Diagnosis and treatment of headache in the ambulatory care setting: a review of classic presentations and new considerations in diagnosis and management.
Headaches represent the most common constellation of neurologic disorders and are a very common cause of morbidity, lost work time, and decreased quality of life among sufferers. In this article, the diagnostic features, workup, and treatment of common, nuanced, and difficult-to-diagnose headache conditions were addressed. The future will hold a number of changes, with respect to both the diagnosis and treatment of headache disorders. As the aging population continues to grow, primary care providers will need to become increasingly familiar with differentiating between benign primary and more serious secondary headache disorders and will need to be able to treat the headache disorders unique to the elderly. With respect to therapeutic options, the future for treatment of the various headache disorders is promising. With the rise in popularity of complementary medical practices, there is likely to be more research on the roles of acupuncture, herbal and alternative remedies, massage therapy, and mind-body techniques. Further, new research is suggesting that neurostimulation may be useful in certain chronic, intractable headache conditions. Finally, the pathophysiology of headache disorders is still poorly understood and there is great hope that better understanding of the underlying mechanics of headache might contribute to improved treatment modalities and better quality of life for patients.
Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA.
Natalie
N
Hale
Medicine Student Programs, University of Washington School of Medicine, Seattle, WA 98195, USA. Electronic address: dpaauw@medicine.washington.edu.
Douglas S
DS
Paauw
D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D006261:Headache / Q000175:diagnosis* / Q000628:therapy*; D020773:Headache Disorders / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D059408:Pain Management / Q000379:methods
Chronic daily headache; Cluster headache; Hypnic headache; Migraine headache; Primary headache; Secondary headache; Tension headache; Triptans