I am indebted to Dr Matthew S. Robbins…for enlisting outstanding and prominent experts in the field to guide us in the diagnosis and management of primary or secondary headache disorders.
This issue of Continuum is devoted to the diagnosis and management of headache and facial pain, symptoms that are common in our clinical practices and have profound effects on patients’ quality of life. To achieve this goal, I am indebted to Dr Matthew S. Robbins for accepting my invitation to serve as guest editor of this issue and for enlisting outstanding and prominent experts in the field to guide us in the diagnosis and management of primary or secondary headache disorders.
The issue begins with two articles that serve as important introductions to the articles that follow. First, Dr David W. Dodick provides a very practical overview of his clinical approach to the diagnosis of patients with secondary and primary headache disorders. Next, Dr Ana Recober reviews the current thinking regarding the underlying pathophysiology of migraine and its various phases from prodrome to postdrome.
Dr Jessica Ailani reviews the many agents and approaches currently available in our armamentarium for the management of acute migraine attacks. Dr Rebecca Burch then discusses the many therapeutic strategies and options available for the prevention of migraine. Dr Stephanie J. Nahas next describes the diagnosis of and current management options for cluster headache and other trigeminal autonomic cephalalgias, stressing the severity of these syndromes and the great impact these painful disorders can have on our patients’ lives.
Dr Jonathan H. Smith reviews the diagnosis and management of the variety of other primary headache disorders; recognition of the unique clinical characteristics of these disorders can lead the clinician to the most appropriate counseling and treatment options. Dr Carrie Robertson then discusses the diagnosis and current management strategies of the cranial neuralgias, including trigeminal and glossopharyngeal neuralgia and other neuralgias of the head and neck.
Dr Jelena M. Pavlović provides us with an extensive overview of the diagnosis and treatment of headache in women, with emphasis on the relation of headache to hormonal changes during the menstrual cycle, in pregnancy, and throughout life. Next, Dr Christina Szperka provides an approach to the unique aspects of history taking, diagnosis, management, and counseling of the most common headache disorders presenting in children and adolescents.
Dr Robbins then reviews the indications, evidence base, technical aspects, and safety considerations of various procedural therapies for headache disorders, particularly migraine and cluster headache. In the final review article of the issue, Dr Shuu-Jiun Wang discusses the variable clinical presentations (including headache and nonheadache symptoms), diagnostic testing, and current therapeutic strategies for patients who present with spontaneous intracranial hypotension.
In this issue’s Medicolegal Issues article, Ms Rachel V. Rose and Dr Joseph S. Kass provide several real-life examples relevant to neurology to discuss the False Claims Act and its implications for neurologists.
After reading the issue and taking the Postreading Self-Assessment and CME Test written by Drs Adam G. Kelly and Allison L. Weathers, readers may earn up to 20 AMA PRA Category 1 CreditsTM toward self-assessment CME or, for Canadian participants, a maximum of 20 hours toward the Self-Assessment Program (Section 3) of the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada. Additional credit can be obtained by listening to Continuum Audio interviews associated with this and other Continuum issues, available to all subscribers, and completing tests on the Continuum Audio web platform or mobile app. Continuum Audio is also accredited by the Royal College of Physicians and Surgeons of Canada.
This issue is part of a pilot program of Continuum issues read aloud. Different from Continuum Audio, these are recordings read verbatim from the print articles by Dr Michael Kentris, a neurologist at Bon Secours Mercy Health in Youngstown, Ohio. The audio files are available to all Continuum subscribers in the AAN’s Online Learning Center at continpub.com/CME. I encourage you to listen and submit the survey with your feedback on this pilot, which has been extended to include this issue and the August 2021 issue.
We are also pleased to introduce the rollout of the new Continuum mobile experience at ContinuumJournal.com. Just follow the directions on the inside front cover in the “Beyond the Page” section of this issue to save Continuum to your phone’s home screen. You will then be able to simply and easily navigate content from any Continuum issue on your mobile phone as well as read full-text articles and access tables and figures wherever you are and whenever you need it, including at the point of care.
My sincere thanks to Dr Robbins for his skillful and dedicated guest editorship and to all of the experienced and thoughtful experts who joined him in this issue. This issue so thoroughly covers so many practical aspects of the diagnosis and management of both the common and uncommon disorders that may present as headaches and whose effective treatment can have such an important impact on improving our patients’ quality of life.
—STEVEN L. LEWIS, MD, FAAN