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Migraine, headache treatment does not resolve pain for some teenage patients
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PHILADELPHIA — Some teenagers with concussion-triggered chronic headache or migraine experienced prolonged pain, suffering and lack of function even after they were considered treated, according to study findings presented at the American Headache Society Scientific Meeting.
“We have seen athletes who suffer a concussion give up sports because they were concerned of the long-term impact such a hit would have,” Marcus Barissi, of the Cleveland Clinic pediatric neurology department told Healio Primary Care. “We wanted to see if these concerns were valid.”
He and A. David Rothner, MD, also of the Cleveland Clinic pediatric neurology department, spoke to 33 pediatric patients who said they never had a headache until their concussion, and then shortly thereafter, started to experience chronic headache or migraine.
Researchers found that after these patients received headache-related treatment, 53% did not drink enough water, 50% did not get enough exercise, 42% used too many over-the-counter medications and 33% did not get enough sleep.
In addition, some of the patients who overused OTC medications were more likely to retain headache-related symptoms than those who did not, had Migraine Disability Assessment Questionnaire, or MIDAS, scores that increased and consistently reported being unable to function to 50% of their ability.
“The nature of what caused the concussion ranged from involvement in a serious car accident to hitting their bed’s headboard. But regardless of what caused the concussion, there was no effect on the intensity or length of their headaches. So, it’s likely that it was not so much how hard their head got hit but the level of treatment they receive that caused those prolonged effects,” Barissi said in the interview.
He added that primary care physicians with patients who experience concussion and then, 3 months later, still have headache pain and/or have MIDAS score of 6 or higher should acknowledge that those are signs that their patient is still in pain.
“These PCPs need to recognize that these patients’ quality of life is unnecessarily going down [and] also need to realize that the older concussion and headache treatments often take longer to work and can have unpleasant side effects,” he told Healio Primary Care.
“Therefore, these clinicians should refer patients with prolonged headache to concussion specialists or neurologists who have the most up-to-date information and tools to properly diagnose the condition, which in turn will help ensure proper treatment.” – by Janel Miller
Disclosures: Healio Primary Care was unable to determine the authors’ relevant financial disclosures prior to publication.