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Managing chronic headaches in the clinic
A J Dowson1, S Bradford, S Lipscombe
1King's College Hospital, London, UK. drandydowson@dowsona.fsnet.w.uk
International Journal of Clinical Practice
|January 14, 2005
Summary
Management algorithms for chronic daily headache (CDH) and cluster headache are outlined for primary care physicians. Optimal treatments involve tailored therapies, medication withdrawal, prophylaxis, and rescue medications for effective headache management.
Area of Science:
- Neurology
- Primary Care Medicine
Background:
- Chronic daily headache (CDH) and cluster headache are common but often underrecognized and undertreated in primary care settings.
- These chronic headache subtypes can be associated with prior migraine, tension-type headache, and medication overuse.
Purpose of the Study:
- To develop management algorithms for CDH and cluster headache tailored for primary care physicians.
- To provide a framework for the effective diagnosis and treatment of chronic headache disorders.
Main Methods:
- Development of evidence-based management algorithms for specific chronic headache subtypes.
- Integration of principles including screening, differential diagnosis, individualized treatment, proactive follow-up, and team-based care.
Main Results:
- Optimal CDH management includes physical therapy, medication withdrawal, prophylaxis, and acute rescue therapy.
- Optimal cluster headache management involves short- and long-term prophylaxis and acute rescue medications.
Conclusions:
- Structured management algorithms can improve the care of patients with CDH and cluster headache in primary care.
- Tailored therapeutic approaches, including medication adjustment and prophylactic strategies, are crucial for managing chronic headaches effectively.