Definitions
Diagnosis
Management
Miscellaneous
100

A secondary headache disorder which develops as a consequence of regular overuse of one or more drugs

What is MOH?

100

Headache diary

How can headache symptoms and acute medication use be correlated?

100

Early withdrawal of overused medication

What is the mainstay/1st line treatment of MOH?

100

Thunderclap headahce, new onset in >50 yrs, focal neurological signs, evolution over days to weeks

What are headache red flags?
200

Not well understood, may be related to central sensitisation or similar mechanisms to migraine or tension headaches.

What is the pathophysiology of Tension headaches?

200

Migraines

What is the most common primary headache type?

200

Triptans, Ergotamines and Simple analgesiacs

What drugs should be stopped abruptly in MOH?

200

Stress, Anxiety, Depression, Sleep disturbance

What are complications of MOH?

300

> 3 months

How long must medication be taken for to be classified as an overuse headache?

300

Typically describe their usual headache, though these symptoms may change overtime

What is the presentation of MOH?
300

Opioids, Barbiturates and benzodiazepines

What drugs should be tapered down over 2-4 weeks with MOH?

300

Medication of a different class

How should headaches be managed after withdrawal of the offending drug associated with MOH?

400

15 or more days per month

How often does a headache have to occur to allow for a diagnosis of MOH?

400

Daily headaches with features of migraine and tension-type headache?

How would MOH present?
400

Strong opioids, barbiturates or Tranquilisers

When should a specialist referral to neurology be made?

400

Skin hypersensitivity, runny nose, tearing, nausea, vomiting

What symptoms can be associated with MOH?

500

10 days or more a month

How often do Ergotamines, triptans, opioids or combination analgesiacs need to be taken a month for a MOH diagnosis?

500

Daily migraine-like headache or an increase in migraine frequency

How might Triptan overuse present with MOH?

500

Bridge therapy

What can be offered for patients with severe or frequent headaches? or Experience headaches on withdrawal of the causative medication?

500

1-2%

What is the 1-year worldwide prevalence of MOH?

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