Diagnosis Of Headache Disorders Research Articles

Pressure on Myofascial Trigger Points Reproduces Migraine and Tension Type Headache Phenotypes in Persistent Post-traumatic Headache: Implications of Physical Findings on the Physiology and Diagnosis of Headache Disorders (P6-12.007)

Pressure on Myofascial Trigger Points Reproduces Migraine and Tension Type Headache Phenotypes in Persistent Post-traumatic Headache: Implications of Physical Findings on the Physiology and Diagnosis of Headache Disorders (P6-12.007)

MBrain: towards the continuous follow-up and headache classification of primary headache disorder patients

BackgroundThe diagnosis of headache disorders relies on the correct classification of individual headache attacks. Currently, this is mainly done by clinicians in a clinical setting, which is dependent on subjective self-reported input from patients. Existing classification apps also rely on self-reported information and lack validation. Therefore, the exploratory mBrain study investigates moving to continuous, semi-autonomous and objective follow-up and classification based on both self-reported and objective physiological and contextual data.MethodsThe data collection set-up of the observational, longitudinal mBrain study involved physiological data from the Empatica E4 wearable, data-driven machine learning (ML) algorithms detecting activity, stress and sleep events from the wearables’ data modalities, and a custom-made application to interact with these events and keep a diary of contextual and headache-specific data. A knowledge-based classification system for individual headache attacks was designed, focusing on migraine, cluster headache (CH) and tension-type headache (TTH) attacks, by using the classification criteria of ICHD-3. To show how headache and physiological data can be linked, a basic knowledge-based system for headache trigger detection is presented.ResultsIn two waves, 14 migraine and 4 CH patients participated (mean duration 22.3 days). 133 headache attacks were registered (98 by migraine, 35 by CH patients). Strictly applying ICHD-3 criteria leads to 8/98 migraine without aura and 0/35 CH classifications. Adapted versions yield 28/98 migraine without aura and 17/35 CH classifications, with 12/18 participants having mostly diagnosis classifications when episodic TTH classifications (57/98 and 32/35) are ignored.ConclusionsStrictly applying the ICHD-3 criteria on individual attacks does not yield good classification results. Adapted versions yield better results, with the mostly classified phenotype (migraine without aura vs. CH) matching the diagnosis for 12/18 patients. The absolute number of migraine without aura and CH classifications is, however, rather low. Example cases can be identified where activity and stress events explain patient-reported headache triggers. Continuous improvement of the data collection protocol, ML algorithms, and headache classification criteria (including the investigation of integrating physiological data), will further improve future headache follow-up, classification and trigger detection.Trial registration This trial was retrospectively registered with number NCT04949204 on 24 June 2021 at www.clinicaltrials.gov.

Headaches in the emergency department \u2013a survey of patients\u2019 characteristics, facts and needs

Background and aimHeadache is very often the cause for seeking an emergency department (ED). However, less is known about the different diagnosis of headache disorders in the ED, their management and treatment. The aim of this survey is to analyse the management of headache patients in two different ED in Europe.MethodsThis retrospective survey was performed from September 2018 until January 2019. Patients were collected from the San Luca Hospital, Milan, Italy and the Ordensklinikum Barmherzige Schwestern, Linz, Austria. Only patients with a non-traumatic headache, as the primary reason for medical clarification, were included. Patients were analysed for their complexity and range of examination, their diagnoses, acute treatment and overall efficacy rate.ResultsThe survey consists of 415 patients, with a mean age of 43.32 (SD ±17.72); 65% were female. Technical investigation was performed in 57.8% of patients. For acute treatment non-steroidal-anti-inflammatory drugs (NSAIDs) were the most used, whereas triptans were not given. A primary headache disorder was diagnosed in 45.3% of patients, being migraine the most common, but in 32% of cases the diagnosis was not further specified. Life-threatening secondary headaches accounted for less than 2% of cases.ConclusionsThe vast majority of patients attending an ED because of headache are suffering from a primary headache disorder. Life-threatening secondary headaches are rare but seek attention. NSAIDs are by far the most common drugs for treating headaches in the ED, but not triptans.

