Clinical outcome of a headache-specific multidisciplinary treatment program and adherence to treatment recommendations in a tertiary headache center: an observational study

Gaul, Charly; Doorn, Christina van; Webering, Nadine; Dlugaj, Martha; Katsarava, Zaza; Diener, Hans‐Christoph; Fritsche, Günther

doi:10.1007/s10194-011-0348-y

Cited by 135 publications

(166 citation statements)

References 28 publications

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“…The patients included in these studies are qualified as ''difficult-to-treat'' and most of them are migraineurs, but not all of them fulfil the criteria for CM. Overall there is a decrease in headache frequency and headache-related disability in all studies [54,[118][119][120]. The 50 % responder rate after a follow-up of 12 months varies between 36.4 % in the largest survey of 841 patients [54] to 62.7 % in the study by Wallasch et al [118] of 201 patients.…”

Section: Integrated Headache Carementioning

confidence: 83%

“…The 50 % responder rate after a follow-up of 12 months varies between 36.4 % in the largest survey of 841 patients [54] to 62.7 % in the study by Wallasch et al [118] of 201 patients. Interestingly, in the Gaul et al report [120], adherence varied between treatment modalities: 35 % for drug treatment, 61 % for relaxation and 72 % for aerobic exercise. Aerobic exercise was evaluated as such against topiramate and relaxation in a randomized trial of EM; it achieved a 50 % responder rate of 30 % compared to 26 and 23 %, respectively, for the two other modalities [121].…”

Section: Integrated Headache Carementioning

confidence: 99%

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Diagnosis, pathophysiology and management of chronic migraine: a proposal of the Belgian Headache Society

Paemeleire

Louis²,

Magis

et al. 2014

Acta Neurol Belg

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Chronic migraine (CM) is a disabling neurological condition affecting 0.5-2 % of the population. In the current third edition of the International Classification of Headache Disorders, medication overuse is no longer an exclusion criterion and CM is diagnosed in patients suffering from at least 15 headache days per month of which at least eight are related to migraine. CM is difficult to treat, and preventive treatment options are limited. We provide a pathogenetic model for CM, integrating the latest findings from neurophysiological and neuroimaging studies. On behalf of the Belgian Headache Society, we present a management algorithm for CM based on the international literature and adapted to the Belgian situation. Pharmacological treatment options are discussed, and recent data on transcranial and invasive neuromodulation studies in CM are reviewed. An integrated multimodal treatment programme may be beneficial to refractory patients, but at present, this approach is only supported by a limited number of observational studies and quite variable between centres

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Section: Integrated Headache Carementioning

confidence: 83%

Section: Integrated Headache Carementioning

confidence: 99%

Diagnosis, pathophysiology and management of chronic migraine: a proposal of the Belgian Headache Society

Paemeleire

Louis²,

Magis

et al. 2014

Acta Neurol Belg

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“…furthermore, limited data propose that aerobic activity may decrease attacks frequency in episodic migraine sufferer (76,77). Regarding the associations between obesity and increased headache frequency, severity, and disability in migraineurs have been suggested in previous investigations (42,46).…”

Section: The Effect Of Weight Loss On Migraine Headachementioning

confidence: 92%

The Effect of Bariatric Surgery on Migraine Headache in Morbid Obese Patients

Hatami

Mohammadi-Farsani

2017

J Minim Invasive Surg Sci

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Background: Migraine is a common and chronic neuro-inflammatory disease with progressive and episodic headache manifestation that leads to considerable disability. Many studies recognized that obesity is a risk factor for progression of migraine. Furthermore, both migraine and obesity is highly prevalent and important risk factors of chronic cardiovascular disease, stroke, and other inflammatory disease. Thus, it is very important if weight loss could alleviate the migraine headache and its related comorbidities. Aim: The present review article was conducted to assess the potential effect of Bariatric surgery on improvement of migraine headaches in morbid obese patients. Search Strategy: Scopus, PubMed and web of science electronic database were systematically searched with key words of "Bariatric surgery", "gastric Bypass"; "Morbid Obesity" and "Migraine headache" for interventional studies investigated the impact of Bariatric surgery on migraine headache. Results: The findings suggest significant improvement in headache frequency, duration, migraine-induced discomfort and migraine derived symptoms (nausea, phono and photophobia and) occurs as early as 3 months after bariatric surgery. Moreover, patients who had higher weight loss were more likely to experience a 50% or higher reduction in headache frequency, duration and severity. Conclusions:The entire evidences suggest patients with indications of bariatric surgery will benefit from the improvements in the Migraine headache after surgery. However, it remains unclear whether Bariatric-induced endocrine, gut-brain axis alterations, or reduction in adipokine contribute to migraine improvement, so further studies are needed to confirm and clarify these findings.

