Cluster Headache In 2 Year Old Girl!
September 13, 2009 by dean · Leave a Comment
Cluster Headache in 2year old
This is amazing!
Whilst I have treated a 3 year-old girl with ‘migraine’ (i.e.one-sided headache with nausea and vomiting) I have never come across this before.
The authors describe that it was difficult to make a diagnosis in such a young patient (given that in adults it is fraught with difficulty!) due to the lack of patient’s inability to describe symptoms well. However it appears that it was the associated symptoms (redness of the eye, tearing of the eye, swelling of the eyelid and itching of the nostril) which enabled a clear diagnosis of cluster headache to be made.
Cheers
Dean
(M Kacinski, A Nowak, S Kroczka & A Gergont. Cluster headache in 2-year-old Polish girl. Cephalalgia 2009;29:1091-1094)
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
Summary of the Watson Headache Institute
September 12, 2009 by dean · Leave a Comment
The Watson Headache Institute was established to increase the awareness of cervicogenic (neck) disorders in headache and migraine by:
imparting my (and that of others) clinical experience and knowledge
and,
undertaking and supporting rigorous clinical and scientific research in this specialty (I am currently a PhD Candidate investigating the role of cervicogenic dysfunction in the mechanism of migraine at Murdoch University, Western Australia).
and,
in determining whether or not a neck (cervicogenic) disorder is the cause of or a significant contributing factor to headache or migraine.
It is recognised
that neck (cervicogenic) dysfunction is significantly underestimated
that a neck (cervicogenic) dysfunction can be the cause of various forms of headache and migraine.
that the necks of all (primary) headache and migraine sufferers should be examined
To this end it is my objective to pass on this experience to my colleagues and headache and migraine sufferers
because
it is irresponsible to treat irrelevant cervicogenic (neck) dysfunction in migraine and headache conditions.
However
given that the causes of migraine and tension headache are not clear, the advances in our knowledge of pain mechanisms and the not insignificant body research supporting cervicogenic factors as key players in the headache and migraine processes,
it is also irresponsible NOT to examine the necks of headache sufferers irrespective of the diagnosis.
Cheers
Dean
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
Worsening Migraine Attacks Decreased Significantly By Cervicogenic (Neck) Treatment
September 11, 2009 by dean · Leave a Comment
Long term worsening of the migraine process
Recent evidence suggests that migraine is an increasing condition in which over time, the attacks become more frequent, more severe, less responsive to medication, and perhaps lasting longer.
Research has shown that by decreasing information (surgically) from cervical (neck) nerves deceases the long term worsening of the migraine process. The natural progression of cervicogenic (neck) headache is exactly the same – if it is left untreated, cervicogenic headache becomes more frequent, more severe and eventually becomes continuous. This indicates that with the passage of time the neck disorder is gradually worsening (and it is likely to be loss of function or stiffness). This research supports the idea that cervicogenic (neck) disorders are the reason for not only worsening of the migraine process but also for the migraine process in the first place i.e. sensitisation of the brainstem.
Now I am not suggesting that migraine sufferers rush off and have the relatively minor surgery performed in this study (in fact I respectfully suggest that skilled treatment of the neck would have achieved the same result), but this research clearly demonstrates disorders of the upper neck are significantly involved in the migraine process.
Cheers
Dean
(Perry CJ, Blake P and Goadsby PJ Intervention altering the natural history of chronic migraine. Is chroni?cation of migraine headache a harbinger of peripheral afferent nerve involvement? Cephalalgia 2009; 29 (Suppl. 1):1–166)
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
A Thorough Examination of Your Neck
September 9, 2009 by dean · Leave a Comment
A skilled examination of the neck
A thorough examination of your neck by a skilled practitioner may be the missing link in finding the root cause of your headache or migraine.
It is appropriate that the first step is for your headache or migraine to be assessed by your doctor who will then determine if a neurological opinion is required and whether a scan of your head is necessary. In the vast majority of cases a scan is negative, that is, no abnormality is present. Subsequently, what usually happens is that medication is suggested, and then starts a ‘merry-go-round’ of trying different medication regimes; you as a headache or migraine sufferer are (perhaps unnecessarily) destined to a lifetime of medication.
At this point, what is missing is a thorough examination of the structures of the upper neck.
Cheers
Dean
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
Hemicrania Continua – The Challenges of Diagnosis!
September 7, 2009 by dean · Leave a Comment
A Constant One Sided Headache
Hemicrania continua is defined as a constant one sided (and always on the same side) headache of moderate intensity with exacerbations and which responds to Indomethacin. Other possible symptoms include redness of the eye, a watery or teary eye, a blocked or runny nostril and drooping of the eyelid.
But we have case reports which show that this supposedly one sided (always the same side) headache can occur on the other side and can also be on both sides at the same time.
Interestingly the traditional classification system of headache and migraine states that Cervicogenic (neck-related) Headache as a one sided headache (and always the same side) also. However my experience of over 21000 hours with headache and migraine patients is that a one sided headache that can occur on the other side is a Cervicogenic Headache. Does this mean that I am saying Hemicrania Continua is likely to be Cervicogenic Headache – Yes!
Cheers
Dean
(Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders, 2nd edn. Cephalalgia 2004; 24(suppl.1):1-151
Marano E, Giampiero V, Gennaro DR, di Stasio E, Bonusa S, Sorge F. ‘Hemicrania continua’: a possible case with alternating sides. Cephalalgia 1994; 14:307–8.
Matharu MS, Boes CJ, Goadsby PJ. Management of trigeminal autonomic cephalalgias and hemicrania continua. Drugs 2003; 63:1637–77.
