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Should GPs have a different approach to assessing headaches during the pandemic? Advice from a GPwSI in headache and migraine PLEASE NOTE: THIS IS NO LONGER RELEVANT AND IS NOT BEING UPDATED BUT HAS BEEN LEFT ON THE SITE FOR REFERENCE PURPOSES ONLY This information is sourced�from�Dr Marcus Lewis�GPwSI in headache and mig ... Date: 07-07-2020 Categories:
What GPs need to know about recovery after Covid-19 infection ... provides information for GPs on post-Covid low mood. Should GPs have a different approach to assessing headaches during the pandemic? A guide from a GP with specialist interest in headache and migraine, giving a summary of advice for GPs to best support patients. Chronic kidney disease On this page is a summary of the NICE Covid-19 rapid guideline on chronic kidney disease, with information o ... Date: 04-05-2021 Categories:
Key questions on oral contraception (1.5 hours) ... mage with abnormal LFTs.4POPs are particularly suited to:� breast-feeding women � women who have risk factors that rule out, or lead to side-effects with, oestrogen-containing methods� women who have migraine with aura � women who have blood-pressure problems on the COC pill� women with <\|><<\|>A<\|> <\|>T<\|>A<\|>R<\|>G<\|>E<\|>T<\|>=<\|>"<\|&g ... Date: 10-02-2010 Categories: • Women's health, gynaecology and obstetrics
Vestibular migraine In this new series, GPs will take you through a case history and associated details of a fascinating but often unrecognised disorder. To kick the series off, Dr Keith Hopcroft outlines vestibular migraine � or migrainous vertigoThe caseA 45-year-old male complains of recurrent episodes of vertigo. You see from his notes that these have been attributed to viral labyrinthitis or possible benign position ... Date: 12-02-2010 Categories:
I, Doctor ... vin Hinkley begins his surreal series 'Through the K hole', offering a sideways look at life in general practice.She returned early from her shift at the hospital where she worked as a registrar. Her migraine had started dully at first, a seed above her left eye which had now blossomed and was sending flashing scintillations across her forehead. Thick, sluggish waves of peristaltic pain radiated from her ... Date: 01-03-2010 Categories: • K Hole • Practice and personal finance
Five-year MOT for GPs launched, ban threat over vaccines and Chinese medicine undercover ... r operation to find out just what it takes to get a herbalist to refer a patient to their GP.Quite a bit, according to the investigation. The Mail reporters visited ten clinics complaining of classic migraine symptoms. �Under official guidelines a pharmacist would send you to a GP to investigate but just one of our group did so,' it found, as well as revealing some enormous charges for �cures'.Spotted a s ... Date: 02-03-2010 Categories:
A 'pain zapper' for headaches, the overhaul of practice boundaries begins and the man caught between a doc and a hard place ... raight. The inside of my nose hurts when I breathe, and if I'm out in the cold air too long I get a piercing pain on the right side of my skull.I've Googled it and apparently it's either sinusitis, a migraine or a brain tumour. So I've turned to today's Daily Digest as a cry for help. To those of you gainfully employed as GPs, I'd like your advice on whether I should consider buying a �pain zapper' that d ... Date: 04-03-2010 Categories:
The lessons from my father's death for the future of out-of-hours care ... ft, Dr Ubani was heavily criticised by the pathologist and an out-of-hours expert for his treatment of a patient who had suffered an MI who subsequently died and he failed to admit to hospital, and a migraine sufferer who he gave a diuretic injection to who did end up in hospital. The next day a nurse in the clinic he was working at was so concerned about his abilities she phoned her superiors. Dr Ubani w ... Date: 04-03-2010 Categories:
Hemicrania continua ... onstriction or ptosis. The textbook definition requires the headache to have continued for at least three months. It is much more common in women and has no obvious triggers.The differential includes migraine, cluster headache, temporomandibular joint pain and atypical facial pain.TreatmentThis condition has an idiosyncratic response to indomethacin. In fact, some authorities view complete resolution of t ... Date: 24-03-2010 Categories:
Spinal manipulation 'has benefits for back pain and migraine' By Mark PownallSpinal manipulation techniques such as osteopathy, chiropractic, massage and physiotherapy are effective in treating acute and chronic low back pain, migraine and some headaches, a review concludes.The review, commissioned by the General Chiropractic Council and conducted by US and Canadian researchers, also supported use of manipulation in hip and knee os ... Date: 13-04-2010 Categories: • Musculoskeletal, rheumatology and sports medicine
Civil servant's �1bn expenses, DVT link to prostate cancer, and Viagra for women moves a step closer ... ows men with prostate cancer are at greater risk of potentially fatal blood clots. Elsewhere, new Cochrane research � reported in the Mail - suggests that aspirin is the best way of combating painful migraines. The Mirror reports that a young child with leukaemia was misdiagnosed as having trapped wind by a foreign doctor working at an out-of-hours service.The Mail is in a particularly cheerful mood today ... Date: 14-04-2010 Categories:
Addictive killer sunbeds, the 20 pint night out; the migraine patient who can�t stop talking Chinese ... s about, after the Government decision to shelve the accelerated rollout of the scheme, they now face the wrath of Daily Mail readers too.Most bizarre story of the day without question is that of the migraine sufferer who has developed the rare Foreign Accent Syndrome, which somehow seems even more sinister when written about in the Daily Mail.Sarah Colwill is now having speech therapy to try to get her D ... Date: 20-04-2010 Categories:
Ten tips on managing dizziness ... M�ni�re's disease lasts at least 20 minutes but not more than 24 hours. Acute dizziness that can take days to subside points toward acute labyrinthitis or vestibular neuronitis. However, veritiginous migraine can straddle all these timelines.3 Think migraine. Up to 20% of migraine patients have dizziness. We all see and diagnose migraine, but rarely associate dizziness with migraine. The important poin ... Date: 18-05-2010 Categories:
Babies born a week early at higher risk; NHS trust clamps 1,700 cars in one year; and it�s official, man flu does exist. ... it. Nice work if you can get it.And man flu exists!, shouts the Mail excitedly. The paper can't wait to tell us the news that half of men will upgrade a common cold to flu and describe headaches as a migraine to gain maximum sympathy. No mention of whether symptoms are particularly acute during the World Cup though�Spotted a story we've missed? Let us know, and we'll update the digest throughout the day.D ... Date: 09-06-2010 Categories:
Rational management of opticians' letters ... on a regular basis, usually annually, with this photograph to hand. It does not matter whether this is done in a hospital setting or by the optician as long as change can be recognised.41267805Ocular migraine is the experience of visual symptoms caused by underlying migrainous pathology. The episodes are usually typical and not necessarily accompanied by a headache. The history is often an individual havi ... Date: 12-08-2010 Categories: • Ear nose and throat and ophthamology
Ophthalmology referral dilemmas ... to be referred quickly to neurosurgery.Transient visual lossThis is a common clinical scenario encountered in ophthalmology and there are two main diagnoses to tease out � amaurosis fugax and ocular migraine. Both are neurological in cause, but are nevertheless routinely dealt with in ophthalmology departments.While the description of transient visual loss incorporates both conditions there are clear dif ... Date: 12-08-2010 Categories: • Ear nose and throat and ophthamology
