| Noteworthy: January, 2001 | |
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There are often interesting articles about small headache studies or other headache news that by themselves aren't enough to warrant a full article. One of these articles might lead one of us to learn a tidbit that helps us or turn out to be of significant importance as the research on headaches continues. Periodically, I'll be bringing you "Noteworthy" reports on a few of them. Here's your first installment!
Diagnosis Delay in
Cluster Headaches
Dr. Jack A. Klapper and associates of the Colorado Neurology and
Headache Center in Denver surveyed users of the web site for the Organization
for the Understanding of Cluster Headaches (OUCH) regarding the time between
onset of their headaches and diagnosis. The results showed that it took a mean
of 6.6 years for the disorder to be correctly diagnosed, and patients saw an
average of 4.3 doctors before that diagnosis was made. Dr. Klapper commented,
"The findings of this study are an alert to physicians to better meet the
needs of this population with faster diagnosis and prescription of effective
medication."
Chronic Daily Headache
Increases Risk of Depression and Anxiety Disorders
Researchers in a Taiwanese headache clinic, studying 261 patients
diagnosed with transformed migraine or chronic tension-type headache, used a
standard interview format to assess the presence of mood disorders such as
anxiety and depression. As reported in the November/December issue of Headache:
- 78% of their patients with transformed migraine also had a mood disorder, most often major depression or panic disorder
- 64% of their patients with chronic tension-type headache also had a mood disorder, most often major depression;
Medication
Misuse and Insomnia
Dr. Rachel Hering-Hanit at Meir General Hospital in Kfar Saba, Israel, and her
colleagues performed a study with 25 women diagnosed with chronic
daily headache (CDH). The use of ergotamine and analgesic medications was
discontinued in all the patients. Sleep studies were performed before the
medication withdrawal and again three months afterward. Dr. Hering-Hanit and her
group reported in the November/December issue of Headache that sleep
efficacy increased by nearly 5%, and the number of arousals declined from an
average of 92 to 31.53.
Elderly
Patients = Management Challenges
Reporting at the annual meeting of the American Headache Society, Dr. David J.
Capobianco of the Mayo Clinic stressed the importance of a thorough history and
exam with laboratory and imaging studies for over-50 population when presenting
with headache. While only 2% of people over 50 develop new-onset migraine
disorder, secondary headaches such as those resulting from mass lesions and
temporal arteritis are more common in the elderly. Other challenges in managing
headache care for the elderly include the increased number of medications taken
in that segment of the population and their reduced tolerance for medication.
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