M. WILKINSON Patients with frequent or daily headaches pose a very difficult problem for the physician who has to treat them, particularly as many patients think that there should be a medicine or medicines which give them instant relief. In the search for the compound which would meet this very natural desire, many drugs have been manufactured and the temptation for the physician is either to increase the dose of a drug which seems to be, at any rate, partially effective, or to add one or more drugs to those which the patient is already taking. Although there have been some references to the dangers of overdosage of drugs for migraine in the past, it was not until relatively recently that it was recognized that drugs given for the relief of headache, if taken injudiciously, may themselves cause headache. The first drugs to be implicated in this way were ergotamine and phenazone. In the case of ergotamine tartrate, the dangers of ergotism were well known as this was a disorder which had been known and written about for many years. In the treatment of headache, fully blown ergotism is rare and in recent years has usually been due to self-medication in doses much greater than those prescribed although there are a few recorded cases where toxic amounts have been given.

Headache is a huge public health problem and migraine alone cost 27 billion Euros per year in Europe. It is therefore important how the health care service for headache patients is organised throughout the world. Patients seen at headache clinics are more severely affected than those seen in general practice, and headache clinics need to be familiar with a long list of relatively rare headache disorders.
Part of the Frontiers in Headache Research series, this volume is the first book to focus specifically on headache clinics, their classification and organization, their methods of diagnosis, and their approaches to multi-disciplinary management. The clinical features of patients seen in headache clinics are thoroughly discussed. The value of a number of diagnostic laboratory techniques including when and how to use neuro-imaging is discussed. Also a number of more specialised methods employed only in referral headache centres are covered, such as nitro-glycerine challenge, indomethacin test, and oxygen breathing. The treatment options for severely affected patients are discussed including the possibilities of combining two or more prophylactic medications, the use of epidural blood patch and the different methods for discontinuation of medication overuse.
This volume will be an invaluable resource for neurologists, physicians in headache/pain clinics and interested general practitioners.

Alle therapierelevanten Informationen, die Sie fur die kompetente Beratung Ihrer Patienten schnell parat haben mussen:
o Wirkstoffe, Indikationen und Nebenwirkungen der Arzneimittel, knappe medizinische Grundlagen.
o Arzneimittelauswahl nach Nutzen-Risiko- und Aufwand-Nutzen-Relation fur Ihre gezielte Bewertung und Empfehlung.
o Band fur Band einheitlich gegliedert, mit ubersichtlichen Tabellen, kompakt und praxisgerecht.
Ihr zusatzliches Beratungs-Plus: Hinweise auf nichtmedikamentose Therapiemoglichkeiten und viele nutzliche Tips fur Ihre Patienten.
Taglich gut beraten: Sichern Sie sich Ihren Vorsprung in der Beratungskompetenz mit dieser handlichen Praxis-Bibliothek.

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