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Sample records for include headache nausea

  1. Headaches

    Science.gov (United States)

    ... and does the pain occur during times of stress or after you have been sitting in one position for a long time?YesNoDo you have intense throbbing pain, often with nausea or vomiting, and see flashing lights or spots before the headache?YesNoDo your headaches occur after you read, watch ...

  2. Variants in the CNR1 gene predispose to headache with nausea in the presence of life stress.

    Science.gov (United States)

    Juhasz, G; Csepany, E; Magyar, M; Edes, A E; Eszlari, N; Hullam, G; Antal, P; Kokonyei, G; Anderson, I M; Deakin, J F W; Bagdy, G

    2017-03-01

    One of the main effects of the endocannabinoid system in the brain is stress adaptation with presynaptic endocannabinoid receptor 1 (CB1 receptors) playing a major role. In the present study, we investigated whether the effect of the CB1 receptor coding CNR1 gene on migraine and its symptoms is conditional on life stress. In a cross-sectional European population (n = 2426), recruited from Manchester and Budapest, we used the ID-Migraine questionnaire for migraine screening, the Life Threatening Experiences questionnaire to measure recent negative life events (RLE), and covered the CNR1 gene with 11 SNPs. The main genetic effects and the CNR1 × RLE interaction with age and sex as covariates were tested. None of the SNPs showed main genetic effects on possible migraine or its symptoms, but 5 SNPs showed nominally significant interaction with RLE on headache with nausea using logistic regression models. The effect of rs806366 remained significant after correction for multiple testing and replicated in the subpopulations. This effect was independent from depression- and anxiety-related phenotypes. In addition, a Bayesian systems-based analysis demonstrated that in the development of headache with nausea all SNPs were more relevant with higher a posteriori probability in those who experienced recent life stress. In summary, the CNR1 gene in interaction with life stress increased the risk of headache with nausea suggesting a specific pathological mechanism to develop migraine, and indicating that a subgroup of migraine patients, who suffer from life stress triggered migraine with frequent nausea, may benefit from therapies that increase the endocannabinoid tone. © 2016 The Authors. Genes, Brain and Behavior published by International Behavioural and Neural Genetics Society and John Wiley & Sons Ltd.

  3. Headache

    Science.gov (United States)

    ... most common type of headache is a tension headache. Tension headaches are due to tight muscles in your shoulders, neck, scalp and jaw. They are often related to stress, depression or anxiety. You are more likely to ...

  4. Headache

    Science.gov (United States)

    ... SEARCH Definition Treatment ... visits to the doctor. The International Classification of Headache Disorders, published by the International Headache Society, is used to classify more than 150 types ...

  5. Internet interventions for chronic pain including headache: A systematic review

    Directory of Open Access Journals (Sweden)

    Monica Buhrman

    2016-05-01

    Full Text Available Chronic pain is a major health problem and behavioral based treatments have been shown to be effective. However, the availability of these kinds of treatments is scarce and internet-based treatments have been shown to be promising in this area. The objective of the present systematic review is to evaluate internet-based interventions for persons with chronic pain. The specific aims are to do an updated review with a broad inclusion of different chronic pain diagnoses and to assess disability and pain and also measures of catastrophizing, depression and anxiety. A systematic search identified 891 studies and 22 trials were selected as eligible for review. Two of the selected trials included children/youth and five included individuals with chronic headache and/or migraine. The most frequently measured domain reflected in the primary outcomes was interference/disability, followed by catastrophizing. Result across the studies showed a number of beneficial effects. Twelve trials reported significant effects on disability/interference outcomes and pain intensity. Positive effects were also found on psychological variable such as catastrophizing, depression and anxiety. Several studies (n = 12 were assessed to have an unclear level of risk bias. The attrition levels ranged from 4% to 54% where the headache trials had the highest drop-out levels. However, findings suggest that internet-based treatments based on cognitive behavioural therapy (CBT are efficacious measured with different outcome variables. Results are in line with trials in clinical settings. Meta-analytic statistics were calculated for interference/disability, pain intensity, catastrophizing and mood ratings. Results showed that the effect size for interference/disability was Hedge's g = −0.39, for pain intensity Hedge's g = −0.33, for catastrophizing Hedge's g = −0.49 and for mood variables (depression Hedge's g = −0.26.

  6. The prevalence of bad headaches including migraine in a multiethnic community.

    Science.gov (United States)

    Thomson, A N; White, G E; West, R

    1993-11-10

    Overall and ethnic specific prevalences of bad headache including migraine, for the New Zealand population, are unknown. A study was carried out in South Auckland to estimate prevalence and to explore ethnic differences in doctor attendance for the diagnosis and management of bad headaches. Telephone interviews were administered to respondents selected by random digit dialing of households. 40.6% of the respondents suffered from bad headaches. 54.5% of these had the characteristics of bad headache with features symptomatic of migraine. Trends in the prevalence of bad headache with features symptomatic of common migraine, peaked between the ages of 30-49 years in both men and women. A difference was seen in the prevalence of bad headache with aura, with or without common migraine features, when ethnic groups and gender were examined. The difference in prevalence of aura was particularly noticeable between Pacific Island men and women. Although there was no difference between ethnic groups in doctor attendance, headaches were more likely to be labelled as migraine in Europeans than in the Polynesian groups. Ways in which people perceive and report their bad headaches have a bearing on management by general practitioners. Although no overall ethnic predominance was seen, there was a gender difference amongst Pacific Island people in reporting bad headaches with aura. The labelling process, and thus the management by general practitioners does demonstrate likely ethnic differences.

