Reference programme: diagnosis and treatment of headache disorders and facial pain. Danish Headache Society, 3rd edition, 2020

Abstract

Headache and facial pain are among the most common, disabling and costly diseases in Europe, which demands for high quality health care on all levels within the health system. The role of the Danish Headache Society is to educate and advocate for the needs of patients with headache and facial pain. Therefore, the Danish Headache Society has launched a third version of the guideline for the diagnosis, organization and treatment of the most common types of headaches and facial pain in Denmark. The second edition was published in Danish in 2010 and has been a great success, but as new knowledge and treatments have emerged it was timely to revise the guideline. The recommendations for the primary headaches and facial pain are largely in accordance with the European guidelines produced by the European Academy of Neurology. The guideline should be used a practical tool for use in daily clinical practice for primary care physicians, neurologists with a common interest in headache, as well as other health-care professionals treating headache patients. The guideline first describes how to examine and diagnose the headache patient and how headache treatment is organized in Denmark. This description is followed by sections on the characteristics, diagnosis and treatment of each of the most common primary and secondary headache disorders and trigeminal neuralgia. The guideline includes many tables to facilitate a quick overview. Finally, the particular challenges regarding migraine and female hormones as well as headache in children are addressed.

Long term evaluation of a multidisciplinary trigeminal neuralgia service

“…There is a considerable delay before patients are referred to specialist centres where there is an agreed care pathway with access to an MDT [ 1 ]. This pathway is supported by recent updated guidelines on the management of TN [ 5 ] and by the Danish Headache Society guidelines [ 20 ]. Robust care pathways that include peri-operative protocols, diagnosis, and surgical process result in improved value-based surgery [ 21 ].…”

The management and clinical knowledge of headache disorders among general practitioners in Norway: a questionnaire survey

“…The vast majority suggested triptans for acute treatment of migraine and adequate prophylactic medication was suggested for frequent episodic migraine by as many as 87%. Candesartan and beta-blockers are two of the first line choices in most treatment guidelines and were the most commonly suggested prophylactic medications [ 12 – 14 , 30 ]. Few GPs suggested topiramate and Botulinum toxin type A. Topiramate has class I evidence and should probably be used more by patients with migraine.…”

Barriers and Gaps in Headache Education: A National Cross-sectional Survey of Neurology Residents in Denmark

“…However, for some of the more popular recommended options (e.g., physiotherapy, acupuncture, and diet), data on potential therapeutic gain of these therapies is discordant, and may also explain why respondents on average feel less con dent in advising patients on non-pharmacological treatment options. 2 These gaps in treatment and management could be related to a lacking use of available national guidelines, 15 but the use of guidelines is reported to be higher than moderate (Table 3).…”