Pub Date : 2020-04-01DOI: 10.1093/med/9780198724322.003.0030
K. Peng, M. Robbins, Shuu-Jiun Wang
New daily persistent headache (NDPH) is a rare headache syndrome affecting both paediatric and adult populations. In the latest revision of International Classification of Headache Disorders, 3rd edition (ICHD-3 beta), it is defined by the onset of daily and unremitting headaches within 24 hours lasting for more than 3 months. Common triggers include flu-like symptoms and stressful life events; however, the pathophysiology is largely unknown. Regarding headache features, in the ICHD-3 beta, migrainous features are allowed in comparison with ICHD-2. Different triggers and heterogeneous clinical presentations suggest that NDPH is more likely a syndrome, rather than a disease entity. Secondary aetiologies must be carefully excluded, especially meningitis, high and low intracranial pressure headaches, medication overuse headache, or reversible cerebral vasoconstriction syndrome. There are no randomized placebo-controlled trials for NDPH; thus, the treatment is mostly empirical. Most patients have persistent headache despite treatment, but approximately one-quarter of them reached remission, usually within 24 months. However, a subgroup of those who reached remission initially might experience relapse after months or years free from pain.
{"title":"New daily persistent headache","authors":"K. Peng, M. Robbins, Shuu-Jiun Wang","doi":"10.1093/med/9780198724322.003.0030","DOIUrl":"https://doi.org/10.1093/med/9780198724322.003.0030","url":null,"abstract":"New daily persistent headache (NDPH) is a rare headache syndrome affecting both paediatric and adult populations. In the latest revision of International Classification of Headache Disorders, 3rd edition (ICHD-3 beta), it is defined by the onset of daily and unremitting headaches within 24 hours lasting for more than 3 months. Common triggers include flu-like symptoms and stressful life events; however, the pathophysiology is largely unknown. Regarding headache features, in the ICHD-3 beta, migrainous features are allowed in comparison with ICHD-2. Different triggers and heterogeneous clinical presentations suggest that NDPH is more likely a syndrome, rather than a disease entity. Secondary aetiologies must be carefully excluded, especially meningitis, high and low intracranial pressure headaches, medication overuse headache, or reversible cerebral vasoconstriction syndrome. There are no randomized placebo-controlled trials for NDPH; thus, the treatment is mostly empirical. Most patients have persistent headache despite treatment, but approximately one-quarter of them reached remission, usually within 24 months. However, a subgroup of those who reached remission initially might experience relapse after months or years free from pain.","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":"31 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":"128349511","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/9780198724322.003.0001
Jes Olesen, R. Lipton
Disease classification systems delineate a group of related disorders and provide operational rules for defining the boundaries among them. Diagnosis refers to the assignment of a particular individual to a particular diagnostic category. A robust disease classification system provides a framework for standardizing diagnosis, studying epidemiology, predicting prognosis, assessing treatment, and implementing therapy in practice. Disease classification is therefore crucial for both clinical practice and research.
{"title":"Classification and diagnosis of headache disorders","authors":"Jes Olesen, R. Lipton","doi":"10.1093/med/9780198724322.003.0001","DOIUrl":"https://doi.org/10.1093/med/9780198724322.003.0001","url":null,"abstract":"Disease classification systems delineate a group of related disorders and provide operational rules for defining the boundaries among them. Diagnosis refers to the assignment of a particular individual to a particular diagnostic category. A robust disease classification system provides a framework for standardizing diagnosis, studying epidemiology, predicting prognosis, assessing treatment, and implementing therapy in practice. Disease classification is therefore crucial for both clinical practice and research.","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":"118 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141217367","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/9780198724322.003.0018
I. F. Coo, L. A. Wilbrink, J. Haan
Cluster headache is a primary headache disorder characterized by attacks of severe-to-very severe unilateral pain, located in the orbital, supraorbital, and/or temporal regions, with ipsilateral autonomic symptoms and/or restlessness. By definition, cluster headache attacks last between 15 and 180 minutes. Based on the temporal course, cluster headache can be categorized into episodic and chronic. A subdivision can also be made in primary and secondary chronic and secondary episodic. The cause of cluster headache is unknown, but probably the hypothalamus, trigeminal sensory system, some cranial blood vessels, and the autonomic nervous system are involved. A combination of acute (oxygen inhalation and/or subcutaneous sumatriptan) and prophylactic (first choice verapamil) treatment is usually necessary. For treatment-resistant patients, some experimental invasive options exist.
