Web resources for treating headaches

Websites related to this week's Clinical Review, selected by Dr Keith Barnard.

CHRONIC TENSION HEADACHE

This account of chronic tension headache originates from BMA's Clinical Evidence series, but I have chosen this version from a US website because it is more concise.

Although Clinical Evidence is an excellent source of information, sometimes there is really more there than a busy GP needs to know. Here the data have been conveniently condensed into two screens, and the main points are covered.

Somewhat confusingly, it starts with treatment effectiveness, but if you scroll down, the rest of the clinical information is there. There is a link to the original publication for the whole article.

Why go there: brief summary.

Downside: none.

Information from: American Family Physician.

Address: www.aafp.org/afp/20030901/british.html

CLUSTER HEADACHES

E-Medicine is such a good source of information, but it's a pity they don't have summary versions of their articles.

Cluster headache is not something you come across every day, but we need to be aware of this important condition. In the US it is also known as histamine headache.

This is more than just a reminder, however, so you need to scroll through it quickly to get the best bits, such as history, physical signs and causes.

The proposed pathophysiology mechanisms are well discussed. The treatment list is extensive, but it will give you plenty of ideas if you are stuck.

Interestingly, the authors claim that the incidence of cluster headache in the UK is the same as that of MS.

Why go there: the treatment section is excellent.

Downside: much more than you really need.

Information from: e-Medicine.

Address: www.emedicine.com/EMERG/topic229.htm

MANAGING MIGRAINE

There is a great deal of information out there on managing migraine, but this site has several advantages. It is a UK-based charity, and has a dedicated section for health professionals.

You will find these pages on the management of migraine up to date, not too long-winded and of practical use in what can be a difficult condition.

The main site is also worth mentioning to patients because there are many services including a helpline, fact sheets and other support.

Why go there: good summary of treatment.

Downside: homepage has an amateurish look.

Information from: The Migraine Trust

Address: www.migraine trust.org/healthprofs/managing.shtml

SELF-HYPNOSIS

Now I'm not saying that this is a load of old cobblers, but this site does make me anxious. These pages offer a set of CDs costing about £26 that provide therapy sessions based on hypnosis.

At the top of the page is a test to see if you can be hypnotised, but I didn't take it in case I fell asleep and there was no one around to wake me up.

So-called instant healing makes me a little wary. Sufferers are told they can progress to learn trance triggers, the five-minute healing trance, and the healing garden.

I cannot help feeling that learning self-hypnosis is not the sort of thing I'd recommend to my patients. But take a look and make up your own mind.

Why go there: for curiosity.

Downside: looks worrying.

Information from: Wendi Friesen.

Address: http://wendi.com/html/headaches.html

- Dr Barnard is a former GP in Fareham, Hampshire

WEBSITE OF THE WEEK

How refreshing to recommend a website that is British and just for GPs. Migraine, chronic daily headache, diagnostic and treatment algorithms - it is all here. This is not exactly a high-flyer when it comes to presentation, but the content is right on the button.

You can access newsletters on various headache issues, and their value is that every one contains information that is relevant to a GP's everyday practice. You will find all the relevant guidelines on headache, and GP trainers and lecturers will be delighted with the slide sets than can be downloaded.

Most of the data is tidily presented as PDFs that are well designed and easy to print. One in particular is mentioned by the writer of this week's Clinical Review - a diagnostic algorithm that is well worth keeping handy.

The site comes from an independent charity and involves doctors, nurses and pharmacists. You can join online and there is no up-front fee.

Why go there: aimed at GPs.

Downside: dull presentation.

Information from: Migraine in Primary Care Advisors.

Address: www.mipca.org.uk/index.html

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