Overview

Course Title: Headache Disorders: Diagnosis and Management
Instructor: Dr. Surat Tanprawate, MD, Division of Neurology, Chiang Mai University
Institution: Northern Neuroscience Centre, Chiang Mai University

This course provides an in-depth exploration of headache disorders, focusing on the skills and knowledge required to diagnose, differentiate, and manage various types of headaches. It is designed for medical students and healthcare professionals who seek to enhance their understanding of headache syndromes and their treatment. The course covers both primary headaches like migraines and tension-type headaches, as well as secondary headaches that may indicate more serious underlying conditions.

Description

Headache disorders are among the most common reasons for neurology consultations. Accurate diagnosis and effective management of headaches are essential for improving patient outcomes. This course introduces the principles of headache evaluation, emphasizing history-taking, physical examination, and the identification of red flag signs that indicate potentially serious conditions. Through lectures, case studies, and practical sessions, students will gain the skills to diagnose primary headaches and recognize when secondary headaches require further investigation.

Participants will learn to differentiate between common headache syndromes, apply the International Classification of Headache Disorders (ICHD-III) criteria, and develop individualized treatment plans. The course includes evidence-based approaches to acute and preventive therapy, with special focus on patient education and lifestyle modifications.

Curriculum

Module 1: Introduction to Headache Disorders

• Overview of headache disorders: prevalence, impact, and importance in clinical practice.

• Introduction to the International Classification of Headache Disorders (ICHD-III).

• Distinguishing between primary and secondary headaches.

Module 2: Clinical Approach to Headache Evaluation

• History taking: Key questions to differentiate headache types, including onset, duration, and triggers.

• Physical examination: Identifying red flag signs (e.g., age over 50, sudden onset, abnormal neurological signs).

• Case studies: Analyzing patient presentations and developing diagnostic hypotheses.

Module 3: Primary Headache Disorders

• Migraine: Pathophysiology, phases (prodrome, aura, headache, resolution), and clinical features.

• Diagnosis using ICHD-III criteria and management approaches, including triptans, NSAIDs, and anti-epileptic drugs.

• Tension-Type Headache (TTH): Recognizing symptoms, including bilateral pressing pain, and managing both episodic and chronic forms.

• Trigeminal Autonomic Cephalalgias (TACs): Understanding cluster headaches, paroxysmal hemicrania, and SUNCT/SUNA. Diagnosis and treatment protocols.

Module 4: Secondary Headache Disorders

• Red flag symptoms and differential diagnosis of secondary headaches (e.g., subarachnoid hemorrhage, meningitis, giant cell arteritis).

• Diagnostic approach: When to order imaging, lumbar puncture, or other tests.

• Case discussions: Real-world examples of secondary headache presentations and management decisions.

Module 5: Pharmacologic Management of Headaches

• Acute treatment strategies for migraine, TTH, and TACs.

• Preventive therapies: Beta-blockers, anti-epileptics, and CGRP monoclonal antibodies.

• Managing medication-overuse headache: Prevention, recognition, and treatment strategies.

Module 6: Non-Pharmacologic Approaches to Headache Management

• Cognitive-behavioral therapy, biofeedback, and physical therapy for tension-type headache.

• Role of lifestyle modifications, dietary considerations, and sleep hygiene in reducing headache frequency.

• Integrating complementary therapies like acupuncture into headache management.

Module 7: Special Topics in Headache Management

• Headaches in special populations: pregnancy, children, and the elderly.

• Management of chronic migraine and refractory cases.

• Patient education: Developing effective communication strategies to empower patients in managing their condition.

Module 8: Case-Based Learning and Practical Application

• Interactive case studies: Diagnosing and managing complex headache presentations.

• Group discussions: Sharing approaches to challenging cases and exploring recent advancements in headache research.

• Role-playing sessions: Practicing history taking and patient communication skills.

Certification