Key learning points - ophthalmology ... ons are important findings - ranging from an insignificant pigment spot to a dark, relatively large area.These are usually innocent but a choroidal naevus has the potential to become malignant.Ocular migraine episodes are usually typical and not necessarily accompanied by a headache.Posterior vitreous detachment is extremely common and usually experienced by patients in late middle age or earlier in myopi ... Date: 12-08-2010 Categories: • Ear nose and throat and ophthamology
What are the sore, red lesions on this woman's legs? ... st after a hot weekend, and were sore rather than itchy. She had tried antihistamines but the lesions seemed to be getting worse rather than better.She had no relevant past medical history other than migraines, for which she took occasional ibuprofen. No other symptoms were volunteered, apart from her feeling a bit below par � which, still in self-diagnosis mode, she attributed to the antihistamines she h ... Date: 13-08-2010 Categories: • Dermatology and wound care
Ten tips on managing chronic headache Headache specialist Dr Andy Dowson provides hints on managing headache and identifying which patients to refer.1 Apart from chronic migraine, chronic tension-type headache (cTTH) is the most common type seen in primary care. Cluster headache is the less common, but has characteristic diagnostic features. Other forms of chronic headache ar ... Date: 13-08-2010 Categories: • Neurology
Migraine 'increases risk of mortality' By Neha Pathakmigraines with auras increase overall as well as cardiovascular mortality rates, according to Icelandic researchers.Researchers evaluated 18,725 migraine patients born between 1907 and 1935 over a 26-year fol ... Date: 31-08-2010 Categories: • Neurology
A 74 year old man with acute onset visual symptoms ... ce A) is characterized by the presence of a flickering spot, followed by a spreading arc of flashing lights that prevents vision within the scotoma. Its pathophysiology puts it within the spectrum of migraine syndromes (it is a type of acephalgic migraine). As with amaurosis fugax�but again, unlike the syndrome in this man�the symptoms of scintillating scotoma are transient; they almost always pass within ... Date: 02-09-2010 Categories: • Ear nose and throat and ophthamology
How to undo a dodgy diagnosis ... he diagnosis was palpably wrong. And I am only a Jobbing GP. I set to work on undiagnosing her. That took months. She is off all the unnecessary medicine, and I am now treating her for her hemiplegic migraine.She is relieved that the sword of Damocles has been removed from above her head. She did reapply for insurance, and was turned down a second time. Maybe the medical officer preferred to believe a dod ... Date: 13-09-2010 Categories: • Uncategorised
New prostate cancer test, how Facebook can 're-wire your brain', and the worst case of Foreign Accent Syndrome since 'Allo 'Allo ... ests itself in unhealthy stalking of ex-partners and people you went to school with, but we have our suspicions. Elsewhere, page 19 of The Mail carries the wonderful headline of �I went to bed with a migraine and woke up with a French accent'. We've all been there, haven't we..?Kay Russell, 49, has been diagnosed Foreign Accent Syndrome, which - contrary to popular belief - isn't a new disease dreamt up ... Date: 15-09-2010 Categories:
Venturing beyond the prescription pad ... given. A double blind placebo controlled crossover trail of magnesium in PMT demonstrated reduced swelling of extremities, mastalgia and abdominal bloating. Magnesium can also be useful for menstrual migraine and uterine cramps. Magnesium can be found in green leafy vegetables, tofu, legumes, nuts, seeds, and whole grains, as well as many multivitamin preparations.Vitamin B6 and evening primrose have been ... Date: 20-09-2010 Categories: • Women's health, gynaecology and obstetrics
Come on in, the gate�s open ... by a headache, needs urgent referral to TIA clinic, please oblige.' Which obviously begs the response: �Fuckwit case officer with acute knowledge deficiency, requires urgent attendance at lecture on migraine with aura � please oblige or start stacking shelves.'But this one really took the HobNob, and I promise I'm not making it up � a letter from an optician stating: �Patient has ingrowing eyelash causin ... Date: 04-10-2010 Categories: • Copperfield
Difficult pain scenarios ... uld be requested only on the basis of specific findings on history or examination, or on results from first-line tests.ManagementIf no organic disease � such as IBS, IBD, coeliac disease or abdominal migraine � is found it's better to try to make a positive diagnosis of functional abdominal pain rather than use it as a �catch-all' term for abdominal pain in which all investigations are negative. There is ... Date: 06-10-2010 Categories: • Gastroenterology and obesity • Musculoskeletal, rheumatology and sports medicine • Paediatrics • Renal medicine, urology and men's health • Women's health, gynaecology and obstetrics
Complementary therapies and chronic pain ... back pain. But the authors noted there was no evidence it was more effective than other active therapies.3A 2009 Cochrane review suggested that acupuncture was at least as effective as medication at migraine prophylaxis4 while another review from the same year showed that it could have some benefit for people with frequent episodic or chronic tension headaches.5There is some evidence that acupuncture may ... Date: 06-10-2010 Categories:
Complex regional pain syndrome ... esidual limb dysfunction prevents most people from going back to their jobs � in fact even after six years, only 30% do. The CRPS aetiology is not well understood. It is associated with osteoporosis, migraine, asthma and ACE-inhibitor use but not with preceding psychological problems.1 Certain unusual features, such as a fluctuating inability to move the affected hand or foot, have led to suggestions it i ... Date: 06-10-2010 Categories:
Long-term tricyclic use beneficial for migraine By Nigel PraitiesA tricyclic antidepressant becomes a more effective treatment for migraine and tension headache the longer it is used, a new analysis concludes.US researchers carried out a meta-analysis of 37 studies comparing tricyclics with other antidepressants and placebo.Tricyclics ha ... Date: 01-11-2010 Categories: • Long-term conditions and prescribing • Neurology
Tricyclic antidepressants 'raise cardiovascular risk' ... ow in epidemiology and public health at University College London told Pulse GPs should consider switching any patient on tricyclics to an alternative.�Tricyclics are also quite widely for headaches, migraines and other kinds of neurological pain. But the increased risk was not specific to what patients were being treated for. If there is an alternative option our data suggests GPs should look at it,' he ... Date: 01-12-2010 Categories: • Mental health, pain and addiction • Musculoskeletal, rheumatology and sports medicine
Orgasmic disorders in men ... in the occipital/cervical region. � Coital cephalgia occurs more suddenly at the point of orgasm, is more severe and generalised, lasting around 20 minutes. It is more common in men with a history of migraine and is thought to be associated with a temporary rise in blood pressure and may be due to vasoconstriction. � Late coital cephalgia occurs after sexual activity and tends to last for hours, often dev ... Date: 08-12-2010 Categories: • Renal medicine, urology and men's health
Symptom sorter on recurrent abdominal pain in children ... nderlying cause in the most persistent cases is usually non-organic.Differential diagnosisCommon� Recurrent viral illnesses� Anxiety and depression � sometimes known as periodic syndrome or abdominal migraine� Recurrent UTI� Constipation� Gastritis and GORD.Occasional� Crohn's and coeliac disease� Duodenal ulcer� Irritable bowel syndrome� Diabetes � Henoch-Schonlein purpura� Hydronephrosis, renal stones a ... Date: 26-01-2011 Categories: • Gastroenterology and obesity • Paediatrics