  7. Etiopathophysiological assessment of cases with chronic daily headache: A functional magnetic resonance imaging included investigation

    Science.gov (United States)

    Hashemi, Akram; Nami, Mohammad Torabi; Oghabian, Mohammad Ali; Ganjgahi, Habib; Vahabi, Zahra

    2012-01-01

    Background Chronic daily headache (CDH) has gained little attention in functional neuro-imaging. When no structural abnormality is found in CDH, defining functional correlates between activated brain regions during headache bouts may provide unique insights towards understanding the pathophysiology of this type of headache. Methods We recruited four CDH cases for comprehensive assessments, including history taking, physical examinations and neuropsychological evaluations (The Addenbrooke's Cognitive Evaluation, Beck's Anxiety and Depression Inventories, Pittsburg Sleep Quality Index and Epworth Sleepiness Scale). Visual analogue scale (VAS) was used to self-rate the intensity of headache. Patients then underwent electroencephalography (EEG), transcranial Doppler (TCD) and functional magnetic resonance imaging (fMRI) evaluations during maximal (VAS = 8-10/10) and off-headache (VAS = 0-3/10) conditions. Data were used to compare in both conditions. We also used BOLD (blood oxygen level dependent) -group level activation map fMRI to possibly locate headache-related activated brain regions. Results General and neurological examinations as well as conventional MRIs were unremarkable. Neuropsychological assessments showed moderate anxiety and depression in one patient and minimal in others. Unlike three patients, maximal and off-headache TCD evaluation in one revealed increased middle cerebral artery blood flow velocity, at the maximal pain area. Although with no seizure history, the same patient's EEG showed paroxysmal epileptic discharges during maximal headache intensity, respectively. Group level activation map fMRI showed activated classical pain matrix regions upon headache bouts (periaqueductal grey, substantia nigra and raphe nucleus), and markedly bilateral occipital lobes activation. Conclusion The EEG changes were of note. Furthermore, the increased BOLD signals in areas outside the classical pain matrix (i.e. occipital lobes) during maximal headaches may

  8. Periictal and interictal headache including migraine in Dutch patients with epilepsy: a cross-sectional study.

    Science.gov (United States)

    Hofstra, W A; Hageman, G; de Weerd, A W

    2015-03-01

    As early as in 1898, it was noted that there was a need to find "a plausible explanation of the long recognized affinities of migraine and epilepsy". However, results of recent studies are clearly conflicting on this matter. In this cross-sectional study, we aimed to define the prevalence and characteristics of both seizure-related and interictal headaches in patients with epilepsy (5-75years) seeking help in the tertiary epilepsy clinic SEIN in Zwolle. Using a questionnaire, subjects were surveyed on the existence of headaches including characteristics, duration, severity, and accompanying symptoms. Furthermore, details on epilepsy were retrieved from medical records (e.g., syndrome, seizure frequency, and use of drugs). Diagnoses of migraine, tension-type headache, or unclassifiable headache were made based on criteria of the International Classification of Headache Disorders. Between March and December 2013, 29 children and 226 adults were evaluated, 73% of whom indicated having current headaches, which is significantly more often when compared with the general population (pheadache, while 29% had solely seizure-related headaches and 22% had both. Migraine occurs significantly more often in people with epilepsy in comparison with the general population (pheadaches conforms to results in the general population. These results show that current headaches are a significantly more frequent problem amongst people with epilepsy than in people without epilepsy. When comparing migraine prevalence, this is significantly higher in the population of patients with epilepsy. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Headaches and Sinus Disease

    Science.gov (United States)

    ... of the following: 1. No nausea or vomiting (anorexia may occur) 2. No more than 1 of ... DIAGNOSIS IN PATIENTS PRESENTING WITH “SINUS HEADACHE” . Multiple studies, including large ... 10:202-209 In cases of non-sinus related headaches, the appropriate specialist ...

  10. Antiphospholipid syndrome (APS) revisited: Would migraine headaches be included in future classification criteria?

    Science.gov (United States)

    Noureldine, Mohammad Hassan A; Haydar, Ali A; Berjawi, Ahmad; Elnawar, Rody; Sweid, Ahmad; Khamashta, Munther A; Hughes, Graham R V; Uthman, Imad

    2017-02-01

    Headaches have been extensively reported in Antiphospholipid syndrome (APS)/Antiphospholipid antibodies (aPL)-positive patients. The aim of this study was to highlight the prevalence of headaches among APS/aPL-positive patients and discuss its association with laboratory, clinical and imaging findings. We searched the literature through Google Scholar and PubMed for publications on the epidemiology, pathogenesis, laboratory, imaging and clinical findings, and management of headaches in APS/aPL-positive patients. The following keywords were used: Antiphospholipid, Hughes syndrome, anticardiolipin, lupus anticoagulant, anti-β2 glycoprotein I, headache, migraine, tension, and cluster. All reports published between 1969 and 2015 were included. Migraine is the most commonly reported type of headache in APS/aPL-positive patients. Thrombotic and platelet dysfunction hypotheses have been studied to uncover the pathogenic role of aPL in the development of headaches. Several studies are reporting higher levels of aPL in primary and secondary APS migraineurs, but only few reached statistical significance. Migraine patients without clinical signs/symptoms of cerebral infarction rarely show positive imaging findings. Digital subtraction angiography shows promise in demonstrating small vascular lesions otherwise not detected on computed tomography, magnetic resonance imaging, or cerebral angiograms. Although it may be solitary and harmless in many cases, the deleterious effect of migraine on the quality of life of APS patients prompts rapid diagnosis and proper management. An anticoagulation trial is advisable in APS patients with migraine as many cases of severe, refractory migraine resolved with anticoagulation therapy. The profile of migraine headaches discussed in this study permits its candidacy for inclusion in future APS classification criteria.

