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Richard B. Lipton - One of the best experts on this subject based on the ideXlab platform.
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quantifying the return of headache in triptan treated migraineurs an observational study
Cephalalgia, 2010Co-Authors: Fred D Sheftell, Ninan T Mathew, Mary Almas, Randall Weeks, Verne Pitman, Richard B. LiptonAbstract:To improve understanding of secondary treatment failure in migraine patients, we evaluated ‘headache return’ as a novel endpoint to assess returning Headaches according to their severity, expanding on current standard assessments of overall recurrence or relapse rates, in a six-month observational study of triptan-treated migraineurs. A total of 359 patients (91% female; mean age, 42.5 years) recorded data for 2168 Headaches in electronic diaries. Two-thirds of Headaches responded to triptan treatment (improved-to-mild or no pain two hours post-dose); 34% of Headaches had a pain-free response. By 48 hours post-dose, 19% of all responding Headaches returned; 24% of Headaches achieving a pain-free response returned, predominantly to mild pain. More severe baseline headache, short duration since diagnosis of migraine, and female gender were associated with increased likelihood of headache return. Treatment satisfaction declined with increasing severity of headache return, demonstrating the value of assessing...
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prevalence and characteristics of allodynia in headache sufferers a population study
Neurology, 2008Co-Authors: Marcelo E. Bigal, Dawn C Buse, Daniel Serrano, M L Reed, Sait Ashina, Rami Burstein, Richard B. LiptonAbstract:Objective: The authors estimated the prevalence and severity of cutaneous allodynia (CA) in individuals with primary Headaches from the general population. Methods: We mailed questionnaires to a random sample of 24,000 headache sufferers previously identified from the population. The questionnaire included the validated Allodynia Symptom Checklist (ASC) as well as measures of headache features, disability, and comorbidities. We modeled allodynia as an outcome using headache diagnosis, frequency and severity of Headaches, and disability as predictor variables in logistic regression. Covariates included demographic variables, comorbidities, use of preventive medication, and use of opioids. Results: Complete surveys were returned by 16,573 individuals. The prevalence of CA of any severity (ASC score ≥3) varied with headache type. Prevalence was significantly higher in transformed migraine (TM, 68.3%) than in episodic migraine (63.2%, p Conclusions: Cutaneous allodynia (CA) is more common and more severe in transformed migraine and migraine than in other primary Headaches. Among migraineurs, CA is associated with female sex, headache frequency, increased body mass index, disability, and depression.
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The differential diagnosis of chronic daily Headaches: an algorithm-based approach
The Journal of Headache and Pain, 2007Co-Authors: Marcelo E. Bigal, Richard B. LiptonAbstract:Chronic daily Headaches (CDHs) refers to primary Headaches that happen on at least 15 days per month, for 4 or more hours per day, for at least three consecutive months. The differential diagnosis of CDHs is challenging and should proceed in an orderly fashion. The approach begins with a search for “red flags” that suggest the possibility of a secondary headache. If secondary Headaches that mimic CDHs are excluded, either on clinical grounds or through investigation, the next step is to classify the Headaches based on the duration of attacks. If the attacks last less than 4 hours per day, a trigeminal autonomic cephalalgia (TAC) is likely. TACs include episodic and chronic cluster headache, episodic and chronic paroxysmal hemicrania, SUNCT, and hypnic headache. If the duration is ≥4 h, a CDH is likely and the differential diagnosis encompasses chronic migraine, chronic tension-type headache, new daily persistent headache and hemicrania continua. The clinical approach to diagnosing CDH is the scope of this review.