A GP guide to neurological referrals ... mal (pituitary) mass lesions. Abrupt, transient, painless monocular visual loss � amaurosis fugax � is a form of TIA and should be managed as such, though the prognosis is better than for other TIAs. migraine visual aura is normally easily recognised, though if definitely monocular, can be confused with retinal detachment. Formed visual hallucinations are largely neurological. They occur in toxic confusio ... Date: 11-05-2011 Categories: • Neurology
Newer antiepileptic drugs not linked to birth defects ... or any major birth defects after exposure to any newer-generation antiepileptic drugs during the first trimester were not statistically different for mothers with epilepsy, mood affective disorder or migraine, or without a diagnosis.' JAMA. 2011;305(19)1996-2002The incidence of birth defects was no higher in babies exposed to AEDs than controls Date: 26-05-2011 Categories: • Long-term conditions and prescribing • Neurology
Tory rebellion on NHS reforms, migraine genetic link found, and why longer A&E waiting times may kill Our round-up of the health headlines on Monday 13 June. With Professor Steve Field's report for the NHS Future Forum due out today, prime minister David Cameron has called an emergency meeting of 143 recently ... Date: 13-06-2011 Categories:
NHS spends billions on expats, should hospitals be allowed to fail and the ultimate wedding gift - organ donation ... and women out there hoping to banish a few wrinkles in the quest to look ten years younger, you're about become extremely jealous. The Daily Telegraph reports that neurologists who treat sufferers of migraines say Botox injections can help people who suffer chronic attacks. They are pushing for it to be offered on the NHS, which means there could be a lot more glamorous grannies and freshened up thirty-ye ... Date: 11-07-2011 Categories:
School guidelines for headaches The RCGP has created a guideline document for schools dealing with headaches and migraine in its pupils. Schools need to develop policies for health problems in the light of their statutory responsibilities and their own assessment of local needs and resources. Extensive guidance to dev ... Date: 17-10-2011 Categories: • Neurology • Paediatrics
Opioids 'not effective' treatment for sciatica ... nt for sciatica, despite being widely used for the condition, an NHS health technology assessment has found. Related articles Spinal manipulation 'has benefits for back pain and migraine' Exercise programmes for patients with low mechanical back pain The review of 270 studies, shortly due to be published in full online, found surgery, epidural steroid injections and ... Date: 22-11-2011 Categories: • Long-term conditions and prescribing • Mental health, pain and addiction • Musculoskeletal, rheumatology and sports medicine
Headache patients 'should drink more water' ... ntervention group, in addition to this, had instructions to increase their daily water intake by 1.5 litres. At three-month follow-up, the intervention group had an improvement of 4.5 points on the migraine-Specific Quality of Life questionnaire and some 47% reported an improvement of six or higher on a 10-point scale, compared with 25% in the control group. But drinking more water had no effect on the ... Date: 01-12-2011 Categories: • Neurology
Acupuncture associated with 'minor' improvements in migraine Patients receiving acupuncture have fewer days with migraine, but the effects of the intervention on migraine frequency and quality of life is 'minor' compared with sham acupuncture, say researchers. Related articles Acupuncture 'an option ... Date: 12-01-2012 Categories: • Neurology
'Indefensible' tax arrangements at the DH, consultant concerns over hospital care, Botox on the NHS? ... uent shift changes. The RCP has set up a commission to investigate the falling standards of care in hospitals called The Future Hospital to be chaired by Sir Michael Rawlins, current chair of NICE. migraines could soon be treated with a dose of Botox after the results of a clinical trial have suggested that the anti-wrinkle drug can halve the effects of chronic migraine, the Mail claims this morning. ... Date: 16-02-2012 Categories:
A tale of two news stories: how to cure an ice cream headache and the hidden camera that found a care home to be less than caring ... lts showed that the pain coincided with an artery called the anterior cerebral artery opening up and flooding the brain with blood.' It is hoped that these findings will lead to better treatments for migraines. The BBC website tells of a �miniature honeycomb - or scaffold [that] could one day be used to encourage damaged nerves to grow and recover, according to an international group of researcher ... Date: 23-04-2012 Categories:
The pharma industry must not dictate GMC drug policy ... about their use of medicines, but there is no getting round prescribing off-label from time to time. One in 10 of the drugs GPs prescribe to children is outside its licensed indication, the standard migraine drug amitriptyline doesn't have a licence for that purpose and prescribing of SSRIs off-label is recommended by NICE. Related articles GPs face clampdown on off-label prescribing ... Date: 24-04-2012 Categories: • Long-term conditions and prescribing
ENT clinic - Ramsay Hunt syndrome �CaseA 51-year-old woman presented to her GP with a three-day history of gradually increasing left-sided head pain.She was being treated for hypertension and also used a triptan to control her migraine. But she insisted this head pain was different, especially in the way it radiated out to her ear.Examination revealed a reddened, swollen right external auditory canal with a normal tympanic membrane ... Date: 27-04-2012 Categories: • Ear nose and throat and ophthamology
�Modest� effect of botox injections on migraine prevention Botox injections show �small to modest' benefits in preventing migraine and headache, say US researchers. Date: 30-04-2012 Categories:
Botox for headaches, contraception and a 'nation of sleeping pill addicts' NICE has reversed its previous guidance and has given the go ahead for the use of botox to treat migraines. Chronic migraine sufferers could be given a 12 week course of botox injections in their head and neck if they don't respond to three other treatments first � at a cost of around �350 per patient. ... Date: 11-05-2012 Categories:
Physiotherapists and complementary therapies ... ; Incontinence · Infant disorder including colic, sleeping, feeding, speech, ear and behavioural problems · migraine and headache · Neurological conditions including Parkinson's disease, Bells Palsy and Cerebral Palsy · Pain · &nb ... Date: 25-08-2012 Categories: • Uncategorised
We rely on self-prescribing ... , there must no more dipping of our sticky paws into the emergency bag for an occasional omeprazole capsule after a night out on the town, a tasty wafer-based triptan to deal with a heartsink-induced migraine or even half a dozen trimethoprim tablets for the girlfriend’s cystitis. The Medical Defence Union puts it this way: ‘Of seven cases involving a prescription for antibiotics, there was a ... Date: 27-08-2012 Categories: • Copperfield • Uncategorised
Letters from general practice Over the years, medicine has given me a lot, particularly migraine and a duodenal ulcer. It’s time to give something back. So, as a service to GPs, I’ve written some letter pro formas which you can photocopy and adapt as you see fit. I know you’ll ... Date: 29-08-2012 Categories: • Copperfield • Uncategorised
GPs should use triptans first-line for acute migraine, says NICE GPs should prescribe a triptan, in combination with NSAIDs or paracetamol, first-line in patients with acute migraine, recommend NICE guidelines published today. Related articles Key questions on migraine (1.5 CPD hours) Headache patients 'should drink more water' The guidance ... Date: 19-09-2012 Categories:

