Pub Date : 2020-04-01DOI: 10.1017/cbo9781316134993.064
S. Graff‐Radford, A. Newman
Orofacial pain involves pain conditions associated with the hard and soft tissues of the head, face, neck, and all the intra-oral structures. The field of orofacial pain encompasses diagnosis and treatment of primary headaches, temporomandibular disorders, neuropathic pain, cervical pain, and myofascial pain. The evaluation and treatment of orofacial pain has evolved into a shared responsibility between the dentist and physician, with considerable overlap, distinguished only by the practitioner’s knowledge and training.
{"title":"Orofacial pain","authors":"S. Graff‐Radford, A. Newman","doi":"10.1017/cbo9781316134993.064","DOIUrl":"https://doi.org/10.1017/cbo9781316134993.064","url":null,"abstract":"Orofacial pain involves pain conditions associated with the hard and soft tissues of the head, face, neck, and all the intra-oral structures. The field of orofacial pain encompasses diagnosis and treatment of primary headaches, temporomandibular disorders, neuropathic pain, cervical pain, and myofascial pain. The evaluation and treatment of orofacial pain has evolved into a shared responsibility between the dentist and physician, with considerable overlap, distinguished only by the practitioner’s knowledge and training.","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120968230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.1093/med/9780198724322.003.0029
S. Evers
Tension-type headache (TTH) is usually a dull, bilateral headache without accompanying symptoms. It is divided into three subtypes: infrequent episodic TTH (< 1 headache day per month), frequent episodic TTH (1–14 headache days per month), and chronic TTH (≥ 15 headache days per month). This division is highly relevant for three reasons. Firstly, impact on quality of life differs considerably between the three subtypes. Secondly, the pathophysiological mechanisms also differ. Peripheral mechanisms such as muscle tension are more important in episodic TTH, whereas central pain sensitization with reduced antinociceptive mechanisms are pivotal in chronic TTH. Thirdly, treatment differs between the subtypes, with symptomatic and prophylactic treatment being more appropriate for episodic and chronic TTH, respectively. Non-pharmacological management should always be part of the treatment. Patients with episodic TTH are treated with analgesics, while prophylactic drugs (in particular antidepressants) should be considered in patients with very frequent episodic or chronic TTH.
{"title":"Tension-type headache","authors":"S. Evers","doi":"10.1093/med/9780198724322.003.0029","DOIUrl":"https://doi.org/10.1093/med/9780198724322.003.0029","url":null,"abstract":"Tension-type headache (TTH) is usually a dull, bilateral headache without accompanying symptoms. It is divided into three subtypes: infrequent episodic TTH (< 1 headache day per month), frequent episodic TTH (1–14 headache days per month), and chronic TTH (≥ 15 headache days per month). This division is highly relevant for three reasons. Firstly, impact on quality of life differs considerably between the three subtypes. Secondly, the pathophysiological mechanisms also differ. Peripheral mechanisms such as muscle tension are more important in episodic TTH, whereas central pain sensitization with reduced antinociceptive mechanisms are pivotal in chronic TTH. Thirdly, treatment differs between the subtypes, with symptomatic and prophylactic treatment being more appropriate for episodic and chronic TTH, respectively. Non-pharmacological management should always be part of the treatment. Patients with episodic TTH are treated with analgesics, while prophylactic drugs (in particular antidepressants) should be considered in patients with very frequent episodic or chronic TTH.","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126780017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.1093/med/9780198724322.003.0057
S. Evers, R. Jensen
Headache and sleep share some clinical and physiological features. In ancient times good sleep was regarded as a cure for headache. The neuroanatomical links between the two conditions is the hypothalamus and one of the physiological links is the orexin metabolism. In the clinical setting, there are headache disorders predominantly occurring during sleep, such as cluster headache, or often occur in the early morning, such as migraine attacks. On the other side, sleep disorders can trigger headache such as sleep apnoea syndrome or bruxism. Recently, a significant association has been described between migraine and restless legs syndrome. Drugs used in headache and migraine treatment can lead to sleep disturbances such as vivid dreams caused by betablockers or hypersomnia caused by tricyclic antidepressants. A specific condition is hypnic headache, which exclusively occurs during the sleep.
