26.01.2022

A neurologist has taught doctors around the world to treat headaches

Neurologist Elena Lebedeva and her colleagues studied the quality of diagnosis and treatment of migraines and headaches in Russia. The study turned the world’s view of this problem upside down.

Tonight, an article by the Ural professor was published in the most respected medical journal The Lancet. There was a lot of work in the neuroscientist’s discovery; together with her colleagues, Elena interviewed and studied the anamnesis of 3,000 residents of the Urals from 3 social groups.

Elena Razumovna Lebedeva is a neurologist of the highest category, doctor of medical sciences, professor. Head of the World Health Organization’s Headache Program in the Sverdlovsk Region. Representative of Russia in the working group at the World Health Organization on the development of a new International Classification of Headaches. Member of the All-Russian, International (International Headache Society) and European (European Headache Federation) headache societies. Author of over 100 scientific papers, 7 teaching aids and a monograph on headaches.

The study involved 1042 students, 1075 business workers and 1007 blood donors. Doctors found that 76% of people experience headaches, 17% of those surveyed have migraines. The Ural professor outlined the main problem that exists all over the world – the lack of high-quality specialized care. According to scientists, migraines and headaches should not be treated by local therapists.

“Migraine is a very serious disease, its importance is underestimated all over the world,” said Elena Lebedeva. – We conducted a study in 2014, 3000 residents of the Ural Federal District took part in it. It turned out that of them only 3 people received preventive treatment, that is, 0.4%. Most doctors prescribed only vascular, nootropic drugs or analgesics, and this treatment does not affect the causes of headaches at all.

Scientists have found that Russia came out on top in headaches from excessive drug use. Due to the constant use of analgesics, headaches become chronic and pain relievers no longer help. 95% of headaches are primary, that is, they are not associated with any pathology. According to a study by Elena Lebedeva, people from the Urals most often experience tension headaches.

Migraine affects one billion people worldwide, and this leads to economic losses, as patients often go on sick leave, and some even quit due to severe headaches.

“For the first time in the world, we have shown that the quality of treatment in Russia practically does not differ from Austria, America, in other countries the situation is practically the same,” said Elena Lebedeva. – It is required that doctors know about headaches and know how to treat them. Recently, I consulted an online patient from Washington, they do not have such a center, he needs to go to New York for a consultation. If we take the countries of Europe, this service is well organized in Denmark, Germany, the Netherlands.

Now Elena Lebedeva is conducting research together with Jes Olesen, professor at the Danish Headache Center, who is one of the most famous scientists in the field of headaches. Neurologist Elena Lebedeva and her colleagues began work on opening a specialized center in Yekaterinburg in 2011. They contacted the Ministry of Health to make this assistance available to all residents.

“We also wanted the center to be not private, but state-owned, and everyone could get help with compulsory medical insurance,” the doctor said.

He is the only neurologist in Russia who completed a two-year master’s degree in headache and received a Master’s degree in Headache disorders.

Since Elena Lebedeva teaches at the Ural Medical University, she has developed a program to train doctors. From 2012 to 2019, together with her colleagues, Elena organized more than 20 trainings in Yekaterinburg on headaches for all doctors; European and Russian experts came to these schools with lectures.

In 2016, together with Russian experts in the field of headaches, Professor Elena Razumovna Lebedeva also developed the All-Russian clinical guidelines for tension headaches and migraines.

“In this article, we say that doctors should understand headaches or refer patients to a specialized headache treatment center. There should be a single guideline for the diagnosis and treatment of migraines around the world. Currently, clinical guidelines have been developed, and they have already been approved by the Russian Ministry of Health. Worldwide cooperation is needed on these issues.

What to do if your head hurts?

We asked the doctor how to behave and who to contact if it pulsates in the temples and you cannot concentrate on work.

– First. You need to understand: is this the same pain that was before, or is this pain different from the previous ones? If the pain intensifies and peaks within one minute, as if you were hit in the head, this is a very serious symptom that could portend a stroke. In this case, you need to immediately identify risk factors for stroke and undergo a competent examination by specialists. If at the same time there was still a loss of consciousness, this may be a harbinger of rupture of the aneurysm. Then you need to do neuroimaging with a specialist.

If the headache has become more frequent and symptoms that did not exist before, for example, nausea, vomiting, photo and sound fear, have joined it, then this may be an alarming symptom of a serious disease – arterial dissection – or another. In this case, you urgently need to go to a headache specialist. If the headache is the same, a simple analgesic should be taken. But remember that they should not be taken more than three times a month. Otherwise it will be overuse of analgesics and lead to drug-induced headaches. But the most important thing: if a common headache occurs at least once a month, you need to go to a headache specialist who has been trained in this profile, – Elena Lebedeva commented.

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