Management of common conditions

• Published in: Migraine and Headache
• Main Author: Mauskop, Alexander
• Format: Book Chapter
• Language: English
• Published: New York, NY Oxford University Press 26.06.2009; Oxford University Press, Incorporated
• Subjects: Pain Medicine; severity; therapeutic; questions; diagnosis; headaches
• ISBN: 9780195368208; 0195368207
• DOI: 10.1093/oso/9780195368208.003.0007

The patient interview is an art that is easy to master, if only one gives the patient a chance to speak. The interview not only is diagnostic, but it can also be therapeutic. Use open-ended questions, such as, “Tell me about your headaches,” “Tell me in your own words how headaches affect your life,” or “What else can you tell me about your headaches?” After presenting the patient with a list of therapeutic options described here, always ask, “What do you think about these options? Do you have any questions about them? And which ones do you want to pursue?” Establishing the correct diagnosis is not a one-time event but rather an ongoing process. Not having a biological marker or a test for primary headaches and relying on the clinical picture for diagnosis require constant vigilance and reappraisal, particularly when headaches change in character or worsen in severity or frequency. A migraine sufferer may develop other conditions, such as hypothyroidism, brain tumor, cervicogenic headaches, or magnesium deficiency, which in the beginning may only worsen the typical migraines without any additional signs and symptoms. Typical migraine, tension, or cluster headaches have been reported to occur with the majority of intracranial pathologies, such as vascular abnormalities, tumors, and infections.