Matharu MS, Bradbury P, Swash M. Hemicrania continua: side alternation and response to topiramate. Cephalalgia 2005; 26: 341-344
Newman LC, Lipton RB, Russell M, Solomon S. Hemicrania continua: attacks may alternate sides. Headache 1992; 32:237–8.
Newman LC, Spears RC, Lay CL. Hemicrania continua: a third case in which attacks alternate sides. Headache 2004; 44:821–3.
Sjaastad O, Fredricksen TA, Pfaffenrath V. Cervicogenic headache: diagnostic criteria. Headache 1998; 38:442-5)
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
The Enormous Amount of Research
September 6, 2009 by dean · Leave a Comment
Despite the enormous amount of research into the various forms of headache and migraine their cause remains a mystery.
To help you, the headache or migraine sufferer know the source of you pain as precisely as possible, latest research into headache and migraine is summarised on this website.
This includes research into migraine, tension-type headache, cluster headache, paroxysmal headache, hemicrania continua, post-traumatic headache, menstrual migraine, sinus headache and cervicogenic (neck) headache.
Cheers
Dean
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
‘Hair Wash Headache’!
September 5, 2009 by dean · Leave a Comment
Weight of hair can pull the upper neck backwards
In recent correspondence to an acclaimed international headache journal, a doctor located in India reported on migrainous headache occurring after washing of the hair – as the author explains this has either not been noticed in other countries or it may be that similar headache presentations in other countries occur but are called something else.
As reported by this doctor, the crucial factor here is that many ladies from India have long hair that is plaited and it is time consuming to dry their hair (it is uncommon to use a hairdryer). Consequently many women do not wet their hair daily. On the days that they wash their hair however they describe throbbing headache developing within 10’-15’ ; their history of these headaches is usually quite long; this is the only headache they get; usage of perfumes or shampoos is uncommon … therefore the author (doctor) considers there are no other triggering factors …..
Are you thinking what I’m thinking? Imagine the weight on the back of the head of all the wet hair pulling the upper neck backwards – the stress on the neck structures would be significant …. could this be an unrecognised cervicogenic headache?
Cheers
Dean
(Ravishanka K. ‘Hair-wash headache’—an unusual trigger for migraine in Indian patients Cephalalgia 2005;(25)12:1184-1185
Ravishanka. Unusual Indian migraine trigger factors. Headache World 2000. Poster Presentation. Cephalalgia 2000; 20:359)
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
Not Tonight … I Have A Migraine!
September 3, 2009 by dean · Leave a Comment
Not tonight....I have a migraine!
Here we have an interesting study which confirms what we already knew – women frequently use migraine as an excuse … just joking!
Seriously whilst ‘not tonight, I have a headache’ is a cliche´, the excuse to avoid sexual activity is frequently attributed to women.
After interviewing 60 women (30 migraine sufferers and 30 non headache sufferers) it was found that only 10% of migraineurs and 30% in the non headache group had used headache as an excuse whilst not having a headache. Twenty-nine of the 30 migraine sufferers reported that their partners always respected them on these occasions (now that is refreshing!).
Another and arguably more important finding in this study was that 67% in the migraine group said that their sexual relationship was affected adversely, with 24% indicating that they had interrupted sexual activity because of headache – it is still a significant problem!
Cheers
Dean
(Carvalho JJF, Magalhaes AG, Morais LC, Menezes NS. How often women use headache as an excuse to avoid sex? Cephalalgia 2009;29(Suppl. 1):1–166)
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
Chronic Paroxysmal Hemicrania, Hemicrania Continua and Cluster Headache – All From The Same Disorder?
September 2, 2009 by dean · Leave a Comment
In recent times the International Headache Society has added a third primary group of headache(s) to the two primary headache types – migraine and tension-type headache.
This third primary group includes Cluster headache, Chronic Paroxysmal Hemicrania, and SUNCT (Short lasting Unilateral Neuralgia form headache attack with Conjunctival injection and Tearing!) and Hemicrania Continua.
Chronic Paroxysmal Hemicrania is very similar to Cluster Headache and is often described as the female equivalent of Cluster Headache (Cluster Headache is more frequent in males).
It is interesting to note a report demonstrating that both chronic Paroxysmal Hemicrania and Hemicrania Continua (thought to be two different types of headache) respond to the same medication – Indomethacin. (Indomethacin is a non steroidal anti inflammatory drug used to reduce pain)
I have written before that Cluster Headache and Hemicrania Continua respond to blocking or injecting of the greater occipital nerve i.e. a feature of Cervicogenic (neck-related) Headache – just more evidence to support the role of neck disorders in many different headache forms …..
Cheers
Dean
(Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders, 2nd edn. Cephalalgia 2004; 24(suppl.1):1-151
Sjaastad O, Antonaci F. Paroxysmal Hemicrania (CPH) and Hemicrania Continua: Transition From One Stage to Another. Headache 1993;(33)10:551-554)
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.
Supporting You, Along With Your Doctor
September 1, 2009 by dean · Leave a Comment
Determining the cause of your head pain and symptoms
Supporting you, along with your doctor, in determining the cause of your head pain and symptoms is one of the goals of the Watson Headache Institute.
It also provides a network of highly trained practitioners who are dedicated to achieving a successful treatment outcome for headache and migraine sufferers.
If you have had medical tests such as an MRI, Cat Scan and X-ray which have proved negative, then before undertaking ongoing medication, a skilled examination of the neck is an important step to understanding the nature of your pain as precisely as possible.
Identifying whether you have any spinal segment involvement in your headache or migraine can be achieved by seeking the advice of a practitioner skilled in assessing the role of the neck in your headache or migraine pain.
If you would you like an Internationally Trained Practitioner to assist you with your Headache or Migraine pain please go to the home page and read the information under the heading of ‘Practitioner’.
Cheers
Dean
© 2009 & Beyond. Watson Headache Institute, All Rights Reserved.