Clinician's Manual on Migraine by Todd A Smitherman

By Todd A Smitherman

This instruction manual is a clinically-focused consultant at the analysis and evidence-based remedy of migraine, the 3rd most typical scientific on this planet. it's a concise but thorough advisor for administration of migraine in scientific perform settings as trained by way of present medical literature and medical guidance. This instruction manual contains diagnostic standards from the newest variation of the overseas class of Headache problems (ICHD-3). the 1st 1/2 the guide offers info on evaluate of migraine (including headache purple flags and symptoms for neuroimaging), screening for universal comorbid stipulations, and crucial way of life thoughts for all migraine sufferers. the second one part covers either acute and preventive headache medicinal drugs and suitable remedy algorithms and symptoms, in addition to different clinical cures and behavioral interventions for migraine. This clinician’s handbook is straightforward to learn and comprises a variety of tables and different content material useful to all companies in need of a go-to source on medical administration of migraine. it's an amazing better half for busy basic practitioners and neurologists, nurses and mid-level services, neurology trainees and citizens, in addition to sufferers wishing to achieve a greater knowing in their condition.

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Patients with suspected sleep apnea should be referred for comprehensive sleep evaluation via overnight polysomnography, as headache often improves once any underlying sleep disorder is addressed. 36 Chapter 3. Education and Lifestyle Recommendations Patients with near-daily insomnia, which characterizes the large majority of those with chronic migraine (CM), often warrant a more programmatic sleep intervention from a behavioral health provider. Two randomized controlled trials have shown that a brief behavioral intervention for insomnia improves headache frequency among patients with CM [2, 3].

The majority of patients experience pain relief 2 h after a standard dose of triptan [4]. A patient who does not respond 50 Chapter 4. Pharmacotherapy Fig. 1 Forest plot of the primary multiple treatment comparison meta-analysis results, triptans versus placebo. (a) Pain-free response at 2 h; (b) 24 h sustained pain-free response (Reproduced with permission from Thorlund et al. [3] ©SAGE) to one triptan usually should be tried on at least one other triptan, or using different route of administration, before resorting to another class of acute medication, as the large majority of migraine patients will respond to at least one triptan.

2003;3:87–92. 22. Smith JH, Swanson JW. Giant cell arteritis. Headache. 2014;54:1273–89. 1 Goals of Treatment The goals of migraine treatment, both pharmacologic and nonpharmacologic, are to prevent future attacks, reduce headache-related disability, and restore normal functioning as quickly as possible. An in-depth overview of pharmacologic treatments is discussed in Chap. 4, and evidence-based nonpharmacologic treatments are reviewed in Chap. 5. This chapter focuses on education and basic lifestyle recommendations that should be part of all migraine treatment plans.

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