Migraine and Other Headaches (Aan Press Quality of Life Guide)

210 Pages·2004·2.11 MB·English

by  William B. Young

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Migraine and
Other Headaches
W B. Y , MD
ILLIAM OUNG
S D. S , MD
TEPHEN ILBERSTEIN
Jefferson Headache Center
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania
AUSTIN J. SUMNER, MD
Series Editor
New York
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Demos Medical Publishing Inc., 368 Park Avenue South, New York, New York 10016
© 2004 by AAN Press, American Academy of Neurology, 1080 Montreal Avenue, Saint
Paul, MN 55116. All rights reserved. This book is protected by copyright. No part of it
may be reproduced, stored in a retrieval system, or transmitted in any form or by any
means, electronic, mechanical, photocopying, recording, or otherwise, without prior
written permission.
Uses for products within this text may include those not currently approved by the
FDA. For more information on the products, please see full prescribing information.
Library of Congress Cataloging-in-Publication Data
Young, William B.
Migraine and other headaches / by William B. Young and Stephen D. Silberstein.
— 1st ed.
p. ; cm.
Includes index.
ISBN 1-932603-03-4 (pbk. : alk. paper)
1. Migraine. 2. Headache.
[DNLM: 1. Migraine. 2. Headache Disorders. WL 344 S582m 2004] I.
Silberstein, Stephen D. II. Title.
RC392.S524 2004
616.8'491—dc22
2004000976
Made in the United States of America
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Contents
About the AAN Press Quality of Life Guides. . . . . . . . . . . . . . . . . . . vii
Foreword. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
SECTION I
HISTORY, PHILOSOPHY, AND GENERAL CONCEPTS
CHAPTER 1
“Just a Headache” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
CHAPTER 2
History of Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
CHAPTER 3
The Causes of Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Causes versus Triggers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Triggers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Location and Duration of Pain . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Frequency and Timing of Attacks . . . . . . . . . . . . . . . . . . . . . . . . 24
Pain Severity and Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25
Family History . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Physical and Neurologic Examinations . . . . . . . . . . . . . . . . . . . . 28
The Concept of Primary Headache . . . . . . . . . . . . . . . . . . . . . . . 32
The Concept of Secondary Headaches . . . . . . . . . . . . . . . . . . . . 34
When You Visit Your Physician . . . . . . . . . . . . . . . . . . . . . . . . . 34
CHAPTER 4
Serious Headaches Requiring Medical Attention . . . . . . . . . . 37
Serious Medical Conditions That Can Cause Headache . . . . . . . 37
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Contents
Spinal Headache and Other Low Pressure Headaches . . . . . . . . . 42
CHAPTER 5
Managing Headaches: An Overview . . . . . . . . . . . . . . . . . . . . . 45
The Mind/Body Connection . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Family Relations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Treatment Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
How to Find a Good Headache Doctor . . . . . . . . . . . . . . . . . . . . 55
Combating Stumbling Blocks Set Up by Insurance Companies . . 56
SECTION II
PRIMARY HEADACHE—MIGRAINE
CHAPTER 6
Migraine: The Big One. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Migraine Without Aura . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
Migraine with Aura . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
The Cause of Migraine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66
How Common Is Migraine? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
Symptoms of Migraine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72
Chronic Migraine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
CHAPTER 7
Treating Migraine with Medication . . . . . . . . . . . . . . . . . . . . . 87
Medication for Acute Migraine . . . . . . . . . . . . . . . . . . . . . . . . . 87
Preventive Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Preventive Medications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98
Special Circumstances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
CHAPTER 8
Alternative Therapies for Migraine . . . . . . . . . . . . . . . . . . . . . 105
Dietary Supplements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106
Physical Treatments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
Behavioral Therapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
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Contents
SECTION III
OTHER PRIMARY HEADACHES AND ASSOCIATED ILLNESSES
CHAPTER 9
Tension-Type Headache. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Causes of Tension-Type Headache. . . . . . . . . . . . . . . . . . . . . . . 124
Treatment of Tension-Type Headache . . . . . . . . . . . . . . . . . . . . 125
CHAPTER 10
Cluster Headaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129
Causes of Cluster Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . 130
Treatment of Cluster Headache . . . . . . . . . . . . . . . . . . . . . . . . 132
CHAPTER 11
Unusual Headaches . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Paroxysmal Hemicrania . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Chronic Daily Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
Hemicrania Continua . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138
New Daily Persistent Headache. . . . . . . . . . . . . . . . . . . . . . . . . 139
“Ice Pick” Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140
Sexual Activity Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
CHAPTER 12
Nonheadache Illnesses that Frequently
Accompany Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Psychological Disturbances . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Fibromyalgia. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Irritable Bowel Syndrome. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Restless Legs Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144
Raynaud’s Phenomenon. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
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Contents
SECTION IV
SECONDARY HEADACHE
CHAPTER 13
Sinus Headache and Nasal Disease . . . . . . . . . . . . . . . . . . . . . 149
Cause of Sinusitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
Diagnostic Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Rhinosinusitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 152
Deviated Septum Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Sinus Headache Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . 153
Confusing Migraine with Sinus Headache . . . . . . . . . . . . . . . . 154
CHAPTER 14
Disorders of the Neck. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 155
CHAPTER 15
Post-Traumatic Headache . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
CHAPTER 16
Atypical Facial Pain and Trigeminal Neuralgia. . . . . . . . . . . . 169
M. Alan Stiles, D.M.D.
APPENDIX
Resources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 181
vi
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About the AAN Press
Quality of Life Guides
IN THE SPIRIT OF THE DOCTOR-PATIENT PARTNERSHIP
T
HE BETTER-INFORMED PATIENT is often able to play a vital role in his or
her own care. This is especially the case with neurologic disorders,
for which effective management of disease can be promoted—indeed,
enhanced—through patient education and involvement.
In the spirit of the partnership-in-care between physicians and
patients, the American Academy of Neurology Press is pleased to pro-
duce a series of “Quality of Life” guides on an array of diseases and ail-
ments that affect the brain and central nervous system. The series, pro-
duced in partnership with Demos Medical Publishing, answers a num-
ber of basic and important questions faced by patients and their families.
Additionally, the authors, most of whom are physicians and all of
whom are experts in the areas in which they write, provide a detailed
discussion of the disorder, its causes, and the course it may follow. You
also find strategies for coping with the disorder and handling a number
of nonmedical issues.
The result: as a reader, you will be able to develop a framework for
understanding the disease and become better prepared to manage the
life changes associated with it.
ABOUT THE AMERICAN ACADEMY OF NEUROLOGY (AAN)
The American Academy of Neurology is the premier organization for
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tific advances, the AAN—along with its sister organization, the AAN
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porter of research for breakthroughs in neurologic patient care.
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About the AAN Press Quality of Life Guides
More information on the activities of the AAN is available on our
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please turn to the AAN Foundation’s website, www.thebrainmatters.org.
ABOUT NEUROLOGY AND NEUROLOGISTS
Neurology is the medical specialty associated with disorders of the brain
and central nervous system. Neurologists are medical doctors with spe-
cialized training in the diagnosis, treatment, and management of
patients suffering from neurologic disease.
Austin J. Sumner, M.D.
Series Editor, AAN Press Quality of Life Guides
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