Diagnosis and management of headaches in young people and adults: summary of NICE guidance

Abstract

Headaches are a common problem that many clinicians in primary and secondary care find difficult to treat.1 2 Once the serious causes of headache have been excluded (such as infection, tumour, bleeding, and arteritis), the major health and social burden of headaches can be attributed to primary headache disorders (cluster headache, migraine, and tension-type headache) and headache caused by the overuse of medications. Straightforward advice is needed for anyone working in the NHS on the diagnosis and treatment of these common disorders and the prevention of medication overuse headache. This article summarises the most recent recommendations from the National Institute for Health and Clinical Excellence (NICE) on the diagnosis and management of headaches in young people and adults.3 NICE recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group’s experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Assessment: indications for considering additional investigation [ All based on the experience and opinion of the Guideline Development Group (GDG )]