TAILIEUCHUNG - Chapter 015. Headache (Part 16)

Unproven but of potential benefit. Many experts favor verapamil as the first-line preventive treatment for patients with chronic cluster headache or prolonged bouts. While verapamil compares favorably with lithium in practice, some patients require verapamil doses far in excess of those administered for cardiac disorders. The initial dose range is 40–80 mg twice daily; effective doses may be as high as 960 mg/d. Side effects such as constipation and leg swelling can be problematic. Of paramount concern, however, is the cardiovascular safety of verapamil, particularly at high doses. Verapamil can cause heart block by slowing conduction in the atrioventricular node,. | Chapter 015. Headache Part 16 Unproven but of potential benefit. Many experts favor verapamil as the first-line preventive treatment for patients with chronic cluster headache or prolonged bouts. While verapamil compares favorably with lithium in practice some patients require verapamil doses far in excess of those administered for cardiac disorders. The initial dose range is 40-80 mg twice daily effective doses may be as high as 960 mg d. Side effects such as constipation and leg swelling can be problematic. Of paramount concern however is the cardiovascular safety of verapamil particularly at high doses. Verapamil can cause heart block by slowing conduction in the atrioventricular node a condition that can be monitored by following the PR interval on a standard EKG. Approximately 20 of patients treated with verapamil develop EKG abnormalities which can be observed with doses as low as 240 mg d these abnormalities can worsen over time in patients on stable doses. A baseline EKG is recommended for all patients. The EKG is repeated 10 days after a dose change in those patients whose dose is being increased above 240 mg daily. Dose increases are usually made in 80-mg increments. For patients on longterm verapamil EKG monitoring every 6 months is advised. Neurostimulation Therapy When medical therapies fail in chronic cluster headache neurostimulation therapy strategies can be employed. Deep-brain stimulation of the region of the posterior hypothalamic gray matter has proven successful in a substantial proportion of patients. Favorable results have also been reported with the less-invasive approach of occipital nerve stimulation. Paroxysmal Hemicrania Paroxysmal hemicrania PH is characterized by frequent unilateral severe short-lasting episodes of headache. Like cluster headache the pain tends to be retroorbital but may be experienced all over the head and is associated with autonomic phenomena such as lacrimation and nasal congestion. Patients with remissions are .

• Y học thường thức
• Headache
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu học ngành y
• Harrisons Internal Medicine
• ABC of headache
• Teenage headache
• Exertional headache
• Thunderclap headache
• Brain tumour
• Facial pain
• BMC Musculoskeletal Disorders
• Tension type headache
• Cervicogenic headache
• Manual therapy
• Mulligan manual therapy
• Treatment of primary headache syndrome
• Lecture Treatment of primary headache syndrome
• Primary headache syndromes
• Ttreatment for migraine
• Treatment of tension headaches
• Approach to headaches
• Cluster headache
• Medication overuse headache
• Menstrual headaches
• Childhood periodic syndromes
• báo cáo khoa học
• báo cáo y học
• công trình nghiên cứu về y học
• tài liệu về y học
• cách trình bày báo cáo
• BMC Anesthesiology
• Cerebral venous thrombosis
• Postdural puncture headache
• Brain CT angiography
• Medical treatment