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Prospective Comparison of Methods for Assessment of Headache DirectionalityHoffman, Carmen 30 March 2018 (has links)
A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Response to prophylactic treatment of migraine
with Onabotulinumtoxin A (BTX-A) has been noted to be significantly correlated to the perceived
direction of headache pain, namely imploding vs. exploding subtype. This study analyzed 3 methods
of assessing migraine directionality in comparison to a 30-day headache log; pictorial
representation, written description, and physician assessment. Each of these assessment types was
shown to have poor agreement with the headache log at the initial visit. However, all 3 assessments
displayed excellent agreement at the return visit, as well as significantly improved confidence in
patient ability to determine headache directionality.
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