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Goal • To discuss the various headache
types described in patients with EDS
• An approach in treating the headaches and potentially improving quality of life.
Objectives • Will briefly discuss the International
Classification for Headache Disorders.
• Discuss the headache types in patient with EDS.
• Discuss potential treatments.
Introduction Pediatric Headache is the 3rd most
common complaint seen in the ER.
While migraine is certainly common, it is
by no means the only headache type.
Introduction
Understanding the various headache
types can potentially help tailor the
treatment and improve quality of life.
ICHD II www. ihs-classification.org
Part 1: Primary headache disorders – 1. Migraine
– 2. Tension type headache
– 3. Cluster headaches and Trigeminal autonomic cephalalgia
– Other primary headaches
Primary Headaches & EDS
• Migraine
• Chronic migraine
• Status migrainosus
• Tension type headaches
• Chronic tension type headaches
Secondary Headaches & EDS
• Headaches due to neck issues
• Headaches due to TMJ issues
• Headaches due to disorders of homeostasis – Sleep
– Poor food intake
– Orthostatic intolerance
Secondary headaches and EDS
• Headaches due to intracranial hypertension
• Headaches due to spontaneous CSF leaks
Headache & EDS • The children will often present with
primary and secondary headache types.
• Treatment will vary depending on the headache type.
Dysautonomia, EDS and Migraine
• The dysautonomia is a constant problem in EDS with or without a headache
• Dysautonomia typically occurs during a migraine attack but not when a person is headache free.
Potential Treatments for
Headaches
Medications Physical Medicine
Cognitive Behavioral Therapy
Atlas orthogonal
Lifestyle
Surgery & Devices
Treatments
Abortives
• Triptans – Maxalt
– Axert
– Zomig
– DHE
• Anti inflammatory – Toradol
– Diclofenac
Preventatives
• Anti epileptics – Topamax
– Depakote
– Keppra
• Calcium Channel Blockers – Flunarizine
• Beta Blockers – Propanolol
– Atenolol
Treatments
Psychology/psychiatry
• Psychotherapy
• Behavioral therapy – CBT
Procedures/PT
• Nerve blocks
• Botox
• Myofascial release
• Transmagnetic stimulation (TMS)
• Occipital nerve decompression
• Neck stabilization