Management of Acute and Chronic Headache Pain, An Issue of Medical Clinics , livre ebook

Management of Acute and Chronic Headache Pain

Steven D. Waldman, MD, JD
Clinical Professor of Anesthesiology, School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri
ISSN  0025-7125 Volume 97 • Number 2 • March 2013
Table of Contents
Cover image
Title page
CME Accreditation Page and Author Disclosure
Learning Objectives
Accreditation
Disclosure of Conflicts of Interest
Unapproved/Off-Label Use Disclosure
To Enroll
Method of Participation
CME Inquiries/Special Needs
Forthcoming Issues
Contributors
Preface
Targeted Headache History
Key points
Chronicity
Age at onset
Duration and frequency of pain
Onset-to-peak time
Character and severity of pain
Premonitory symptoms and aurae
Associated symptoms
Precipitating factors
Previous diagnostic tests
Summary
The Role of the Physical Examination in the Evaluation of Headache
Key points
Introduction
The clinical problem defined
The goal: a correct diagnosis
The physical examination
Anisocoria
Papilledema
Summary
The Role of Laboratory Testing in the Evaluation of Headache
Key points
Introduction
What tests should I order?
Special situations
Summary
Factors That Cause Concern
Key points
Red flags for secondary headaches
Application of a history-taking scheme to identify factors that are concerning
The physical and neurologic examination
Summary
Imaging in the Evaluation of Headache
Key points
Introduction
When to perform imaging
How to perform imaging
What abnormalities may be found
Summary
Managing and Treating Headache of Cervicogenic Origin
Key points
Introduction
History
Epidemiology
Patient presentation
Diagnostic criteria
Anatomic considerations
Neuroanatomy
Bony pathology
Cervical disk disease
Differential diagnosis
Diagnostic studies
Medical management
Interventional treatment
Botox injection
Noninterventional/nonpharmacologic approaches
Summary
Managing and Treating Tension-type Headache
Key points
Historical considerations
Pathophysiology
Epidemiology
Clinical examination
Diagnostic testing
Differential diagnosis
Treatment considerations
Summary
Pain of Ocular and Periocular Origin
Key points
The sensory innervation of the eye
Common causes of ocular pain
Referred eye pain
Headache Pain of Ear, Nose, Throat, and Sinus Origin
Key points
Otalgia
Pain of the nose and sinuses
Throat pain
Summary
Trigeminal Autonomic Cephalalgias Other than Cluster Headache
Key points
PH
SUNCT and SUNA
Giant Cell Arteritis
Key points
The clinical syndrome
Relationship between PMR and GCA
Clinical testing
Treatment
Prognosis
Summary
Medication Overuse Headaches
Key points
Criteria for diagnosis
History
Place in classification
Offending agents
Clinical picture
Epidemiology
Illustrative cases
Etiology and pathophysiology
Prevention
Differential diagnosis
Prognosis
Treatment
Summary
Index
CME Accreditation Page and Author Disclosure

Program Objective
The goal of Medical Clinics of North America is to keep practicing physicians up to date with current clinical practice by providing timely articles reviewing the state of the art in patient care.

Target Audience
All practicing physicians and other healthcare professionals.

Learning Objectives
Upon completion of this activity, participants should be able to:

1.  Review the management and treatment of headaches from the following origins: Cervicogenic; Ocular and Periocular; ear, nose, throat and sinus.
2.  Describe the use of laboratory testing and imaging in the evaluation of headaches.
3.  Recall the use of physical examination to better manage acute and chronic headache pain.

Accreditation
The Elsevier Office of Continuing Medical Education (EOCME) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The EOCME designates this journal-based CME activity for a maximum of 11 AMA PRA Category 1 Credit (s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
All other health care professionals completing continuing education credit for this activity will be issued a certificate of participation.

Disclosure of Conflicts of Interest
The EOCME assesses conflict of interest with its instructors, faculty, planners, and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by EOCME for fair balance, scientific objectivity, and patient care recommendations. EOCME is committed to providing its learners with CME activities that promote improvements or quality in healthcare and not a specific proprietary business or a commercial interest.
The planning committee, staff, authors and editors listed below have identified no financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interest related to the content of this CME activity:
Bernard M. Abrams, MD; Stephanie Carter; Nicole Congleton; Charles D. Donohoe, MD; Sandra Lavery; Malisa S. Lester, MD; Benjamin P. Liu, MD; Jill B. McNair; Santha Priya; Maunak V. Rana, MD; Stephen D. Silberstein, MD; Nailia Vodovskaia, MD; Steven D. Waldman, MD, JD; Corey W. Waldman, MD; Jennifer E. Waldman; and Reid A. Waldman.
The planning committee, staff, authors and editors listed below have identified financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interest related to the content of this CME activity:
Frederick Freitag, DO has participated on the speakers bureau and as a consultant for Allergan and Zogenix; and speakers bureau for Nautilus.

