Migraine Headache | Headache & Dizziness Assessment

Migraine Headache | Headache & Dizziness Assessment
Headaches can manifest on their own but are also a very common symptom in neck pain patients as more than 60% of patients with a primary neck pain complaint report having concordant episodes of neck pain. Therefore it’s essential to find out what kind of headache the patient is suffering from.
To start off let’s differentiate between primary and secondary types of headaches. But what does this mean? Simply put, primary headaches are a “disease themselves” whereas, in secondary headaches, the headache is a symptom of another condition. So primary headaches would be migraines, tension-type headaches & cluster headaches. Secondary-type headaches are headaches caused by tumors, hemorrhage, other trauma, TMJ dysfunction, substance overdose, or neck pain aka the Cervicogenic headache.
Now let’s take a closer look at migraines, which are primary types of headaches.
Migraines have a mean 1-year prevalence of 11.2% around the world with women being more often affected than men in an age range between 20-50. Migraines exist in two distinct forms: That is either With or without the presence of a phenomenon called Aura. But we will get to that later.
Diagnostic criteria for migraine without aura (A-D need to be fulfilled):
A. At least 5 attacks fulfilling criteria
B. Headache attacks lasting 4-72 hours (untreated or unsuccessfully treated)
C. Headache has at least 2 out of the following 4 characteristics:
- Unilateral location
- Pulsating quality
- Moderate or severe pain intensity
- Aggravation by or causing avoidance of routine physical activity (e.g.walking or climbing stairs)
D. During headache at least one of the following:
- Nausea and/or vomiting
- Photophobia and phonophobia
E. Not better accounted for by another ICHD-3 diagnosis
In order for a headache to be classified as migraine with aura, a patient has to present with the previously mentioned criteria AND one or more reversible Aura symptoms. These are disturbances in the following subsystems:
- Visual
- Sensory
- Speech
- Motor
- Brainstem
- Retina
Imagine vision changes, numbness, dizziness, confusion, etc.
Furthermore, at least 2 of the 4 characteristics have to apply:
- At least one aura symptom spreads gradually over ≥ 5 minutes, and/or two or more symptoms occur in succession
- each individual aura symptom lasts 5-60 minutes
- at least one aura symptom is unilateral
- the aura is accompanied, or followed within 60 minutes, by headache
While the Aura symptoms resemble those of a CVA, they build up much slower. Over 5 minutes compared to within seconds in a CVA.
100% FREE HEADACHE HOME EXERCISE PROGRAM
Tools you can use to assess the impact of a headache on your patient are the HIT-6 questionnaire which you can find in the video description. Also note that it can be difficult for a patient to answer all of the questions on duration, intensity, and characteristics of their headache during your assessment. Therefore asking them to complete a headache diary can help in the assessment and management of the headache and you should be aware that there can be overlap between multiple headache disorders.
If you would like to learn how to diagnose other common forms of headaches, check out the posts below:
The Watson Test is a common provocation test used in the assessment of tension-type headaches and migraines.
References:
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What others say about the Online Course "Headache Treatment in Clinical Practice"
- Max Dienemann09/10/23Headache Treatment in Clinical Practice TOP
Great course! Everything is covered from diagnosis to treatment (-options) including the latest evidence backing everything up. The practical/skills videos on are also perfectly explained, therefore hands on skills and exercises can be easily implemented in daily practice.Danitsja Wendt11/09/23Headache Treatment in Clinical Practice UITGEBREIDE HOOFDPIJNCURSUS
Veel informatie over de drie meest voorkomende hoofdpijnsoorten. Eerst uitgebreid theoretische achtergrond.
Daarna ook veel aandacht voor onderzoeken en behandelingen, verduidelijkt met filmpjes.
Fijn dat deze informatie ten alle tijden teruggekeken kan worden voor een opfrisser.
De cursus zelf is vertaald in het Nederlands, maar de vele wetenschappelijke artikelen zijn dat helaas niet.
Hierdoor ging bij mij wel erg veel tijd zitten in het doornemen daarvan.
Comment Physiotutors: All scientific literature is in English. That is a reality that we cannot change.Willem Nijssen31/07/23Headache Treatment in Clinical Practice GOOD QUALITY COURSE WITH UP-TO-DATE LITERATURE
The course is well structured and with up-to-date literature. It provides enough practical tips. There’s definitely a lot to learn about this subject! - Jesse de Louw11/07/23Headache Treatment in Clinical Practice GOOD COURSE
Good EBP study, with a nice variety of information. Sometimes a little bit hard to follow the information given in another language than my own. (Comment Physiotutors: This customer probably did not see the option to switch to Dutch)Hamad Alkahtani16/06/23Headache Treatment in Clinical Practice Very Interesting info and practical knowledgeM.A.G. Kuipers15/06/23Headache Treatment in Clinical Practice INFORMATIEVE CURSUS MBT HOOFDPIJN
Goede cursus, helaas niet in Nederlands en helaas zijn ook niet alle artikelen makkelijk te verkrijgen
duidelijke filmpjes met goede technieken mbt onderzoek en behandeling
Opmerking Physiotutors: De gehele cursus is wel in het Nederlands verkrijgbaar. - Lennart Kroes17/04/23Headache Treatment in Clinical Practice A PERFECT COURSE TO UPDATE YOUR KNOWLEDGE ABOUT HEADACHE
Evidence-based, easy to follow. Perfect!Erik Swarts09/03/23Headache Treatment in Clinical Practice GREAT COURSE!
