Pathophysiology of Headaches


Book Description

This book provides a detailed overview of the current state of knowledge regarding the pathophysiology of both primary headaches – migraine, tension-type headache (TTH), and cluster headache – and the very important and frequent type of secondary headache, medication overuse headache (MOH). After an introductory chapter describing relevant neuroanatomy and vascular anatomy, the evidence gained from animal models regarding the pathophysiology of migraine and the other primary headaches is reviewed. Knowledge of the genetic component in the different types of headache is then examined with reference to recent evidence, for example regarding the implication of the trigeminovascular system and cortical spreading depression in migraine. Detailed information is provided on insights into primary headaches from imaging studies, including functional magnetic resonance imaging and positron emission tomography and on their neurophysiology and biochemistry. A further series of important chapters describe present knowledge of the pathophysiology of each specific type of headache and consider future directions. Written by acknowledged experts in their fields from Europe and the United States, clinicians and students will find Pathophysiology of Headaches to be an excellent source of up-to-date information on why patients experience headaches. In addition, it will be of value for pain researchers investigating the underlying mechanisms of headache.




Drug-Induced Headache


Book Description

M. WILKINSON Patients with frequent or daily headaches pose a very difficult problem for the physician who has to treat them, particularly as many patients think that there should be a medicine or medicines which give them instant relief. In the search for the compound which would meet this very natural desire, many drugs have been manufactured and the temptation for the physician is either to increase the dose of a drug which seems to be, at any rate, partially effective, or to add one or more drugs to those which the patient is already taking. Although there have been some references to the dangers of overdosage of drugs for migraine in the past, it was not until relatively recently that it was recognized that drugs given for the relief of headache, if taken injudiciously, may themselves cause headache. The first drugs to be implicated in this way were ergotamine and phenazone. In the case of ergotamine tartrate, the dangers of ergotism were well known as this was a disorder which had been known and written about for many years. In the treatment of headache, fully blown ergotism is rare and in recent years has usually been due to self-medication in doses much greater than those prescribed although there are a few recorded cases where toxic amounts have been given.




Pharmacological Management of Headaches


Book Description

In this book, headache experts summarize all the currently available therapies for primary headaches and most importantly, describe the ‘tricks’ that can ensure the success of headache pharmacotherapy. Prevention and acute treatment of migraine and cluster headache receive particular attention and individual chapters are devoted to the treatment of primary headaches in special groups, i.e. children, pregnant women and the elderly. Further chapters focus on selected secondary headache disorders and cranial neuralgias for which pharmacotherapy is available. The book is designed to meet the daily practice needs of general physicians, general neurologists, neurologists in training and medical students. Headache remains a leading reason for people to seek medical consultation, and migraine and other primary headache disorders are classified by the WHO as among the most disabling medical conditions in the general population, often affecting individuals during their most productive years. Unfortunately, under treatment and mismanagement are the fate of many headache patients and this book provides a sound basis for optimizing treatment.




Magnesium in the Central Nervous System


Book Description

The brain is the most complex organ in our body. Indeed, it is perhaps the most complex structure we have ever encountered in nature. Both structurally and functionally, there are many peculiarities that differentiate the brain from all other organs. The brain is our connection to the world around us and by governing nervous system and higher function, any disturbance induces severe neurological and psychiatric disorders that can have a devastating effect on quality of life. Our understanding of the physiology and biochemistry of the brain has improved dramatically in the last two decades. In particular, the critical role of cations, including magnesium, has become evident, even if incompletely understood at a mechanistic level. The exact role and regulation of magnesium, in particular, remains elusive, largely because intracellular levels are so difficult to routinely quantify. Nonetheless, the importance of magnesium to normal central nervous system activity is self-evident given the complicated homeostatic mechanisms that maintain the concentration of this cation within strict limits essential for normal physiology and metabolism. There is also considerable accumulating evidence to suggest alterations to some brain functions in both normal and pathological conditions may be linked to alterations in local magnesium concentration. This book, containing chapters written by some of the foremost experts in the field of magnesium research, brings together the latest in experimental and clinical magnesium research as it relates to the central nervous system. It offers a complete and updated view of magnesiums involvement in central nervous system function and in so doing, brings together two main pillars of contemporary neuroscience research, namely providing an explanation for the molecular mechanisms involved in brain function, and emphasizing the connections between the molecular changes and behavior. It is the untiring efforts of those magnesium researchers who have dedicated their lives to unraveling the mysteries of magnesiums role in biological systems that has inspired the collation of this volume of work.







Chronic Headache


Book Description

This comprehensive, practical title invites all clinicians to take a fresh look at the evaluation and management of chronic daily headache (CDH). Developed by a distinguished international panel of experts, the book examines key social and economic issues around CDH and clarifies the diagnosis of CDH disorders, providing an understanding of the underlying biological substrates, offering guidance on the use of diagnostic testing and additional consultations, and outlining treatment strategies with the greatest potential to alleviate the burden of these patients and to provide the highest quality of care. The book fully examines the constellation of symptoms that constitute chronic daily headache, while also discussing the role of behavioral medicine and the important elements involved in taking a good history. The major forms and biology of chronic daily headache are covered, as is the role of diagnostic testing and treatment. The risk factors that lead patients to transform episodic primary headache disorders into the chronic form are examined. Invasive and neuromodulatory techniques are also discussed. A section on the classification of these disorders rounds out this important contribution to the literature. Chronic Headache – A Comprehensive Guide to Evaluation and Management will be of great interest to neurologists, primary care physicians, nurse practitioners, physician assistants, medical students, and other clinicians with an interest in chronic daily headache.




Pain Management and the Opioid Epidemic


Book Description

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.




Migraine in Women


Book Description

Fifteen specialists serve as chapter authors, covering sex hormones and genetics, as well as the social, cultural, psychiatric, and psychological factors that contribute to headache disorders. Their approach is evidence-based, but where there are gaps in research, the authors provide advice based on expert consensus and clinical experience. Each chapter opens with a case report that synthesizes the chapter's treatment recommendations, as well as key points listing the chapter's contents. The main body of the chapter features an introductory overview, a closing summary, tables, and an extensive list of suggestive reading.




Common Pitfalls in the Evaluation and Management of Headache


Book Description

Discussing real-world cases, this practical guide highlights areas of diagnostic uncertainty and shows common pitfalls in headache diagnosis and treatment.




Headache and Migraine Biology and Management


Book Description

There are two crucial issues in the treatment and management of headache patients: More than 50% of individuals experiencing headache have only been treated symptomatically, with no appropriate diagnosis established; and history and neurologic examination are essential to establishing a diagnosis, and thus selecting appropriate therapy. Headache and Migraine Biology and Management is a practical text that addresses these issues, featuring contributions from expert clinical authors. The book covers in detail topics including chronic and episodic migraine, post-traumatic headache, sinus headache, cluster headache, tension headache, and others. Chapters are also dedicated to treatment subjects, including psychiatric and psychological approaches, medication overuse, inpatient treatment, and pediatric issues. This book is an ideal resource for researchers and clinicians, uniting practical discussion of headache biology, current ideas on etiology, future research, and genetic significance and breakthroughs. This resource is useful to those who want to understand headache biology, treat and manage symptoms, and for those performing research in the headache field. - A practical discussion of headache biology, current ideas on etiology, future research, and genetic significance and breakthroughs - Features chapters from leading physicians and researchers in headache medicine - Full-color text that includes both an overview of multiple disciplines and discusses the measures that can be used to treat headaches