{"title":"Headache and sleep","authors":"S. Evers, R. Jensen","doi":"10.1093/med/9780198724322.003.0057","DOIUrl":"https://doi.org/10.1093/med/9780198724322.003.0057","url":null,"abstract":"Headache and sleep share some clinical and physiological features. In ancient times good sleep was regarded as a cure for headache. The neuroanatomical links between the two conditions is the hypothalamus and one of the physiological links is the orexin metabolism. In the clinical setting, there are headache disorders predominantly occurring during sleep, such as cluster headache, or often occur in the early morning, such as migraine attacks. On the other side, sleep disorders can trigger headache such as sleep apnoea syndrome or bruxism. Recently, a significant association has been described between migraine and restless legs syndrome. Drugs used in headache and migraine treatment can lead to sleep disturbances such as vivid dreams caused by betablockers or hypersomnia caused by tricyclic antidepressants. A specific condition is hypnic headache, which exclusively occurs during the sleep.","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":"150 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133550964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.1093/med/9780198724322.003.0034
H. Koppen, A. van Sonderen, S. F. de Bruijn
Severe headache of sudden onset is relatively common, especially in emergency departments, and has an extensive differential. Neurovascular disorders often present with thunderclap headache. Although the initial work-up is focused to exclude subarachnoid haemorrhage, several other serious life-threatening disorders must be considered, such as cerebral venous sinus thrombosis and stroke. Furthermore, other causes like reversible cerebral vasoconstriction syndrome are recognized more and more. In this chapter the work-up of alert, neurologically intact patients presenting with an acute and severe headache, not related to trauma, will be described.
{"title":"Thunderclap headache","authors":"H. Koppen, A. van Sonderen, S. F. de Bruijn","doi":"10.1093/med/9780198724322.003.0034","DOIUrl":"https://doi.org/10.1093/med/9780198724322.003.0034","url":null,"abstract":"Severe headache of sudden onset is relatively common, especially in emergency departments, and has an extensive differential. Neurovascular disorders often present with thunderclap headache. Although the initial work-up is focused to exclude subarachnoid haemorrhage, several other serious life-threatening disorders must be considered, such as cerebral venous sinus thrombosis and stroke. Furthermore, other causes like reversible cerebral vasoconstriction syndrome are recognized more and more. In this chapter the work-up of alert, neurologically intact patients presenting with an acute and severe headache, not related to trauma, will be described.","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":"93 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125975381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.1093/med/9780198724322.003.0051
Jonathan H. Smith, Andreas Straube, Jerry W. Swanson
There is a non-controversial definition about who is an elderly patient. The age group above 85 years is the fastest growing segment in the total population. Persisting pain is not rare in this patient group and the prevalence for persisting pain is 40–79%. Migraine prevalence declines gradually after the age of 40 years, but even in the age group of 60 years and older up to 5% complain of migraine and in some patients the symptoms change towards more tension type-like headaches. Tension-type headaches are thought to be the most prevalent primary headaches in the elderly, with a 1-year prevalence of about 36%; secondary headaches often present as tension type-like headaches. A typical age-bounded headache is hypnic headache, which is only seen in patients older than 55 years of age. In the treatment of headaches in the elderly, the pharmacokinetic changes with age should be considered; the distribution volume and elimination kinetics are different in the elderly. Therefore, treatment should be initiated as ‘slow and low’.
{"title":"Headaches in the elderly","authors":"Jonathan H. Smith, Andreas Straube, Jerry W. Swanson","doi":"10.1093/med/9780198724322.003.0051","DOIUrl":"https://doi.org/10.1093/med/9780198724322.003.0051","url":null,"abstract":"There is a non-controversial definition about who is an elderly patient. The age group above 85 years is the fastest growing segment in the total population. Persisting pain is not rare in this patient group and the prevalence for persisting pain is 40–79%. Migraine prevalence declines gradually after the age of 40 years, but even in the age group of 60 years and older up to 5% complain of migraine and in some patients the symptoms change towards more tension type-like headaches. Tension-type headaches are thought to be the most prevalent primary headaches in the elderly, with a 1-year prevalence of about 36%; secondary headaches often present as tension type-like headaches. A typical age-bounded headache is hypnic headache, which is only seen in patients older than 55 years of age. In the treatment of headaches in the elderly, the pharmacokinetic changes with age should be considered; the distribution volume and elimination kinetics are different in the elderly. Therefore, treatment should be initiated as ‘slow and low’.","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126165646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.1093/med/9780198724322.003.0036
Nikolai Bogduk
Idiopathic intracranial hypertension (IIH) is a disorder of raised intracranial pressure, almost always associated with papilloedema, in the absence of underlying central nervous system pathology. It is a rare disease, with an annual incidence of around 1 in 100,000 persons, with an age of onset between 11 and 58 years. It is predominantly seen in obese women of childbearing age (incidence 10–20 per 100,000), but can affect any age, ethnicity, or sex. The two morbidities associated with IIH are vision loss and headache, with headache ultimately affecting > 90% of patients. The exact mechanisms underlying IIH related headache pain are still unknown, but it is often debilitating and significantly impacts on quality of life. The goal of treatment is to reduce intracranial pressure to minimize vision loss and headaches. Effective medical and surgical interventions are available for treatment of headache in IIH and are tailored to each individual patient. Overall, the prognosis for treatment of headache in IIH is good.
