1.1. 89 0 obj endobj <> endobj 105 0 obj <> Review the best available evidence for selected medicines. <> All NICE products on headaches. <> Four per cent of adults have a primary care consultation for headache per year2 but GPs lack confidence in the diagnosis and management . %PDF-1.7 Headaches Diagnosis and management of headaches in young people and adults Clinical Guideline 150 Methods, evidence and recommendations September 2012 Commissioned by the National Institute for Health and Clinical Excellence Clinical guideline V2 (2016) 3) NICE Clinical Guideline (CG150); Headaches in over 12s: diagnosis and management (reviewed November 2016) 4) www.migrainetrust.org. Information for Clinicians. It aims to improve the recognition and management of headaches, with more . Tension type headaches are the most common, affecting upwards of 75% of all headache sufferers. overuse with tension type headaches NICE recommends keeping a headache diary Usually episodic Deemed chronic if >15days per month Stress is common trigger but not . endobj 43 0 obj newonset cognitive dysfunction. Review. Globally, 3 billion people suffer from either migraine or tension-type headache disorder over their lifetime. endobj endobj <> r&L -2P Of'L&L^1I1I30K330$FByR2167{6 +@-6bG0Xdue SS, The NICE guideline recommends considering use of a headache diary for at least 8 weeks to help diagnose a primary headache. 81 0 obj x?E#. Set out priority areas for quality improvement in health and social care. endobj <> endobj endobj endobj This guideline covers advice on the diagnosis and management of tension-type headache, migraine (including migraine with aura and menstrual-related migraine), cluster headache and medication overuse headache in young people (aged 12 years and older) and adults. 60 0 obj 65 0 obj Headache Measurement Work Group (Work Group) to review existing guidelines, current evidence, and gaps in care in order to update the 2013 headache measures to drive better outcomes for patients with headache. 1 The guideline focuses on the most common primary headache disorders, which include tension-type headache, migraine and cluster headache, as well as medication overuse headache, which is, by classification, a secondary headache disorder. 49 0 obj 1.1.1 Evaluate people who present with headache and any of the following features, and consider the need for further investigations and/or referral: worsening headache with fever. endobj \ :64) l~ F7w \> `c. endobj This approach is supported by the NHS RightCare and EHF joint publications, with the latter noting that information on headache pattern, frequency, and response to medication can help to diagnose the headache disorder . 8 0 obj Please provide your Kindle email. NICE has recommended that the drug be stopped after 12 weeks of treatment if, in episodic migraine (less than 15 headache days a month), the frequency does not reduce by at least 50% or, in chronic migraine (15 headache days a month or more), by at least 30%. <> endobj 0 BD was a NICE CG 150 Headache guidelines group member 2010-2012, NICE Evidence Update Work member 2014 and provided headache-related advisory consultancy work for . Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. 80 0 obj endobj endobj XML. hbbd```b`` "H@,bf*J`2,[feS"`6y"@ b6AL*!w f <> Propranolol, metoprolol and timolol are licensed, but only propranolol is on formulary for this indication. <> It aims to improve the recognition and management of headaches, with more targeted treatment to improve the quality of life for people with headaches, and to reduce unnecessary investigations. 56 0 obj endobj endobj stream 82 0 obj % 13 0 obj Headaches Diagnosis and management of headaches in young people and adults Issued: September 2012 NICE clinical guideline 150 guidance.nice.org.uk/cg150 NHS Evidence has accredited the process used by the Centre for Clinical Practice at NICE to produce guidelines. endobj In the majority of cases-even for patients seen in an emergency setting-headache is a primary . endobj endobj 7 0 obj 94 0 obj If a woman has tension or migraine headaches, the healthcare professional should offer advice on relaxation and avoidance of factors associated with the onset of. New NICE guideline will help doctors recognise and refer people with suspected neurological conditions. 53 0 obj 40 0 obj Non-specic postnatal headache. It aims to improve the recognition and management of headaches . endobj endobj endobj In September 2012, NICE published a guideline: Headache in Over 12s: Diagnosis and Management. 62 0 obj endobj <> <>/Metadata 4707 0 R/ViewerPreferences 4708 0 R>> These account for fewer than 10% of all headaches. endobj 85 0 obj This Guidelines summary covers advice on the diagnosis and management of tension-type headache, migraine (including migraine with aura and menstrual-related migraine), cluster headache, and medication overuse headache in young people (aged 12 years and older) and adults. 