Current pain and headache reports
-
Pediatric and adolescence headache is one of the most common causes of access in emergency departments (ED). Primary headache and headache secondary to self-limited conditions are the majority of cases. Secondary life-threatening headaches are less frequent and may be recognized by a careful history and physical examination. The primary objective for ED physicians is to recognize the serious life-threatening conditions requiring immediate medical care among the wide spectrum of headache diagnoses.
-
Curr Pain Headache Rep · Mar 2015
ReviewPsychiatric comorbidity in childhood and adolescence headache.
Primary headaches among children and adolescents have a substantial impact on quality of life, daily activities, social interaction, and school performance in combination with psychopathological symptoms. The main purpose of the present paper is to summarize clinical and epidemiological evidence for psychiatric comorbidity among children and adolescents with headaches, to describe how evidence in headache research suggest different pathways involved in the development and maintenance of these comorbid conditions, and finally suggest some elements professionals may find helpful to assess the scope of complaints, related functional impairment, and potential precipitating factors in planning of more targeted treatments.
-
Curr Pain Headache Rep · Mar 2015
ReviewWhen indomethacin fails: additional treatment options for "indomethacin responsive headaches".
Indomethacin has been used for the treatment of headache disorders since the 1960's, shortly after it was introduced as a treatment for pain and joint swelling in rheumatologic conditions. A subgroup of primary headache disorders, often refractory to other pharmacologic treatment such as triptans and the usual non-steroidal anti-inflammatories, was noted to be exquisitely and absolutely responsive to the analgesic effects of indomethacin. These disorders have been better characterized over the past decade and classified into primary headache disorders of paroxysmal hemicrania (PH) and hemicrania continua (HC). ⋯ More rarely, the development of new headaches have been reported in chronic indomethacin use. In these settings, other classes of medications such as selective cyclooxygenase-2 inhibitors (celecoxib), anti-epileptic agents (topiramate), calcium channel blockers (verapamil, flunarizine), melatonin, and local nerve blocks with anesthetic and steroids have been shown to be effective in case reports and series. We review the literature and provide our clinical recommendations on alternative therapies for the "indomethacin-responsive headaches".