The patient with daily headaches.
The term "chronic daily headache" (CDH) describes a variety of headache types, of which chronic migraine is the most common. Daily headaches often are disabling and may be challenging to diagnose and treat. Medication overuse, or drug rebound headache, is the most treatable cause of refractory daily headache. A pathologic underlying cause should be considered in patients with recent-onset daily headache, a change from a previous headache pattern, or associated neurologic or systemic symptoms. Treatment of CDH focuses on reduction of headache triggers and use of preventive medication, most commonly anti-depressants, antiepileptic drugs, and beta blockers. Medication overuse must be treated with discontinuation of symptomatic medicines, a transitional therapy, and long-term prophylaxis. Anxiety and depression are common in patients with CDH and should be identified and treated. Although the condition is challenging, appropriate treatment of patients with CDH can bring about significant improvement in the patient's quality-of-life.
Maizels
Morris
M
Department of Family Practice, Kaiser Permanente, Woodland Hills, California 91365, USA. Morris.Maizels@kp.org
D000700:Analgesics / Q000009:adverse effects; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D002908:Chronic Disease; D015897:Comorbidity; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003937:Diagnosis, Differential; D019317:Evidence-Based Medicine; D005194:Family Practice / Q000379:methods* / Q000592:standards; D006261:Headache / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008019:Life Style; D008487:Medical History Taking; D010353:Patient Education as Topic; D010507:Periodicity; D010808:Physical Examination; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D011322:Primary Prevention; D011788:Quality of Life; D012017:Referral and Consultation; D012307:Risk Factors
D000700:Analgesics