66 0 obj endobj <> 2 0 obj 67 0 obj <> In December 2021, we changed the strength of our recommendation on metoclopramide or prochlorperazine for acute migraine from offer to consider, to better reflect the balance of benefits and risks of these treatments. endobj Includes any guidance, advice and quality standards. 63 0 obj 9 0 obj <> endobj \ <> endobj endobj The draft guidance is under consultation. Print out and share or encourage your . (de2d/mm6%[Vgy8uk-{lf>+;S_nS5-WVF1i4B(-:5' =0~p~%MzGhmnil2@sISNk(JJQGVgj:Qam3L/#\&.djIw`; Alex J Sinclair 1, 2, Aaron Sturrock 2, . MHRA advice on antiepileptic drugs in pregnancy: In May 2021, we amended our recommendation on topiramate for migraine prophylaxis to include discussion of the potential benefits and risks, and the importance of effective contraception for women and girls of childbearing potential when taking topiramate. Stakeholders can comment on draft guidance and participate in workshops and events. 84 0 obj International Classification of Headache Disorders (ICHD), 3rd Edition. /b|\9e!|GfId+kJWH'k6)c(|aSBlHd4UQADv%8|ftyT,iuVx[[hrvL7Ej|v%$wIQ5\IO4>S&Nm;8UxVjr~[+L#d;fL^`h`&q6lH57PNuV\N=fx)vZsSeVwZSk&x=t(AVw^?9n*.rhRhzS1b5N{/;1 Oxfordshire Headache Pathway for the Efficient Diagnostic and Management Support of Headache Disorders. <> 73 0 obj 86 0 obj The ICHD presents classification criteria, comments and further . Showing 1 of 1 shared learning examples for this topic: New NICE guideline will help doctors recognise and refer people with suspected neurological conditions. 68 0 obj Reviews the clinical and cost-effectiveness of new treatments. endstream endobj 1880 0 obj <. 71 0 obj `6 J h&f `TbOT3] @XmgL $3&K 4OgD igdD l~ x E`'dL xmj 3l3]( @`\;gwC*^ Fl~ 4~O#- )H hOEH ~. Last updated: 48 0 obj <> The International Classification of Headache Disorders (ICHD) is an algorithmic system to define and classify all known headache disorders. 79 0 obj endobj <> 54 0 obj The International Classification of Headache Disorders 2nd Edition (ICHD-II), published in 2004, marks an unquestionable progress from the preceding 1988 edition, but the in-depth analysis it . Occipital Nerve Stimulation in Migraine IPG452 . 4 0 obj They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. 55 0 obj 5. 7.1.4 Headache attributed to intracranial hypertension secondary to hydrocephalus 7.2 Headache attributed to low cerebrospinal fluid (CSF) pressure 7.2.1 Post-dural puncture headache 7.2.2 CSF fistula headache 7.2.3 Headache attributed to spontaneous intracranial hypotension 7.3 Headache attributed to non-infectious inflammatory disease 78 0 obj endstream endobj startxref Paediatric Clinical Practice Guideline The Alex Clinical Practice Guideline - Management of acute headache Page 2 of 10 Assessment History - Ask explicitly about parental concerns and take them seriously Headache - location, severity, character, onset, duration, timing, waking from sleep, frequency, history of recurrence (see image below), exacerbating and relieving factors, <> <> 39 0 obj rst-occurrence headache or unusual headache not corres-ponding to prior experience; headache unresponsive to usual treatment; chronic headache no longer tolerated. 64 0 obj <> endobj Newer treatments for headache with a specific UK license are also recommended if Headache management: pharmacological approaches. Headaches are common in children (3% for ages 3-7 years) and even more so in adolescents (8% to 23% for ages 11-15 years). It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. Critical assessment of evidence to help you make decisions. !) ) G4eB `4p |rtANS.B FA{LgzK HmkxMt q`#t 1ijw//gHLQ.t9 (w)#x)P3]FW2$}F]pm6 9c7We5pwXvj-sk3l~ C2/M(emNxMil^YYW6asE #)'v_W3]$k,5<>|u}Eo+ `P/2tYrA9lImO\N-58 i5Z#NjS*:c)e.h*[y_4~`k~I 6l}R=.%r=lYbM_}x(IY}c h*]}+~#j%?v(e/VJ^0? `Ua_T6Y?@k-bMStNkdBu\'s@uR!k+ 2}wR? cY rv yjyw_U%G[{n&te2Z?E> Rv8{=Z7>qz/w|--''/y!LZpdjaTm~UeJW_7v @CK/(Oo}#Cwj%8eq?LyT6Aa;qDzd[ `(vw}#OK?\~V?^{]{yq(cVOe{xQ'^( .,c^#?E|].;|.^,?k}7vZ_-ss*G_~{UPnWz dnl_4:M|l''?OW/&_|{Py(9rD[%mJ^ Wd)}yYl wR;K6nPys/!z,ykPut A}a}p:}+CG2 :l}U/jN$6 (cTxo#zj%UI"~N>Eld6CI~w/ `}]l#%rY/0ImyrKoa2(mL&]g8[m}A3q Q9Z|W;{TwW#8tC{qn} GYO`by>= VBkfWUf H/u#ND ? <> Guidance and quality standards awaiting development. 92 0 obj The Need for a Guideline 93 0 obj 10 0 obj Types of Headaches . endobj <> <> <> As many as 90% of adults have had tension-type headache These headaches are typically a steady ache rather than a throbbing one, and affect both sides of <> documentation of no medication overuse headache may be required for health plan coverage. <> <> endobj PDF. endobj endobj <> <> It is divided into primary headache disorders such as migraine and symptomatic headaches which are a symptom of a different disorder. Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. 1 0 obj 670 Canadian Family Physician Le Mdecin de famille canadien | Vol 61:august aot 2015 liical Reie Abstract Objective To increase the use of evidence-informed approaches to diagnosis, investigation, and treatment of headache for patients in primary care. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> Headache is one of the most common reasons patients seek help from family physicians. endobj <> Cefaly in Migraine IPG559. Headaches Information for the public Published: 1 September 2012 www.nice.org.uk About this information NICE guidelines provide advice on the care and support that should be offered to people who use health and care services. <> endobj <> 58 0 obj You are here: NICE . Botox in Chronic Migraine TA260. 1990 0 obj <>stream <> newonset neurological deficit. <> This guideline covers advice on the diagnosis and management of tension-type headache, migraine (including migraine with aura and menstrual-related migraine), cluster headache and medication overuse headache in young people (aged 12 years and older) and adults. 47 0 obj <> <> NICE's new guideline is the first to offer comprehensive information on neurological conditions to help non-specialist healthcare professionals to identify people who should be referred for specialist assessment and care. 6 NICE has developed technology appraisal guidance on Botulinum toxin type A for the prevention of headaches in adults with chronic migraine <> endobj Assessments of whether procedures are safe enough and work well enough for wider use in the NHS. <> endobj postpartum headache are: 1. endobj Includes any guidance, advice and quality standards. Published: Approximately 50% of American adults suffering from headache or migraine have used complementary and alternative medicine (CAM), however, the quality and quantity of recommendations associated with such therapies across clinical practice guidelines (CPGs) for the treatment . . 76 0 obj %PDF-1.6 % <> 74 0 obj NICE Headache Guideline CG150. <> endobj Guidelines for Trials of Behavioral Treatments for Recurrent Headache: Purpose, Process, and Product. It endobj These guidelines help promote AHS as the most comprehensive source in the field of headaches for both professionals and patients. This information explains the advice about headaches that is set out in NICE guideline CG150. endobj 1900 0 obj <>/Filter/FlateDecode/ID[<0AD12809462DD04AB1F70861DD02C2AF>]/Index[1879 112]/Info 1878 0 R/Length 114/Prev 450302/Root 1880 0 R/Size 1991/Type/XRef/W[1 3 1]>>stream there is usually a short course, but occasionally it can have a duration of years. 95 0 obj 44 0 obj endobj DBS for Trigeminal Autonomic Cephalalgias IPG381. i `t fvmP` 0 6? Introduction . stream The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. usually no identifiable underlying cause. Assessment of a person with headache should include asking about: Red flags suggesting a serious secondary cause needing specialist assessment. Headaches Reference: 1703 Written by: Judith Gilchrist 2015, revised by Laura Flemons June 2018 Peer reviewer: Judith Gilchrist . Pre-eclampsia (recent labour complicated with condition up to 10 days postpartum). 57 0 obj 1 0 obj As a preamble, we recall that headache intensity and severity are not correlated. 12 0 obj Tension-type Headaches . The estimated lifetime prevalence of headache is 66%: 14% to 16% for migraine, 46% to 78% for tension-type headache, and 0.1% to 0.3% for cluster headache. It aims to improve the recognition and management of headaches, with more targeted . The onset, duration, frequency, pattern, and characteristics of pain including location, severity, and quality. endobj 52 0 obj 91 0 obj <> <> endobj 2012 Jun;52(6):930-45. doi: 10.1111/j.1526-4610.2012.02185.x. Guidance, quality standards and advice being developed. <> 2 0 obj 72 0 obj 4 About 90% of migraine sufferers report moderate to . ;0J=\bL@+yr_imRK,+,-.b'5Cfw_0}Jl2Z9s#-0VjfJD(bg#Y1FDvK_9q$NQ`4"cb1}ng ;RxeP`^YhO5*`;p-4ewm=PwW`$1khrfh!!(kJ=}zAD]xEi$ View and Download PDF. 17 December 2021. View and Download PDF. endobj endobj <> Adult Headache Guideline Page 6 of 8 Notes: 1. <> 3. Review the evidence across broad health and social care topics. <> Measure Development Process The Quality and Safety Subcommittee (QSS) approved an update to the Headache Quality Measurement Set. A headache diary consists of tracking the following information: DATE TIME (start/finish) INTENSITY rate 1 -10 (most severe being 10) PRECEDING SYMPTOMS TRIGGERS MEDICATION (and dosage) RELIEF (complete/moderate/none) For more information about headache causes and treatments, visit the NHF web site at www.headaches.org or call 312-274-2650. We use the best available evidence to develop recommendations that guide decisions in health, public health and social care. 61 0 obj Headache Guidelines; Treatments . Published quality standards on this topic (2). guidelines is not consistent, BASH has therefore chosen only to recommend treatments that are consistently considered to have class A evidence and are recommended in two or more of the following guidelines (NICE, SIGN, AHS & EFNS). %%EOF American Academy of Neurology (AAN) Practice Guidelines. 