The Spanish Society of Neurology publishes the fourth edition of the "Manual de Práctica Clínica de Cefaleas" ("Headache Clinical Practice Manual") with the intention of serving as a guide for healthcare professionals caring for patients with headache or migraine.
51% of the European population report suffering from regular headaches and 4% from chronic headaches, i.e. those who have headaches more than 15 days a month. In addition, at least 60% of the population suffer from "tension headaches" and 15% from migraine, making them the most common types of headache among headache sufferers.
These are two of the findings presented in the "Manual de Práctica Clínica de Cefaleas" published by the Headache Study Group of the Spanish Neurological Society (SEN).
These are two neurological conditions that, according to experts, are the main cause of demand in neurological consultations, but also one of the first in primary care. For this reason, SEN has updated this paper with the aim of providing professionals with a quick and practical review of recommendations for the management of each type of headache.
Neurological innovations
The "Manual de Práctica Clínica de Cefaleas" is an update of the guidelines regularly published by SEN (the previous edition was published in 2015), based on the latest scientific evidence.
This edition includes all the new therapeutic developments, especially in the field of migraine prevention. "Particularly noteworthy is the inclusion of biological treatments, which has made it possible for the first time to have preventive treatments adapted to the pathophysiology of migraine," says Dr José Miguel Láinez, President of the Spanish Society of Neurology (SEN).
The manual is aimed at physicians in private practice or general practitioners, as well as clinical neurologists and other health professionals who care for people with headaches.
"The goal in creating this manual was to make it a reference work for all those colleagues, neurologist or not, who care for patients with craniofacial or cervical pain," emphasises Dr Pablo Irimia, current coordinator of the SEN Headache Study Group.
The experts in charge of the update emphasise that the latest 2018 International Headache Classification of the International Headache Society (IHS) Headache Classification Committee was taken into account in the drafting process.
As the authors explain, not only the most important therapeutic advances have been incorporated, but also the most important pathophysiological and diagnostic advances.
Fourth edition
With the aim of updating and disseminating new knowledge, the fourth edition of this handbook on headache includes new chapters.
The authors highlight the sections dealing with the practice of blockades as a therapeutic alternative for multiple headaches and facial pain, or the section devoted to headache with excessive medication use.
The latter, they explain, is a complex and common entity, affecting 1-2% of the population, and its treatment "is not always easy".
"Not only has a comprehensive overview been given of all the advances made in recent years, but very practical content has also been added, with the aim of further integrating these new techniques into clinical practice and for readers to take a more interventionist role in the management of patients with headache," Dr Irimia explains.
Types of headache
According to the World Health Organisation (WHO), headaches are one of the most common disorders of the nervous system and are characterised by recurrent headaches.
They are painful and disabling underlying conditions, explains the WHO, such as migraine headache, tension headache and cluster headache.
It can also be caused by many other disorders, the most common of which is the overuse of painkillers.
In this manual, the following headaches are grouped together:
- Episodic migraine
- Chronic migraine
- Tension-type headache
- Trigeminal autonomic headache
- Other primary headaches
- Secondary headache I
- Secondary headache II
- Medication-overuse headache
- Painful cranial neuropathies and other facial pain
- Other headache disorders and appendix to the International Classification of Headache Disorders International Classification of Headache Disorders (ICN-3)
- Headache in special situations
Masks and headache
According to the authors of the manual, many patients have seen their doctor because of an exacerbation of headache associated with mask use. Some have even asked their doctors for a prescription to be exempted from wearing a mask in public places.
However, SEN warns that the occurrence of these symptoms does not exempt them from complying with Decree SND/422/2020, which established the widespread use of masks in the Spanish population as a measure against COVID-19.
Therefore, they stress, the occurrence of headaches associated with the use of masks is not a justifiable health reason to exempt their compulsory use.
It is recommended by the Spanish Neurological Society, in order to avoid the occurrence of these types of headaches, to change the way the masks are worn, always respect the manufacturer's instructions, identify a model of mask that minimises or avoids these symptomatology and / or reduce the time of use.
Sociedad Española de Neurología/EFE - 18 March 2021
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