Should GPs have a different approach to assessing headaches during the pandemic? Advice from a GPwSI in headache and migraine PLEASE NOTE: THIS IS NO LONGER RELEVANT AND IS NOT BEING UPDATED BUT HAS BEEN LEFT ON THE SITE FOR REFERENCE PURPOSES ONLY This information is sourced�from�Dr Marcus Lewis�GPwSI in headache and mig ... Date: 07-07-2020 Categories:

What GPs need to know about recovery after Covid-19 infection ... provides information for GPs on post-Covid low mood. Should GPs have a different approach to assessing headaches during the pandemic? A guide from a GP with specialist interest in headache and migraine, giving a summary of advice for GPs to best support patients. Chronic kidney disease On this page is a summary of the NICE Covid-19 rapid guideline on chronic kidney disease, with information o ... Date: 04-05-2021 Categories:

Key questions on oral contraception (1.5 hours) ... mage with abnormal LFTs.4POPs are particularly suited to:� breast-feeding women � women who have risk factors that rule out, or lead to side-effects with, oestrogen-containing methods� women who have migraine with aura � women who have blood-pressure problems on the COC pill� women with <|><<|>A<|> <|>T<|>A<|>R<|>G<|>E<|>T<|>=<|>"<|&g ... Date: 10-02-2010 Categories: • Women's health, gynaecology and obstetrics

