Discover and read the best of Twitter Threads about #headache

Most recents (23)

What is a spontaneous spinal CSF leak?

It’s so much more than a headache. It’s extremely debilitating.

When I experienced a CSF leak in 2014, I had to lie down all day every day for several months.

#leakweek2022 #csfleak #spinalCSFleak #SIH #headache

csfleak.uk/living-with-th…
Sometimes people are wrongly diagnosed with postural orthostatic tachycardia syndrome #POTS when it’s actually a spinal CSF leak.

I gave a short talk at the PoTS UK London Masterclass in December 2019

#leakweek2022 #CSFleak #spinalCSFleak #SIH #headache

I was interviewed for the National Migraine Centre HeadsUp Podcast about my experiences with a spontaneous spinal CSF leak (Series 2, Ep 6) to help educate healthcare professionals & patients

Sometimes a #CSFleak is misdiagnosed as chronic #migraine

#headache #SIH #leakweek2022
Read 4 tweets
@DailyAstorian officially excluded from "filling empty bellies"

for complaining about unfair exclusions

or for witnessing an assault

or whatever, my long email to erin carlsen
the beacon house guy who assaulted the filling empty bellies guy

still gets to go to beacon house

i found out today

erin says he has a different version of the story as if my first hand witnessing is corrupted.

wow.
kinda wild that an elderly old drunk homeless filling empty bellies client got assaulted---and the only person defending him----gets excluded.

nothing makes sense.

i mentioned a lot of the assaults, and i guess they need everything sugar coated or walking on eggshells
Read 8 tweets
1) Welcome to a #tweetorial on what every #ICU #nurse should know about #hypertensive crisis, or #hypertensive #emergency as it is now more properly termed. I’m Bryan Boling @bryanboling, ICU #NP, & co-host of the @icuscenarios podcast. Follow this 🧵for 🆓CE/#CME credit!
2) This accredited educational activity is intended for healthcare providers & is supported by grants from AstraZeneca, Bayer, & Chiesi. Faculty disclosures cardiometabolic-ce.com/disclosures/. Like ❤️this topic? More CE/#CME on #hypertension mgt at cardiometabolic-ce.com/category/hyper….
3) So let's start with a case: 65yo ♂️, presents to the #ED with #headache, lethargy & confusion. PMH: #HTN, #hyperlipidemia, #DM2, COPD. Initial VS: HR 85, BP 205/120, T 37.2 RR 12, SpO2 92% on RA. Family reports that he has been more lethargic over the past 2 days.
Read 37 tweets
High levels of an #infection in #Massachusetts is causing both gastrointestinal (#diarrhoea, #vomiting) & respiratory (#cough, #sinus, #headache) symptoms WITHOUT typical fever or runny nose - School children & parents/guardians across #boston suburbs affected for last 3 weeks.
Note the CDC data suggests very little SARS-CoV-2 (Omicron) or influenza (flu) at this time in Massachusetts or Connecticut or New Hampshire. So diagnostic tests being used are not catching this circulating pathogen, or a seasonal coronavirus/norovirus/adenovirus is the culprit
According to the data on SARS-CoV-2-positive PCR tests there is very low levels of COVID-19 over last 3 weeks in Massachusetts, CT, NH, RI & VT. Yet there are several #school #children, #teachers and #parents with gastrointestinal & respiratory #infection symptoms in these states Image
Read 12 tweets
A lot of people mistakenly believe that to become a professional trader you need to have a degree in commerce, mathematics or economics.

This is due to a huge misconception that Forex/crypto trading is complicated. FALSE!

THREAD
It’s not a prerequisite to have any fancy university degrees or other qualifications in any special fields to become a trader.

In fact, the ‘high school dropout’ has just as good of a chance of becoming a successful trader as any doctor, engineer, or physicist would.
Actually, the high school dropout probably has a better chance to succeed in the market over a seasoned mathematician.
The humble high school student is able to read things at the surface level and be content – not over complicating the issues by trying to understand...
Read 5 tweets
#Migraine is a neurological disorder, not a terrible, disabling #headache," expert @DavidDodick explains. #Pain is "just 1 clinical manifestation deriving from a sensory processing disturbance affecting the nervous system" (Morgan, Lancet 2020). /Thread thelancet.com/journals/laneu…
Billie lost her insurance when #migraine disabled her: “There are days I don't see anything except for shapes." Visual warnings are the most commonly recognized auras, but these symptoms are highly variable, both in different patients & on different days for the same patient. 2/
Difficulty speaking or speaking clearly is another common #migraine symptom, either preceding or during an attack.

