Headache Management: Pharmacological Approaches
REVIEW Headache management: Pract Neurol: first published as 10.1136/practneurol-2015-001167 on 3 July 2015. Downloaded from pharmacological approaches Alex J Sinclair,1,2 Aaron Sturrock,2 Brendan Davies,3 Manjit Matharu4 ▸ Additional material is ABSTRACT be very rewarding for the clinician. The published online only. To view Headache is one of the most common conditions purpose of this article, the first of two please visit the journal online (http://dx.doi.org/10.1136/ presenting to the neurology clinic, yet a linked articles, is to provide an up-to-date practneurol-2015-001167). significant proportion of these patients are overview of the pharmacological manage- unsatisfied by their clinic experience. Headache ment of common headache disorders 1Department of Neurobiology, School of Clinical and can be extremely disabling; effective treatment is (as well as a limited number of non- Experimental Medicine, College not only essential for patients but is rewarding pharmaceutical strategies). of Medical and Dental Sciences, for the physician. In this first of two parts review The University of Birmingham, of headache, we provide an overview of Birmingham, UK THE COMMON PRIMARY HEADACHE 2Neurology Department, headache management, emerging therapeutic DISORDERS University Hospitals Birmingham strategies and an accessible interpretation of In European populations, the annual sex- NHS Trust, Queen Elizabeth clinical guidelines to assist the busy neurologist. Hospital Birmingham, adjusted prevalence for tension-type Birmingham, UK headache is 35%, for migraine is 38%, 3 Department of Neurology, Royal BACKGROUND but for cluster headache is only Stoke University Hospital, ’ 0.15%.45These three together comprise Stoke-on-Trent, UK Headache is listed among the WHO s 4Headache Group, Institute of major causes of disability with a global the most prevalent primary headache dis- Neurology, London, UK prevalence of 47% (symptoms occurring orders.
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