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Refractory Headaches.
Begasse de Dhaem, Olivia; Rizzoli, Paul.
  • Begasse de Dhaem O; Headache Specialist at Hartford HealthCare, Hartford, Connecticut.
  • Rizzoli P; Department of Neurology at the University of Connecticut, Milford, Connecticut.
Semin Neurol ; 42(4): 512-522, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-2096904
ABSTRACT
Medication overuse headache (MOH), new daily persistent headache (NDPH), and persistent refractory headache attributed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection represent a significant burden in terms of disability and quality of life, and a challenge in terms of definition, pathophysiology, and treatment. Regarding MOH, prevention without withdrawal is not inferior to prevention with withdrawal. Preventive medications like topiramate, onabotulinumtoxinA, and calcitonin gene-related peptide (CGRP) monoclonal antibodies improve chronic migraine with MOH regardless of withdrawal. The differential diagnosis of NDPH is broad and should be carefully examined. There are no guidelines for the treatment of NDPH, but options include a short course of steroids, nerve blocks, topiramate, nortriptyline, gabapentin, CGRP monoclonal antibodies, and onabotulinumtoxinA. The persistence of headache 3 months after SARS-CoV2 infection is a predictor of poor prognosis.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Botulinum Toxins, Type A / Headache Disorders / Headache Disorders, Secondary / COVID-19 / COVID-19 Drug Treatment Type of study: Diagnostic study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Semin Neurol Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Botulinum Toxins, Type A / Headache Disorders / Headache Disorders, Secondary / COVID-19 / COVID-19 Drug Treatment Type of study: Diagnostic study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Semin Neurol Year: 2022 Document Type: Article