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Published on: June 2, 2014
Chronic daily headache: a rational approach to a challenging problem
Jonathan Gladstone1, Eric Eross, David Dodick
1Department of Neurology, Mayo Clinic, Scottsdale, Arizona 85259, USA.
Insights
Chronic daily headache (CDH) affects millions globally, presenting diagnostic and management challenges. Effective treatment requires understanding specific CDH types and medication overuse strategies for improved patient outcomes.
Area of Science:
- Neurology
- Public Health
Background:
- Chronic daily headache (CDH) affects 3-5% of the global population.
- CDH poses significant clinical challenges requiring systematic management approaches.
Observation:
- The 2004 International Headache Society Classification provides criteria for CDH disorders.
- Common CDH disorders include chronic migraine, medication overuse headache, and SUNCT syndrome.
Findings:
- Medication overuse is prevalent in patients with CDH presenting for medical care.
- Effective management involves drug-withdrawal and detoxification protocols.
Implications:
- Clinicians need expertise in managing CDH, including chronic migraine and cluster headaches.
- Successful management of CDH significantly improves patient quality of life and reduces disability.
Abstract:
Chronic daily headache (CDH) is a significant public health problem with 3 to 5% of the population worldwide experiencing daily or near-daily headaches. Patients with CDH can be particularly challenging, and clinicians require a systematic approach to help guide investigations and management. The revised 2004 International Headache Society Classification Criteria introduces formalized criteria for several CDH disorders including chronic migraine and medication overuse headache as well as new daily persistent headache, hemicrania continua, hypnic headache, and SUNCT syndrome. Medication overuse is common in patients with CDH who present to physicians. Familiarity and comfort with drug-withdrawal and detoxification strategies is therefore essential. Patients with chronic migraine and chronic cluster experience significant disability and diminished quality of life. The ability to manage these patients effectively is a rewarding clinical experience.
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