Headaches and migraines
Which are the symptoms?
Although pain in the head is the primary symptom that characterizes headaches, patients with migraine or cluster headaches may also experience a plenty of symptoms, such as nausea, watery eyes, concentrating difficulty, increased sensitivity to light or sounds. These complaints may precede the onset of pain or may persist even after resolution of the headache.
- Tearing up
- Increased sensitivity to sound
- Concentrating difficulty
How is it diagnosed?
The diagnosis process at the Headache and Facial Pain Center consists of several stages:
- Neurological examination: the neurological specialist investigates the clinical manifestations of headache, lifestyles and any risk factors of the patient through accurate anamnesis and accurate objective neurological examination;
- Clinical diary: the person is asked to write down the episodes of headache to assess the frequency, intensity and any triggering factors daily, until the next visit;
- Diagnosis: the doctor elaborates a personalized procedure and, if necessary, prescribes instrumental tests.
As part of the diagnosis, all neurophysiological or neuroradiological tools can be used if the headache complained of by the patient is of such a quality that a secondary form, i.e. symptomatic of an underlying neurological disorder, is suspected. Based on the assessment of the neurologist, after the medical history collection, the patient may be offered some tests useful to understand the type of headache in case secondary forms are suspected:
- Nuclear Magnetic Resonance Tomography
- Magnetic Resonance Angiography
- Cervical X-Ray
- Basal electroencephalogram
Follow up: follow up visits and checks are scheduled to check and evaluate the progress.
How is it treated?
Based on the diary and examinations performed, the specialist identifies the type of headache and proposes a personalized treatment, including with the involvement of other specialists depending on the causes of the headache. Headache therapy is based on symptomatic treatment (i.e., capable of resolving the attack itself in the short term) and, if the crises exceed a certain number per month and the disability experienced by the patient is particularly severe, on preventive therapy (i.e., capable of reducing the frequency and intensity of the attacks themselves). Dietary support and lifestyle corrections are also provided.
Based on the results of the examinations, the specialist will propose to the patient personalized therapy according to the type of headache identified and subsequent follow-up visits to verify the results of the therapy and any further steps. The following treatments are offered by the Center:
- Symptomatic drug therapies;
- Treatment with neuro-modulating drugs;
- Treatment with botulinum toxin;
- Treatment with monoclonal antibodies;
- Infiltration of the great occipital nerve;
- Nutraceutical and dietary approaches;
- Admissions for detoxification from drug abuse.
The Headache and Facial Pain Center is actively participating in the study of monoclonal antibodies that block the receptor for CGRP and have demonstrated efficacy and safety in migraine prophylaxis. The center is currently conducting clinical trials to evaluate the efficacy and safety of new monoclonal antibodies in the prevention of migraine in children and adolescents suffering from this disease.