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self awareness of migraine interpreting the labels that headache sufferers apply to their Headaches
Headache, 2003Co-Authors: Richard B. Lipton, Walter F Stewart, Joshua N LibermanAbstract:Neurology. 2002;58(9 suppl 6):S21-S26. Although people with migraine are aware of their Headaches they are often not aware that they have migraine. This can lead to inappropriate or ineffective use of treatments, delays in seeking appropriate care, and miscommunication during clinical encounters. This article assesses self-recognition of migraine and identifies terms used by migraine sufferers to describe their migraine Headaches. Individuals were selected for telephone interview by random digit dialing in several large United States cities as a part of a clinical trials recruiting initiative. Individuals (n = 30 758) aged 18 to 65 years of age were interviewed about their Headaches using a validated computer-assisted telephone interview. Among the 23 564 respondents who reported headache, their Headaches were classified as migraine (with or without aura) by the criteria of the International Headache Society (IHS). The relationships among the terms subjects used for their Headaches and their IHS diagnosis of migraine were assessed. Of the 23 564 respondents, 4967 individuals called their headache migraine and 3074 individuals reported headache that met the IHS criteria for migraine. The positive predictive value for self-assessed migraine is 33.1%; the negative predictive value for a self-assessment other than migraine is 92.3%. Therefore, individuals who called their Headaches migraine were about three times more likely to meet IHS criteria for migraine. Among the 3074 individuals meeting IHS criteria for migraine, only 53.4% recognized their Headaches as migraine (sensitivity 54%; specificity 83.8%). Among migraineurs, stress Headaches (n = 345) and sinus Headaches (n = 365) were the most common erroneous labels reported. Age influenced the erroneous terminology. Individuals less than 40 years of age were more likely to misidentify their migraine as stress Headaches, whereas individuals 40 years of age and older were more likely to misidentify their migraines as sinus Headaches. In a population sample, 54% of individuals with IHS migraine did not know that their Headaches are migraine. Those who called their Headaches migraine were much more likely to have migraine. Migraine awareness programs that rely solely on the term “migraine” may miss individuals who urgently need to be reached. Therefore, public education should target people with severe or disabling headache and aim to create awareness of the diagnostic possibilities. Comment: In the general population, and in contrast to the doctor's office, episodic tension-type headache is more common than migraine. When a person in the general population self-diagnoses nonmigraine, the diagnosis is likely to be correct. These tension or “stress” Headaches do not frequently rise to a level that compels those afflicted to seek medical attention. SJT
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risk factors for chronic daily headache
Current Pain and Headache Reports, 2002Co-Authors: Ann I Scher, Richard B. Lipton, Walter W StewartAbstract:There are many people who experience Headaches that are independent of illness, injury, or hangover. Approximately 4% of the population suffer from Headaches on a daily or near-daily basis. It is apparent that patients with chronic daily headache in community samples differ in important ways from patients with chronic daily headache in subspecialty clinics. In this manuscript, we review clinic-based data on risk factors for chronic daily headache and summarize the current data on the epidemiology of chronic daily headache.
Espen Saxhaug Kristoffersen - One of the best experts on this subject based on the ideXlab platform.
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migraine tension type headache and medication overuse headache in a large population of shift working nurses a cross sectional study in norway
BMJ Open, 2018Co-Authors: Bjorn Bjorvatn, Stale Pallesen, Bente E Moen, Siri Waage, Espen Saxhaug KristoffersenAbstract:Objectives To investigate associations between different types of Headaches and shift work. Design, participants and outcome measures Nurses with different work schedules (day work, two-shift rotation, night work, three-shift rotation) participated in a cohort study with annual surveys that started in 2008/2009. In 2014 (wave 6), a comprehensive headache instrument was included in the survey, in which 1585 nurses participated. Headaches were assessed according to the International Classification of Headache Disorders IIIb. Frequent headache (≥1 day per month), migraine, tension-type headache, chronic headache (headache >14 days per month) and medication-overuse headache (chronic headache + acute headache medication ≥10 days last month) comprised the dependent variables. Adjusted (for sex, age, percentage of full-time equivalent, marital status, children living at home) logistic regression analyses were conducted with work schedule, number of night shifts worked last year, number of quick returns ( Results Frequent headache, migraine and chronic headache were associated with shift work disorder (OR 2.04, 95% CI 1.62 to 2.59; 1.60, 1.21 to 2.12; 2.45, 1.25 to 4.80, respectively) and insomnia disorder (OR 1.79, 95% CI 1.43 to 2.23; 1.55, 1.18 to 2.02; 3.03, 1.54 to 5.95, respectively), but not with work schedule, number of night shifts or number of quick returns. Tension-type headache was only associated with >20 night shifts last year (OR 1.41, 95% CI 1.07 to 1.86). Medication-overuse headache was only associated with insomnia disorder (OR 7.62, 95% CI 2.48 to 23.41). Conclusions We did not find any association between different types of Headaches and work schedule. However, tension-type headache was associated with high number of night shifts. Nurses with sleep disorders (insomnia disorder and shift work disorder) reported higher prevalence of frequent Headaches, migraine, chronic headache and medication-overuse headache (only insomnia) compared with nurses not having insomnia disorder and shift work disorder, respectively.
