Chronic Daily - PDF document

Chronic Daily Headache Division of Child and Adolescent Neurology Providers: Svinder Toor, MD Matthew Frank, MD Larry White, MD Ralph Northam, MD Donald Lewis, MD Matt Warren, PA Jennifer Kalb, PA There are medicines that make headaches worse! Medications that cause headache include: • Oral • Hormone steroids) • Caffeine, • Non-sedating • Blood blockers) • Overuse • Asthma • Antidepressant reuptake inhibitors) • Antibiotics Overuse of pain medicine too much over-the-counter canactuallymakeheadacheworse.Overuseisde�ned the headache pattern, a condition called “analgesic overuse headache.” headache are: • OTC • opioids • butalbital • isometheptene • ergotamine • triptans Complementary or alternative treatments complementary and alternative measures to consider Vitamins - Minerals - Herbs - Co-enzyme Q-10 Acupuncture Chiropractic manipulation Will headaches get better? It is important to be patient when the treatment plan is started.TheheadacheswillNOTgoawayovernight;ittakes ment is started: • 77% frequency. • 56% frequency. • 33% Division of Child and Adolescent Neurology Children’s Specialty Group 850 Southampton Avenue Virginia Notes: ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ ______________________________________ Chronic Daily Headache daily,daily, CDHisde�nedasmorethanfourmonthsduringwhich headaches last more than four hours per day. day. The majority of adolescents with CDH have chronic brain, like a brain tumor, for someone to develop a pattern of chronic daily headache. How common is chronic daily headache? Chil

dren’sKing’s Five types of CDH • chronic • chronic • mixed most common) • new • hemicrania Many teens with CDH will have a daily tension- type headache, and on top of that pain, they’ll have migraine attacks 3-4 times a week (mixed pattern). New daily persistent headache is one that starts quite abruptly but persists for weeks or months. Hemicrania continua is a daily or continuous pain of hemicrania continua is responsiveness to a medicine known as indomethacin. CDH is one of the most difcult types of headache to treat, but it can be treated! The impact of CDH The quality of life for teens with CDH can be severely im friends and to society. The disability that results from CDH can be measured in after-school To help patients with CDH porates several components with emphasis upon preventive This is a different approach and treatment philosophy for many families who have focused on primarily intermit problem worse. Successful treatment requires: • Lifestyle • Behavioral tions • Cautious Medications alone are not Lifestyle changes • Return not the answer). • Ensure • Get • Maintain • Maintain water a day) and avoid caffeine. • Identify Behavioral therapies • Stress • Time • Relaxation • Biofeedback Medicines used to break the cycle of CDH The medical treatment of CDH requires an individu ally tailored plan with the careful use of preventative medicines and periodic pain medications used at the appropriate times. Preventive therapies used for CDH include: • Tricyclic • Antiepileptic • Beta-blockers • Calcium • Non-steroidal Analgesic (pain) medicines must be used at the Some of the frequently used medicines include: • Naproxen • Triptans: •Almotriptan • •Sumatriptan • Rule of Thumb Hit the headache hard when it starts to spike in pain