{"title":"Cluster headache","authors":"I. F. Coo, L. A. Wilbrink, J. Haan","doi":"10.1093/med/9780198724322.003.0018","DOIUrl":"https://doi.org/10.1093/med/9780198724322.003.0018","url":null,"abstract":"Cluster headache is a primary headache disorder characterized by attacks of severe-to-very severe unilateral pain, located in the orbital, supraorbital, and/or temporal regions, with ipsilateral autonomic symptoms and/or restlessness. By definition, cluster headache attacks last between 15 and 180 minutes. Based on the temporal course, cluster headache can be categorized into episodic and chronic. A subdivision can also be made in primary and secondary chronic and secondary episodic. The cause of cluster headache is unknown, but probably the hypothalamus, trigeminal sensory system, some cranial blood vessels, and the autonomic nervous system are involved. A combination of acute (oxygen inhalation and/or subcutaneous sumatriptan) and prophylactic (first choice verapamil) treatment is usually necessary. For treatment-resistant patients, some experimental invasive options exist.","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":"15 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":"114182060","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/9780198724322.003.0004
A. Charles
Headache disorders involve widespread disturbances in nervous system function, resulting in a broad array of symptoms in addition to head pain. A general understanding of these disorders requires not only an understanding of the mechanisms underlying the pain, but also of those causing symptoms that may precede, accompany, or follow the pain. Imaging and clinical electrophysiological studies provide strong evidence that rather than being primarily vascular disorders, the major primary headaches disorders are fundamentally disorders of brain excitability. Changes in the activity of the thalamus and cortex appear to be particularly important in migraine, and alterations in hypothalamic function likely play a critical role in both migraine and cluster headache. Migraine aura involves propagated waves of activity in the cortex; cortical spreading depression (CSD) in animal models provides insight in the mechanisms of these waves. Elevations of extracellular potassium and release of the excitatory transmitter glutamate appear to be critical in the initiation of CSD, whereas sustained uncoupling of the normal relationship between neural and vascular activity occurs in the wake of CSD. Headache pain may be transmitted not only by trigeminal nerves, but also by the upper cervical nerves. The trigeminal nucleus caudalis, dorsolateral pons and midbrain, periaqueductal gray, thalamus, and sensory cortex may all play important roles in headache. Increasing evidence implicates the release of neuropeptides, particularly calcitonin gene-related peptide as a primary mediator of headache. Each of these and other basic mechanisms of headache may represent distinct therapeutic targets
{"title":"Headache mechanisms","authors":"A. Charles","doi":"10.1093/med/9780198724322.003.0004","DOIUrl":"https://doi.org/10.1093/med/9780198724322.003.0004","url":null,"abstract":"Headache disorders involve widespread disturbances in nervous system function, resulting in a broad array of symptoms in addition to head pain. A general understanding of these disorders requires not only an understanding of the mechanisms underlying the pain, but also of those causing symptoms that may precede, accompany, or follow the pain. Imaging and clinical electrophysiological studies provide strong evidence that rather than being primarily vascular disorders, the major primary headaches disorders are fundamentally disorders of brain excitability. Changes in the activity of the thalamus and cortex appear to be particularly important in migraine, and alterations in hypothalamic function likely play a critical role in both migraine and cluster headache. Migraine aura involves propagated waves of activity in the cortex; cortical spreading depression (CSD) in animal models provides insight in the mechanisms of these waves. Elevations of extracellular potassium and release of the excitatory transmitter glutamate appear to be critical in the initiation of CSD, whereas sustained uncoupling of the normal relationship between neural and vascular activity occurs in the wake of CSD. Headache pain may be transmitted not only by trigeminal nerves, but also by the upper cervical nerves. The trigeminal nucleus caudalis, dorsolateral pons and midbrain, periaqueductal gray, thalamus, and sensory cortex may all play important roles in headache. Increasing evidence implicates the release of neuropeptides, particularly calcitonin gene-related peptide as a primary mediator of headache. Each of these and other basic mechanisms of headache may represent distinct therapeutic targets","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":"133 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":"116757259","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/9780198724322.003.0059
G. Onderwater, M. Ferrari
Visual snow is characterized by continuous visual disturbances in the form of countless tiny particles present in the entire visual field, often interpreted as television static. The visual disturbances are almost always accompanied by additional symptoms, including palinopsia, nyctalopia, photophobia, entoptic phenomenon, bilateral tinnitus, concentration problems, lethargy, and irritability. Visual snow has been linked to migraine and the migrainous aura. The clinical phenotype of visual snow clearly different from migraine; however, the co-occurrence with migraine (aura) might imply that both conditions share underlying pathophysiological mechanism(s). Visual snow is currently diagnosed on patient history alone, as additional investigations are typical normal and do not contribute to the diagnosis. However, ophthalmological investigation, neuroimaging, and, in selected cases, electroencephalography are recommend to rule out other disorders. Although self-limiting in some cases, visual snow typically remains a chronic condition that is very difficult to suppress with drug or non-pharmacological treatment.
{"title":"Visual snow","authors":"G. Onderwater, M. Ferrari","doi":"10.1093/med/9780198724322.003.0059","DOIUrl":"https://doi.org/10.1093/med/9780198724322.003.0059","url":null,"abstract":"Visual snow is characterized by continuous visual disturbances in the form of countless tiny particles present in the entire visual field, often interpreted as television static. The visual disturbances are almost always accompanied by additional symptoms, including palinopsia, nyctalopia, photophobia, entoptic phenomenon, bilateral tinnitus, concentration problems, lethargy, and irritability. Visual snow has been linked to migraine and the migrainous aura. The clinical phenotype of visual snow clearly different from migraine; however, the co-occurrence with migraine (aura) might imply that both conditions share underlying pathophysiological mechanism(s). Visual snow is currently diagnosed on patient history alone, as additional investigations are typical normal and do not contribute to the diagnosis. However, ophthalmological investigation, neuroimaging, and, in selected cases, electroencephalography are recommend to rule out other disorders. Although self-limiting in some cases, visual snow typically remains a chronic condition that is very difficult to suppress with drug or non-pharmacological treatment.","PeriodicalId":281151,"journal":{"name":"Oxford Textbook of Headache Syndromes","volume":" 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120828930","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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