Consensus recommendations on the role of nurses in headache care: A European e-Delphi study.

Background: Nurses work at headache centres throughout Europe, and their care for migraine patients is acknowledged. However, the specific roles and tasks of nursing vary, and a unified understanding is lacking, posing challenges to knowledge sharing and research.

Objectives: Using an e-Delphi study method, the objective is to obtain healthcare professional headache experts' opinions on nursing-specific roles and tasks and combine this into consensus statements for nurse recommendations for migraine treatment.

Implementing a digital solution for patients with migraine-Developing a methodology for comparing digitally delivered treatment with conventional treatment: A study protocol.

Migraine is one of the most frequent and expensive neurological disease in the world. Non-pharmacological and digitally administered treatment options have long been used in the treatment of chronic pain and mental illness. Digital solutions increase the patients' possibilities of receiving evidence-based treatment even when conventional treatment options are limited.

Accuracy of migraine diagnosis and treatment by neurologists in the Baltic states: e-survey with clinical case challenge.

Background: Underdiagnosis of migraine causes a significant health burden, including lower quality of life, excessive medication use, and a delay in effective treatment. The purpose of this study was to evaluate migraine diagnosis accuracy and to review the treatment approaches used by neurologists in the Baltic states.

Methods: The research was conducted as an anonymous e-survey with four cases in March and April 2021.

European Headache Federation (EHF) consensus on the definition of effective treatment of a migraine attack and of triptan failure.

Background: Triptans are migraine-specific acute treatments. A well-accepted definition of triptan failure is needed in clinical practice and for research. The primary aim of the present Consensus was to provide a definition of triptan failure.

Risk factors for development of personal protective equipment induced headache: e-survey of medical staff in Baltic states.

Background: The COVID-19 pandemic led to an unprecedented increase in the use of personal protective equipment (PPE) among medical personnel. The goal of this study was to determine the risk factors and frequency of PPE-induced headache during the COVID-19 pandemic.

Methods: From January 25 to March 1, 2021, an anonymous online survey was undertaken in the Baltic states.

Effect of Altmetric score on manuscript citations: A randomized-controlled trial.

Background: Alternative metrics to traditional, citation-based metrics are increasingly being used. These are complementary to traditional metrics, like downloads and citations, and give information on how often a given journal article is discussed and used in professional (reference managers) and social networks, such as mainstream media and Twitter. Altmetrics is used in most journals and is available in all indexed headache medicine journals.

Structured headache services as the solution to the ill-health burden of headache: 1. Rationale and description.

In countries where headache services exist at all, their focus is usually on specialist (tertiary) care. This is clinically and economically inappropriate: most headache disorders can effectively and more efficiently (and at lower cost) be treated in educationally supported primary care. At the same time, compartmentalizing divisions between primary, secondary and tertiary care in many health-care systems create multiple inefficiencies, confronting patients attempting to navigate these levels (the "patient journey") with perplexing obstacles.

Diagnosis and management of migraine in ten steps.

Migraine is a disabling primary headache disorder that directly affects more than one billion people worldwide. Despite its widespread prevalence, migraine remains under-diagnosed and under-treated. To support clinical decision-making, we convened a European panel of experts to develop a ten-step approach to the diagnosis and management of migraine.

Burden and attitude to resistant and refractory migraine: a survey from the European Headache Federation with the endorsement of the European Migraine & Headache Alliance.

Background: New treatments are currently offering new opportunities and challenges in clinical management and research in the migraine field. There is the need of homogenous criteria to identify candidates for treatment escalation as well as of reliable criteria to identify refractoriness to treatment. To overcome those issues, the European Headache Federation (EHF) issued a Consensus document to propose criteria to approach difficult-to-treat migraine patients in a standardized way.

Secondary headache attributed to exposure to or overuse of a substance.

Background: Secondary headaches attributed to exposure to or the overuse of a substance are classified under chapter eight in the International Classification of Headache Disorders 3rd edition. Three distinct sub-chapters consider: 1. Headache attributed to exposure to a substance, 2.

European headache federation consensus on the definition of resistant and refractory migraine : Developed with the endorsement of the European Migraine & Headache Alliance (EMHA).

Introduction: Despite advances in the management of headache disorders, some patients with migraine do not experience adequate pain relief with acute and preventive treatments. It is the aim of the present document to provide a definition of those migraines which are difficult-to-treat, to create awareness of existence of this group of patients, to help Healthcare Authorities in understanding the implications, and to create a basis to develop a better pathophysiological understanding and to support further therapeutic advances.