  11. Epidemiology, etiology and study of clinical findings of headache

    Directory of Open Access Journals (Sweden)

    Ghaffarpoor M

    1998-09-01

    Full Text Available In a cross-sectional epidemiological study of headache disorders in neurology clinic of Fatemieh hospital of Semnan (August 22-November 20.1996, information on types of headaches, quality, severity, location, duration, frequency, precipitating factors, age of onset, influence of menstruation and pregnancy, positive familial history, use of oral contraceptive pills and other epidemiological factors including socioeconomic and age/sex composition was collected. The presence of any types of headaches was ascertained by a clinical interview and examination using the operational diagnostic criteria of the International Headaches Society. The prevalence of migraine and tension type headache was also analysed in relation to variables of life style (physical activity and sleep pattern and associated signs and symptoms (nausea, vomiting, photophobia and phonophobia. In this study migraine and tension headache were also compared in variable aspects with each other. 1 Headache was more prevalent in women than men (F/M=3/1. 2 The most common types of headache included: tension type headache (41.4%, migraine (31.2% and unclassified headaches (17.2%. 3 Migraine and T.T.H were more prevalent in early adult life and middle ages. 4 In both migraine and tension type headache the time profiles (duration, frequency, age of onset, quality and location were like that noted in textbook and previous studies. 5 In both migraine and tension type headache the most conspicuous precipitating factor was stress and mental tension and frequent headaches were accompanied with psychiatric problems (e.g depression and or anxiety. 6 Nausea, vomiting, phonophobia and photophobia were the most common associated symptoms in both of them. 7 Positive familial history and aggravation of headache in perimenstual period were more commonly seen in patients with migraine than tension type headache. In conclusion using the operational diagnostic criteria of International Headache Society in

  12. Migraine headaches in a nutshell

    African Journals Online (AJOL)

    According to the International Headache Society, a migraine is a headache that lasts for 4–72 hours and presents with at least two of the following symptoms: unilateral localisation, moderate to severe pain intensity, aggravation by movement, and a pulsating feeling. The headache is also usually accompanied by nausea ...

  13. Tension headache.

    Science.gov (United States)

    Ziegler, D K

    1978-05-01

    Headache is an extremely common symptom, and many headaches undoubtedly have a relationship to stressful situations. The clear definition, however, of a "tension headache" complex and its differentiation from migraine in some patients is difficult. The problems are in the identification of a specific headache pattern induced by stress or "tension" and the relationship of the symptom to involuntary contraction of neck and scalp muscles. Treatment consists of analgesics and occasionally mild tranquilizers. Psychotherapy consists of reassurance and often other supportive measures, including modification of life styles. Various feedback techniques have been reported of value, but their superiority to suggestion and hypnosis is still problematic.

  14. Cluster headache

    Science.gov (United States)

    Histamine headache; Headache - histamine; Migrainous neuralgia; Headache - cluster; Horton's headache; Vascular headache - cluster ... Doctors do not know exactly what causes cluster headaches. They ... (chemical in the body released during an allergic response) or ...

  15. Exercise Headaches

    Science.gov (United States)

    ... headaches may require emergency medical attention. Symptoms Primary exercise headaches These headaches: Are usually described as throbbing ... sides of the head in most cases Secondary exercise headaches These headaches may cause: The same symptoms ...

  16. Headache and endovascular procedures.

    Science.gov (United States)

    de Biase, Stefano; Longoni, Marco; Gigli, Gian Luigi; Agostoni, Elio

    2017-05-01

    The International Classification of Headache Disorders (ICHD-3 beta) includes headache attributed to intracranial endovascular procedures (EVPs). The aim of this review is to describe the clinical and pathophysiological aspects of headache related to vascular lesions and EVPs. Current studies regarding this issue are contradictory, although generally favouring headache improvement after EVPs. Further large studies are needed to adequately assess the effect of EVPs on headache.

  17. Granisetron transdermal system improves refractory nausea and vomiting in gastroparesis.

    Science.gov (United States)

    Simmons, Kellie; Parkman, Henry P

    2014-06-01

    Symptoms of gastroparesis include nausea and vomiting, which can markedly diminish quality of life. Nausea and vomiting can also make treatment with oral antiemetics problematic. Our aim was to determine whether treatment-resistant nausea and vomiting in patients with gastroparesis improve after granisetron transdermal patch (GTP) therapy. In an open-label pilot study, patients with gastroparesis and symptoms of nausea and vomiting refractory to conventional treatment were treated with GTP. After 2 weeks, patients were asked to assess their therapeutic response using the Clinical Patient Grading Assessment Scale (CPGAS; +7 = completely better; 0 = no change; -7 = very considerably worse). Responders were defined as CPGAS score >0, non-responders as ≤0. Patients (n = 36) were treated with GTP. Of these 36 patients, one patient discontinued treatment due to the GTP not adhering to the skin. Of the remaining 35 patients, 18 improved, 15 remained the same, and two worsened. The average CPGAS score was +1.8 ± 0.4 (SEM) (P < 0.05 vs 0). Of the 18 patients with improvement, the average CPGAS score was +3.7 ± 0.3 (SEM), corresponding to "somewhat" to "moderately better" improvement in nausea/vomiting. Side effects occurred in nine patients: four developed constipation, three patients had skin rash, and two reported headaches. GTP was moderately effective in reducing refractory symptoms of nausea and/or vomiting from gastroparesis in 50% of patients. Mild side effects were reported by 25% of patients. GTP may be an effective treatment for nausea and vomiting in gastroparesis, and further study is warranted.

