Chronic Daily Headache
Preface
Statistics
Table of Contents
Chapter 1
What is Chronic Daily Headache?
Distinguishing Primary Headaches to Secondary Headaches. Where should CM be?
Is my Headache a Chronic Daily Headache?
Are there Canadian migraine neurologists with knowledge of this issue?
So where do I find further information for myself, a medical student or a physician?
Medication Overuse Headache (MOH)
A Toronto headache neurologist speaks out on the various subtypes of CDH
Diagnosis
Chronic Migraine (formerly Transformed Migraine)
Chronic Tension-Type Headache
New Daily Persistent Headache
Hemicrania Continua
Treatment
Preventative Therapy
Types of Chronic Daily Headache (CDH)
Chronic Migraine (CM)
Chronic Tension-type Headache (CTTH)
New Daily Persistent Headache (NDPH)
Hemicrania Continua (HC)
Prevalence of CDH
Treatment of CHD
Non-drug approach:
Drug approach:
Types of Chronic Daily Headache
Chapter 2
What is Chronic Migraine (CM)? Global Estimates
Classification of CM in Wolff’s Headache and Other Head Pain (textbook for physicians)
Definition of CM as it is defined by the International Headache Society (IHS)
Prevalence of CM in Canada
Prevalence of CM in the United States
What impact does CM have on our society?
If hospitalization is Required to treat CM’s where do I Find Help?
Canada
United States
Stages of Chronic Migraine
Why you should Try to Bring your CM’s back to Episodic Migraine
Interview with Dr Joel Saper, Headache Neurologist, Michigan Headache & Neurological Institute, Ann Arbor, Michigan
Botox for Chronic Migraine
Chapter 3
Migraine in Women
Migraine and the Menstrual Cycle
Non Pharmacologic Rx
Migraine and Oral Contraceptives
Migraine and stroke – is there a link?
What is a stroke?
Is there a risk of stroke during a migraine attack?
What do the statistics show about migraine and stroke?
Why should young women with migraine with aura be at anincreased risk of stroke?
What are the implications?
What about older people with migraine?
Migraine and Pregnancy
Management of Migraine in Pregnancy
I am pregnant / breastfeeding and experiencing migraine
Migraine and Menopause
From the Section on Menopause
Chapter 4
ACUTE MEDICINES (or Abortive Medicines)
Categories of Acute Medicines
Over-the-Counter Medicines (OTCs)
“Just Take a Pill”: Consumer’s Perception of Over-the-Counter Medication
Behaviour Modification when Treating Headache
Patient Assistance Programs
Risk Factors that can Lead the Headache Sufferer toward Developing Chronic Daily Headaches
New Migraine Treatment: Cambia®
Chapter 5
What are preventative medicines? How a Migraine is treated with Preventative Treatment?
How do Preventative Medicines work? What is their purpose?
Prevent the Next Migraine Attack in Frequency, Severity, & Length
When to Use Preventative Treatments to treat Migraines?
Which preventive medications should be used?
A strategy for patients who are overweight
Depression / anxiety strategy for patients who have depression and / or anxiety in addition to migraine
CONCLUSION
Issues to consider when taking preventative medicines
Categories of Preventative Medicines
Antidepressants
Beta-Blockers
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
Calcium Channel Blockers
Methysergide
Monoamine Oxidase Inhibitors (MAOIs)
Anticonvulsants or Antiseizure Medications
Botulinum Toxin Injection (see Chapter 2)
Alternative Preventatives
Headache and Migraine Patients searching for Financial Assistance
What Preventative Medicines are used to treat Chronic Daily Headache?
Preventative Medicines used for Chronic Daily Headache
Table 1: Brief Summary of some Prophylactic Drugs used to treat Chronic Daily Headache Types
Chapter 6
Alternative Approaches
Herbs, Supplements and Botanicals
Magnesium
Riboflavin
Coenzyme Q10 (CoQ10)
Migralex (a newer treatment)
Feverfew
Butterbur (Petasites hybridus)
Physical Approaches
Acupuncture
Chiropractic Manipulation
Cranial Sacral Therapy
Massage
Aromatherapy
Physical Therapy
Homeopathy
Yoga
Electrical stimulation of the occipital nerve
Behavioural Treatments
Relaxation Techniques
Cognitive Behavioural Therapy (CBT)
Meditation
Psychotherapy
Hypnotherapy
Caffeine
Multidisciplinary Headache Treatment Centres
Summary
Chapter 7
Medication Overuse: A Brief Mention
Patients can become hopelessly stuck
Do not expect immediate results
Depression and Anxiety in Migraine Patients
Symptoms of depression and anxiety are most common among persons with chronic migraine
Warning Symptoms - Especially Feelings and Thoughts
Anxiety Types
Treatment Options
Information From Research and a Simple Treatment Plan
Risk Factors For a Sleep Disorder
More on Sleep Plans
Caffeine, Snoring and Chronic Daily Headache
Methods of the Study
Caffeine and Medication
Factors
Conclusions
References
Stumbling Blocks When Accessing Care
Medicines Not Covered
Alternatives Not Covered
Co-existing Conditions
Research Funding
Numerous Referrals
Internet Health (Sometimes Good, Sometimes Bad)
More People in the World
Chapter 8
HEADACHE HYGIENE (What is it?)
1. Lifestyle Changes
2. Trigger avoidance
Patient Compliance/Adherence
Adherence: What is it and why does it matter?
Motivation and Behavior Change
Partnership and Communication with your HCP
What can you do to Manage your Headaches?
What are Headache Triggers?
What is Relaxation Training and Stress Management?
Headache Diary
Headache Diary Instructions
Why the Headache Diary is such an Important Tool for Physicians
Relaxation Techniques
What Are Some Relaxation Techniques I Can Use to Help my Headaches?
Biofeedback
How do I find a Headache Doctor with a High Interest in Treating Headaches?
Chapter 9
Diagnostic Tests
Magnetic Resonance Imaging (MRI)
Computerized Tomography Scan (CT)
Electroencephalograms (EEG)
Lumbar Puncture (LP)
Miscellaneous Tests
Online Headache Assessment Tools Available
Headache Impact Test (HIT)
Migraine Disability Assessment (MIDAS)
Do I Need an Imaging Study for my Headache?
Introduction.
Imaging studies used to examine headache
Chapter 10
How a Doctor Diagnoses Headache
How long have you had these headaches?
Do other members of your family get headaches?
How often do you get these headaches?
Has the pattern or frequency changed?
Describe the pain for me
What other symptoms do you have with the headache attacks?. 210 How long does the headache attack last?
Do you tend to get your headaches at a particular point in the day, week or month?
Have you noticed or has your family noticed a change in your mood or behaviour because of these headaches?
Do you get any warning that a headache is coming on?
What do you take to try to stop a headache? How much do you take?
What seems to trigger your headaches?
Your Doctor and Your Headache - A Vital Partnership
Getting the most from your doctor
Getting the most out of your appointment
Specialist clinics
Reasons Why you Should Search for a New Doctor
Physicians Should not Blame the Patient
Blaming the Patient
Patient-Centred Care
Chapter 11
Life and Migraine - Documentary about Life with Chronic Migraine
Organizations and Centres specific to helping Headache Sufferers
Finding the Key to the Migraine Riddle
References
Appendix I
Why Patients do not Get Better (for some CDH sufferers)
Appendix II
How to View the Headache Classification guide, produced by the International Headache Society (IHS)
Glossary
Index
