Abortive migraine therapy should be used as soon as possible after symptom development for maximum benefit; if abortive therapy is unsuccessful or used more than twice weekly, consider adding prophylactic therapy. Patients with nausea and vomiting may require nonoral medication. For all medications, consider patient comorbidities and contraindications.
It is an Autosomal Recessive trait, also known as Progressive Hepatolenticular Degeneration. Liver biopsy is the single most sensitive and accurate investigation for the disease. Males are more likely to develop neuropsychiatric disease, whereas females are more likely to develop acute liver failure due to Wilson's disease.
A stroke that occurs along with a migraine headache affects more commonly younger women. Overdose of Ergotamine and dihydroergotamine, high dose Oral contraceptives Pills, propranolol, and serotonergic medications are among the most common precipitating factors. The patient should meet the ICHD criteria for migrainous infarction for the diagnosis.
Recurrent migraine significantly impairs the quality of life and the patient's functionality, despite prompt treatment of acute attacks demands prophylactic treatment to be provided to the patients. Medication should be started on a low dose with adequate monitoring for 2-3 months. The safest drug to use in pregnant is metoprolol. This chapter emphasizes prophylactic treatment in migraine patients and also gives insight into preferred drugs to be used
Tension-type headache is characterized as a diffuse, dull pain or tightness around the forehead also called muscle contraction headache or stress headache. ICHD diagnostic criteria should be used to categorize the headache. Chronic tension-type headache at baseline, coexisting migraine disorder, and sleep disorders are associated with poor outcomes. A physician needs proper insight into provoking and preventing factors to best educate the patients.
Cluster headache, also called trigeminal autonomic cephalgia is defined as a sudden onset, extremely painful, unilateral headache with at least one autonomic symptom ipsilateral to the headache. Verapamil, starting dose 240 mg with increments of 80mg is considered to be first-line treatment for this headache.
Whenever a person experiences a headache, the first step involved is to categorize the type of headache by the neurologist. A great majority of headaches arise due to benign conditions. ICHD-3 criteria should be used to recognize the type of headache a patient is experiencing. This chapter will not just give you insight into diagnostic criteria but also the management of each type of headache.