By Lawrence Robbins
This state of the art booklet will disguise a variety of elements of headache administration, with a spotlight on tricky sufferers. functional, step by step suggestion for treating tough complications, together with migraine, refractory and cluster complications, might be supplied intimately in addition to the best way to process sufferers of other a long time and people with mental problems. special and intricate case reports and entire causes to the massive array of medicines can also be featured. Authored through one of many best specialists on refractory complications, complicated Headache administration could be a useful advisor for the resident or clinician and an easy-to-read source for lots of patients.
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Additional resources for Advanced Headache Therapy: Outpatient Strategies
Unipolar depression, whether it is major depression or dysthymia, is better recognized than bipolar depression. Up to 60 % of adults with chronic depression fit into the bipolar spectrum. It is vital to treat both pain and depression, as they fuel one another. Patients do say, “Of course I am depressed. ” My answer is, “Headaches do make the depression worse, but many people (60 %) with chronic pain are not depressed. ” Headache and the Bipolar Spectrum The relationship between bipolar illness and migraine has not been as well studied as depression and migraine.
Occipital pain may be originating in the cervical region; blocks or injections may help. Dental, Massage, Acupuncture Dental consultations may be beneficial for those who clench their jaw, and certainly if they are bruxing. For the associated clenching, bite splints may help, along with physical therapy. Massage can benefit a wide range of patients, but the benefits often are short-lasting. It has been difficult to prove in studies that acupuncture is more effective than sham treatment. After examining more than 500 randomized controlled trials of acupuncture for various conditions, nothing definite can be concluded as far as efficacy .
There is a solid track record of TMS for depression, and it appears to be safe; for depression, thousands of pulses are given; for headache, only two pulses or so. DHE is probably underutilized. DHE nasal spray (Migranal: generic available) is safe, but is not always effective. Migranal often leads to severe nasal congestion. DHE injections are much more effective, but are expensive, and often are not available. There is an inhaled version of DHE in the works, and should be available soon. It appears as if the inhaled DHE works better than the nasal spray, but not quite as effective as the injections.
Advanced Headache Therapy: Outpatient Strategies by Lawrence Robbins