What are the best treatment options for persistent post-traumatic headaches when first line agents like TCAs have failed?
Answer from: at Academic Institution
Would treat post-traumatic headache according to the primary headache disorder phenotype.Post-traumatic headaches statistically most often have a migraine disorder phenotype. So if one does not respond to TCA as a preventative medication then I would consider other migraine disorder preventative med...
Comments
at UPMC Good response @Josif. I like the thinking.
To my 20 years of experience, you treat most of them like migraine.
It seems to me different pills we know, with different side effects are 60-70% effective. I prefer TCA and sometimes Beta blockers if they have sympathetic overdrive.
Monthly shots CGRP Inhibitors are 80-85% effective.
Botox ever...
Agree with all the above.
Adding screen also for occipital neuralgia and consider blocks. Most importantly it is best to work on a holistic approach that educates on the importance of lifestyle modifications- hydration, exercise, behavioral health support, and medical therapy.
We remind all those ...
Agree that most have a pattern of migraine and with a careful history, often there is a prior history of headache disorder (usually undiagnosed). Those individuals tend to have lingering headaches and will require treating the headache based on characteristics. I will say that I have had post-trauma...
Good response @Josif. I like the thinking.