Chronic Headache Update Nov 8, 2019 Spokane Pain Conference David R. Greeley, MD, FAAN Northwest Neurological, PLLC Principal Investigator for TEVA for Phase II study for post-traumatic headache otherwise • not employed by any pharmaceutical company for headache or pain • not on any speaking bureaus or advisory boards • no patents, no royalties, no stock or options • no industry-sponsored grants for headache
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Chronic Headache UpdateNov 8, 2019
Spokane Pain ConferenceDavid R. Greeley, MD, FAAN
Northwest Neurological, PLLC
Principal Investigator for TEVA for Phase II study for post-traumatic headacheotherwise
• not employed by any pharmaceutical company for headache or pain• not on any speaking bureaus or advisory boards• no patents, no royalties, no stock or options• no industry-sponsored grants for headache
Chronic Headache —what’s usually most helpful
to me?
History?
Exam?
Lab work?
CT or MRI?
EEG?
History — which part?
Place?
Quality?
Radiation?
Severity?
Associated symptoms?
History— which part?
Place — most syndromes can be unilateral or bilateral, front or back
Quality —‘throbbing’
Radiation — tough to describe
Severity — “10/10” is most common answer
Associated symptoms — almost everyone says they get nausea and light-sensitivity
History— timing
I want to know about the first headaches as much if not more than the most recent
Onset, Duration and Frequency
History— behavior
Continue to work?
Go to sleep?
What medication do they take, when do they take it and how many do they take in a month?