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Headache: insight, understanding, treatment and patient management


  • Disclosures Hans-Christoph Diener received honoraria for participation in clinical trials, contribution to advisory boards or oral presentations from: Addex Pharma, Allergan, Almirall, Autonomic Technology, AstraZeneca, Bayer Vital, Berlin Chemie, Böhringer Ingelheim, Bristol-Myers Squibb, Coherex, CoLucid, GlaxoSmithKline, Grünenthal, Janssen-Cilag, Lilly, La Roche, 3M Medica, Medtronic, Menerini, Minster, Merck Sharp & Dohme, Neuroscore, Novartis, Johnson & Johnson, Pierre Fabre, Pfizer, Reckitt Benckiser, Schaper and Brümmer, Sanofi, St. Jude and Weber & Weber. Financial support for research projects was provided by Allergan, Almirall, AstraZeneca, Bayer, GlaxoSmithKline, Janssen-Cilag, Merck Sharp & Dohme and Pfizer. Headache research at the Department of Neurology in Essen is supported by the German Research Council (DFG), the German Ministry of Education and Research (BMBF) and the European Union. Hans-Christoph Diener has no ownership interest and does not own stocks of any pharmaceutical company.

Hans-Christoph Diener, Department of Neurology and Headache Center, University Hospital Essen, Hufelandstrasse 55, 45147 Essen, Germany
Tel.: +49 201 723 2460
Fax: +49 201 723 5901


Tension-type headache and migraine are the most frequent primary headaches. Diagnosis is based on the patient’s history and a normal neurological examination. Most patients with these two headache entities treat headache episodes with over-the-counter analgesics or non-steroidal anti-inflammatory drugs (NSAIDs). There is good scientific evidence from randomised, placebo-controlled trials indicating that aspirin, ibuprofen, ketoprofen, diclofenac and naproxen are effective in tension-type and migraine headache. Paracetamol seems to be less effective. In patients with migraine who do not respond to analgesics or NSAIDs, triptans should be prescribed. Frequent primary headaches should not be treated with frequent intake of analgesics or triptans. In these cases, preventive therapy needs to be implemented.