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Abstract Pediatric chronic headaches are a common complaint and one of the primary reasons for seeking medical treatment. Headache medications have limited effects on children with chronic headaches. Few studies examined the effects of complementary alternative medicine (CAM) to optimize pain management in children with chronic headaches. The objective is to evaluate whether CAM [acupuncture, cognitive behavioral therapy (CBT), and biofeedback therapy (BFT)] reduces headache frequency and pain scores when used in addition to medications in children with chronic headaches. This was a retrospective review of electronic health records from September 2016-January 2020 to examine the effects of CAM. Inclusion criteria: children 10 to 18 years, diagnosis of chronic headaches, and received one or more CAM types. Demographics and clinical information related to headaches were collected (number of headaches per week, pain scores on 0-10 scale, and change in pain quality). Quantitative follow-up telephone surveys were conducted to evaluate the effectiveness and continued use of CAM. Descriptive statistics, Chi-square (categorical variables), Wilcoxon Signed Rank Test (ordinal comparisons) of headache frequency and pain quality and paired t-tests used to evaluate pain scores before and after CAM. Children (n=78; 14 2.4 years) were mostly female (81%), Hispanic (45%), and had chronic migraines (47%). Children received acupuncture (68%) or combined acupuncture and CBT (25%). Pain scores (n=40) were significantly different before (7.0 2.0) and after (2.53 3.1, p = 0.03) treatment. Children who received acupuncture (n=28) had a significant decrease in pain scores before (7.0 1.6) and after (1.8 1.6, p
Pediatric headache is the most common neurological complaint that presents to the general pediatrician, urgent care and emergency rooms, and to pediatric neurology. Despite how common headaches are in the pediatric population and how many children continue to suffer from their headaches on a daily basis, there remains a tremendous disconnect for those tasked with being the first-line providers (general pediatric providers). This stems from the fact that headache patients can be so variable and challenging, with numerous comorbid concerns, all the while requiring an individualized treatment approach without a cure. The purpose of this proposed book is to help foster a better understanding of how to approach, assess, and ultimately treat pediatric headache for the general pediatric provider in an attempt to make what once was a daunting, overwhelming complaint from patients and their families into something each general pediatric provider can conquer with confidence. With the aid of experts in the field of pediatric headache, this book will begin by providing the foundation as to what types of headaches, primary and secondary as well as their precursors, are commonly seen in the pediatric population. From there, the focus will turn to when should the provider worry about a patient who presents with headaches. The clinic visit -- from the history to the “red flags” to the pertinent exam -- will be reviewed in depth to help distinguish between primary and secondary headaches as well as who warrants an evaluation. Additionally, comorbid concerns will be covered as these may have direct impact on the evaluation and subsequent treatments offered. The next section will delve into the treatment of pediatric headache with a comprehensive approach covering everything from lifestyle to complementary and alternative therapies/treatments, to medications, both acute and prophylactic. Other more specialized treatment options such as procedures and devices will also be discussed albeit these options are more likely to be offered by a specialist rather than a general provider. A subsequent section will highlight the unique challenges for the older adolescent patients as they transition into young adulthood. The closing section will highlight the future of pediatric headache.
This practical and comprehensive title provides illuminating, evidence-based approaches in headache medicine for using traditional medical therapies in conjunction with alternative approaches to care. In all, the book details how multidisciplinary management and the combination of conventional and complementary medical services – integrative medicine – leads to superior patient outcomes: improved patient satisfaction, reduced stress, and more readily treatable, less serious illness. State-of-the-art and developed by experts in their fields, these 12 chapters present research and analysis of a wide range of non-pharmacologic interventions in headache care, seeking to inspire clinicians to formulate personalized headache treatment plans, and to work together by integrating their expertise in a multidisciplinary context to address patients’ unique conditions, needs, circumstances, and treatment. Chapter one provides an overview of integrative medicine and proposes a step-wise approach for incorporating integrative modalities into a headache practice. Chapter two focuses on the attention to be paid to relevant aspects of a patient’s medical history. The next four chapters discuss lifestyle factors that play a role in headache, including trigger identification, exercise, nutrition, and sleep. The scope of mind-body therapies such as acupuncture, yoga, and mindfulness is explored in chapter seven, and the psychology of pain is the subject of chapter eight. Chapter nine investigates the safety and efficacy of nutraceuticals, or pharmaceutical alternatives. The final three chapters review neuromodulation and interventional approaches to headache management. An invaluable and timely contribution to the clinical literature, Integrative Headache Medicine – An Evidence-Based Guide for Clinicians will be of great interest to neurologists, pain physicians, primary care clinicians, behavioral psychologists, psychiatrists, physical therapists, social workers, nutritionists and any other health professionals interested in delivering the highest quality care for headache patients.
Based on careful analysis of burden of disease and the costs ofinterventions, this second edition of 'Disease Control Priorities in Developing Countries, 2nd edition' highlights achievable priorities; measures progresstoward providing efficient, equitable care; promotes cost-effectiveinterventions to targeted populations; and encourages integrated effortsto optimize health. Nearly 500 experts - scientists, epidemiologists, health economists,academicians, and public health practitioners - from around the worldcontributed to the data sources and methodologies, and identifiedchallenges and priorities, resulting in this integrated, comprehensivereference volume on the state of health in developing countries.
