At Hyatt Regency Pune

10-13 Aug, 2017

Workshop on Headache & Orofacial Pain

Time 
Topic 
 Speaker 
10;15 am - 10:20 am  
General Introduction on Headache and orofacial pain - Problem Statement, Epidemiology
Karthick 
Babu 
Natarajan 
 10:20 am - 10:30 am 
Classification and Short Pathophysiology of Different kinds of Headache. 
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  Case 1    Migraine
Case 1 *= A 38 year old woman with a past medical history of calcium phosphate kidney stones, depression, and familial essential tremor presents to you for evaluation of headache. She has episodic headache since her early 20s. However, her headache frequency has increased over the last 6-8 months. She now has pounding unilateral headache about 4-5 times per month lasting up to 24 hours. These headaches are associated with photophobia but not photophobia and interfere with her daily activities. She denies any warning prior to her headaches. Het other medical problems are currently well controlled without medications. Her neurological examination is unremarkable.
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 10:30 am - 10:35 am 
Case 1 discussion + investigation findings  
Subrata Goswami   
 10:35 am - 10:45 am
 Diagnostic criteria, investigation advices. For Migraines
  10:45 am - 10:55 am 
 Discussion with Audience 
  1. What is the most likely diagnosis?
  2. What are the differential diagnoses?
  3. What treatment is best for this patient (considering the co morbidities)?
Subrata Goswami
 10:55 am - 11:15 am 
 Neurostimulation for intractable Migraines
 Sukdev 
Datta
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 Case 2  Trigeminal autonomic cephalalgia  
 A 38 year old male presents with a 5 year history of episodic debilitating headaches. He reports a strictly unilateral right sided unbearable headache that occurs only 2 months in one year, waking him up at night from sleep. He denies nausea and vomiting but reports that, when severe, the headache is associated with right sided eye tearing and nasal congestion. He has failed to respond to standard preventive treatment for migraine. His neurologic exam is normal, and he has never had MRI of his brain. He states that he can’t tolerate his headaches anymore, and feels suicidal due to severe pain. He was referred to you for treatment and evaluation of his severe migraines.
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  11:15 am -  11:20 am 
 Case 2 discussion + investigation findings  
Karthick 
Babu
Natarajan 
  11:20 am - 1130 am 
 Diagnostic criteria, investigation advices  for Trigeminal autonomic cephalalgia 
 Sripurna Mandal
  11:30 am - 11:40 am 
  Questions:
1. What is the most likely diagnosis? What are the diagnostic pitfalls?
2. Does the specific diagnosis matter?
3. What is the importance of suicidal thoughts?
4. prognosis
Karthick 
Babu
Natarajan 
 11:40 am -  11:50 pm 
Treatment consideration with  evidence, Newer Treatment options for  Trigeminal autonomic cephalalgia 
Sripurna Mandal
'
 Case 3 Tension type headache  
Case 3 *= A 35 year old female with past medical history significant for anxiety and depression presents with complaints of headaches that have been worsening for over 3 years. She reports that the pain starts in the back of her neck and moves to the forehead. The characteristic of the pain has been the same over the years, but the frequency has increased. She does not have any associated symptoms such as nausea, vomiting, blurry vision, photophobia or phonophobia. She is single and works as an advocate at a prestigious law firm. She uses aspirin and paracetamol, which provide some relief. 
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  11:50 am - 12:55 am
 Case 3 discussion + investigation findings 
Subrata Goswami 
   12:55 am -12:05 pm 
 Diagnostic criteria, investigation advices for Tension type headache  
 Ratul Kundu
  12:05 pm - 12:15 pm 
  Questions:
1. What is the most likely diagnosis? What are the differentials?
2. Psychological evaluation tools.
3. What are the non-pharmacological treatment methods/advices?
 Subrata Goswami 
  12:15 pm - 12:25 pm 
 Treatment consideration with  evidence, Newer Treatment options  for Tension type headache  
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Case 4 Trigeminal Neuralgia
 Case 4 *= 73 year old male with hypertension and CAD who presented to pain clinic with a complaint of intermittent, 10/10 intensity pain in the distribution of the V2 division of the right trigeminal nerve that had electrical, knife like and shooting qualities. The patient describes an 8-10 kg weight loss over the past 2 years, isolation and limited ability to eat. The pain had begun 6 years earlier and initially occurred approximately once every 1-2 months and attacks lasted only seconds. These attacks were eventually controlled with a regimen of carbamazepine and baclofen until 1 year prior to presentation when, despite the use of medication, the attacks returned and progressed to the point where they were unrelenting, occurring daily without significant periods of relief. Neither physical examination nor MRI revealed a source of the pain. The patient was treated with percutaneous RF rhizotomy of the gasserian ganglion at 60 degree for 60 seconds. The patient was pain free for 1 year following the procedure and only experienced mild facial hypo-esthesia for 2 months. 
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 12:25 pm - 12:30 pm 
 Case 4 discussion + investigation findings 
 Karthick 
Babu
 Natarajan 
 12:30 pm - 12:40 pm 
 Diagnostic criteria, investigation advices for  Trigeminal Neuralgia    
 12:40 pm - 12:50 pm  
 Questions:
1. What is the most likely diagnosis? What are the differentials?
2. Clinical approach, red flag sign
3. Important points to remember during the procedure.
 Karthick 
Babu
 Natarajan 
  12:50 pm - 1:00 pm 
 Treatment consideration with  evidence, Newer Treatment options  for  Trigeminal Neuralgia