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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

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Refractory Headaches.

Olivia Begasse de Dhaem^1,2, Paul Rizzoli³

¹Headache Specialist at Hartford HealthCare, Hartford, Connecticut.

Seminars in Neurology

|November 2, 2022

Summary

This summary is machine-generated.

Medication overuse headache (MOH) treatment can be managed without withdrawal. New daily persistent headache (NDPH) and persistent refractory headache after SARS-CoV-2 infection require careful diagnosis and management.

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Area of Science:

Neurology
Headache Medicine

Background:

Medication overuse headache (MOH), new daily persistent headache (NDPH), and persistent refractory headache following SARS-CoV-2 infection pose significant challenges in diagnosis and treatment.
These conditions substantially impact patient disability and quality of life.

Purpose of the Study:

To review current understanding and treatment strategies for MOH, NDPH, and post-SARS-CoV-2 headaches.
To highlight the efficacy of preventive treatments for chronic migraine with MOH and discuss NDPH management options.

Main Methods:

Literature review of studies on MOH, NDPH, and post-viral headaches.
Analysis of treatment outcomes for various preventive medications and interventions.

Main Results:

Prevention of MOH is effective whether or not medication withdrawal occurs.
Preventive treatments like topiramate, onabotulinumtoxinA, and CGRP monoclonal antibodies are beneficial for chronic migraine with MOH.
No specific guidelines exist for NDPH, but treatments like steroids, nerve blocks, and various medications show potential.
Headache persistence 3 months post-SARS-CoV-2 infection indicates a poor prognosis.

Conclusions:

MOH management can prioritize prevention over withdrawal, with several effective preventive options available.
NDPH diagnosis requires thorough differential examination, and treatment is individualized.
Persistent headaches after SARS-CoV-2 infection warrant close monitoring due to prognostic implications.