Abstract
Headache and facial pain are among the most common, disabling and costly diseases in Europe, which demands for high quality health care on all levels within the health system. The role of the Danish Headache Society is to educate and advocate for the needs of patients with headache and facial pain. Therefore, the Danish Headache Society has launched a third version of the guideline for the diagnosis, organization and treatment of the most common types of headaches and facial pain in Denmark. The second edition was published in Danish in 2010 and has been a great success, but as new knowledge and treatments have emerged it was timely to revise the guideline. The recommendations for the primary headaches and facial pain are largely in accordance with the European guidelines produced by the European Academy of Neurology. The guideline should be used a practical tool for use in daily clinical practice for primary care physicians, neurologists with a common interest in headache, as well as other health-care professionals treating headache patients. The guideline first describes how to examine and diagnose the headache patient and how headache treatment is organized in Denmark. This description is followed by sections on the characteristics, diagnosis and treatment of each of the most common primary and secondary headache disorders and trigeminal neuralgia. The guideline includes many tables to facilitate a quick overview. Finally, the particular challenges regarding migraine and female hormones as well as headache in children are addressed.
Highlights
Headache diseases, especially migraine, are at the very top of the WHO’s list of the most disabling diseases, especially in the most productive years of young adulthood [1]
Attacks often show a striking rhythmicity as they often occur at the same time of day and year, and most patients experience that they are awaken by the attacks from sleep [33]
Medication overuse headache (MOH) is secondary to overuse of short-term medication, i.e. analgesics and migraine medication
Summary
Especially migraine, are at the very top of the WHO’s list of the most disabling diseases, especially in the most productive years of young adulthood [1]. The vast majority of Danes suffering from headache are treated in the primary sector and should for the most part continue to be treated there in the future, but there is an increasing need for clear guidelines for examining and organizing specialist treatment of severe and rare headache conditions. Neurological specialists in Denmark typically treat patients with trigeminal neuralgia and other types of facial pain, but here too there is an increasing need for the organization and systematization of treatment options. This type of pain condition is often taken care of by headache specialists and is included in the current guidelines. The original reference program in Danish can be downloaded at https://dhos.dk/wp-content/uploads/2020/06/2 932-Referenceprogram_2020_final_web-24.06.20.pdf
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