Differential Diagnosis of Craniofacial Pain
	International Headache Society
	The Primary Headaches
	The Secondary Headaches
	Headache attributed to head and/or neck trauma
	Headache attributed to cranial or cervical vascular disorders
	Headache attributed to a substance or its withdrawal (8.1-4)
	Headache or facial pain attributed to
	Cranial neuralgias, central and primary facial pain and other headaches
	Cranial neuralgias, central and primary facial pain and other headaches, cont.
	Unusual Causes of Headache
	“Red Flags” in the Headache History
	“SSNOOPP” for Secondary HA
	The Primary Headaches (1-4)
	What is Migraine?
	How Migraine Stacks Up Against Other Common Diseases
	Most Patients’ Headaches Are Severe or Extremely Severe
	Migraine Takes Quality Time Out From Your Life
	Migraine Takes Time Out From Your Life
	Unnecessary Suffering
	Migraine Pathophyisology
	How Migraine Works
	Migraine Pathophysiology: Phases
	Protective Factors
	Triggers and Risk Factors
	Triggers: Changes in Daily Cycles
	Triggers: Environment or Diet
	Triggers: Mental
	What You Might Feel Before or During an Attack
	What You Might Experience During an Attack
	Migraine without Aura
	Migraine with Aura
	Migraine Aura
	Tension-Type Headache
	Tension-Type Headache
	Cluster HA and Other TACs
	Cluster Headache
	Paroxysmal Hemicrania
	Chronic Daily Headache
	Chronic Daily Headache
	Chronic Daily Headache
	Headache Attributed to As Substance or Its /Withdrawal
	Analgesic Rebound Headache / Medication-Induced Headache
	Common Medications Associated with MOH
	Pharmacotherapy for Migraine
	Headache Treatments
	Self Treatment Efforts: What You Can Do For Your Migraines
	Pharmacologic Management of Headache: Symptomatic Therapies
	Pharmacologic Management of Migraine: Prophylactic Therapies
	Pharmacologic Management of Headache: Prophylactic Therapies
	Medicines to Stop a Migraine Attack
	Other Factors Involved in the Choice of Medication
	Fast Relief vs. Long-lasting Relief
	Options for Preventive Treatment
	Pharmacological Therapy
	Acute (Abortive) Medication Therapy
	DHE
	Acute Therapy for Migraine
	Acute Therapy for Migraine
	Acute Therapy for Migraine
	Acute Therapy of Migraine
	Acute Therapy of Migraine
	Triptans
	Triptans: Efficacy Headache Relief at 2 hours
	Triptans
	Preventive Therapies for Migraine
	Daily scheduled opioids for intractable head pain
	Daily scheduled opioids for intractable head pain
	Nonpharmacologic Management of Headache
	Other CAM Therapies
	Topical Agents
	Magnesium
	Magnesium for Headache
	MigraHealth and MigraLief
	Vitamin B2 (Riboflavin)
	Vitamin B2 (Riboflavin)
	Coenzyme Q 10 (ubiquinone)
	CoQ 10
	Feverfew
	Feverfew
	St. John’s Wort (Hypericum perforatum)
	Butterbur (Petasites hybridus)
	Women’s Issues and Headache
	Pure Menstrual Migraine & Menstrually Associated Migraine
	Oral Contraceptives and Migraine
	Pregnancy and Headache
	Pregnancy and Headache
	Menopause and Migraine
	Botulinum Toxin – A (BTX-A)
	Headache and Craniofacial Pain Disorders I: Slide 90
	BTX-A
	BTX-A
	Side Effects
	Antibody Formation & Resistance
	Contraindications and Cautions
	How Does BTX Decrease Pain??
	Mechanisms of Analgesic Activity??
	Mechanisms of Analgesic Activity??
	Mechanisms of Analgesic Activity??
	Mechanisms of Analgesic Activity??
	Mechanisms of Analgesic Activity??
	FDA Approval (1989)
	Other Common Uses
	Chronic Headaches
	Chronic Headache (Migraine, Tension-type, CDH)
	Botulinum Toxin
	Botulinum Toxin
	Botulinium Toxin and EMG
	Botulinum Toxin Type A
	Botulinum Toxin
	Botulinum Toxin, cont.
	Botulinum Toxin, cont.
	Botox CDH
	Botox CDH, cont.
	Botox CDH, cont.
	Differential Diagnosis of Craniofacial Pain
	Trigeminal Neuralgia
	Characteristics of Patients
	Classification of TN
	Etiology??
	Trigeminal Neuralgia Therapeutic Options
	Headache and Craniofacial Pain Disorders I: Slide 122
	Anticonvulsants (AEDs)
	Pharmacological Effect and Mechanism of Pain Relief
	AEDs for TN – RCTs
	Pharmacological Therapy for Trigeminal Neuralgia
	Pharmacological Therapy
	Surgical Interventions
	Acute Therapy
	Differential Diagnosis of Craniofacial Pain
	Neuropathic Facial Pain “Old & New Names”
	Persistent Idiopathic Facial Pain
	Chronic Neuropathic Facial Pain
	CRPS of the Head and Neck
	Burning Mouth/Tongue (Oral Burning)
	Treatment of Neuropathic Craniofacial Pain
	Pain Management
	Voltaire’s Cynicism
	Prudent Polypharmacy!!!
	Pharmacological Therapy
	Pharmacological Therapy
	NMDA-Receptor Antagonists
	Topical Agents
	Advances in Neuropathic Pain
	CAM Use for Headache & Facial Pain
	Complementary and Alternative Medicine (CAM)
	Local Anesthetic Nerve Block Injections
	Electrical Stimulation
	The Spectrum of Pain in Herpes Zoster
	PHN: Clinical Presentation
	Vasculitides with Headache & Facial Pain
	Temporal Arteritis
	Superficial Temporal Artery
	Temporal Ateritis
	Temporal Arteritis

• Session 1: Essentials
• Evidence-based Pain Therapy
• Urine Drug Testing in Clinical Practice
• Acute Postoperative Pain: Context, Outcomes and Clinical Interventions
• Neuropathic Pain I