{"title":"Cervicogenic headache","authors":"Nikolai Bogduk","doi":"10.1093/med/9780198724322.003.0036","DOIUrl":"https://doi.org/10.1093/med/9780198724322.003.0036","url":null,"abstract":"Idiopathic intracranial hypertension (IIH) is a disorder of raised intracranial pressure, almost always associated with papilloedema, in the absence of underlying central nervous system pathology. It is a rare disease, with an annual incidence of around 1 in 100,000 persons, with an age of onset between 11 and 58 years. It is predominantly seen in obese women of childbearing age (incidence 10–20 per 100,000), but can affect any age, ethnicity, or sex. The two morbidities associated with IIH are vision loss and headache, with headache ultimately affecting > 90% of patients. The exact mechanisms underlying IIH related headache pain are still unknown, but it is often debilitating and significantly impacts on quality of life. The goal of treatment is to reduce intracranial pressure to minimize vision loss and headaches. Effective medical and surgical interventions are available for treatment of headache in IIH and are tailored to each individual patient. Overall, the prognosis for treatment of headache in IIH is good.","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":"105 26","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141217059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.1093/med/9780198724322.003.0016
D. Magis
A significant proportion of migraine patients appears reluctant to take migraine preventive drugs, or do not sufficiently improve when on available medications. The concept of non-pharmacological migraine approaches includes a large diversity of treatments: oral therapies (nutraceuticals or herbal medicines); exercise, behavioural therapies, and multidisciplinary care; acupuncture; peripheral invasive or non-invasive nerve stimulation; and, finally, brain neuromodulation (transcranial magnetic stimulation and transcranial direct current stimulation). The majority of these treatments have few adverse events and their efficacy often seems within the range of usual migraine preventive drugs. However, large placebo-controlled studies are often lacking. Thus, keeping these alternatives in mind when taking care of migraine patients in daily clinical practice is worthwhile.
{"title":"Treatment and management","authors":"D. Magis","doi":"10.1093/med/9780198724322.003.0016","DOIUrl":"https://doi.org/10.1093/med/9780198724322.003.0016","url":null,"abstract":"A significant proportion of migraine patients appears reluctant to take migraine preventive drugs, or do not sufficiently improve when on available medications. The concept of non-pharmacological migraine approaches includes a large diversity of treatments: oral therapies (nutraceuticals or herbal medicines); exercise, behavioural therapies, and multidisciplinary care; acupuncture; peripheral invasive or non-invasive nerve stimulation; and, finally, brain neuromodulation (transcranial magnetic stimulation and transcranial direct current stimulation). The majority of these treatments have few adverse events and their efficacy often seems within the range of usual migraine preventive drugs. However, large placebo-controlled studies are often lacking. Thus, keeping these alternatives in mind when taking care of migraine patients in daily clinical practice is worthwhile.","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124076368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.1093/med/9780198724322.003.0013
Y. Cha
The phenomena of migraine headache and vertigo share many epidemiological, anatomical, and clinical characteristics. The historically parallel development of the neuroscience of each field has formally intersected in the development of consensus criteria for vestibular migraine and the inclusion of vestibular migraine in the International Classification of Headache Disorders. Differences exist in the temporal profile of head pain and vertigo as manifestations of migraine, which can obscure the association. However, the growing body of evidence on the common demographic, neurochemical signature, and treatment responses of pain and vestibular symptoms indicate that they exist as symptoms of a common syndrome, one which can only be fully understood by recognizing the significance of each kind of manifestation.
