Handbook of Headache Disorders, 2d ed. - book reviews

Journal of Family Practice, August, 1995 by Roger Cady

The Handbook of Headache Disorders by Arthur H. Elkind, MD, is a concise and thorough reference for clinicians managing headache. It is ideally suited for primary care physicians treating headache within the context of general practice.

The book is well organized and provides key information about headache care. There are clinically relevant distillations covering headache prevalence, classification, diagnoses, pathogenesis, and treatment. The book reviews pharmacologic interventions, encompassing appropriate indications and precautions for most headache therapies. Newer headache drugs such as sumatriptan and valproic acid are described, as are updated reviews of established headache medications such as dihydroergotamine. The book integrates pharmacologic therapies with important nonpharmacologic interventions including diet, physical therapy, biofeedback, and psychology. Several tables are provided that organize information practically and succinctly. Of special interest is a table listing foods that may precipitate migraine, and another table summarizing medications frequently abused by headache patients.

This book is ideally suited for physicians in active practice who need a resource that provides quick access to concise therapeutic information. For those who desire a more in-depth review of a particular subject, the book is annotated with key references on many headache topics. This book would be extremely useful to physicians treating patients with headache in the context of many other medical conditions.

The only drawback I find in reading Dr Elkind's book is that the important role of the family physician in headache management is not clearly defined. Although the pieces necessary for headache management are available, the book does not provide a comprehensive overview of the role of family physicians in the ongoing management of this chronic disorder. Bearing in mind that family physicians are the specialists most often consulted for headaches, and that family physicians are the specialists who most often manage chronic disease, the biopsychosocial model of disease care needs to be reinforced. Overall, however, I believe the Handbook of Headache Disorders to be an excellent primer that would be an asset in the office library of any family physician treating patients with headache.