Guideline on the preventive treatment of chronic migraine, chronic tension type headache, hemicrania continua and new daily persistent headache on behalf of the Colombian Association of Neurology

Muñoz-Cerón JF., Rueda Sánchez M., Pradilla-Vesga OE., Volcy M., Hernández N., Ramírez SF. et al. Consenso https://doi.org/10.22379/24224022300 A cta N eurológica C olombiana Guideline on the preventive treatment of chronic migraine, chronic tension type headache, hemicrania continua and new daily persistent headache on behalf of the Colombian Association of Neurology Guía de la Asociación Colombiana de Neurología para el tratamiento preventivo de la migraña crónica, cefalea tipo tensión crónica, hemicránea continua y cefalea diaria persistente de novo Joe Fernando Muñoz-Cerón (1), Mauricio Rueda Sánchez (2), Oscar Enrique Pradilla-Vesga (3), Michel Volcy (4) Natalia Hernández (5), Sergio Francisco Ramírez (6), Fidel Sobrino (7), Bernardo Uribe (8), Carolina Guerra (9), Juan Diego Jiménez (10), Marta Liliana Ramos (11), Gustavo Pradilla () (12), José David Martínez (13), Cesar Daniel Torres (14), Gabriel Torres (15) SUMMARY INTRODUCTION: chronic daily headache is a high impact entity in the general population. Although chronic migraine and tension-type headache are the most frequent conditions, it is necessary to consider hemicrania continua and new daily persistent headache as part of the differential diagnoses to perform a correct therapeutic approach. OBJECTIVE: to make recommendations for the treatment of chronic daily headache of primary origin METHODOLOGY: The Colombian Association of Neurology, by consensus and Grade methodology (Grading of recommendations, assessment, development and evaluation), presents the recommendations for the preventive treatment of each of the entities of the daily chronic headache of primary origin group. RESULTS: for the treatment of chronic migraine, the Colombian Association of Neurology recommends onabotulinum toxin A, erenumab, topiramate, flunarizine, amitriptyline, and naratriptan. In chronic tensiontype headache the recommended therapeutic options are amitriptyline, imipramine, venlafaxine and mirtazapine. Topiramate, melatonin, and celecoxib for the treatment of hemicrania continua. Options for new daily persistent headache include gabapentin and doxycycline. The recommendations for inpatient treatment of patients with chronic daily headache and the justifications for performing neural blockades as a therapeutic complement are also presented. CONCLUSION: the therapeutic recommendations for the treatment of chronic daily headache based on consensus methodology and Grade System are presented. (1) Hospital Universitario Mayor, CIMED - Universidad del Rosario, Clínica Universitaria Colombia, Bogotá, Colombia. (2) Práctica privada, Bucaramanga, Colombia. (3) Fundación Oftalmológica de Santander, Clínica Carlos Ardila Lulle, Bucaramanga, Colombia. (4) Instituto de Dolor de Cabeza y Enfermedades Neurológicas(Indocen), Medellín, Colombia. (5) Promedan, Neuroclínica, Neuromédica, Medellín, Colombia. (6) Colsanitas, Hospital San José Infantil, Bogotá, Colombia. (7) Hospital de Kennedy, Universidad de La Sabana, Bogotá, Colombia. (8) Universidad de Manizales, Manizales, Colombia. (9) Clínica Soma, Medellín, Colombia. (10)Clínica Confamiliar Risaralda, Pereira, Colombia. (11)Hospital La Samaritana, Bogotá - Colombia. (12)Universidad Industrial de Santander, Bucaramanga, Colombia. (13)Clínica Universitaria Bolivariana - IPS Neuromédica, Medellín, Colombia. (14)Clínica Universitaria Colombia, Bogotá, Colombia. (15)Universidad de York, York, Reino Unido. Recibido 9/5/20. Aceptado: 9/5/20. Acta Neurol Colomb. 2020; 36(3): 150-167 Correspondencia: Joe Muñoz, 150 Guideline on the preventive treatment of chronic migraine KEYWORDS: consensus; chronic daily headache; chronic migraine; chronic tension-type headache; hemicrania continua (MeSH) RESUMEN INTRODUCCIÓN: la cefalea crónica diaria es una entidad de alto impacto en la población general. Aunque la migraña crónica y la cefalea tipo tensión son las condiciones más frecuentes, es necesario considerar la hemicránea continua y la cefalea diaria persistente de novo como parte de los diagnósticos diferenciales para realizar un enfoque terapéutico correcto. OBJETIVO: hacer recomendaciones para el tratamiento de la cefalea crónica diaria de origen primario METODOLOGÍA: la Asociación Colombiana de Neurología, mediante consenso y metodología Grade (Grading of reccomendations, assesment, development and evaluation), presenta las recomendaciones para el tratamiento preventivo de cada una de las entidades del grupo de la cefalea crónica diaria de origen primario. RESULTADOS: para el tratamiento de la migraña crónica, la Asociación Colombiana de Neurología recomienda onabotulinum toxina A, erenumab, galcanezumab, fremanezumab, topiramato, flunarizina, amitriptilina y naratriptan. En cefalea tipo tensional crónica las opciones terapéuticas recomendadas son amitriptilina, imipramina, venlafaxina y mirtazapina. Para el tratamiento de la hemicránea continua topiramato, melatonina y celecoxib. Las opciones para cefalea diaria persistente de novo incluyen gabapentin y doxiciclina. Se presentan adicionalmente las recomendaciones para el tratamiento intrahospitalario de los pacientes con cefalea crónica diaria y las justificaciones para la realización de bloqueos neurales como complemento terapéutico. CONCLUSIÓN: se presentan las recomendaciones terapéuticas para el tratamiento de la cefalea crónica diaria basado en metodología de consenso y sistema Grade. PALABRAS CLAVE:consenso; cefalea crónica diaria; migraña crónica; cefalea tipo tensión crónica; hemicránea continua (DeCS). INTRODUCTION At least 50% of the general population has suffered from headache during the last year (1). Although chronic tension-type headache represents the most prevalent etiology, migraine is the entity with the greatest impact related to disease burden (2,3). Both entities can evolve to chronic daily headache (CDH), which is characterized by reaching a headache frequency equal to or greater than 15 days per month during the last three months (4,5). This syndrome presents a population prevalence of 2.6%, 1.1% for chronic migraine (CM) and 0.5% for chronic tension-type headache (CTTH) (1). In Latin America a prevalence between 5.12 and 7.76 has been reported (6). The CDH group is complemented by hemicrania continua (HC) and new daily persistent headache (NDPH), members of groups III and IV of the International Headache Society (IHS) classification, which represent 0.07% and 1.15%, respectively, in the clinical population (6). Although the IHS classification does not directly consider the concept of CDH, it does define the diagnostic criteria of each of these entities, which allows its application to clinical practice (table 1). According to the data of disease burden and therapeutic refractoriness of the CDH, this syndrome generates a high impact on the general population, measured in years lived with disability, excessive use of analgesics, decrease in labor production and role restriction (7-9). Delphy methodology consis (...truncated)