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Although medication use is the prevailing method for treating pain, excessive use of acute medication is usually not a successful strategy, particularly in the case of headaches where it may lead to medication-overuse headache (MOH), a chronic headache disorder with daily or near-daily symptoms, caused by overuse of acute headache medication [1, 2].
Only in the case of headaches and sleep disorder, did sensitivity prevail over specificity (table 3 classification table).
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In case of headache they were instructed to take another 1 tablet at the headache onset.
Moreover, even one case of headache symptomatic of a cerebral infarction has been reported as CPH [16].
In the case of headache care, this means data on the burden attributable to headache disorders harvested from the population of Nepal as the basis of needs assessment.
We have reported the case of headache fulfilling all diagnostic criteria for SUNCT syndrome except the criterion of unilateral presentation, associated with microprolactinoma and highly responsive to lamotrigine.
In conclusion, in the case of headache of long duration our findings suggest that the benefit from detoxification and advice can be excluded in MOH patients.
A third case of headache secondary to infectious/autoimmune causes involved a 32-year-old woman with a history of headache (>4 per month), treated with NSAIDs (F. De Santis, Avezzano).
A preventive therapy is recommended in the case of headache-related disability for ≥4 days/month or poor response to symptomatic treatment even if the headache frequency is lower.
A further case of headache in rare syndromes was a 54-year-old male admitted to the emergency room with headache and transient visual loss (G. Ruiz-Ares, Madrid).
In the case of headache, taking the acute medication is beneficial because the attack is aborted but it also leads to risks in terms of the potential development of MOH.
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