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Management of Headache Related to COVID-19

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Headache Disorders in Pandemic Conditions

Part of the book series: Headache ((HEAD))

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Abstract

Headache is a disabling symptom, both during and after the acute phase of coronavirus disease 2019 (COVID-19). Most patients require acute medication to alleviate headache, with paracetamol and non-steroidal anti-inflammatory drugs being the most frequently used medications. A substantial proportion of patients are symptomatic treatment resistant (10–30%) and may need additional treatments, such as metamizole or triptans, which are not consistently effective. In most cases, headache resolves within 1 to 2 weeks; however, in approximately a fifth of patients, especially if it persists 2 months after the acute phase, headache becomes persistent. Patients should be referred to the general practitioner, neurologists, or headache experts to evaluate the need for treatment if headache persists beyond 2 months. Evidence regarding the optimal preventive medications is limited; however, most experts recommend to treat patients based on the clinical phenotype. COVID-19-related headache may present as a tension-type-like headache, but typical migraine symptoms are also frequent. The preferred treatment so far has been amitriptyline. The preliminary studies report a 50% responder rate around 44%, and a median reduction of headache days per month of 9.6, when comparing the frequency of headache days per month between weeks 8 and 12 of treatment with the baseline. Prior history of tension-type headache and presence of nausea were associated with a higher probability of response. Other oral preventive medications and local treatments, such as anesthetic blockades or onabotulinumtoxinA, have been used with various results, but being beneficial in some selected cases.

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Authors and Affiliations

  1. Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain

    David Garcia-Azorin, Ana Echavarría-Íñiguez & Ángel Luis Guerrero Peral

  2. Headache Unit, Department of Neurology, Hospital Universitario La Paz, Madrid, Spain

    Javier Díaz de Terán

  3. Headache Unit, Neurology Department, Hospital Universitario Marques de Valdecilla, Santander, Spain

    Vicente González-Quintanilla

  4. Headache Unit, Neurology Department, Hospital Universitario de la Princesa and Instituto de Investigación Sanitaria La Princesa, Madrid, Spain

    Ana Beatriz Gago-Veiga & Alicia González-Martínez

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  1. David Garcia-Azorin
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  2. Javier Díaz de Terán
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  3. Vicente González-Quintanilla
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  4. Ana Beatriz Gago-Veiga
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  6. Ana Echavarría-Íñiguez
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  7. Ángel Luis Guerrero Peral
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Correspondence to David Garcia-Azorin .

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Editors and Affiliations

  1. Department of Neurology, Mersin University Faculty of Medicine, Mersin, Türkiye

    Aynur Özge

  2. Neurology, Brain 360-Brain Health Center, Istanbul, Türkiye

    Derya Uludüz

  3. Dept of Neurology & Algology, NÖROM, Neuropsychiatry Center, Gazi University, Ankara, Türkiye

    Hayrunnisa Bolay

  4. Department of Neurology, Gülhane Faculty of Medicine, Ankara, Türkiye

    Ömer Karadaş

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Garcia-Azorin, D. et al. (2023). Management of Headache Related to COVID-19. In: Özge, A., Uludüz, D., Bolay, H., Karadaş, Ö. (eds) Headache Disorders in Pandemic Conditions . Headache. Springer, Cham. https://doi.org/10.1007/978-3-031-26309-5_14

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  • DOI: https://doi.org/10.1007/978-3-031-26309-5_14

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