New Delhi :

Dr. Anita Krishnan

Specialist Neurologist and Divisional Director of Clinical, The Walton Centre NHS Foundation Trust talked to ETHealthWorld’s

Prathiba Raju

On how headache is an extremely global condition and is among the most frequently requested referrals for neurology services and types. She warns that excessive treatment with painkillers for headaches results in additional medication-induced headaches. A chatbot that is based on artificial intelligence could be able to identify and treat headaches specifically.


What are the reasons why headaches require to be treated seriously? How do they affect the general wellbeing?

Headaches are commonplace and are a major worldwide disorder. It is estimated by the global Burden of Diseases estimate that about 50% of the population of the world, roughly 4. billion people suffer headaches frequently. Three percent of people suffer from everyday headaches with no break, that can be a depressing and debilitating.

It could be surprising to learn that migraine is among the most frequent headache conditions and is second in the causes of disability around the globe. It is the most significant reason for disability and lost days at work for young women.

Nearly all headaches that range from moderate to severe in severity and impair the ability of an individual to function normally, may be classified as migraine. Very few migraine sufferers (only 1 out of 5) have bright lights or wavy lines as well as pins and needles weakening (‘migraine aura’) as part of their migraine. It is also frequent to experience a feeling of pressure around the eyes and neck pain, as well as visual blurring and fatigue, a inability to concentrate, word problems, dizziness nausea, and frequent headaches. Thus, migraines and other headaches result in significant difficulties and disability for sufferers due to the pain and other symptoms that accompany it.


What type of headaches require immediate medical assistance?

Certain “red flags” indicate the presence of sinister causes for headaches. These warning signs typically appear in the description of the headache provided by the patient, as well as results of the clinical examination. The new headaches that are severe and explosive immediately after onset, headaches associated with features of meningitis headaches with double vision , constant loss of vision and also new headaches among people who are elderly or who have an history of cancer need more urgent examinations, such as scans.


What do we know about the current state of knowledge of headaches?

Contrary to what many believe, headaches are not always due to a physical issue in the brain or other areas of the neck and head. 99.99 percent of headache conditions that are common to the population are classified as ‘primary headaches which are actual, painful headaches which result from the occurrence of malfunctioning pain signals coming emanating from an inherent system for headaches located in the human brain. Migraine and cluster headaches or tension headaches are all primary headaches. Primary headaches are not a reason to undergo an investigation. It is recommended to investigate headaches with red flags of danger.

For a long time, headaches have been viewed as stigmatized or dismissed as psychological condition or as coming from eyes, sinuses and necks, etc. After the identification of neural pathways in the brain that cause headaches Researchers have identified the neurochemicals involved in these systems in the brain. The result has been the creation of targeted therapies to control pain and also for prevention


There are many people who use painkillers for headaches. Are there other options that are available?

The use of specific painkillers is immediately at the beginning of an attack of headache to receive full or total pain relief. In contrast to other pain-related conditions it isn’t recommended to use regular painkillers for headaches. The general advice for migraine sufferers is that patients shouldn’t take painkillers more frequently than 2to 3 times per week. Frequent use of painkillers can trigger additional headaches. This is among the factors that increase the likelihood of developing a condition known as chronic daily headache.

If someone is experiencing headaches more than 2 times a week, they must be taking a distinct group of medication known as preventatives. They must be taken on a regular basis as they try to block the signal of pain. A variety of preventatives are available in injections or tablets. It should be noted that they must be administered for a couple of months before they begin to take effect , and they must be maintained for 6 to 12 months to be effective.


What’s the most common mistakes that can be made when it comes to managing headaches?

We are all accustomed to discomfort that is a sign of a physical issue such as an infection or a fracture. It is difficult to accept the notion that primary headaches and the fact that there is no physical issue in the brain. Therefore, many people go through repeated brain scans that are not needed. In addition to the scans, it’s the description of headache symptoms and the associated symptoms that give doctors the required information to a diagnosis.

Most people are unaware that headaches may manifest in a sporadic manner (one-off intense headaches with clear, long intervals between attacks) or as long-term headaches (frequent intense headaches 3-4 times per week with a dull headache/hangover-like sensation in Between attacks).

It is also possible that “tension headaches are overdiagnosed. The majority of headaches that prompt patients to seek medical assistance are migraines. The use of painkillers is different in headaches in comparison to other ailments that can cause pain. Doing more than 2to 3 times a week, or using strong painkillers containing codeine, or morphine is not recommended because they can make headaches more severe.


What is the different in tension headaches and migraines? What precautions are necessary to take?

Tension headaches are the most common headaches that affect all sides of the head, both around the front and back that don’t have any other symptoms that accompany them and should not impact the patient’s day-today functioning. The sensation of tension or tightness does not necessarily indicate the presence for tension headaches. However migraine headaches even a single episode generally cause a person to feel they are unable to work effectively and they require take a break or rest. Both of these kinds of headaches can be present together.

A consistent sleep schedule and staying hydrated through drinking water, observing a regular diet routines, and limiting coffee consumption are all suggested for the general control of headaches particularly chronic headaches. There is no need to follow a specific diet plan for the treatment of headaches.


Headaches are a frequent manifestation of COVID-19. What is the impact will it have on patients, specifically those suffering from COVID for a long time?

Headaches can occur spontaneously or trigger due to illness, hectic lifestyles and irregular sleeping patterns, dehydration, etc. Many people suffering from viral illnesses such as COVID suffer from a persistent headache that is characterized by pressure or a “head fog. If the neurological exam is normal, the headaches will likely to originate as primary headaches. The consequences and treatment for these headaches is similar to the way we deal with chronic migraine.

What is the purpose of the new conversational AI chatbot created in collaboration with NHS, UK in partnership with Tata Consultancy Services (TCS) aid patients and specialists, and how will it accelerate the process of diagnosis and treatment? What are the advantages the chatbot can make over a typical consultation?

The Walton Centre NHS Foundation Trust is a hospital trust that specializes in the UK that is dedicated to providing complete neurology, neurosurgery and spinal and pain treatment services. The area we serve is which includes 3.5 million people in Merseyside, Cheshire, Lancashire, Greater Manchester, the Isle of Man, North Wales and beyond through collaborations together with more than 18 NHS hospitals. Headaches are among the most frequently referred cases to the neurology clinic and is responsible for more than 40% of referrals for outpatients. We have developed extensive procedures and guidelines that guide the general practitioner and patients about the diagnosis and treatment of headaches.

Based on the discussions so far you will see that asking the correct question is crucial in determining between dangerous headaches as well as primary headaches. Based of the descriptions and patterns, the treatment options can be different. There are a variety of treatments readily available if the type of headache is properly identified.

Our current model is that patients are referred to our service, and they wait until they get an appointment. They then review their information and receive advice on management. It is an AI Chatbot for headaches is currently being created by brilliant minds from TCS and the clinical input of our team. A patient who is referred for headache is guided through a series of pertinent questions, and the possible answers are provided by the chatbot. Based on the answers that the patient provides the chatbot constructs the profile and the pattern of the headache condition, including symptoms and trigger factors. This can be extremely beneficial in ensuring referrals are triaged efficiently as it ensures that patients are sent to the correct clinic within the timeframe and are given the right recommendations. This means that the initial consultation could be devoted to providing treatments and other recommendations, thereby increasing the efficiency and satisfaction of patients. The chatbot’s role could be expanded to include different aspects related to headache treatment.

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