Main Body: Definitions were established with a consensus process using the Delphi method.

The applicability of web-based solutions in headache epidemiology research.

Background: Epidemiological research of headache is vital but resource consuming prerequisite for evidence-based development in the field. Rapid evolution of information technology may provide new opportunities for population-based surveys. The aim of this study was to evaluate the applicability of web-based solutions in epidemiological studies of primary headaches.

European Academy of Neurology guideline on the management of medication-overuse headache.

Background: The frequent use of medication to treat migraine attacks can lead to an increase in migraine frequency and is called medication-overuse headache (MOH).

Methods: Based on the available literature in this guideline, the first step in patient management is education and counselling.

Results: Patients with MOH should be managed by a multidisciplinary team of neurologists or pain specialists and behavioral psychologists.

European Academy of Neurology guideline on trigeminal neuralgia.

Background And Purpose: Trigeminal neuralgia (TN) is an extremely painful condition which can be difficult to diagnose and treat. In Europe, TN patients are managed by many different specialities. Therefore, there is a great need for comprehensive European guidelines for the management of TN.

Headache service quality: the role of specialized headache centres within structured headache services, and suggested standards and criteria as centres of excellence.

In joint initiatives, the European Headache Federation and Lifting The Burden have described a model of structured headache services (with their basis in primary care), defined service quality in this context, and developed practical methods for its evaluation.Here, in a continuation of the service quality evaluation programme, we set out ten suggested role- and performance-defining standards for specialized headache centres operating as an integral component of these services. Verifiable criteria for evaluation accompany each standard.

The prevalence of primary headache disorders in the adult population of Estonia.

Objective: To estimate the one-year prevalence of primary headaches, most importantly migraine and tension type headache, but also other primary headaches, in Estonia.

Methods: A population-based random sample of 2162 subjects in Tartu City and Tartu County were interviewed by telephone or face to face using a previously validated questionnaire.

Results: Of the 2162 contacted participants, 1215 (56%) fully completed the study.

The association between migraine and physical exercise.

Background: There is an unmet need of pharmacological and non-pharmacological treatment options for migraine patients. Exercise can be used in the treatment of several pain conditions, including. However, what exact role exercise plays in migraine prevention is unclear.

Structured education to improve primary-care management of headache: how long do the benefits last? A follow-up observational study.

Background And Purpose: Our earlier study showed that structured education of general practitioners (GPs) improved their practice in headache management. Here the duration of this effect was assessed.

Methods: In a follow-up observational study in southern Estonia, subjects were the same six GPs as previously, managing patients presenting with headache as the main complaint.

Headache service quality: evaluation of quality indicators in 14 specialist-care centres.

Background: The study was a collaboration between Lifting The Burden (LTB) and the European Headache Federation (EHF). Its aim was to evaluate the implementation of quality indicators for headache care Europe-wide in specialist headache centres (level-3 according to the EHF/LTB standard).

Methods: Employing previously-developed instruments in 14 such centres, we made enquiries, in each, of health-care providers (doctors, nurses, psychologists, physiotherapists) and 50 patients, and analysed the medical records of 50 other patients.

Neurosyphilis as a great imitator: a case report.

Background: Neurosyphilis is defined as any involvement of the central nervous system by the bacterium Treponema pallidum. Movement disorders as manifestations of syphilis have been reported quite rarely.

Case Presentation: We report a case of a 42-year-old Russian man living in Estonia with rapidly progressive dementia and movement disorders manifesting as myoclonus, cerebellar ataxia and parkinsonism.

3D Cinema and Headache: The First Evidential Relation and Analysis of Involved Factors.

Background: A possible link between 3D movies and headache (HA) has never been a target of specific and systematic investigations. The aim of this study was to investigate the relationship between 3D cinema and HA and to evaluate possible risk factors of developing HA during or after watching a 3D movie.

Methods: This was a prospective, non-randomized, observational study.

Structured education can improve primary-care management of headache: the first empirical evidence, from a controlled interventional study.

Background: Headache disorders are under-recognized and under-diagnosed. A principal factor in their suboptimal management is lack of headache-related training among health-care providers, especially in primary care. In Estonia, general practitioners (GPs) refer many headache patients to neurological specialist services, mostly unnecessarily.

Headaches after traumatic spinal cord injury in Estonia.

Background: Patients with traumatic spinal cord injury (TSCI) often suffer from different types of pain. However, headaches after TSCI have not been studied.

Aim: The aim of this article is to examine the occurrence of headache among patients with TSCI.