Approximately 28 million Americans suffer from migraines, a type of headache that is often so severe it is disabling. These painful headaches may or may not be accompanied by an aura, such as flashes of light and blind spots as well as other symptoms such as nausea and vomiting and extreme sensitivity to light and sound.
Primary headaches also may be either tension-type or cluster headaches. Patients with tension-type headache pain often complain about feeling like they have a tight band around their head. Cluster headaches, although rare, can be excruciatingly painful. A distinctive feature of cluster headache is that the attacks occur in cyclical patterns, or clusters.
Making an accurate diagnosis and implementing an optimal treatment plan can be complicated. The primary care clinician plays a critical role in this identification and differential diagnosis. Patients’ trust in their primary care clinician helps in the recognition of symptoms and triggers as well as the ongoing and the collaboration of care.
Each lecture includes a case study that the primary care clinician might commonly see in clinical practice. Together, this four-part program will address the multi-faceted nature of headache management including: appropriate history and physical examination, differential diagnosis, medication overuse, prevention, and pharmacological and behavioral therapy.

This activity is intended for nurse practitioners and other advanced practice clinicians involved in the management of patients with headache.

After completing this activity, participants should be able to:

• Distinguish between primary headaches (migraines) and secondary headaches by learning to look for red flags in history and examination.
• Understand the differences among diagnostic tests and when to use them appropriately.
• Learn the common side effects and risks associated with the triptans.
• Describe how to evaluate cardiac risk in patients prior to use of the triptans.
• Recognize medication overuse in patients and identify strategies to avoid creating medication overuse headache.
• Develop strategies for the treatment of medication overuse headache, specifically detoxification.
• Optimize behavioral prevention via lifestyles and trigger reduction.
• Recognize effective drug preventatives for primary headaches.
• Learn to prevent chronic headache and analgesic rebound

Lynda Krasenbaum MSN, CS, ARNP
Adult Nurse Practitioner
Assistant Professor
Columbia University Medical Center
New York, NY

Vincent T. Martin, MD
Professor of Medicine
University if Cincinnati

Timothy R. Smith, M.D., R. Ph.
Ryan Headache Center
Mercy Health Research
St. Louis, MO

Frederick R. Taylor, MD
Director, Headache Clinic and Research Center
Park Nicollet Health Services
Adjunct Associate Professor of Clinical Neurology
University of Minnesota School of Medicine
Minneapolis, MN

This activity has been planned and implemented in accordance with (NPACE) Nurse Practitioner Associates for Continuing Education.  NPACE is an approved provider of continuing nursing education by the Massachusetts Association of Registered Nurses, Inc., an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.  This activity is supported by an independent educational grant from Merck & Co., Inc.