First time doing a Physiotutors course. great way to learn on a high level of evidence. You can watch and rewatch everything for as long as you want before you take the exam.Daniel Klimsa31/01/23Headache Treatment in Clinical Practice GREAT COURSE!
Well-structured course with lots of evidence-based material.
Theory is well explained and you get a lot of additional reading material.
I would like to see improved quality of the explanations in the video portion of the course. - Barbara Fasol18/01/23Headache Treatment in Clinical Practice A LOT OF INFORMATION!
a lot of good informations, articles.
A really good help to improve your comprehension and your practice
The only downside on this course was for some videos in the practice section, the sound wasn’t working (Comment from Physiotutors: This is intended like this). However, the videos were fairly straight forward without the sound so it was fine to understand the content, so it wasn’t much of an issue to have no sound.
For some section, it didn’t include the latest research but it’s difficult to constantly update the content of a course when new research is published everyday.
One very good point was the fact that the teacher critics some of the studies that were published so you feel that it’s not just reading the conclusion.Alice Dehout28/12/22Headache Treatment in Clinical Practice GOOD INSIGHT ON HEADACHE TREATMENT
First time doing a course with physiotutors.
I would say the content is very useful, interesting and up to date.
The only downside on this course was for some videos in the practice section, the sound wasn’t working (Comment from Physiotutors: This is intended like this). However, the videos were fairly straight forward without the sound so it was fine to understand the content, so it wasn’t much of an issue to have no sound.
For some section, it didn’t include the latest research but it’s difficult to constantly update the content of a course when new research is published everyday.
One very good point was the fact that the teacher critics some of the studies that were published so you feel that it’s not just reading the conclusion.Mathias28/11/22Headache Treatment in Clinical Practice QUALITY GUARANTEED
First time using Physiotutors; a very user friendly way of learning. An in depth theoretic background to start off with, before continuing to a more practical approach. After every chapter, you’re invited to do a little quiz and thus test yourself. Highly applicable course for your practice. - Anthony02/09/22GREAT LEARNING EXPERIENCE INFORMATIEVE CURSUS
First time doing a full online formation on a subject and it was amazing, great way to move through the different topics.
The assessment and quizz keeps you accountable and you have a great, practical tool that you can apply directly into your practice like next day in.
Highly recommendedIngeborg Dols-de Jonge16/02/22Headache Treatment in Clinical Practice INFORMATIEVE CURSUS
Leuke en interessante hoofdpijn cursus waarbij gebruik gemaakt wordt van up to date wetenschappelijke onderzoeken. Er wordt een mooie afwisseling gemaakt tussen theorie en praktijk. Na deze cursus kun je goed onderscheid maken tussen verschillende soorten hoofdpijn en weet je wat de beste behandelmethode is.Svein Inge31/01/22Headache Treatment in Clinical Practice QUALITY COURSE
I highly recommend this course. You will get many tips of articles who are relevant for diagnostic and treatment of the most common headaches and migraine. Castien is also a great teacher, and explain the stuff in a good way. He has also informative videos. - Azad Khan04/01/22Headache Treatment in Clinical Practice AN EXPERTS GUIDE THROUGH THE HEADACHE LANDSCAPE!
No better tutor than René Castien to introduce us to the fascinating field of the treatment rationale and possibilities for physio- and manual therapists. Uptodate, for so far as possible in this fast moving field, practical and with a good deal of treatment options that are both evidence based and with a good deal of clinical expertise. I thoroughly enjoyed the course and was pleasantly surprised by the clear and methodogical presentation of the material. I can highly recommend this course to any clinician engaged with or interested in the treatment of patients with headache. A no nonsense, applicable and practical course!Elisabetta12/12/21Headache Treatment in Clinical Practice DETAILED AND VERY INFORMATIVE
This course is ideal to expand one’s knowledge on headaches and how to effectively treat them.
The instructor is extremely knowledgeable and provides very practical information, easily applicable in the clinic.
I would highly recommend taking this course to anyone interested in becoming an expert at treating headaches.Dylan08/12/21Headache Treatment in Clinical Practice GREAT COURSE
Good didactic qualities of the teacher with clearly noticeable theoretical knowledge