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excessive daytime sleepiness in secondary chronic headache from the general population
Journal of Headache and Pain, 2017Co-Authors: Christofer Lundqvist, Espen Saxhaug Kristoffersen, Knut Stavem, Michael Bjorn RussellAbstract:Excessive daytime sleepiness (EDS, defined as Epworth sleepiness scale score > 10) is a common symptom, with a prevalence of 10–20% in the general population. It is associated with headache and other chronic pain disorders. However, little is known about the prevalence of EDS among people with secondary chronic Headaches. A total of 30,000 persons aged 30–44 from the general population was screened for headache by a questionnaire. The 633 eligible participants with self-reported chronic headache were interviewed and examined by a headache specialist who applied the International Classification of Headache Disorders with supplementary definitions for chronic rhinosinusitis and cervicogenic headache. A total of 93 participants had secondary chronic headache and completed the ESS. A total of 47 participants had chronic post-traumatic headache (CPTH) and/or cervicogenic headache (CEH), 39 participants had headache attributed to chronic rhinosinusitis (HACRS), while 7 had other secondary Headaches. 23.3% of those with CPTH, CEH or HACRS reported EDS. In multivariable logistic regression analysis the odds ratios of EDS were not significantly different in people with CPTH/CEH or HACRS. Almost one out of four subjects with secondary chronic headache reported EDS with no differences between the various secondary chronic Headaches.
Lawrence C Newman - One of the best experts on this subject based on the ideXlab platform.
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hemicrania continua a third case in which attacks alternate sides
Headache, 2004Co-Authors: Lawrence C Newman, Roderick C. Spears, Christine LayAbstract:Hemicrania continua (HC) is an uncommon, primary headache disorder characterized by a continuous unilateral headache of moderate intensity with superimposed exacerbations of more severe pain. HC exists in two temporal subtypes, a continuous form in which Headaches persist continuously without remission periods, and a less common remitting form in which bouts of continuous Headaches are separated by pain-free remissions. There have been more than 100 prior reports of HC; in the majority of which the headache is strictly unilateral and without side shift. We now report the third patient in whom Headaches alternated sides during different attacks.
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effective management of ice pick pains sunct and episodic and chronic paroxysmal hemicrania
Current Pain and Headache Reports, 2001Co-Authors: Lawrence C NewmanAbstract:Idiopathic stabbing Headaches, the SUNCT syndrome, and the paroxysmal hemicranias are a group of primary headache disorders that are characterized by brief, short-lived attacks of head pain, which recur multiple times throughout the day. These syndromes are much less prevelant than other types of primary Headaches such as migraine and tension-type Headaches but are significantly more disabling. Recognition of these uncommon disorders is important because their management differs from standard headache therapies.
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Hemicrania continua attacks may alternate sides
Headache, 1992Co-Authors: Lawrence C Newman, Richard B. Lipton, R N Marjorie Russell, Seymour SolomonAbstract:Hemicrania continua (HC) is characterized by a continuous unilateral headache of moderate severity, occurring in 2 patterns; a continuous form in which Headaches persist continuously without remission for years, and a remitting form, consisting of headache phases separated by periods of pain-free remission. The remitting form of HC must be distinguished from other cyclical headache disorders such as episodic paroxysmal hemicrania and episodic cluster headache. Characteristically, the headache of HC is unilateral and without sideshift. We now report a case of HC in which Headaches alternate sides.
Michael Bjorn Russell - One of the best experts on this subject based on the ideXlab platform.
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excessive daytime sleepiness in secondary chronic headache from the general population
Journal of Headache and Pain, 2017Co-Authors: Christofer Lundqvist, Espen Saxhaug Kristoffersen, Knut Stavem, Michael Bjorn RussellAbstract:Excessive daytime sleepiness (EDS, defined as Epworth sleepiness scale score > 10) is a common symptom, with a prevalence of 10–20% in the general population. It is associated with headache and other chronic pain disorders. However, little is known about the prevalence of EDS among people with secondary chronic Headaches. A total of 30,000 persons aged 30–44 from the general population was screened for headache by a questionnaire. The 633 eligible participants with self-reported chronic headache were interviewed and examined by a headache specialist who applied the International Classification of Headache Disorders with supplementary definitions for chronic rhinosinusitis and cervicogenic headache. A total of 93 participants had secondary chronic headache and completed the ESS. A total of 47 participants had chronic post-traumatic headache (CPTH) and/or cervicogenic headache (CEH), 39 participants had headache attributed to chronic rhinosinusitis (HACRS), while 7 had other secondary Headaches. 23.3% of those with CPTH, CEH or HACRS reported EDS. In multivariable logistic regression analysis the odds ratios of EDS were not significantly different in people with CPTH/CEH or HACRS. Almost one out of four subjects with secondary chronic headache reported EDS with no differences between the various secondary chronic Headaches.
