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Doody's Review ServiceReviewer: Andrea M Harriott, M.D., Ph.D.(Mayo Clinic Florida)
Description: This concise book on migraine and other headache disorders covers diagnosis to management and treatment strategies, and includes case presentations.
Purpose: In the introduction, the author makes clear the prevalence of migraine, disability associated with it, and its under-recognition and undertreatment. These simple observations are the impetus for providing information to help clinicians in diagnosing and managing the disease. The significance of a concise book about headache disorders that can be easily read by general neurologists or primary care physicians is summed up in the last paragraph of the introduction - it can change the life of the patient and increase the job satisfaction of the clinician.
Audience: The basic nature of the book and the explanation of the pathogenesis make the book most suitable for neurology residents, neurologists outside of the field of headache, and emergency room or primary care physicians with an interest in being able to recognize and initiate treatment for migraine.
Features: The nine chapters focus on treatments of various kinds, including alternative, pharmacological, nonpharmacological, and interventional approaches. There are few illustrations or algorithms, among other shortcomings. There is a brief and simplified discussion of pathogenesis/mechanism following a description of classification and diagnosis that does not take into account the heterogeneity of the disease or the current debate about mechanisms involved in the initiation or maintenance of migraine. There is even less pathogenic explanation for the other headache disorders. The mechanism of action of the therapies, particularly of the triptans, which may be more widely used than some of the other therapies mentioned, is not tackled much. The book provides a broad overview of the material without highlighting some of the elegant preclinical experiments that have been performed. Some key factors may have benefited from being consolidated in one chapter (migraine mimics, red flags to another underlying disease, etc.). That being said, the information is presented in a way that is easy to read and retain. The book's major strength is the focus on therapy, with clinical cases at the end that provide take-home pearls.
Assessment: This is a concise, somewhat simplified, but well-written overview of headaches, focusing on migraine recognition and treatment.