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“…A multidiszciplináris megközelítés hasznosságát több tanulmány igazolta. Egy német vizsgálatban 56 FTTF-beteg közül 51-nek volt sikeres a kezelése [62]. Egy másik vizsgálat során a komplex kezelési programba bevont betegek 33,8%-ának volt FTTF-je, ami a kezelési időszak végére 1,6%-ra csökkent, az FTTF miatt kezelt betegek fejfájás-gyakorisága pedig átlagosan havi 18,8 napról 10,9 napra csökkent [63].…”

Section: A Kezelés Nem Gyógyszeres Elemeiunclassified

Fájdalomcsillapító-túlhasználathoz társuló fejfájás

et al. 2015

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A fájdalomcsillapító-túlhasználathoz társuló fejfájás a lakosság 1-2%-át érinti. Bármely fájdalomcsillapító rendszeres, havonta legalább 10 napon történő szedése kiválthatja, ezért minden olyan esetben gondolni kell rá, amikor koráb-ban is panaszos betegek fejfájásának gyakorisága -nagyobb mennyiségben szedett fájdalomcsillapítók mellett -megnő. A kórkép leggyakrabban a 40-50 éves nőket érinti: kockázatát növeli a dohányzás, az elhízás, a depresszió, valamint a szorongásos zavar. Kialakulásában biológiai (genetikai megalapozottság, neurokémiai és neurofi ziológiai eltérések) mellett pszichológiai, illetve életvezetési tényezők, így a fejfájásokra vonatkozó anticipátoros szorongás, a fájdalom katasztrofi zálása, az ezek miatti kényszeres gyógyszerszedő magatartás is fontos szerepet játszanak. A fáj-dalomcsillapító-túlhasználathoz társuló fejfájás kezelésének elengedhetetlen része a kiváltó szer megvonása, a megvonási tünetek (köztük a rebound fejfájás) kezelése, a hatásos preventív terápia bevezetése, a komorbid betegségek kezelése, valamint a betegek megfelelő oktatása és pszichés támogatása. Mivel a visszaesés esélye megfelelő kezelés mellett is 30-40% lehet, alapvető fontosságú a megelőzés, amelyben az alapellátás szerepét nem lehet eléggé hangsúlyozni. Orv. Hetil., 2015, 156(30), 1195-1202. Kulcsszavak: fejfájás, fájdalomcsillapító-túlhasználat Medication-overuse headacheMedication-overuse headache affects 1 to 2 percent of the population. Any kind of painkiller, if taken regularly at least 10 days per month can cause medication-overuse headache, and therefore the possibility of this headache has to be raised whenever a patient with a preexistent headache notices a signifi cant increase in headache frequency during a period of frequent painkiller consumption. Medication-overuse headache is most prevalent in females between 40 and 50 years of age. Its main risk factors are smokig, obesity, depression, and anxiety. The pathomechanism of medication-overuse headache is complex, with a probable genetic propensity and other biological (neurochemical and neurophysiological), as well as psychological and behavioural factors (such as anticipatory anxiety, catastrophisation of pain and consequentially a compulsive painkiller use) contributing to its genesis. The prerequisite of successful treatment is the withdrawal of the overused substance, other necessary elements of the therapy include the treatment of withdrawal symptoms including rebound headache, the introduction of an effective preventative therapy, taking into consideration the highly prevalent comorbid disorders as well, and the education and psychological support of patients. As the relapse rate can be as high as 30 to 40% regardless of effective treatment, the prevention of medication-overuse headache is of paramount importance, and the role of general practitioners can hardly be overstated.

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Clinical outcome of a headache-specific multidisciplinary treatment program and adherence to treatment recommendations in a tertiary headache center: an observational study

Cited by 135 publications

References 28 publications

Diagnosis, pathophysiology and management of chronic migraine: a proposal of the Belgian Headache Society

Diagnosis, pathophysiology and management of chronic migraine: a proposal of the Belgian Headache Society

The Effect of Bariatric Surgery on Migraine Headache in Morbid Obese Patients

Fájdalomcsillapító-túlhasználathoz társuló fejfájás

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