Vestibular migraine In this new series, GPs will take you through a case history and associated details of a fascinating but often unrecognised disorder. To kick the series off, Dr Keith Hopcroft outlines vestibular migraine � or migrainous vertigoThe caseA 45-year-old male complains of recurrent episodes of vertigo. You see from his notes that these have been attributed to viral labyrinthitis or possible benign position ... Date: 12-02-2010 Categories:

I, Doctor ... vin Hinkley begins his surreal series 'Through the K hole', offering a sideways look at life in general practice.She returned early from her shift at the hospital where she worked as a registrar. Her migraine had started dully at first, a seed above her left eye which had now blossomed and was sending flashing scintillations across her forehead. Thick, sluggish waves of peristaltic pain radiated from her ... Date: 01-03-2010 Categories: • K Hole • Practice and personal finance

Five-year MOT for GPs launched, ban threat over vaccines and Chinese medicine undercover ... r operation to find out just what it takes to get a herbalist to refer a patient to their GP.Quite a bit, according to the investigation. The Mail reporters visited ten clinics complaining of classic migraine symptoms. �Under official guidelines a pharmacist would send you to a GP to investigate but just one of our group did so,' it found, as well as revealing some enormous charges for �cures'.Spotted a s ... Date: 02-03-2010 Categories:

A 'pain zapper' for headaches, the overhaul of practice boundaries begins and the man caught between a doc and a hard place ... raight. The inside of my nose hurts when I breathe, and if I'm out in the cold air too long I get a piercing pain on the right side of my skull.I've Googled it and apparently it's either sinusitis, a migraine or a brain tumour. So I've turned to today's Daily Digest as a cry for help. To those of you gainfully employed as GPs, I'd like your advice on whether I should consider buying a �pain zapper' that d ... Date: 04-03-2010 Categories:

The lessons from my father's death for the future of out-of-hours care ... ft, Dr Ubani was heavily criticised by the pathologist and an out-of-hours expert for his treatment of a patient who had suffered an MI who subsequently died and he failed to admit to hospital, and a migraine sufferer who he gave a diuretic injection to who did end up in hospital. The next day a nurse in the clinic he was working at was so concerned about his abilities she phoned her superiors. Dr Ubani w ... Date: 04-03-2010 Categories:

Hemicrania continua ... onstriction or ptosis. The textbook definition requires the headache to have continued for at least three months. It is much more common in women and has no obvious triggers.The differential includes migraine, cluster headache, temporomandibular joint pain and atypical facial pain.TreatmentThis condition has an idiosyncratic response to indomethacin. In fact, some authorities view complete resolution of t ... Date: 24-03-2010 Categories:

Spinal manipulation 'has benefits for back pain and migraine' By Mark PownallSpinal manipulation techniques such as osteopathy, chiropractic, massage and physiotherapy are effective in treating acute and chronic low back pain, migraine and some headaches, a review concludes.The review, commissioned by the General Chiropractic Council and conducted by US and Canadian researchers, also supported use of manipulation in hip and knee os ... Date: 13-04-2010 Categories: • Musculoskeletal, rheumatology and sports medicine

Civil servant's �1bn expenses, DVT link to prostate cancer, and Viagra for women moves a step closer ... ows men with prostate cancer are at greater risk of potentially fatal blood clots. Elsewhere, new Cochrane research � reported in the Mail - suggests that aspirin is the best way of combating painful migraines. The Mirror reports that a young child with leukaemia was misdiagnosed as having trapped wind by a foreign doctor working at an out-of-hours service.The Mail is in a particularly cheerful mood today ... Date: 14-04-2010 Categories:

Addictive killer sunbeds, the 20 pint night out; the migraine patient who can�t stop talking Chinese ... s about, after the Government decision to shelve the accelerated rollout of the scheme, they now face the wrath of Daily Mail readers too.Most bizarre story of the day without question is that of the migraine sufferer who has developed the rare Foreign Accent Syndrome, which somehow seems even more sinister when written about in the Daily Mail.Sarah Colwill is now having speech therapy to try to get her D ... Date: 20-04-2010 Categories:

