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Services delivered via telemedicine have been shown to be effective against common types of headaches, potentially making care for headaches more convenient.
It’s a scenario all too familiar to most men. A gourmet dinner by candlelight, her favorite music playing softly in the background. It seems to be going just as he hoped. And then, all of a sudden, his carefully laid plans for a romantic evening are stopped dead in their tracks when his partner turns to him and pleads, “Not tonight, please. I have a splitting headache.”
No gentleman would press forward when his lady is in distress. So with visions of what might have been playing through his brain, he offers to fetch her a couple of aspirin or acetaminophen in the hope that perhaps a quick cure might salvage the evening. In his heart, however, he knows it’s a lost cause.
Telemedicine to the Rescue
For men whose sex lives have been sabotaged by their partners’ chronic headaches, telemedicine may have an answer. With professional medical services now available 24 hours a day, seven days a week through your laptop, smartphone, or tablet, help is only a few keystrokes away.
And, according to a study published in the June 14, 2017, online issue of “Neurology,” telemedicine offers medical care for headaches that is every bit as effective as an in-person visit to the doctor’s office. And for those who suffer from them, headache disorders are clearly no laughing matter.
Findings from the Global Burden of Disease Study 2013, published in the August 22, 2015, issue of “Lancet,” indicate that migraine, perhaps the most debilitating of all headache disorders, ranks as the sixth largest cause of disability worldwide. However, when combined with other types of headaches, all such disorders are the third largest cause of disability worldwide.
Most Common Neurological Disorder
According to Kai I. Muller, M.D., lead author of the study published online by “Neurology,” the headache is the most common neurologic disorder, yet it is one that often goes undiagnosed and untreated or treated inadequately. “New technology is available to diagnose and treat people through telemedicine, but few studies have looked at whether it is effective for people with headaches.”
Dr. Muller and his colleagues, all associated with academic medical institutions in northern Norway, set out to discover how one-time telemedicine consultations for nonacute headaches compared in efficacy and safety to in-person treatment.

Northern Norway, said Dr. Muller, provides an ideal location for research into the advantages offered by telemedicine because it is a sprawling area that is sparsely populated. Given that setting, “traveling to see a doctor can be cumbersome and expensive for many people.” However, even in areas less remote, he said, telemedicine provides a simple and cost-effective way for headache patients to consult a specialist “without any extra hassle or inconvenience.”
402 Patients in Study Group
The Norwegian research team looked at the cases of 402 patients, all of whom suffered from nonacute headaches, or headaches that came on gradually. On the basis of their initial diagnosis of nonacute headaches, all patients had been referred by their primary doctor to a neurologist.
Roughly half of the patients in the study group were examined in person by a neurologist at a hospital somewhere in northern Norway. The other half also went to the hospital but interacted with the neurologist via teleconferencing, just as they would do in a typical telemedicine consultation from their homes.
Follow-up Questionnaires
All headache patients were required to fill out questionnaires that documented the impact their headaches had on their daily lives. They also were required to grade their level of pain at the start of the study, again after three months, and finally one full year after medical intervention. The research team found no difference in outcome between patients who were seen in person and those who consulted neurologists via telemedicine.
Of the 402 patients who started the study, 342 filled their questionnaire three months after their consultations, and 291 fully responded to the 12-month questionnaire. Of the 291 respondents to the 12-month questionnaire, 156 reported that their most prominent type of headache was migraine, 17 had tension-type headaches, 53 suffered from medication overuse headaches, and 23 were diagnosed with trigeminal autonomic cephalagias, or TACs.
TAC Headaches Explained

This last type of headache is characterized by pain on one side of the head in the trigeminal nerve area accompanied by symptoms in the autonomic system on the same side of the head. The trigeminal nerve is responsible for sensation in the face and motor functions such as biting and chewing. Symptoms accompanying a TAC headache might include eye redness or watering and drooping eyelids.
To assess the thoroughness and safety of telemedicine consultation for headaches, the 12-month post-consultation questionnaire asked if the patient was experiencing a secondary headache. Such headaches are symptoms of a disease or other underlying condition. Only one patient in the telemedicine group and one in the group receiving in-person treatment reported experiencing a secondary headache. According to Dr. Muller this demonstrated that “there was no difference in the diagnosis and treatment” between the two groups.
Gretchen Tietjen, M.D., chair of neurology at the University of Toledo Medical Center and director of the medical center’s Headache Treatment and Research Program, was asked by “Neurology Today” to assess the importance of the Norwegian study’s findings.
Important for Patients in Remote Locations
“This is a particularly important study for patients with headaches who are trying to get access to care in places that are very remote,” said Dr. Tietjen. “It’s hard to do effective follow-up when your patient lives four or five hours away or more; often, the headache specialist ends up doing a one-time visit, writes down their recommendations, and the patient’s subsequent follow-up is only with their primary care provider.”
The Norwegian study’s findings were very similar to those reached in a 10-patient pilot study, dubbed a “virtual headache clinic,” led by Nauman Tariq, M.D., during his fellowship in headache medicine at the Cleveland Clinic. For that study, conducted between 2014 and 2015, headache patients followed up initial face-to-face consultations by using the clinic’s proprietary version of a Skype-style teleconferencing app, download to patients’ smartphone or tablet.
Prefers In-Person Initial Consultation
Dr. Tariq feels strongly that the initial consultation should be conducted in person, which allows for the establishment of rapport between patient and physician, as well as a thorough physical examination. However, once a diagnosis is reached, said Dr. Tariq, “telemedicine visits for headaches are very feasible and cost-effective. They save time for both the patient and the doctor, and they save money for the patient as well.”
In yet another sign that telemedicine is being used more often to provide headache care, representatives from St. Louis-based Mercy Virtual reported in 2015 that more than three-quarters of its follow-up migraine patients were prescribed evidence-based acute medication via telemedicine.
With telemedicine’s rapid growth and increasing availability in markets large and small, getting help for those inconvenient headaches and a host of other medical problems is easier to access than it’s ever been before.
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