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Cusi C, Blanchard EB. Contact Table 1 Causes of primary and secondary chronic daily headache on page S38. Chronic daily headaches can interfere with your job, your relationships and your quality of life. JOSEPH R. YANCEY, MAJ, MC, USA, Fort Belvoir Community Hospital, Fort Belvoir, Virginia, RICHARD SHERIDAN, CPT, MC, USA, 1/25 Stryker Brigade Combat Team, Fort Wainwright, Alaska, KELLY G. KOREN, LT, MC, USN, Fort Belvoir Community Hospital, Fort Belvoir, Virginia. Sterzi RR, Do not do imaging for uncomplicated headache. Chronicle EP. 11. All rights Reserved. et al. Boes C. Most patients with long-duration chronic daily headaches have migraines or tension-type headaches. et al. White AR. Goadsby PJ. Stovner LJ, Chronic daily headache is diagnosed in approximately 3% to 5% of patients presenting with acute headache.1,3 For patients with migraine, modifiable risk factors for progression to chronic migraine include obesity, medication overuse, stressful life events, snoring, caffeine overuse, and other causes of chronic pain.4, In the United States, chronic daily headache is 33% more common in whites and in women.5 The prevalence in women ranges from 5% to 9%, compared with 1% to 3% in men.5,6 In men and women, the prevalence of chronic daily headache is highest in those with lower total education levels.5,6 Overall, among persons who have chronic daily headache, 63% have used medication on 14 days or more of the month in an attempt to treat their headaches.6. 2. Here are suggestions to help you cope with the challenges. Study Group. Headache. This clinical content conforms to AAFP criteria for continuing medical education (CME). Hagen K, et al. A randomized controlled trial on medication-overuse headache: outcome after 1 and 4 years. Study Group. Develops during sleep; lack of autonomic symptoms; must have 2 of 3 criteria: (1) occurs more than 15 times per month, (2) lasts more than 15 minutes after awakening, and (3) starts after 50 years of age, Onset from cough or Valsalva maneuver; generalized pain; lasts from 1 second to 30 minutes; must rule out secondary causes, Pulsating pain; lasts 5 minutes to 48 hours; brought on by physical exertion; must rule out secondary causes, Transient and localized stabs of pain; felt over orbit, temple, or parietal area; no accompanying symptoms, Deep stabbing pain behind the eye; abrupt onset; lasts 15 to 180 minutes; accompanied by at least 1 of the following ipsilateral symptoms: (1) conjunctival injection or lacrimation, (2) nasal congestion or rhinorrhea, (3) eyelid edema, (4) forehead or facial sweating, (5) miosis and/or ptosis, or (6) sense of agitation or restlessness; frequency of once every other day to 8 episodes per day; recurs for longer than 1 year without remission of more than 1 month's time, Abortive: 100% oxygen, sumatriptan (Imitrex), Severe unilateral orbital, supraorbital, or temporal pain; lasts 2 to 30 minutes; accompanied by 1 of the ipsilateral symptoms consistent with cluster headache; more than 5 attacks per day more than half the time; by definition, headache is prevented by indomethacin (unlike cluster headaches, which are longer and are not prevented by indomethacin), Unilateral orbital, supraorbital, or temporal stabbing or pulsating pain; lasts 5 to 240 seconds; accompanied by ipsilateral conjunctival injection and lacrimation; 3 to 200 attacks per day, Unilateral, continuous pain of moderate severity; has at least 1 of the following: (1) conjunctival injection and/or lacrimation, (2) nasal congestion and/or rhinorrhea, and (3) ptosis and/or miosis; defined by a complete response to indomethacin, Lasts 4 to 72 hours; usually unilateral; often with nausea/vomiting and photophobia or phonophobia; aggravated by activity, Abortive: analgesics, antiemetics, triptans, Prophylactic: amitriptyline, propranolol, topiramate (Topamax), valproate (Depacon), Present daily for more than 3 months; unremitting within 3 days of onset; usually bilateral with a pressing/tightening quality; not aggravated by activity; usually not with autonomic symptoms, Migraine prophylactic agents; new daily persistent headaches generally refractory to treatment, Gradual increase in frequency from episodic to chronic headache; usually bilateral with a pressing/tightening quality; not aggravated by activity; usually not with autonomic symptoms. Park ER, At Another Johns Hopkins Member Hospital: Mixture of types (most commonly migraine and tension). Several prophylactic treatments for chronic daily headache can reduce headache frequency and severity, as well as improve overall quality of life. This article follows a single illustrative case of a patient with chronic daily headache. ; Want to use this article elsewhere?
2012;307(16):1736–1745. Goadsby PJ. Manheimer E, Wiendels NJ,
For many people, complementary or alternative therapies offer relief from headache pain. 2006;26(12):1434–1442. Cochrane Database Syst Rev. 2002;72 suppl 2:ii19–ii26.
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