This episode makes reference to guidelines produced by the "National Institute for Health and Care Excellence" in the UK, also referred to as "NICE". Please note that the content on this channel reflects my professional interpretation/summary of the guidance and that I am in no way affiliated with, employed by or funded/sponsored by NICE. My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I will go through the NICE guideline on “Headaches in over 12s: diagnosis and management”, or NICE guideline CG150. I will summarise the guidance from a Primary Care perspective only. I am not giving medical advice; this video is intended for health care professionals; it is only my interpretation of the guidelines and you must use your clinical judgement.     There is a YouTube version of this and other videos that you can access here:  The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The NICE guideline CG150 “Headaches in over 12s: diagnosis and management” can be found here: ·      https://www.nice.org.uk/guidance/cg150/chapter/Recommendations Thumbnail photo: from Freepik: https://www.freepik.com/ ·      Image by Drazen Zigic on Freepik ·      a href="https://www.freepik.com/free-photo/low-angle-view-distraught-man-holding-his-head-pain-while-sitting-living-room_26343742.htm#query=headache&position=2&from_view=search&track=sph"Image by Drazen Zigic/a on Freepik Intro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release]     Music provided by Audio Library Plus  Watch: https://youtu.be/aBGk6aJM3IU Free Download / Stream: https://alplus.io/halfway-through  Transcript Hello and welcome, I am Fernando, a GP in the UK. Today, we will go through the NICE guideline on headaches and I will summarise the guidance from a Primary Care perspective only. So, let’s jump into it. We will start by looking at the diagnostic clinical features that could help differentiate between tension‑type headache, migraine and cluster headache. ·      First, we have the Pain location which: o  In Tension headache:  is usually Bilateral o  In Migraine: can be Unilateral or bilateral o  And in Cluster headache: is Unilateral (usually around the eye, above the eye and along the side of the head/face) ·      Then we look at the Pain quality which: o  In Tension headache: is usually Pressing or tightening and non‑pulsating o  In Migraine: is generally Pulsating (although it can be described as throbbing or banging in those aged 12 to 17 years) o  And in Cluster headache: it is Variable (sharp, boring, burning, throbbing or tightening) ·      The Pain intensity is: o  Mild or moderate in Tension headache: o  Moderate or severe in Migraine: o  And Severe or very severe in Cluster headache: ·      In terms of the Effect on activities we find that: o  Tension headache: Is Not aggravated by routine activities o  Migraine: is Aggravated by, or causes avoidance of, routine activities o  And Cluster headache: causes Restlessness or agitation ·      Looking at Other possible symptoms we find that: o  Tension headache: doesn’t usually have any o  Migraine: usually produces Sensitivity to light and/or sound or nausea and/or vomiting. There can also be aura symptoms, which we will cover in more detail later. o  and Cluster headache: will normally present On the same side as the headache: red and/or watery eyenasal congestion and/or runny noseswollen eyelidforehead and facial sweatingconstricted pupil and/or drooping eyelid·      and finally, in terms of Duration of the headache: o  Tension headaches can be from 30 minutes to continuous: o  Migraine: can be 4 to 72 hours in adults but 1 to 72 h in those aged 12 to 17  o  And Cluster headache:  usually lasts 15 to 180 minutes Episodic tension-type headaches or episodic migraines o