Cefaleas: un buen diagnóstico es primordial

The doctor. Láinez is a neurologist specialized in the treatment of pathologies such as headaches, migraines or Alzheimer's. In this article, he explains what are the factors that headaches develop and the most effective treatments to combat them.

The most frequent headaches are migraine headache, tension headache and cluster headache. The diagnosis of headaches is essentially clinical. A good history and a neurological examination are enough to establish a correct diagnosis. Explorations such as CT or MRI are only necessary when a secondary pathology is suspected.

The treatment begins with an appropriate diagnosis. Surprisingly, among the patients we see in neurology clinics, there is still a significant percentage without proper diagnosis and treatment. Along with medical treatment it is recommended to avoid the factors that trigger the crisis, especially stress. Food plays an important role in a limited number of patients, therefore global food prohibitions should not be given to all patients when in many of them they do not have any relevance; A good example would be chocolate.

Medical treatment combines acute treatment to fight crises when they appear and preventive treatment to reduce the number of crises when they are very frequent. In migraine, the acute treatments with greater effectiveness are the NSAIDs and triptans, and as preventive topiramate or betabloquenates. In botulinum toxin, botulinum toxin is very useful.

The treatment must be individualized for each patient according to the characteristics of their crisis. At present, in the reference units, studies with very promising results are carried out with neuro-stimulators and monoclonal antibodies