  18. Other primary headaches

    Directory of Open Access Journals (Sweden)

    Anish Bahra

    2012-01-01

    Full Text Available The ′Other Primary Headaches′ include eight recognised benign headache disorders. Primary stabbing headache is a generally benign disorder which often co-exists with other primary headache disorders such as migraine and cluster headache. Primary cough headache is headache precipitated by valsalva; secondary cough has been reported particularly in association with posterior fossa pathology. Primary exertional headache can occur with sudden or gradual onset during, or immediately after, exercise. Similarly headache associated with sexual activity can occur with gradual evolution or sudden onset. Secondary headache is more likely with both exertional and sexual headache of sudden onset. Sudden onset headache, with maximum intensity reached within a minute, is termed thunderclap headache. A benign form of thunderclap headache exists. However, isolated primary and secondary thunderclap headache cannot be clinically differentiated. Therefore all headache of thunderclap onset should be investigated. The primary forms of the aforementioned paroxysmal headaches appear to be Indomethacin sensitive disorders. Hypnic headache is a rare disorder which is termed ′alarm clock headache′, exclusively waking patients from sleep. The disorder can be Indomethacin responsive, but can also respond to Lithium and caffeine. New daily persistent headache is a rare and often intractable headache which starts one day and persists daily thereafter for at least 3 months. The clinical syndrome more often has migrainous features or is otherwise has a chronic tension-type headache phenotype. Management is that of the clinical syndrome. Hemicrania continua straddles the disorders of migraine and the trigeminal autonomic cephalalgias and is not dealt with in this review.

  19. Traumatic-event headaches

    Directory of Open Access Journals (Sweden)

    Haas David C

    2004-10-01

    Full Text Available Abstract Background Chronic headaches from head trauma and whiplash injury are well-known and common, but chronic headaches from other sorts of physical traumas are not recognized. Methods Specific information was obtained from the medical records of 15 consecutive patients with chronic headaches related to physically injurious traumatic events that did not include either head trauma or whiplash injury. The events and the physical injuries produced by them were noted. The headaches' development, characteristics, duration, frequency, and accompaniments were recorded, as were the patients' use of pain-alleviative drugs. From this latter information, the headaches were classified by the diagnostic criteria of the International Headache Society as though they were naturally-occurring headaches. The presence of other post-traumatic symptoms and litigation were also recorded. Results The intervals between the events and the onset of the headaches resembled those between head traumas or whiplash injuries and their subsequent headaches. The headaches themselves were, as a group, similar to those after head trauma and whiplash injury. Thirteen of the patients had chronic tension-type headache, two had migraine. The sustained bodily injuries were trivial or unidentifiable in nine patients. Fabrication of symptoms for financial remuneration was not evident in these patients of whom seven were not even seeking payments of any kind. Conclusions This study suggests that these hitherto unrecognized post-traumatic headaches constitute a class of headaches characterized by a relation to traumatic events affecting the body but not including head or whiplash traumas. The bodily injuries per se can be discounted as the cause of the headaches. So can fabrication of symptoms for financial remuneration. Altered mental states, not systematically evaluated here, were a possible cause of the headaches. The overall resemblance of these headaches to the headaches after

  20. Side Effects: Nausea and Vomiting

    Science.gov (United States)

    Types of nausea and vomiting caused by cancer treatment include: anticipatory, acute, and delayed. Controlling these side effects will help to prevent serious problems such as malnutrition and dehydration in people with cancer.

  1. Chronic daily headaches

    Directory of Open Access Journals (Sweden)

    Fayyaz Ahmed

    2012-01-01

    Full Text Available Chronic Daily Headache is a descriptive term that includes disorders with headaches on more days than not and affects 4% of the general population. The condition has a debilitating effect on individuals and society through direct cost to healthcare and indirectly to the economy in general. To successfully manage chronic daily headache syndromes it is important to exclude secondary causes with comprehensive history and relevant investigations; identify risk factors that predict its development and recognise its sub-types to appropriately manage the condition. Chronic migraine, chronic tension-type headache, new daily persistent headache and medication overuse headache accounts for the vast majority of chronic daily headaches. The scope of this article is to review the primary headache disorders. Secondary headaches are not discussed except medication overuse headache that often accompanies primary headache disorders. The article critically reviews the literature on the current understanding of daily headache disorders focusing in particular on recent developments in the treatment of frequent headaches.

  2. Tension Headache

    Science.gov (United States)

    ... tight band around your head. A tension headache (tension-type headache) is the most common type of headache, and ... Headache after a head injury, especially if the headache gets worse ... tension or stress. But research suggests muscle contraction isn't the ...

  3. Primary headaches in children

    Directory of Open Access Journals (Sweden)

    Ajay Kumar Pan

    2015-01-01

    Full Text Available Headache is a widespread clinical problem; the prevalence is high in all age groups, from which children and teenagers are not spared. It has been reported that, as many as 75% of school-age children may experience headache infrequently, among them 10% have recurrent headaches. [1],[2] The vast majority of headaches are primary and classified as migraine, tension-type headache (TTH, cluster headache, and other trigeminal autonomic cephalgias. The type of primary headaches could usually be diagnosed by a thorough and careful history taking, and physical examination. Once the diagnosis of migraine is established and appropriate reassurance provided, a balanced and individually tailored treatment plan can be instituted. The goal of treatment includes abortive or acute pain treatment, preventive long-term treatment, and biobehavioral therapy. Knowledge of precise impact of primary headaches on child′s quality of life helps to design a proper comprehensive treatment plan.

  4. [Different headache forms of chapter 4 of the International Headache Classification].