Unapproved/Off-Label Use Disclosure
The EOCME requires CME faculty to disclose to the participants:

1.  When products or procedures being discussed are off-label, unlabelled, experimental, and/or investigational (not US Food and Drug Administration (FDA) approved); and
2.  Any limitations on the information presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinions. Faculty may discuss information about pharmaceutical agents that is outside of FDA-approved labelling. This information is intended solely for CME and is not intended to promote off-label use of these medications. If you have any questions, contact the medical affairs department of the manufacturer for the most recent prescribing information.

To Enroll
To enroll in the Medical Clinics of North America Continuing Medical Education program, call customer service at 1-800-654-2452 or sign up online at http://www.theclinics.com/home/cme . The CME program is available to subscribers for an additional annual fee of USD $267.

Method of Participation
In order to claim credit, participants must complete the following:

1.  Complete enrolment as indicated above.
2.  Read the activity.
3.  Complete the CME Test and Evaluation. Participants must achieve a score of 70% on the test. All CME Tests and Evaluations must be completed online.

CME Inquiries/Special Needs
For all CME inquiries or special needs, please contact elsevierCME@elsevier.com .
Forthcoming Issues
May 2013 Early Diagnosis and Intervention in Predementia Alzheimer’s Disease Jose Molinuevo, Jeffrey Cummings, Bruno Dubois, and Philip Scheltens, Editors
July 2013 The Diabetic Foot Andrew Boulton, Editor
September 2013 Infectious Disease Threats Douglas Paauw, Editor
RECENT ISSUES
January 2013 Diabetic Chronic Kidney Disease Mark E. Williams, MD, FACP, FASN, Editor
November 2012 Interventions in Infectious Disease Emergencies Nancy Misri Khardori, MD, PhD, FACP, FIDSA, Editor
July 2012 Chronic Obstructive Pulmonary Disease Stephen I. Rennard, MD, and Bartolome R. Celli, MD, Editors

RELATED INTEREST
Medical Clinics of North America, Volume 94, Issue 5 (September 2010) Otolaryngology for the Internist Matthew Ryan, Editor

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Contributors
EDITOR

STEVEN D. WALDMAN, MD, JD ,      Clinical Professor of Anesthesiology, School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri
AUTHORS

BERNARD M. ABRAMS, MD ,      Clinical Professor of Neurology, School of Medicine, University of Missouri-Kansas City, Kansas City, Missouri

CHARLES D. DONOHOE, MD ,      Neurologist, Associate Clinical Professor of Neurology, School of Medicine, University of Missouri-Kansas City, Independence, Missouri

FREDERICK FREITAG, DO ,      Medical Director, Department of Neurosciences, Baylor University Medical Center, Dallas, Texas

MALISA S. LESTER, MD ,      Instructor of Radiology, Section of Neuroradiology, Department of Radiology, Northwestern Memorial Hospital, Feinberg School of Medicine of Northwestern University, Chicago, Illinois

BENJAMIN P. LIU, MD ,      Assistant Professor of Radiology, Section of Neuroradiology, Department of Radiology, Northwestern Memorial Hospital, Feinberg School of Medicine of Northwestern University, Chicago, Illinois

MAUNAK V. RANA, MD ,      Medical Director, Chicago Anesthesia Pain Specialists; Department of Anesthesiology, Director of Pain Management, Advocate Illinois Masonic Medical Center, Clinical Assistant Professor of Anesthesiology, University of Illinois-Chicago, Chicago, Illinois

STEPHEN D. SILBERSTEIN, MD ,      Professor of Neurology, Jefferson Medical College, Thomas Jefferson University; Director, Jefferson Headache Center, Philadelphia, Pennsylvania

NAILIA VODOVSKAIA, MD ,      Jefferson Headache Center, Philadelphia, Pennsylvania

COREY W. WALDMAN, MD ,      Krieger Eye Institute at Sinai Hospital, Baltimore, Maryland

JENNIFER E. WALDMAN ,      Brain Tissue Bank