Poor St. Husband. He watched this clip & said, "Yup, that's you." I spent a lotta years in school to talk like this. 3/
Read 7 tweets
#Migraine is the most common & disabling brain disease, but @SocialSecurity still doesn't recognize it as potentially disabling, making it much harder for people to qualify for earned benefits.

🔵Bookmarkable Thread! Info about #SSDI & #disability for migraine.
Globally, #migraine is the #1 cause of disease-related #disability for people 10-24 & the 4th cause for people 25-49. Yet @SocialSecurity still doesn't treat it as a potentially disabling disease. ssa.gov/disability/pro… Image
Severe #migraine is profoundly disabling. The World Health Organization uses objective metrics to determine disease burden & ranks severe migraine in the highest category of disability alongside terminal-stage cancer.

Shame on @SocialSecurity. Image
Read 24 tweets
@ravensspirit68 @funchefchick @NitaGhei @StefanKertesz @AllysonVarley @PainPtFightBack @LelenaPeacock @tal7291 @urbanfatbiker I'm working on a big annotated bibliography of #cpp/rx #opioid research that I'll put online for activists to use. Here are studies I've got on #CPP-associated #suicide. Send me titles & authors for papers I'm missing & I'll add them. I'll link them below.
Tang et al 2006 review: Risk of death by #suicide at least doubled in #ChronicPain patients. Ideation is 3 times more common; lifetime prevalence of about 20%. 8 risks for suicidality in chronic pain were identified, half are physical.
researchgate.net/profile/Cather…
Tang et al: 8 risks for #suicide in #ChronicPain patients: 4 are physical, including type, intensity & duration of pain & sleep-onset insomnia co-occuring with #pain; 4 are psychological. CP is a neurological suicide risk AND a psychological risk.
Read 15 tweets
Med Schools offer almost no instruction in the world's #1 cause of working-age disability. It'd be like Dental Schools not covering cavities.

7 words diagnose most #migraine: Recurrent #pain w/ hypersensitivity &/or nausea. 60% of patients go undiagnosed. #MedicalTwitter #PCP
#Migraine is PROGRESSIVE. A 40% diagnostic rate condemns some to lifelong #disability: Late diagnosis & ineffective treatment of acute #migraine are leading risks for continuous migraine. #PCP #MedicalTwitter mdedge.com/jcomjournal/ar…
🔴HOW DOES THIS CHILD GO 8 YEARS WITHOUT A DIAGNOSIS? She has textbook ICHD-3 #migraine! 1>sudden hypersensitivity (smell) 2>throbbing #pain 3>nausea 4>need for bedrest

She might've avoided #disability w/ early diagnosis & treatment. #PCP blogs.webmd.com/my-experience/…
Read 10 tweets
1) Migraine Premonitory(Prodromal) Phase::
Presences of non-painful Symptoms, which can start hours to days before the onset of migraine pain and can be predictive of an impending headache.
2) Three Separate Groups of Symptoms::
1::Fatigue & Cognitive changes...
Concentration difficulty, Irritability, depression, fatigue, memory impairment.
2::Homeostatic Changes...
Food craving, Thirst, Yawning, Increased Urination, Sleep disturbance.
3) 3::Sensory Changes...
Photo, phono, osmo, Phobia, nause, neckstiffness.
Read 7 tweets
1) Migraine with AURA::
Recurrent attacks of unilateral fully reversible visual, sensory, or other CNS symptoms that develops gradually over minutes and usually followed by Headache and associated Migraine Symptoms.
2) Total 20-40% prevalent,Increased risk in 1st degree Relative + twins + Heritibility. Onset::
Gradual and progressive, unlike abrupt in Stroke.
AURA consists of Positive symptoms like flashing lights, and paresthesia while stroke dominates Negative symptoms like weakness.
3) Duration::
Typically 30 minutes but may be Prolong upto 4 hours. Symptoms::
Visual(90%,most common) > Sensory, language, motor.
Visual::
Scintillating scotoma, Flashing lights, Blurry Visions.
Read 12 tweets
#PARENTS: If kids wet the bed over age 5, they might be at higher risk for the onset of #migraine. If they're over 5, peeing while sleeping AND have #migraine or #headache, the bedwetting is likely neurological, not behavioral. /thread ncbi.nlm.nih.gov/pmc/articles/P…
The relationship bwn #migraine & #sleep disorders is well known: sleepwalking, sleep terrors, insomnia, and, in kids, betwetting over age 5.