    Science.gov (United States)

    Göbel, A; Heinze, A; Göbel, H

    2012-12-01

    Chapter 4 of the International Classification of Headaches contains a group of clinically very heterogeneous primary headache forms. Little is known about the pathogenesis of these headache types and therapy is usually based on isolated case reports and uncontrolled studies. The forms include primary stabbing headache, primary cough headache, primary exertional headache, primary headache associated with sexual activity, hypnic headache, primary thunderclap headache, hemicrania continua and the new daily persistent headache. Some of these headache forms may be of a symptomatic nature and require careful examination, imaging and further tests. Primary and secondary headache forms must be carefully distinguished.

  5. Association between primary headaches and depression in young adults in southern Brazil

    Directory of Open Access Journals (Sweden)

    Asdrubal Falavigna

    2013-12-01

    Full Text Available OBJECTIVE: To verify the association between depression and headache in young adults, as well as to identify the features of headache associated with depression and the influence of this mood disorder on headache-related disability. METHODS: A cross-sectional study with self-administered questionnaires about headache and depression was conducted at the Universidade de Caxias do Sul. Beck Depression Inventory (BDI and Migraine Disability Assessment (MIDAS were used to evaluate depressive symptoms and headache-related disability, respectively. Depression was considered if BDI > 15. RESULTS: A thousand and thirteen young adults were included in the study. A clear relationship was observed between headache and depression among the participants. Multivariate analyses demonstrated that nausea or vomiting related to headache and higher headacherelated disability scores were independent factors associated with depression. Migraine was more associated with depression than the other types of headache. CONCLUSION: The results demonstrate an association between headache and depression. Depressive symptoms are more likely to be found in young adults with more disabling headaches.

  6. Nausea and Vomiting (PDQ)

    Science.gov (United States)

    ... anticipatory nausea and vomiting is identified, the more effective treatment may be. When symptoms of anticipatory nausea ... detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health ...

  7. [Risk factors and frequency of postoperative nausea and vomiting in patients operated under general anesthesia].

    Science.gov (United States)

    Grabowska-Gaweł, Anna; Porzych, Katarzyna; Piskunowicz, Grazyna

    2006-01-01

    Postoperative nausea and vomiting belong to fairly frequent postoperative complications, but they occupy a distant position on the list of complications, which most probably result from a general conviction that they do not pose a direct threat to patients. The objective of this work is specification of factors facilitating occurrence of postoperative nausea and vomiting, and determination of frequency of their occurrence in patients operated under general anesthesia. Questionnaire about the occurrence of postoperative nausea and vomiting (PONV), was carried out and included 253 adult sick persons (102 female and 151 male patients), in the age between 23-76 (average 42.3 +/- 6.1 years), who had undergone operative procedure in the field of abdominal and urology surgery, orthopedic, thyroid surgery and laryngological, ophthalmology and plastic surgery, under general anesthesia. The questionnaire form included preoperative characteristics of a patient (age, sex, smoking, motion sickness and migraine headaches in history, and PONV occurring earlier), type of operative procedure, used anesthetic agents, and analgesic agents applied in postoperative analgesia. The anesthesiologist administering anesthetic was not informed about the investigation carried out and did not receive any additional pieces of advice regarding the type of applied anesthetic agents or the method of conducting postoperative analgesia. Visual Analogue Scale (VAS) was used in the evaluation of nausea. Nausea and vomiting were assessed every two hours within the first postoperative 12 hours and every 4 hours for the next 24 hours. Nausea and vomiting were treated as two separate complications. Nausea itself occurred in 22.7% of patients; whereas vomiting in 13.2%. Both symptoms occurred in 14.2% of patients. Nausea occurred 4.1 +/- 0.8 hours after operation; whereas vomiting after 5.3 +/- 1.1 hours. Women suffered more often than men from (R = 0.678 p patients suffering from PONV earlier (R = 0

  8. Headache diaries and calendars

    DEFF Research Database (Denmark)

    Torelli, Paola; Jensen, Rigmor

    2010-01-01

    Headache is one of the most common types of pain and, in the absence of biological markers, headache diagnosis depends only on information obtained from clinical interviews and physical and neurological examinations. Headache diaries make it possible to record prospectively the characteristics...... of every attack and the use of headache calendars is indicated for evaluating the time pattern of headache, identifying aggravating factors, and evaluating the efficacy of preventive treatment. This may reduce the recall bias and increase accuracy in the description. The use of diagnostic headache diaries...... practice for diagnosis and follow-up of treatments; and (2) describe the tools that have been developed for research and their main applications in the headache field. In addition, we include information on diaries available online and proposals for future areas of research....

  9. Hemodialysis-related headache.

    Science.gov (United States)

    Sav, Murat Yusuf; Sav, Tansu; Senocak, Elif; Sav, Nadide Melike

    2014-10-01

    Headache is one of the most frequently encountered neurological symptoms during hemodialysis. According to International Classification of Headache criteria dialysis-related headache was defined as the headache occurring during hemodialysis with no specific characteristic. It resolves spontaneously within 72 hours after the hemodialysis session ends. There are few studies in the literature investigating the clinical features of dialysis headache. The pathophysiology of hemodialysis-related headache is not known, but various triggering factors have been identified, including changes in blood pressure, serum sodium and magnesium levels during hemodialysis sessions, caffeine deprivation and stress. The aim of this article is to evaluate and analyze features of headache in patients undergoing hemodialysis. © 2014 International Society for Hemodialysis.

  10. Sex Headaches

    Science.gov (United States)

    Sex headaches Overview Sex headaches are brought on by sexual activity — especially an orgasm. You may notice a dull ache in your head ... severe headache just before or during orgasm. Most sex headaches are nothing to worry about. But some ...