5 Chronic migraine and chronic tension-type headache commonly overlap. endobj <> xde [aK @=v((*"^PTI}?^trTs Hf pe;+/VH. Overview. The aims of any physical examination should be fully . Particular consideration is given to the needs of girls and women of reproductive age. The 2012 AHS/AAN guidelines for prevention of episodic migraine: a summary and comparison with other recent clinical practice guidelines. endobj <> hb```b``Ab, 0\,a>SP>i%,l7X9mxjqE]h{-${>w\ [z[(&+)Ps%z((p#?{%8iZ-+-+L'3^QV( #-8AF0,f3Z@ bA` k k`Pc+bGGa 83 0 obj 69 0 obj Examples of how our guidance and standards have been put into practice in the NHS, local authorities, voluntary sector and a range of other organisations. <> This guideline covers advice on the diagnosis and management of tension-type headache, migraine (including migraine with aura and menstrual-related migraine), cluster headache and medication overuse headache in young people (aged 12 years and older) and adults. 4. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendationswherever possible. endobj <> All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme. <> Finding more information and committee details, assess and reduce the environmental impact of implementing NICE recommendations, Healthcare professionals who provide care for young people and adults with headaches, Young people (12 years and older) and adults with headaches, and their families and carers. <> 6 0 obj endobj 70 0 obj Accreditation is valid for 5 years from September 2009 and applies to guidelines @IV'e?_4Y2LwBj*Ai0A'9+{$WEMaVYe[^WEMUA~)QArw5#P5E[` 0tbCqz([Wc~22=z]yC endobj <> endobj <> Septic and aseptic meningitis (increasing headache,nausea, vomiting &neck stiffness). 11 0 obj <> NICE's new guideline is the first to offer comprehensive information on neurological conditions to help non-specialist healthcare professionals to identify people who should be referred for specialist assessment and care. 50 0 obj 77 0 obj endobj xVn0+xLr`~ A+v\ Migraine (history of migraine,unilateral pulsatile headache, associated with vasomotor signs). 46 0 obj c^s~aH6;ntTlWp)ciMJqJ_U2U,BGkXFZ! View and Download PDF. 90 0 obj <> Background. (NIHR-CS-011-028) and the Medical Research Council, UK (MR/K015184/1). post-coital headache. If there are any features of migraine, diagnose chronic migraine. Published: Clinical guideline [CG150] endobj 4 The pain-free period between cluster headache bouts. <> <> endobj <> Medications That Are Not Recommended KP Washington and national headache guidelines advise against the use of opioids and butalbital-containing medications (e.g., Fiorinal, Floricet) for treatment of headaches. 1- NICE Guidelines - Full - Free ebook download as PDF File (.pdf), Text File (.txt) or read book online for free. 1879 0 obj <> endobj Background. All NICE products on headaches. <> 42 0 obj View and Download PDF. NICEs new guideline is the first to offer comprehensive information on neurological conditions to help non-specialist healthcare professionals to identify people who should be referred for specialist assessment and care. <> endobj 59 0 obj Associated symptoms such as aura; nausea and vomiting; motion sensitivity; photophobia and . endobj <> <> 87 0 obj <> 75 0 obj endobj endobj <> endobj x67%e O 6? This guideline should be read in conjunction with NG193. 45 0 obj endstream % endobj 51 0 obj By using this service, you agree that you will only keep content for personal use, and will . 1.1 Assessment. 3 0 obj pW.ie ZGr~BFMs?n jr\FO?4G9E'L bsTH"s0R8]f;?JG:}YSeRbl_G#Kny@\(.:ekp%iIXPUPI%GKHv(rOv_ctN'\<9i93dG|o'4.t')L X/b. 2. endobj Overview . Quality of evidenceA comprehensive search was conducted for relevant guidelines and systematic reviews This guideline covers advice on the diagnosis and management of tension-type headache, migraine (including migraine with aura and menstrual-related migraine), cluster headache and medication overuse headache in young people (aged 12 years and older) and adults. stream endobj This guideline, for use by primary care providers, explains the evaluation, treatment, and referral process for children and adolescents (ages 3-21 years) whose chief complaint is headache.
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