Ten tips on managing dizziness ... M�ni�re's disease lasts at least 20 minutes but not more than 24 hours. Acute dizziness that can take days to subside points toward acute labyrinthitis or vestibular neuronitis. However, veritiginous migraine can straddle all these timelines.3 Think migraine. Up to 20% of migraine patients have dizziness. We all see and diagnose migraine, but rarely associate dizziness with migraine. The important poin ... Date: 18-05-2010 Categories:

Babies born a week early at higher risk; NHS trust clamps 1,700 cars in one year; and it�s official, man flu does exist. ... it. Nice work if you can get it.And man flu exists!, shouts the Mail excitedly. The paper can't wait to tell us the news that half of men will upgrade a common cold to flu and describe headaches as a migraine to gain maximum sympathy. No mention of whether symptoms are particularly acute during the World Cup though�Spotted a story we've missed? Let us know, and we'll update the digest throughout the day.D ... Date: 09-06-2010 Categories:

Rational management of opticians' letters ... on a regular basis, usually annually, with this photograph to hand. It does not matter whether this is done in a hospital setting or by the optician as long as change can be recognised.41267805Ocular migraine is the experience of visual symptoms caused by underlying migrainous pathology. The episodes are usually typical and not necessarily accompanied by a headache. The history is often an individual havi ... Date: 12-08-2010 Categories: • Ear nose and throat and ophthamology

Ophthalmology referral dilemmas ... to be referred quickly to neurosurgery.Transient visual lossThis is a common clinical scenario encountered in ophthalmology and there are two main diagnoses to tease out � amaurosis fugax and ocular migraine. Both are neurological in cause, but are nevertheless routinely dealt with in ophthalmology departments.While the description of transient visual loss incorporates both conditions there are clear dif ... Date: 12-08-2010 Categories: • Ear nose and throat and ophthamology

Key learning points - ophthalmology ... ons are important findings - ranging from an insignificant pigment spot to a dark, relatively large area.These are usually innocent but a choroidal naevus has the potential to become malignant.Ocular migraine episodes are usually typical and not necessarily accompanied by a headache.Posterior vitreous detachment is extremely common and usually experienced by patients in late middle age or earlier in myopi ... Date: 12-08-2010 Categories: • Ear nose and throat and ophthamology

What are the sore, red lesions on this woman's legs? ... st after a hot weekend, and were sore rather than itchy. She had tried antihistamines but the lesions seemed to be getting worse rather than better.She had no relevant past medical history other than migraines, for which she took occasional ibuprofen. No other symptoms were volunteered, apart from her feeling a bit below par � which, still in self-diagnosis mode, she attributed to the antihistamines she h ... Date: 13-08-2010 Categories: • Dermatology and wound care

Ten tips on managing chronic headache Headache specialist Dr Andy Dowson provides hints on managing headache and identifying which patients to refer.1 Apart from chronic migraine, chronic tension-type headache (cTTH) is the most common type seen in primary care. Cluster headache is the less common, but has characteristic diagnostic features. Other forms of chronic headache ar ... Date: 13-08-2010 Categories: • Neurology

Migraine 'increases risk of mortality' By Neha Pathakmigraines with auras increase overall as well as cardiovascular mortality rates, according to Icelandic researchers.Researchers evaluated 18,725 migraine patients born between 1907 and 1935 over a 26-year fol ... Date: 31-08-2010 Categories: • Neurology

A 74 year old man with acute onset visual symptoms ... ce A) is characterized by the presence of a flickering spot, followed by a spreading arc of flashing lights that prevents vision within the scotoma. Its pathophysiology puts it within the spectrum of migraine syndromes (it is a type of acephalgic migraine). As with amaurosis fugax�but again, unlike the syndrome in this man�the symptoms of scintillating scotoma are transient; they almost always pass within ... Date: 02-09-2010 Categories: • Ear nose and throat and ophthamology

How to undo a dodgy diagnosis ... he diagnosis was palpably wrong. And I am only a Jobbing GP. I set to work on undiagnosing her. That took months. She is off all the unnecessary medicine, and I am now treating her for her hemiplegic migraine.She is relieved that the sword of Damocles has been removed from above her head. She did reapply for insurance, and was turned down a second time. Maybe the medical officer preferred to believe a dod ... Date: 13-09-2010 Categories: • Uncategorised

New prostate cancer test, how Facebook can 're-wire your brain', and the worst case of Foreign Accent Syndrome since 'Allo 'Allo ... ests itself in unhealthy stalking of ex-partners and people you went to school with, but we have our suspicions. Elsewhere, page 19 of The Mail carries the wonderful headline of �I went to bed with a migraine and woke up with a French accent'. We've all been there, haven't we..?Kay Russell, 49, has been diagnosed Foreign Accent Syndrome, which - contrary to popular belief - isn't a new disease dreamt up ... Date: 15-09-2010 Categories:

Venturing beyond the prescription pad ... given. A double blind placebo controlled crossover trail of magnesium in PMT demonstrated reduced swelling of extremities, mastalgia and abdominal bloating. Magnesium can also be useful for menstrual migraine and uterine cramps. Magnesium can be found in green leafy vegetables, tofu, legumes, nuts, seeds, and whole grains, as well as many multivitamin preparations.Vitamin B6 and evening primrose have been ... Date: 20-09-2010 Categories: • Women's health, gynaecology and obstetrics