EHMTI-0300. Clinical application of korean version of the international classification of headache disorders, 3rd edition, beta version in university hospitals

International Classification of Headache Disorder, an essential tool in the diagnosis of headache disorder, has been revised as 3rd Edition, beta (ICHD-3β).

The role of neuroimaging in the diagnosis of headache disorders

Headache is a common clinical feature in patients in the emergency room and in general neurology clinics. For physicians not experienced in headache disorders it might be difficult sometimes to decide in which patients neuroimaging is necessary to diagnose an underlying brain pathology and in which patients cerebral imaging is unnecessary. Most patients presenting to the primary-care physician with a nonacute headache and no further neurological signs or symptoms will not be suffering from an underlying serious condition. This review focuses on the main primary headache diseases, including migraine, tension-type headache and cluster headache, as well as frequent secondary headache entities with common clinical presentation and appropriate diagnostic and therapeutic algorithms to help guide the decision on the utilization of neuroimaging in the diagnostic workup.

Primary headache disorders in children under 7 years of age

Research on headache disorders in young children is limited. This study aims to determine causes and clinical presentations of headache in young children attending a specialist clinic. All children attending the headache clinic over 9-year period were included. Data were collected prospectively on demography and clinical presentations of headache at every attendance. The diagnosis of headache disorders was based on the International Classification of Headache Disorders-II (2004). Of the 921 children (491 male) who attended the clinic, 73 children (8%) were under 7 years of age at presentation; 34 children had migraine, 11 had tension-type headache (4 chronic), 4 had mixed types of headache and 16 children had unclassified headaches. Anorexia, nausea, vomiting, light intolerance and noise intolerance were common during migraine attacks and forehead was the most common site of maximal pain. Migraine is the most common headache disorder in young children attending a specialist clinic. Headache presentation is often atypical and in 20% of young children headache disorders are unclassified. Chronic tension-type headache, often considered a disease of adolescents and adults, is shown to present in early age.

Psychological trauma in chronic pain: Implications of PTSD for fibromyalgia and headache disorders

The association of traumatic exposures with posttraumatic stress disorder (PTSD) and other mental health conditions is well known. Patients with chronic pain, particularly headache disorders and fibromyalgia (FM), associated with psychological traumas need a special management strategy. Diagnosis of headache disorders and FM in traumatized patients and collecting the clinical history of a traumatic event or diagnosing PTSD in chronic pain patients is of great importance. Psychotherapy and pharmacotherapeutic options should be started on patients with comorbid PTSD and headache disorders and/or FM.

The Classification and Diagnosis of Headache Disorders

The Classification and Diagnosis of Headache Disorders

Classification and diagnosis of headache disorders

Headache is a common medical condition often associated with high personal and socioeconomic burdens. Before 1988, there were no internationally accepted means by which to identify, classify, and study the hundreds of different headache syndromes presenting to the medical community for evaluation. With the introduction of the International Classification of Headache Disorders (ICHD) in 1988, a system for headache classification became available that has standardized headache diagnosis for use in research and clinical practice. The second edition of the ICHD (ICHD-II) was published in 2004 and has introduced important revisions to the classification schema based on our growing understanding of the many headache types found in the general population and their pathogenesis. General principles related to the clinical evaluation and diagnostic classification of headache disorders using the ICHD-II are reviewed in this article.

Exteroceptive Suppression Periods of Temporal Muscle Activity and Their Value in Differential Diagnosis of Headache Disorders

Exteroceptive Suppression Periods of Temporal Muscle Activity and Their Value in Differential Diagnosis of Headache Disorders

The Classification and Diagnosis of Headache Disorders

Headache disorders recently have been reclassified, and new operational diagnostic criteria assist in making the correct diagnosis. These diagnostic criteria have been accepted worldwide.