This book assists appropriate headache assessment and decision-making in pediatrics. It covers many aspects and causes of headache disorders in children and adolescents using case studies to illustrate important points in history, examination, diagnosis, choice of management approach, therapy selection, and communication of the most helpful advice to the child and parents. Case studies have been taken from real clinical practice and presented in a consistent style. They are discussed by the authors to highlight important points in history, important positive and negative points in examination, the diagnosis, and full analysis and justification of treatment options. Headache in Children and Adolescents: A Case-Based Approach is an ideal reference for primary care physicians, paediatricians, neurologists and paediatric neurologists in their daily practice, in their consulting rooms and wards.
Tourette syndrome (TS) has become increasingly recognised within society and has gained scientific interest worldwide. Knowledge of its clinical presentation, mechanisms of disease, and available treatment approaches has increased remarkably over the last two decades. Likewise, the way clinicians, teachers, social care workers, and families face the problems manifested by patients with TS is rapidly evolving. Tourette Syndrome, edited by Davide Martino and James F. Leckman, offers a unique opportunity to capture this knowledge advance through a comprehensive and up-to-date overview. Tourette Syndrome covers all the main aspects related to TS, analyzing its complex clinical presentation, the novel viewpoints of causes and mechanisms, state-of-the-art assessment techniques, and the diversity of treatment options. Multidisciplinarity is the main asset of this volume, which represents a source of consultation for a wide audience of professionals, integrated with video tutorials related to particularly complex areas of patient management. Medical and PhD students, as well as post-doctoral scientists, will be able to use the volume as a valuable learning source.
Integration of complementary and alternative medicine therapies (CAM) with conventional medicine is occurring in hospitals and physicians offices, health maintenance organizations (HMOs) are covering CAM therapies, insurance coverage for CAM is increasing, and integrative medicine centers and clinics are being established, many with close ties to medical schools and teaching hospitals. In determining what care to provide, the goal should be comprehensive care that uses the best scientific evidence available regarding benefits and harm, encourages a focus on healing, recognizes the importance of compassion and caring, emphasizes the centrality of relationship-based care, encourages patients to share in decision making about therapeutic options, and promotes choices in care that can include complementary therapies where appropriate. Numerous approaches to delivering integrative medicine have evolved. Complementary and Alternative Medicine in the United States identifies an urgent need for health systems research that focuses on identifying the elements of these models, the outcomes of care delivered in these models, and whether these models are cost-effective when compared to conventional practice settings. It outlines areas of research in convention and CAM therapies, ways of integrating these therapies, development of curriculum that provides further education to health professionals, and an amendment of the Dietary Supplement Health and Education Act to improve quality, accurate labeling, research into use of supplements, incentives for privately funded research into their efficacy, and consumer protection against all potential hazards.
Most of the variables suggestive of hypnotic responsiveness in the adult have their precursors in the creative, affective, and play experiences of youngsters. This remarkable book explores the fascinating gifts of imagery and natural trance that seem almost organic to childhood ? and their immense therapeutic potential. Sixteen specialists describe in lucid, accessible terms the current state of their diverse clinical work and thinking: theoretical foundations; assessments of the presenting problems, associated etiologies, and corresponding approaches; the intervention process; and future trends in treatment. Among the topics covered are hypnotic strategies for different developmental stages; treatment for a variety of habit disorders; treatment of childhood traumas, motor and vocal tics, somatoform disorders, and learning disorders; and the use of hypnosis for the management of chronic nausea and vomiting and acute and chronic pain.
An essential survival guide for parents whose children suffer with persistent and often debilitating pain Approximately ten million children are living with chronic pain. Most people would be surprised at such numbers, but for the parents of these children, the challenge of helping a pain-stricken child live a normal life is a frightening and frustrating reality. Chronic pain in children can manifest as abdominal, migraine, or facial pain. It also stems from a wide variety of disorders such as juvenile rheumatoid arthritis, cystic fibrosis, hemophilia, and childhood cancers. No matter what type of chronic pain the child suffers with, a parent must be armed with an understanding of how a child's expression and experience of pain differs from an adult's. Trained in pediatric anesthesia and intensive care at Boston Children's Hospital, Dr. Elliot Krane has devoted his entire professional life to refining and innovating techniques, strategies, and therapies to relieve the suffering of children with pain. In his book, Relieve Your Child's Chronic Pain, parents will find the information and tools they need to get the very best care for their child. It will help you: Recognize, measure, and evaluate your child's pain properly Learn about the many alternative pain-management approaches that can be used at home Dispel fears about addiction if your child is prescribed a narcotic Find an appropriate pain-management clinic for your child Reduce the stress and anxiety in the home in a way that benefits the entire family You may not always be able to eliminate chronic pain entirely, but you can succeed in minimizing your child's suffering.
This comprehensive, practical title invites all clinicians to take a fresh look at the evaluation and management of chronic daily headache (CDH). Developed by a distinguished international panel of experts, the book examines key social and economic issues around CDH and clarifies the diagnosis of CDH disorders, providing an understanding of the underlying biological substrates, offering guidance on the use of diagnostic testing and additional consultations, and outlining treatment strategies with the greatest potential to alleviate the burden of these patients and to provide the highest quality of care. The book fully examines the constellation of symptoms that constitute chronic daily headache, while also discussing the role of behavioral medicine and the important elements involved in taking a good history. The major forms and biology of chronic daily headache are covered, as is the role of diagnostic testing and treatment. The risk factors that lead patients to transform episodic primary headache disorders into the chronic form are examined. Invasive and neuromodulatory techniques are also discussed. A section on the classification of these disorders rounds out this important contribution to the literature. Chronic Headache – A Comprehensive Guide to Evaluation and Management will be of great interest to neurologists, primary care physicians, nurse practitioners, physician assistants, medical students, and other clinicians with an interest in chronic daily headache.