Come on in, the gate�s open ... by a headache, needs urgent referral to TIA clinic, please oblige.' Which obviously begs the response: �Fuckwit case officer with acute knowledge deficiency, requires urgent attendance at lecture on migraine with aura � please oblige or start stacking shelves.'But this one really took the HobNob, and I promise I'm not making it up � a letter from an optician stating: �Patient has ingrowing eyelash causin ... Date: 04-10-2010 Categories: • Copperfield

Difficult pain scenarios ... uld be requested only on the basis of specific findings on history or examination, or on results from first-line tests.ManagementIf no organic disease � such as IBS, IBD, coeliac disease or abdominal migraine � is found it's better to try to make a positive diagnosis of functional abdominal pain rather than use it as a �catch-all' term for abdominal pain in which all investigations are negative. There is ... Date: 06-10-2010 Categories: • Gastroenterology and obesity • Musculoskeletal, rheumatology and sports medicine • Paediatrics • Renal medicine, urology and men's health • Women's health, gynaecology and obstetrics

Complementary therapies and chronic pain ... back pain. But the authors noted there was no evidence it was more effective than other active therapies.3A 2009 Cochrane review suggested that acupuncture was at least as effective as medication at migraine prophylaxis4 while another review from the same year showed that it could have some benefit for people with frequent episodic or chronic tension headaches.5There is some evidence that acupuncture may ... Date: 06-10-2010 Categories:

Complex regional pain syndrome ... esidual limb dysfunction prevents most people from going back to their jobs � in fact even after six years, only 30% do. The CRPS aetiology is not well understood. It is associated with osteoporosis, migraine, asthma and ACE-inhibitor use but not with preceding psychological problems.1 Certain unusual features, such as a fluctuating inability to move the affected hand or foot, have led to suggestions it i ... Date: 06-10-2010 Categories:

Long-term tricyclic use beneficial for migraine By Nigel PraitiesA tricyclic antidepressant becomes a more effective treatment for migraine and tension headache the longer it is used, a new analysis concludes.US researchers carried out a meta-analysis of 37 studies comparing tricyclics with other antidepressants and placebo.Tricyclics ha ... Date: 01-11-2010 Categories: • Long-term conditions and prescribing • Neurology

Tricyclic antidepressants 'raise cardiovascular risk' ... ow in epidemiology and public health at University College London told Pulse GPs should consider switching any patient on tricyclics to an alternative.�Tricyclics are also quite widely for headaches, migraines and other kinds of neurological pain. But the increased risk was not specific to what patients were being treated for. If there is an alternative option our data suggests GPs should look at it,' he ... Date: 01-12-2010 Categories: • Mental health, pain and addiction • Musculoskeletal, rheumatology and sports medicine

Orgasmic disorders in men ... in the occipital/cervical region. � Coital cephalgia occurs more suddenly at the point of orgasm, is more severe and generalised, lasting around 20 minutes. It is more common in men with a history of migraine and is thought to be associated with a temporary rise in blood pressure and may be due to vasoconstriction. � Late coital cephalgia occurs after sexual activity and tends to last for hours, often dev ... Date: 08-12-2010 Categories: • Renal medicine, urology and men's health

Symptom sorter on recurrent abdominal pain in children ... nderlying cause in the most persistent cases is usually non-organic.Differential diagnosisCommon� Recurrent viral illnesses� Anxiety and depression � sometimes known as periodic syndrome or abdominal migraine� Recurrent UTI� Constipation� Gastritis and GORD.Occasional� Crohn's and coeliac disease� Duodenal ulcer� Irritable bowel syndrome� Diabetes � Henoch-Schonlein purpura� Hydronephrosis, renal stones a ... Date: 26-01-2011 Categories: • Gastroenterology and obesity • Paediatrics

A GP guide to neurological referrals ... mal (pituitary) mass lesions. Abrupt, transient, painless monocular visual loss � amaurosis fugax � is a form of TIA and should be managed as such, though the prognosis is better than for other TIAs. migraine visual aura is normally easily recognised, though if definitely monocular, can be confused with retinal detachment. Formed visual hallucinations are largely neurological. They occur in toxic confusio ... Date: 11-05-2011 Categories: • Neurology

Newer antiepileptic drugs not linked to birth defects ... or any major birth defects after exposure to any newer-generation antiepileptic drugs during the first trimester were not statistically different for mothers with epilepsy, mood affective disorder or migraine, or without a diagnosis.' JAMA. 2011;305(19)1996-2002The incidence of birth defects was no higher in babies exposed to AEDs than controls Date: 26-05-2011 Categories: • Long-term conditions and prescribing • Neurology

Tory rebellion on NHS reforms, migraine genetic link found, and why longer A&E waiting times may kill Our round-up of the health headlines on Monday 13 June. With Professor Steve Field's report for the NHS Future Forum due out today, prime minister David Cameron has called an emergency meeting of 143 recently ... Date: 13-06-2011 Categories:

NHS spends billions on expats, should hospitals be allowed to fail and the ultimate wedding gift - organ donation ... and women out there hoping to banish a few wrinkles in the quest to look ten years younger, you're about become extremely jealous. The Daily Telegraph reports that neurologists who treat sufferers of migraines say Botox injections can help people who suffer chronic attacks. They are pushing for it to be offered on the NHS, which means there could be a lot more glamorous grannies and freshened up thirty-ye ... Date: 11-07-2011 Categories:

School guidelines for headaches The RCGP has created a guideline document for schools dealing with headaches and migraine in its pupils. Schools need to develop policies for health problems in the light of their statutory responsibilities and their own assessment of local needs and resources. Extensive guidance to dev ... Date: 17-10-2011 Categories: • Neurology • Paediatrics

Opioids 'not effective' treatment for sciatica ... nt for sciatica, despite being widely used for the condition, an NHS health technology assessment has found. Related articles Spinal manipulation 'has benefits for back pain and migraine' Exercise programmes for patients with low mechanical back pain The review of 270 studies, shortly due to be published in full online, found surgery, epidural steroid injections and ... Date: 22-11-2011 Categories: • Long-term conditions and prescribing • Mental health, pain and addiction • Musculoskeletal, rheumatology and sports medicine

Headache patients 'should drink more water' ... ntervention group, in addition to this, had instructions to increase their daily water intake by 1.5 litres. At three-month follow-up, the intervention group had an improvement of 4.5 points on the migraine-Specific Quality of Life questionnaire and some 47% reported an improvement of six or higher on a 10-point scale, compared with 25% in the control group. But drinking more water had no effect on the ... Date: 01-12-2011 Categories: • Neurology

Acupuncture associated with 'minor' improvements in migraine Patients receiving acupuncture have fewer days with migraine, but the effects of the intervention on migraine frequency and quality of life is 'minor' compared with sham acupuncture, say researchers. Related articles Acupuncture 'an option ... Date: 12-01-2012 Categories: • Neurology

'Indefensible' tax arrangements at the DH, consultant concerns over hospital care, Botox on the NHS? ... uent shift changes. The RCP has set up a commission to investigate the falling standards of care in hospitals called The Future Hospital to be chaired by Sir Michael Rawlins, current chair of NICE. migraines could soon be treated with a dose of Botox after the results of a clinical trial have suggested that the anti-wrinkle drug can halve the effects of chronic migraine, the Mail claims this morning. ... Date: 16-02-2012 Categories:

A tale of two news stories: how to cure an ice cream headache and the hidden camera that found a care home to be less than caring ... lts showed that the pain coincided with an artery called the anterior cerebral artery opening up and flooding the brain with blood.' It is hoped that these findings will lead to better treatments for migraines. The BBC website tells of a �miniature honeycomb - or scaffold [that] could one day be used to encourage damaged nerves to grow and recover, according to an international group of researcher ... Date: 23-04-2012 Categories:

The pharma industry must not dictate GMC drug policy ... about their use of medicines, but there is no getting round prescribing off-label from time to time. One in 10 of the drugs GPs prescribe to children is outside its licensed indication, the standard migraine drug amitriptyline doesn't have a licence for that purpose and prescribing of SSRIs off-label is recommended by NICE. Related articles GPs face clampdown on off-label prescribing ... Date: 24-04-2012 Categories: • Long-term conditions and prescribing

ENT clinic - Ramsay Hunt syndrome �CaseA 51-year-old woman presented to her GP with a three-day history of gradually increasing left-sided head pain.She was being treated for hypertension and also used a triptan to control her migraine. But she insisted this head pain was different, especially in the way it radiated out to her ear.Examination revealed a reddened, swollen right external auditory canal with a normal tympanic membrane ... Date: 27-04-2012 Categories: • Ear nose and throat and ophthamology

�Modest� effect of botox injections on migraine prevention Botox injections show �small to modest' benefits in preventing migraine and headache, say US researchers. Date: 30-04-2012 Categories:

Botox for headaches, contraception and a 'nation of sleeping pill addicts' NICE has reversed its previous guidance and has given the go ahead for the use of botox to treat migraines. Chronic migraine sufferers could be given a 12 week course of botox injections in their head and neck if they don't respond to three other treatments first � at a cost of around �350 per patient. ... Date: 11-05-2012 Categories:

Physiotherapists and complementary therapies ... ; Incontinence · Infant disorder including colic, sleeping, feeding, speech, ear and behavioural problems · migraine and headache · Neurological conditions including Parkinson's disease, Bells Palsy and Cerebral Palsy · Pain · &nb ... Date: 25-08-2012 Categories: • Uncategorised

We rely on self-prescribing ... , there must no more dipping of our sticky paws into the emergency bag for an occasional omeprazole capsule after a night out on the town, a tasty wafer-based triptan to deal with a heartsink-induced migraine or even half a dozen trimethoprim tablets for the girlfriend’s cystitis. The Medical Defence Union puts it this way: ‘Of seven cases involving a prescription for antibiotics, there was a ... Date: 27-08-2012 Categories: • Copperfield • Uncategorised

Letters from general practice Over the years, medicine has given me a lot, particularly migraine and a duodenal ulcer. It’s time to give something back. So, as a service to GPs, I’ve written some letter pro formas which you can photocopy and adapt as you see fit. I know you’ll ... Date: 29-08-2012 Categories: • Copperfield • Uncategorised

GPs should use triptans first-line for acute migraine, says NICE GPs should prescribe a triptan, in combination with NSAIDs or paracetamol, first-line in patients with acute migraine, recommend NICE guidelines published today. Related articles Key questions on migraine (1.5 CPD hours) Headache patients 'should drink more water' The guidance ... Date: 19-09-2012 Categories:

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