  11. Cluster Headache

    OpenAIRE

    Pearce, Iris

    1985-01-01

    Cluster headache is the most severe primary headache with recurrent pain attacks described as worse than giving birth. The aim of this paper was to make an overview of current knowledge on cluster headache with a focus on pathophysiology and treatment. This paper presents hypotheses of cluster headache pathophysiology, current treatment options and possible future therapy approaches. For years, the hypothalamus was regarded as the key structure in cluster headache, but is now thought to be pa...

  12. Temporomandibular disorders and migraine headache

    OpenAIRE

    Demarin, Vida; Bašić Kes, Vanja

    2010-01-01

    Migraine headache and temporomandibular disorders show significant overlap in the area or distribution of pain, the gender prevalence and age distribution. Temporomandibular disorders may cause headaches per se, worsen existent primary headaches, and add to the burden of headache disorders. The patients with combined migraine and tension-type headaches had a higher prevelance of temporomandibular disorders. Evidence supporting a close relationship include the increased masticatory...

  13. [Venous angiomas and headache in children. A case report].

    Science.gov (United States)

    López, Mauricio; Huete, Isidro; Hernández, Marta

    2016-01-01

    Venous angiomas (VA) are benign entities; however infrequent symptomatic cases may occur. Case report and literature review. A 6 year old girl was referred with a history of bi-frontal, non-pulsatile, headache with no nausea or vomiting. Headache intensity was 4-6/10. The episodes were frequent, 3-4 times per week. Triggers include academic work. Computed tomography showed a small VA in left caudate nucleus, which was confirmed by a brain MRI, with no evidence of inflammatory or ischaemic changes, or another vascular malformation. Psychological and psycho-pedagogic techniques were used, combined with relaxation and cognitive-behavioural techniques to reduce the intensity and frequency. There was a good outcome, and the headache decreased to 10 episodes per year. The patient was monitored for 12 years until graduation from high school. The VA remained without complications. In the study of a headache, a VA usually is an incidental finding. The International Classification of Headache Disorders III provides specific criteria of frequent episodic tension-type headache, and allows us begin specific therapy for it. Monitoring of non-symptomatic VA cases should be clinical. The surgical management of these entities is exceptional. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Caffeine in the management of patients with headache.

    Science.gov (United States)

    Lipton, Richard B; Diener, Hans-Christoph; Robbins, Matthew S; Garas, Sandy Yacoub; Patel, Ketu

    2017-10-24

    Caffeinated headache medications, either alone or in combination with other treatments, are widely used by patients with headache. Clinicians should be familiar with their use as well as the chemistry, pharmacology, dietary and medical sources, clinical benefits, and potential safety issues of caffeine. In this review, we consider the role of caffeine in the over-the-counter treatment of headache. The MEDLINE and Cochrane databases were searched by combining "caffeine" with the terms "headache," "migraine," and "tension-type." Studies that were not placebo-controlled or that involved medications available only with a prescription, as well as those not assessing patients with migraine and/or tension-type headache (TTH), were excluded. Compared with analgesic medication alone, combinations of caffeine with analgesic medications, including acetaminophen, acetylsalicylic acid, and ibuprofen, showed significantly improved efficacy in the treatment of patients with TTH or migraine, with favorable tolerability in the vast majority of patients. The most common adverse events were nervousness (6.5%), nausea (4.3%), abdominal pain/discomfort (4.1%), and dizziness (3.2%). This review provides evidence for the role of caffeine as an analgesic adjuvant in the acute treatment of primary headache with over-the-counter drugs, caffeine doses of 130 mg enhance the efficacy of analgesics in TTH and doses of ≥100 mg enhance benefits in migraine. Additional studies are needed to assess the relationship between caffeine dosing and clinical benefits in patients with TTH and migraine.

  15. Pediatric Headache: An Overview.

    Science.gov (United States)

    Langdon, Raquel; DiSabella, Marc T

    2017-03-01

    Headache represents the most common neurologic disorder in the general population including children and is increasingly being recognized as a major source of morbidity in youth related to missed school days and activities. In this article, we take a holistic approach to the child presenting with headache with a focus on the detailed headache history, physical and neurologic examinations, and diagnostic evaluation of these patients. Clinical presentations and classification schema of multiple primary and secondary headache types in children are discussed using the International Headache Criteria (IHCD-3) as a guide, and a summary provided of the various treatment modalities employed for pediatric headache including lifestyle modifications, behavioral techniques, and abortive and preventive medications. Copyright © 2017 Mosby, Inc. All rights reserved.

  16. Secondary Headaches

    Science.gov (United States)

    ... in the medical history or examination to suggest secondary headache. Headache can be caused by general medical conditions such as severe hypertension, or by conditions that affect the brain and ...

  17. Cluster Headache

    Science.gov (United States)

    ... a role. Unlike migraine and tension headache, cluster headache generally isn't associated with triggers, such as foods, hormonal changes or stress. Once a cluster period begins, however, drinking alcohol ...

  18. Headache in autoimmune diseases.

    Science.gov (United States)

    John, Seby; Hajj-Ali, Rula A

    2014-03-01

    Autoimmune diseases are a group of heterogeneous inflammatory disorders characterized by systemic or localized inflammation, leading to ischemia and tissue destruction. These include disorders like systemic lupus erythematosus and related diseases, systemic vasculitides, and central nervous system (CNS) vasculitis (primary or secondary). Headache is a very common manifestation of CNS involvement of these diseases. Although headache characteristics can be unspecific and often non-diagnostic, it is important to recognize because headache can be the first manifestation of CNS involvement. Prompt recognition and treatment is necessary not only to treat the headache, but also to help prevent serious neurological sequelae that frequently accompany autoimmune diseases. In this review, we discuss headache associated with autoimmune diseases along with important mimics. © 2014 American Headache Society.

