Spotlight on Medication overuse headache

Medication overuse headache is a chronic headache that occurs in people with a pre-existing primary headache, such as migraine or tension-type headache, following overuse of any kind of acute headache medications. It is a common and disabling disorder that affects 1% to 2% of the general population, and it is extremely important to recognize and treat this condition. Generally, treatment of medication overuse headache requires a multidisciplinary setting and includes education of patients, discontinuation of the overused medication, and initiation of preventive treatment.

In this recently updated article, Dr. Chia-Chun Chiang of the University of California, San Diego provides an update on the definition, pathophysiology, clinical aspects, and treatment strategies of this headache type.

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Spotlight on Drug-induced neuropathies

Although uncommon, medication-induced neuropathies are critical to identify because of potential reversibility and limitation of toxicity. Numerous medications have well-established neuropathy links, but many others have only occasional temporal associations. Neuropathy-inducing medications are continually approved, including some that are not known to cause neuropathy prior to release, for example, the rheumatoid arthritis drug leflunomide and tumor necrosis alpha inhibitors. The importance of some, such as phenytoin, is likely overestimated. Peripheral neuropathy from chronic drug exposure is more problematic to establish, and the association with idiopathic neuropathy and statin drugs is a prime example.

In this article, Dr. Louis Weimer of Columbia University discusses the best evidence available for neuropathy and many commonly used medications.

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