American Headache Society Guidelines released earlier in April 2012, provide evidence-based and effective treatments that can prevent migraine attacks and lessen their severity. They state 38% of migraine sufferers require preventive therapy, but just 3%  to 13% currently use any preventatives. Some patients are taking preventatives that have never been shown to work. The guidelines show that prevention of migraines requires daily medication. Mark Green, MD, director of the Headache Center at Mount Sinai School of Medicine, in New York says “If these guidelines are used widely, we will be able to up the odds of reducing headaches by 50 percent…Evidence is building to suggest that if we allow migraines to progress, the frequency of attacks may increase, and they may also become harder to treat.” The guidelines panel found the following: • The anti-seizure medications … Read more

Botox Injections Have Benefit for Chronic Headaches

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A new review and analysis of previous studies has found that botulinum toxin A (“Botox”) injections have a small to modest benefit for those with chronic migraine headaches and chronic daily headache. Botulinum toxin A injections were first proposed as headache treatment when it was observed that patients with chronic headaches receiving cosmetic botulinum injections experienced headache improvement, prompting several case series that suggested benefit. Jeffrey L. Jackson, M.D., M.P.H., of the Medical College of Wisconsin, Milwaukee, and colleagues performed a review and meta-analysis to assess the association of botulinum toxin A with reducing headache frequency when used for preventive treatment of migraine, tension, or chronic daily headaches in adults. In the study, headaches were categorized as episodic (less than 15 headaches per month) or chronic (15 or more headaches per month) migraine and episodic or chronic daily or tension … Read more

Cluster Headache Features and Therapeutic Options

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A review article titled “Cluster Headache: Clinical Features and Therapeutic Options” written by Charly Gaul, Hans-Christoph Diener, and Oliver M. Muller published in Deutsches Ärzteblatt International (vol. 108, issue 33, pages 543-549, 2011) provides an interesting look on new options for those with a chronic refractory cluster headache. The article discusses how 120,000 people in Germany are affected by cluster headache. The attacks are in the periorbital area on one side and last 90 minutes on average. The attacks often posses a circadian and seasonal rhythm. The author lists the diagnostic criteria for cluster headache as from the International Classification of Headache Disorders (ICHD-II). First line drugs for treatment include verapamil and cortisione or lithium and topirmate. In addition, short term relief can be obtained by local anesthetics and steroids along the course of the greater occipital nerve. I have … Read more

Headaches after Traumatic Brain Injury Highest in Adolescents and Girls

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A recent study has been conducted by the Seattle Children’s Research Institute and appeared in Pediatrics, vol 129, number 1, January 2012, pages 1 to 9, titled Headache After Pediatric Traumatic Brain Injury: A Cohort Study, wirtten by Heidi K. Blume and et al. The article discusses how in the adult population 18% to 33% of those who suffer from traumatic brain injury suffer from headaches 1 year after the injury. In the child population most of the investigations conducted have been small, retrospective, lacked a control, or involved only short term follow up. Chronic headaches with children are associated with interference in social function, parental productivity, and poor quality of life. The study randomly selected 1507 patients with TBI and 495 controls with arm injury (AI) for the study. However, some patients were not reachable, others were inegligible, and … Read more

Behavioral Treatment for Migraine Headaches

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A recently study titled Direct Costs of Preventive Headache Treatments: Comparison of Behavioral and Pharmacologic Approaches appearing in Headache: The Journal of Head and Face Pain, 51 (6): 985 -991, June 2011, and written by Allison M. Shafer et al., finds that treating chronic migraines using inexpensive prophylactic medicines such as beta-blockers or tricyclic antidepressants and behavioral approaches such as relaxation training, biofeedback, cognitive behavioral therapy, and stress management are a low cost and effective treatment option particularly after 1 year of treatment. The authors used a cost minimization analysis and found that after 1 year, the cost of minimal-contact behavioral treatment was cheaper than the least expensive headache treatment medications. Minimal-contact or home based intervention is when a patient sees a therapist for around 3 or 4 visits and  largely practices the behavioral techniques at home through the use of … Read more