The Cleveland Clinic has been a leader in the field of headache management and education for many years. Compassionate care and understanding are essential elements in the successful treatment of the patient suffering with chronic headaches. Education of the headache sufferer as well as their families, friends, employers, and health care providers as to the different causes and possible triggers of their headaches is also an important aspect of a successful treatment outcome.
Recurring headaches are due to legitimate biological conditions. Research has shown that the majority of recurring headaches are associated with metabolic disturbances or neuronal dysfunction in various areas of the brain. However, in persons suffering with frequent or chronic headaches, psychological factors often are very significant and need to be addressed along with the use of appropriate medical treatment. Recent studies have documented that the incidence of childhood abuse (physical, psychological, and sexual) is much higher in those suffering with chronic headaches than in those without frequent headaches.
For years, the treatment of severe, disabling headaches was quite limited. Ergotamine tartrate, which has been available for over 70 years, is fairly effective in the acute migraine attack but has many unpleasant side effects. Most frequently, non-specific pain-relieving drugs (often narcotics) and/or sedatives were prescribed. The introduction of the “migraine-specific” triptan drugs was a major step forward in the treatment of acute migraine.
Surprisingly, methysergide is the only preventive drug ever developed specifically to treat migraine. However, long-term use may cause serious problems, and it is no longer available in the U.S. As discussed in this book, there are many different preventive medications available for the treatment of headaches today, but most are effective in only 50−60% of patients, and all were initially developed to treat other medical conditions.
In the management of migraine, perhaps even more important than the development of the triptans in recent years has been the recognition that the frequent use of acute medications may lead to medication overuse headache (MOH). MOH has also been called rebound, analgesic-induced headache, and analgesic withdrawal headache and is a huge problem in the headache field. The pathophysiology of this condition is not well understood as yet. It is very easy for one to get into an overuse situation.
We tell patients to take their medicines early and not to wait, but then also warn them to be sure it is a migraine and not take any acute medicine unnecessarily or too often. The use of preventive medications for frequent recurring headaches is grossly underutilized. Decreasing the frequency of headaches will lessen the chance of medication overuse. The management of MOH is discussed in detail in this book. The Teppers and their colleagues put together this book based on years of experience in treating difficult, complicated headache patients. This is a book for the practicing physician.
Although understanding the pathophysiology of head pain is important in learning more about the underlying mechanisms involved in the various types of headaches; busy health care professionals caring for their headache patients really just want to know how to make the correct diagnosis and what is an effective, appropriate therapy.
This book is a “nuts and bolts” practical volume that is easy to read and should be a great help for the busy practitioner who sees patients complaining of headaches.
Contents
Part I: Diagnosis of Episodic Primary Headaches
- Chapter 1. Diagnosis of Migraine and Tension-Type Headaches
- Chapter 2. Diagnosis of Trigeminal Autonomic Cephalalgias and Other Primary Headache Disorders
Part II: Diagnosis of Chronic Headaches
- Chapter 3. Diagnosis of Primary Chronic Daily Headaches
Part III: Diagnosis of Secondary Headaches
- Chapter 4. Diagnosis of Major Secondary Headaches 1, The Basics, Head and Neck Trauma, and Vascular Disorders
- Chapter 5. Diagnosis of Major Secondary Headaches 2, Non-traumatic and Non-vascular Disorders
Part IV: Diagnosis of Pediatric Headaches
- Chapter 6. Headache in Children and Adolescents: Evaluation and Diagnosis and Episodic Migraine and its Subtypes
- Chapter 7. Diagnosis of Childhood Periodic Syndromes, Pediatric Tension–type Headaches, and Pediatric Daily Headache Syndromes
Part V: Treatment of Episodic Headaches
- Chapter 8. Acute Treatment of Episodic Migraine
- Chapter 9. Preventive Treatment of Episodic Migraine
- Chapter 10. Treatment of Trigeminal Autonomic Cephalalgias and Other Primary Headaches
Part VI: Treatment of Chronic and Refractory Headaches
- Chapter 11. Treatment of Medication Overuse Headache
- Chapter 12. Medical Treatment of Chronic Daily Headaches: Chronic Migraine, Chronic Tension-type Headaches, New Daily Persistent Headaches, Hemicrania Continua, and Medication Overuse Headache
- Chapter 13. Psychological Assessment and Behavioral Management of Refractory Daily Headaches
Part VII: Treatment of Secondary Headaches
- Chapter 14. Treatment of Major Secondary Headaches
Part VIII: Treatment of Pediatric Headaches
- Chapter 15. Treatment of Pediatric and Adolescent Headaches
Part IX: Special Topics In Headache
- Chapter 16. Behavioral Treatment of Headaches
- Chapter 17. Treatment of Facial Pain and Neuralgias
- Chapter 18. Treatment and Consideration of Women’s Issues in Headache
- Chapter 19. Nursing Issues in the Diagnosis and Treatment of Headaches
- Chapter 20. Diagnosis and Treatment of Dizziness and Headache
About the Authors
- Stewart J. Tepper, MD, Center for Headache and Pain, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA; Professor of Medicine (Neurology), Cleveland Clinic Lerner College of Medicine.
- Deborah E. Tepper, MD, Center for Headache and Pain, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Book Review
For starters, this is not your typical medical textbook. Reading this book, it is clear that the authors’ goal was to create an innovative text in which to present Headache Medicine for all levels of care providers. Although it is not a novel, it is quite a novel format. As with the standard headache medicine texts, this tome also features chapters on the diagnosis and treatment of both primary and secondary headaches, facial pain syndromes, and special populations (women’s issues, behavioral strategies, headache and dizziness, pediatric and adolescent headache syndromes). But rather than presenting a straightforward didactic lecture with a prolonged literature review, the authors, all members of the Cleveland Clinic Center for Headache and Pain, thoroughly discuss their subject matter and infuse their topics with clinically relevant “pearls” developed from their vast clinical experience in the practice of Headache Medicine – and that is what distinguishes this book from others I have read about Headache Medicine.
This is not the sort of textbook to reach for if you are looking for the latest scientific theory regarding migraine pathophysiology (that was never the intention of the authors). But, this is the place to go when you want an up-to-date, practical treatise on how to treat an actual patient who suffers from headache.
Whether you are a resident searching for a clue in a diagnostic dilemma, or an established clinician in need of a suggestion for a treatment paradigm, this book will provide a wide array of useful answers. Here you will have the opportunity to be privy to the clinical thoughts of the authors. It is an up-close and personal view of real-world Headache Medicine written by real-world headache experts. I have no doubt that you will refer to it often and rely on it frequently.
- By L. Newman, Albert Einstein School of Medicine, Director, Roosevelt Hospital Headache Institute, New York, NY, USA -
Product Details
- Paperback: 316 pages
- Publisher: Springer; 1st Edition (2011)
- Language: English
- ISBN-10: 146140178X
- ISBN-13: 978-1461401780
- Product Dimensions: 8.9 x 5.7 x 0.2 inches
List Price: $59.95