Headache Management. Tom Miller MD. Why talk about headaches?. Headaches are a common problem They are sometimes difficult to treat Can usually be treated well by internists Headache management is often not optimal Recent advances can translate into better treatment.
Tom Miller MD
Schreiber, Archives of Int. Med. 2004; 164: 1769
111 consecutive patients with primary or metastatic brain tumor
Forsyth, Neurology, 1993
Buring, JAMA, 1990
“A healthy robust man of middle age was suffering from troublesome pain which came on every day at the same hour at the same spot above the orbit of the left eye: after a short time the left eye began to redden, and to overflow with tears; then he felt as if his eye was slowly forced out of its orbit with so much pain, that he nearly went mad. After a few hours all these evils ceased, and nothing in the eye appeared at all changed.”
Leone, Neurology, 2000
Holroyd, JAMA, 2001
Amitriptyline produced results more quickly.
Combination treatment (AM+SM) produced greater than 50% reduction in HA severity in 2/3 of patients