The same abnormalities in brain structure & function that make migraine also make sleep disorders.
Migraine & sleep disorders share "common pathophysiological substrates. In particular, the increased prevalence of #migraine in patients with #sleep disorders is associated with the hypothalamus regulation of circadian rhythm" (Ferrara 2016).
Read 15 tweets
Study found that head pain (#migraine & #headache) has the "strongest association with suicidality" of all types of #pain. The risk is independent of depression & likely linked to altered functioning of serotonergic systems, not poor coping (Ilgen et al). ncbi.nlm.nih.gov/pmc/articles/P…
"People with chronic #headache or #migraine were 4.3 times more likely to think about suicide, 4.6 times more likely to plan suicide, & 6.5 times more likely to have attempted suicide in the past 12-months than those without chronic headaches" (Ilgen).
Multiple studies report a particularly strong relationship between #migraine & #suicide. But "even after controlling for depression, anxiety disorders, & substance use disorders," most types of severe &/or #ChronicPain are "associated with suicidal thoughts and attempts" (Ilgen).
Read 6 tweets
The Vertebral Artery Test Part II:

Risk assessment of the cervical spine

4 clinical cases to try and make sense of risk assessment.

Of interest to ALL #Physiotherapy #PhysicalTherapy #FCP clinicians #Neck #Headache #Haemodynamics #Risk #VBI #CAD

A consideration of major or serious adverse events.

#Risk #LossOfVision #Stroke #Death #VBI #CarotidArtery #CAD Image
Into the 4th decade we go!

#Physio #PhysicalTherapy #VBI #CervicalSpine #Risk

How do we move forward from here? Image
Read 5 tweets
3% of US kids 3-7 have #migraine.

@IASPpain now internationally diagnoses all #pain from chronic disease as pain from chronic disease, EXCEPT pain from #migraine or severe #headache disorders, which it diagnoses as "emotional distress without a known cause."

That hurts kids. Image
.@winedarkme Did you hear the news? The Inter'l Association for the Study of #Pain (@IASPpain) decided that #migraine pain isn't from the Disease Known As Migraine, but a sign of "emotional distress & disability."

I was happy at 3 when diagnosed. How about you? Image
Mother (@janpurcell2) Remember when you picked me up at Elem School, and the nurse said if you stopped paying attention, my #migraine would go away & you said "That's the stupidest thing I've ever heard c'mon Jill let's get out of here"?

Say it to THESE GUYS: @IASPpain Image
Read 13 tweets
1/4
43yr chronic #alcohol user on Liv.52 #Herbal supplement for 1yr. Believes Liv52='hepatoprotective'. Consumes along with to cancel alcohol-toxicity. Diabetes uncontrolled on #Ayurveda. Comes with #jaundice, severe #headache, eyes 'bulged' 2 days, nasal discharge #livertwitter Image
2/4
At admission, #seizures, uncontrolled, put on #ventilator. Deep jaundice, comatose. Investigations=acute on #chronic liver failure #aclf
#MRI Brain Part 1👇
Extensive hemorrhagic infarcts, almost all of anterior and mid #brain.
#medicine #MedTwitter #radiology Image
3/4
MRI Brain Part 2👇
Both sides cortical venous thrombosis and anterior third of superior saggitsl sinus thrombus.
#imaging #stroke #NeuroTwitter #neurology #NeuroTwitterNetwork Image
Read 5 tweets
In 2017 @cdcorg didn't know that chronic, continuous #migraine is a thing. In fact, it's the world's #1 cause of working-age disability, & using objective metrics, @WHO ranked severe migraine in the highest class of disability burden w/ terminal-stage cancer & active psychosis. Image
This is what happens when Med Schools fail to include instruction the 1st & 2nd most common medical complaints (per NIH): #headache & #migraine. The #1 complaint is cavities. It's literally like #dentists getting maybe an hour on cavities at #Dental School. #MedicalTwitter
I did a quick search for her contact info & didn't find it. I'll write up my basic migraine spiel (NIH, Global Burden, prevalence, progression) sometime & send it to you to tidy up. Then we can easily email or tweet people the "It's CM. WTF?" basics. cdc.gov/injury/pressro…
Read 4 tweets
2006! #Psychologists "predicted" #anxiety & "catastrophizing" would "predict the presence & intensity of persistent #headache, as well as other non-pain physical symptoms of headache." HA+nonpain=#migraine. If headache has non-pain symptoms, it's #migraine webmd.com/migraines-head…
✔️ FACT "Researchers believe that #migraine is the result of fundamental neurological abnormalities caused by genetic mutations at work in the brain." New models help scientists study "the biological cascade, genetic components & mechanisms of migraine." ninds.nih.gov/Disorders/All-…
Participants in the 2006 study got 1 #anxiety or #castrophizing point per #migraine symptom: light/sound sensitivity; nausea; visual disturbance; speech difficulty; 1-sided weakness, numbness, tingling.