  19. Treatment in carbon monoxide poisoning patients with headache: a prospective, multicenter, double-blind, controlled clinical trial.

    Science.gov (United States)

    Ocak, Tarik; Tekin, Erdal; Basturk, Mustafa; Duran, Arif; Serinken, Mustafa; Emet, Mucahit

    2016-11-01

    There is a lack of specificity of the analgesic agents used to treat headache and underlying acute carbon monoxide poisoning. To compare effectiveness of "oxygen alone" vs "metoclopramide plus oxygen" vs "metamizole plus oxygen" therapy in treating carbon monoxide-induced headache. A prospective, multicenter, double-blind, controlled trial. Three emergency departments in Turkey. Adult carbon monoxide poisoning patients with headache. A total of 117 carbon monoxide-intoxicated patients with headache were randomized into 3 groups and assessed at baseline, 30 minutes, 90 minutes, and 4 hours. The primary outcome was patient-reported improvement rates for headache. Secondary end points included nausea, need for rescue medication during treatment, and reduction in carboxyhemoglobin levels. During observation, there was no statistical difference between drug type and visual analog scale score change at 30 minutes, 90 minutes, or 4 hours, for either headache or nausea. No rescue medication was needed during the study period. The reduction in carboxyhemoglobin levels did not differ among the 3 groups. The use of "oxygen alone" is as efficacious as "oxygen plus metoclopramide" or "oxygen plus metamizole sodium" in the treatment of carbon monoxide-induced headache. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. May headache triggered by odors be regarded as a differentiating factor between migraine and other primary headaches?

    Science.gov (United States)

    Silva-Néto, Raimundo Pereira; Rodrigues, Ânderson Batista; Cavalcante, Dandara Coelho; Ferreira, Pedro Henrique Piauilino Benvindo; Nasi, Ema Pereira; Sousa, Kamila Maria de Holanda; Peres, Mário Fernando Pietro; Valença, Marcelo Moraes

    2017-01-01

    Objectives The objective of this article is to characterize olfactory stimulation as a trigger of headaches attacks and differentiation between migraine and other primary headaches. Participants and methods The study was prospective and experimental, with comparison of groups. A total of 158 volunteers (73 men and 85 women) were diagnosed with primary headaches, according to the criteria of the International Classification of Headache Disorders, Third Edition (beta version) (ICHD-3β). The study was conducted by two examiners; one of them was assigned to diagnose the presence and type of primary headache, while the other was responsible for exposing the volunteers to odor and recording the effects of this exposure. Results Of the 158 volunteers with headache, there were 72 (45.6%) cases of migraine and 86 (54.4%) with other primary headaches. In both groups, there were differences in headache characteristics (χ 2  = 4.132; p = 0.046). Headache attacks (25/72; 34.7%) and nausea (5/72; 6.9%) were triggered by odor only in patients with migraine, corresponding to 19.0% (30/158) of the sample, but in none with other primary headaches (χ 2  = 43.78; p Headache occurred more often associated with nausea ( p = 0.146) and bilateral location ( p = 0.002) in migraineurs who had headache triggered by odor. Headache was triggered after 118 ± 24.6 min and nausea after 72.8 ± 84.7 min of exposure to odor. Conclusions The odor triggered headache attacks or nausea only in migraineurs. Therefore, headache triggered by odors may be considered a factor of differentiation between migraine and other primary headaches and this trigger seems very specific of migraine.

  1. Eliminating Postoperative Nausea and Vomiting in Outpatient Surgery with Multimodal Strategies including Low Doses of Nonsedating, Off-Patent Antiemetics: Is “Zero Tolerance“ Achievable?

    Directory of Open Access Journals (Sweden)

    Susan J. Skledar

    2007-01-01

    Full Text Available For ondansetron, dexamethasone, and droperidol (when used for prophylaxis, each is estimated to reduce risk of postoperative nausea and/or vomiting (PONV by approximately 25%. Current consensus guidelines denote that patients with 0–1 risk factors still have a 10–20% risk of encountering PONV, but do not yet advocate routine prophylaxis for all patients with 10–20% risk. In ambulatory surgery, however, multimodal prophylaxis has gained favor, and our previously published experience with routine prophylaxis has yielded PONV rates below 10%. We now propose a “zero-tolerance” antiemetic algorithm for outpatients that involves routine prophylaxis by first avoiding volatile agents and opioids to the extent possible, using locoregional anesthesia, multimodal analgesia, and low doses of three nonsedating off-patent antiemetics. Routine oral administration (immediately on arrival to the ambulatory surgery suite of perphenazine 8 mg (antidopaminergic or cyclizine 50 mg (antihistamine, is followed by dexamethasone 4 mg i.v. after anesthesia induction (dexamethasone is avoided in diabetic patients. At the end of surgery, ondansetron (4 mg i.v., now off-patent is added. Rescue therapy consists of avoiding unnecessary repeat doses of drugs acting by the same mechanism: haloperidol 2 mg i.v. (antidopaminergic is prescribed for patients pretreated with cyclizine or promethazine 6.25 mg i.v. (antihistamine for patients having been pretreated with perphenazine. If available, a consultation for therapeutic acupuncture procedure is ordered. Our approach toward “zero tolerance” of PONV emphasizes liberal identification of and prophylaxis against common risks.

  2. Headache attributed to intracranial pressure alterations: applicability of the International Classification of Headache Disorders ICHD-3 beta version versus ICHD-2.

