Headache is a huge public health problem and migraine alone cost 27 billion Euros per year in Europe. It is therefore important how the health care service for headache patients is organised throughout the world. Patients seen at headache clinics are more severely affected than those seen in general practice, and headache clinics need to be familiar with a long list of relatively rare headache disorders. Part of the Frontiers in Headache Research series, this volume is the first book to focus specifically on headache clinics, their classification and organization, their methods of diagnosis, and their approaches to multi-disciplinary management. The clinical features of patients seen in headache clinics are thoroughly discussed. The value of a number of diagnostic laboratory techniques including when and how to use neuro-imaging is discussed. Also a number of more specialised methodsemployed only in referral headache centres are covered, such as nitro-glycerine challenge, indomethacin test, and oxygen breathing. The treatment options for severely affected patients are discussed including the possibilities of combining two or more prophylactic medications, the use of epidural bloodpatch and the different methods for discontinuation of medication overuse. This volume will be an invaluable resource for neurologists, physicians in headache/pain clinics and interested general practitioners.
Classification and organization of headache clinics; The epidemiology and cost of severe headache disorders; Should an acute headache service be part of a headache clinic?; A multidisciplinary academic headache centre in the United States; Organization of a multidisciplinary headache centre in Europe; Approach to headache management - USA, UK and India compared; Organization of a headache centre - an Indian perspective; Establishment and organization of a research headache clinic: advantages and disadvantages; Favourable results in a migraine clinic: objectives and background; A local network as a headache clinic in the French Alpes; Discussion Summary: Classification and organization of headache clinics; Patient characteristics in headache clinics; Characteristics of patients in headache centres; Hospitalization of headache patients: why, when and how?; Cormorbidity of migraine in a specialized headache clinic; Medical and psychological characteristics of patients with chronic daily headache with migrainous features: compared to migraineurs in the French general population. GRIM 3 survery; Similarities and differences in tension-type headache and migraine patients of primary care providers and a tertiary care headache centre in Switzerland; Demographic, nosological, and therapeutic characteristics in a headache outpatient clinic; Headache management in a neurological university clinic without a specialized headache centre; Pericranial muscle tenderness is associated with widespread pain sensitivity, psychiatric cormorbidity and dysfunctional psychological responses to pain in healthy young adult females; Discussion Summary: Patient characteristics in headache clinics; Diagnostic methods; Electronic charts and diaries in a headache clinic; Evaluation and quantification of tenderness and sensitization; Provocation and treatment as diagnostic procedures; Imaging and other tests in headache diagnosis; Diaries and calenders for migraines. A review.; The development of an electronic web diary for the monitoring of primary headaches; Stress-induced pain and muscle activity in patients with migraine and tension-type headache; Frequent tension-type headache sufferers exhibit widespread pain sensitivity across pressure and thermal pain modalities; Discussion Summary: Diagnostic methods; Multidisciplinary management; The team approach (overall concept and use of other specialities); Headache clinics: physical therapy; Psychological therapy; The role of the clinical nurse specialist in headache; Therapy of medication overuse headache; Migraine management in a 10-year perspective: an interim analysis; Social care: litigation, compensation, disability claims; Efficacy of therapeutic intervention in headache units in patients with frequent headaches. EFUNCE study; Medication overuse headache: long-term results of stationary versus ambulatory withdrawal therapy; Discussion Summary: Multidisciplinary management; Discussion Summary: Multidisciplinary management - medication overuse; The future of headache clinics; Cost-effectiveness of headache clinics; National healthcare plans for headache?; Headache clinics for children; Discussion Summary: The future of headache clinics;
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