✔️ These are all standard migraine symptoms (& just the START of the fun).
Read 12 tweets
Brain imaging confirms what your grandmother told you: overworrying makes you feel worse. Treating #anxiety can often ease the burden of #ChronicPain.

Thread: comparing tests that screen for anxiety with & without physical symptoms threadreaderapp.com/thread/1270853…
The Hospital Anxiety & Depression Scale (HADS) doesn't include specific physical symptoms. HADS assesses #anxiety by asking how often a person feels tense, restless, worried, vaguely frightened, or panicked. svri.org/sites/default/…
By contrast, 40% of the items on the 4 Dimensional Symptoms Questionnaire ask about specific physical symptoms, every 1 of which can be indicate #migraine. semanticscholar.org/paper/The-Four…
Read 19 tweets
THE PROMISED NEUROLOGY FELLOWSHIP THREAD: I’ve taken it upon myself to hype up neurology despite being under the tutelage of medicine for the next year. Neurology gets left behind when students resolve never to live in a world where ‘dysdiadochokinesia’ is used unironically.
Disclaimer: This thread is NOT comprehensive. Neurologists practice in vast spectrums that cannot be conveyed here. This is simply meant to inform prospective applicants about the options within the field of neurology, and hopefully, to entice them to explore something(s) new.
1/ #movementdisorders (MD)- starting out this thread with a backslap to naysayers who still make the tired claim that “there’s no instant gratification in neurology.” WRONG!
Read 48 tweets
@CContrarus @hope411adcock @painadvocateAR @tal7291 @fightpaindaily @speakingabtpain @jillyannjiggs @JoeFalzone8 @JSG_54 @LadyAg72 @brent_kellogg @dr4liberty @Irishbrat1966 @ThomasKlineMD @DanLairdMD @D321Debbie @Angelsgal02 @esteckler2 I've been housebound w/ continuous #migraine for 15 yrs, direct @headsUPmigraine, & disagree profoundly w/ overpsychologizing pain.

#Psychologists are wrong to diagnose "catastrophizing" w/ this test w/o telling patients that doctors may use results to taper/deny #opioids.
@CContrarus @hope411adcock @painadvocateAR @tal7291 @fightpaindaily @speakingabtpain @jillyannjiggs @JoeFalzone8 @JSG_54 @LadyAg72 @brent_kellogg @dr4liberty @Irishbrat1966 @ThomasKlineMD @DanLairdMD @D321Debbie @Angelsgal02 @esteckler2 @headsUPmigraine Thread below: @headsUPmigraine's response to "catastrophizing" survey & diagnosis, as well as its "possible predictive value for #opioid prescription" (sec 4: Discussion, Sharifzadeh, Darnall, et al., 2017). ncbi.nlm.nih.gov/pmc/articles/P…
People should be informed if a questionnaire they're given to diagnose a #psychological disorder might potentially be used by a physician to deny them treatment for a physical disease.
Read 18 tweets
#Migraine patients were excluded from Eli Lilly's trial of #Emgality 300 in which 71.4% of people got +50% reduction in #headache days. Only 28% of people taking 120 mg hit this benchmark. Trial exclusion means FDA did NOT approve 2.5x more effective 300 for CM. @LillyPad thread
Trial exclusions determine FDA "labeled" usage. Insurers routinely cover off-label use of inexpensive meds & deny off-label use of expensive meds. Eli Lilly priced #Emgality high: $6,900/year. investor.lilly.com/news-releases/…
Both #cluster & #migraine are profoundly disabling diseases w/ overlapping symptoms. #Emgality treats both. People fully disabled by 1 are no more/less disabled than people fully disabled by the other, so why did Lilly assume #cluster required nearly 3x more med?
Read 11 tweets
If you have an interest in #AI, #HealthTech or #PatientSafety - then please read this evidence based thread which tells the story of @DrMurphy11 & an #eHealth #AI #Chatbot.

Read on, or see single tweet summary here👇0/44
is not a 'nerd'; he's a pretty typical NHS consultant with an interest in #PatientSafety.

On 6th Jan 2017 a tweet about an #eHealth #AI #Chatbot in #NHS trials caught his attention, so he thought he'd take a look. 1/44

Evidence here 👇
Dr Murphy downloaded the @babylonhealth App & tried the #Chatbot with a few simple clinical presentations. It quickly became apparent that the #Chatbot had flaws, raising the question if the App had been validated as a triage tool?

As evidenced by👇 2/44
Read 45 tweets

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