{"title":"Migraine and vertigo","authors":"Y. Cha","doi":"10.1093/med/9780198724322.003.0013","DOIUrl":"https://doi.org/10.1093/med/9780198724322.003.0013","url":null,"abstract":"The phenomena of migraine headache and vertigo share many epidemiological, anatomical, and clinical characteristics. The historically parallel development of the neuroscience of each field has formally intersected in the development of consensus criteria for vestibular migraine and the inclusion of vestibular migraine in the International Classification of Headache Disorders. Differences exist in the temporal profile of head pain and vertigo as manifestations of migraine, which can obscure the association. However, the growing body of evidence on the common demographic, neurochemical signature, and treatment responses of pain and vestibular symptoms indicate that they exist as symptoms of a common syndrome, one which can only be fully understood by recognizing the significance of each kind of manifestation.","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124434649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.1093/med/9780198724322.003.0021
Johan Lim, Joost Haan
Hemicrania continua is an uncommon primary headache characterized by continuous, unilateral cranial pain of moderate intensity, more painful exacerbations with cranial autonomic features, and an absolute response to indomethacin. It is considered one of the trigeminal autonomic cephalalgias. Activation of the trigeminal–autonomic reflex and the contralateral posterior hypothalamic grey is thought to play an important role in its pathophysiology. The mean age of onset is in the third decade and there is a female preponderance of 2:1. Hemicrania continua can be divided into a remitting and an unremitting type; most patients suffer from the unremitting type. Any part of the head or neck can be affected, and pain is mainly described as throbbing. Many patients experience migrainous features during exacerbations. Physical and supplementary investigations are mostly normal. Other trigeminal autonomic cephalalgias and migraine are the main differential diagnostic alternatives for consideration.
{"title":"Hemicrania continua","authors":"Johan Lim, Joost Haan","doi":"10.1093/med/9780198724322.003.0021","DOIUrl":"https://doi.org/10.1093/med/9780198724322.003.0021","url":null,"abstract":"Hemicrania continua is an uncommon primary headache characterized by continuous, unilateral cranial pain of moderate intensity, more painful exacerbations with cranial autonomic features, and an absolute response to indomethacin. It is considered one of the trigeminal autonomic cephalalgias. Activation of the trigeminal–autonomic reflex and the contralateral posterior hypothalamic grey is thought to play an important role in its pathophysiology. The mean age of onset is in the third decade and there is a female preponderance of 2:1. Hemicrania continua can be divided into a remitting and an unremitting type; most patients suffer from the unremitting type. Any part of the head or neck can be affected, and pain is mainly described as throbbing. Many patients experience migrainous features during exacerbations. Physical and supplementary investigations are mostly normal. Other trigeminal autonomic cephalalgias and migraine are the main differential diagnostic alternatives for consideration.","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121539606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-01DOI: 10.1093/med/9780198724322.003.0019
G. Bussone, E. Cittadini
Paroxysmal hemicrania is classified as a trigeminal autonomic cephalalgia by the International Classification of Headache Disorders, third edition. The current criteria require at least 20 attacks of severe unilateral orbital, supraorbital, or temporal pain, lasting 2–30 minutes, accompanied by ipsilateral cranial autonomic features such as ptosis, eyelid oedema, conjunctival injection, lacrimation, nasal blockage, or rhinorrhoea. Attacks usually have a frequency of more than five per day, and respond exquisitely to indomethacin.
{"title":"Paroxysmal hemicrania","authors":"G. Bussone, E. Cittadini","doi":"10.1093/med/9780198724322.003.0019","DOIUrl":"https://doi.org/10.1093/med/9780198724322.003.0019","url":null,"abstract":"Paroxysmal hemicrania is classified as a trigeminal autonomic cephalalgia by the International Classification of Headache Disorders, third edition. The current criteria require at least 20 attacks of severe unilateral orbital, supraorbital, or temporal pain, lasting 2–30 minutes, accompanied by ipsilateral cranial autonomic features such as ptosis, eyelid oedema, conjunctival injection, lacrimation, nasal blockage, or rhinorrhoea. Attacks usually have a frequency of more than five per day, and respond exquisitely to indomethacin.","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129682279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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