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prevalence of secondary chronic Headaches in a population based sample of 30 44 year old persons the akershus study of chronic headache
Cephalalgia, 2008Co-Authors: K Aaseth, R B Grande, Kari J Kvaerner, Pal Gulbrandsen, Christofer Lundqvist, Michael Bjorn RussellAbstract:We studied secondary chronic Headaches (> or = 15 days/month for at least 3 months) in a random sample of 30 000 persons aged 30-44 years. They received a mailed questionnaire. Those with self-reported chronic headache within the last month and/or year were invited to an interview and examination by a neurological resident. The criteria of the International Classification of Headache Disorders (ICHD-II) were applied. The questionnaire response rate was 71%, and the participation rate of the interview was 74%. Of the 633 participants, 298 had a secondary chronic headache. The 1-year prevalence of secondary chronic headache was 2.14%, i.e. chronic posttraumatic headache 0.21%, chronic headache attributed to whiplash injury 0.17%, post-craniotomy headache 0.02%, medication-overuse headache (MOH) 1.72%, cervicogenic headache 0.17%, headache attributed to chronic rhinosinusitis 0.33% and miscellaneous Headaches 0.04%. The majority of those with ICHD-II-defined secondary chronic headache had MOH, while about one-third had other secondary Headaches often in combination with MOH.
Marcelo E. Bigal - One of the best experts on this subject based on the ideXlab platform.
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prevalence and characteristics of allodynia in headache sufferers a population study
Neurology, 2008Co-Authors: Marcelo E. Bigal, Dawn C Buse, Daniel Serrano, M L Reed, Sait Ashina, Rami Burstein, Richard B. LiptonAbstract:Objective: The authors estimated the prevalence and severity of cutaneous allodynia (CA) in individuals with primary Headaches from the general population. Methods: We mailed questionnaires to a random sample of 24,000 headache sufferers previously identified from the population. The questionnaire included the validated Allodynia Symptom Checklist (ASC) as well as measures of headache features, disability, and comorbidities. We modeled allodynia as an outcome using headache diagnosis, frequency and severity of Headaches, and disability as predictor variables in logistic regression. Covariates included demographic variables, comorbidities, use of preventive medication, and use of opioids. Results: Complete surveys were returned by 16,573 individuals. The prevalence of CA of any severity (ASC score ≥3) varied with headache type. Prevalence was significantly higher in transformed migraine (TM, 68.3%) than in episodic migraine (63.2%, p Conclusions: Cutaneous allodynia (CA) is more common and more severe in transformed migraine and migraine than in other primary Headaches. Among migraineurs, CA is associated with female sex, headache frequency, increased body mass index, disability, and depression.
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The differential diagnosis of chronic daily Headaches: an algorithm-based approach
The Journal of Headache and Pain, 2007Co-Authors: Marcelo E. Bigal, Richard B. LiptonAbstract:Chronic daily Headaches (CDHs) refers to primary Headaches that happen on at least 15 days per month, for 4 or more hours per day, for at least three consecutive months. The differential diagnosis of CDHs is challenging and should proceed in an orderly fashion. The approach begins with a search for “red flags” that suggest the possibility of a secondary headache. If secondary Headaches that mimic CDHs are excluded, either on clinical grounds or through investigation, the next step is to classify the Headaches based on the duration of attacks. If the attacks last less than 4 hours per day, a trigeminal autonomic cephalalgia (TAC) is likely. TACs include episodic and chronic cluster headache, episodic and chronic paroxysmal hemicrania, SUNCT, and hypnic headache. If the duration is ≥4 h, a CDH is likely and the differential diagnosis encompasses chronic migraine, chronic tension-type headache, new daily persistent headache and hemicrania continua. The clinical approach to diagnosing CDH is the scope of this review.
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classification of primary Headaches
Neurology, 2004Co-Authors: R Lipton, Marcelo E. Bigal, Stephen D Silberstein, Timothy J Steiner, Jes OlesenAbstract:Given the range of disorders that produce headache, a systematic approach to classification and diagnosis is an essential prelude to clinical management. For the last 15 years, the diagnostic criteria of the International Headache Society (IHS) have been the accepted standard. The second edition of The International Classification of Headache Disorders (January 2004) reflects our improved understanding of some disorders and the identification of new disorders. Neurologists who treat headache should become familiar with the revised criteria. Like its predecessor, the second edition of the IHS classification separates headache into primary and secondary disorders. The four categories of primary Headaches include migraine, tension-type headache, cluster headache and other trigeminal autonomic cephalalgias, and other primary Headaches. There are eight categories of secondary headache. Important changes in the second edition include a restructuring of these criteria for migraine, a new subclassification of tension-type headache, introduction of the concept of trigeminal autonomic cephalalgias, and addition of previously unclassified primary Headaches. Several disorders were eliminated or reclassified. In this article, the authors present an overview of the revised IHS classification, highlighting the primary headache disorders and their diagnostic criteria. They conclude by presenting an approach to headache diagnosis based upon these criteria.