    Science.gov (United States)

    Curone, M; Peccarisi, C; Bussone, G

    2015-05-01

    The association between headache and changes in intracranial pressure is strong in clinical practice. Syndromes associated with abnormalities of cerebrospinal fluid (CSF) pressure include spontaneous intracranial hypotension (SIH) and idiopathic intracranial hypertension (IIH). In 2013, the Headache Classification Committee of the International Headache Society (IHS) published the third International Classification of Headache Disorders (ICHD-3 beta version). The aim of this study was to investigate applicability of the new ICHD-3 versus ICHD-2 criteria in a clinical sample of patients with intracranial pressure (ICP) alterations. Patients admitted at our Headache Center for headache evaluation in whom a diagnosis of ICP alterations was performed were reviewed. 71 consecutive patients were studied. 40 patients (Group A) were diagnosed as IIH, 22 (Group B) as SIH, 7 (Group C) and 2 (Group D), respectively, as symptomatic intracranial hypertension and symptomatic intracranial hypotension. Main headache features were: in Group A, daily or nearly-daily headache (100 %) with diffuse/non-pulsating pain (73 %), aggravated by coughing/straining (54 %) and migrainous-associated symptoms (43 %). In Group B, an orthostatic headache (100 %) with nausea (29 %), vomiting (24 %), hearing disturbance (33 %), neck pain (48 %), hypacusia (24 %), photophobia (22 %) was reported. In Group C, a diffuse non-pulsating headache was present in 95 % with vomiting (25 %), sixth nerve palsy (14 %) and tinnitus (29 %). In Group D, an orthostatic headache with neck stiffness was reported by 100 %. Regarding applicability of ICHD-2 criteria in Group A, 73 % of the patients fitted criterion A; 100 %, criterion B; 100 %, criterion C; and 75 %, criterion D; while applying ICHD-3 beta version criteria, 100 % fitted criterion A; 97.5 %, criterion B; 100 %, criterion C; and 100 %, criterion D. In Group B, application of ICHD-2 showed 91 % patients fitting criterion A; 100 %, criterion B; 100

  3. [Headache Treatment].

    Science.gov (United States)

    Diener, Hans Christoph; Holle-Lee, Dagny; Nägel, Steffen; Gaul, Charly

    2017-03-01

    A precondition for the successful treatment of headaches is the correct headache diagnosis. Triptans are effective for attack treatment of migraine and cluster headache. However, there are not effective for the treatment of tension-type headache. For the prevention of frequent episodic migraine betablockers, flunarizine, topiramate and amitriptyline are recommended. For the prevention of chronic migraine evidence is only available for onabotulinumtoxinA and topiramate. For prophylactic treatment of tension-type headaches tricyclic antidepressants are used. In cluster headache verapamil (in combination with steroids) is the most frequently used prophylactic agent. This article focusses on the current acute and prophylactic treatment of common headache syndromes. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Neurostimulation in cluster headache

    DEFF Research Database (Denmark)

    Pedersen, Jeppe L; Barloese, Mads; Jensen, Rigmor H

    2013-01-01

    PURPOSE OF REVIEW: Neurostimulation has emerged as a viable treatment for intractable chronic cluster headache. Several therapeutic strategies are being investigated including stimulation of the hypothalamus, occipital nerves and sphenopalatine ganglion. The aim of this review is to provide...... effective strategy must be preferred as first-line therapy for intractable chronic cluster headache....

  5. Headache in children's drawings.

    Science.gov (United States)

    Wojaczyńska-Stanek, Katarzyna; Koprowski, Robert; Wróbel, Zygmunt; Gola, Małgorzata

    2008-02-01

    Headache is a common health problem in childhood. Children's drawings are helpful in the diagnosis of headache type. Children, especially younger ones, communicate better through pictures than verbally. The aim of the present study is to evaluate the usefulness of drawings of the child's headache in the diagnostic process carried out by a pediatrician and a pediatric neurologist. At the beginning of a visit in a neurological clinic, or on the first day of hospitalization, the child was asked, "Please draw your headache," or "How do you feel your headache?" without any additional explanations or suggestions. Clinical diagnosis of headache type was made on the basis of the standard diagnostic evaluation. For the purpose of this study, children's headaches were categorized as migraine, tension-type headache, or "the others." One hundred twenty-four drawings of children with headaches were analyzed by 8 pediatricians and 8 pediatric neurologists. The analysts were unaware of the clinical history, age, sex, and diagnosis of the patients. The clinical diagnosis was considered the "gold standard" to which the headache drawing diagnosis was compared. There were 68 girls 5-18 years of age and 56 boys 7-18 years of age. Of the 124 children, 40 were clinically diagnosed with migraine (32.2%), 47 with tension-type headache (37.9%), and 37 (29.8%) as the others. Children with migraine most frequently draw sharp elements. Children with tension-type headache mainly drew compression elements and pressing elements. In the group of "the other" headaches, 21 children were diagnosed with somatoform disorders. The most frequent element in this group's drawings was a whirl in the head. Colors used most frequently were black and red, which signify severe pain. There was no difference in sensitivity of diagnoses between neurologists and pediatricians. Because the evaluation of drawings by children with headaches done both by pediatricians and pediatric neurologists was correct for

  6. Thunderclap headache

    OpenAIRE

    Dodick, D

    2002-01-01

    The aim is to review the background underlying the debate related to the alternative nomenclatures for and the most appropriate diagnostic evaluation of patients with thunderclap headache. The clinical profile and differential diagnosis of thunderclap headache is described, and a nosological framework and diagnostic approach to this group of patients is proposed.

  7. Environmental toxin acrolein alters levels of endogenous lipids, including TRP agonists: A potential mechanism for headache driven by TRPA1 activation

    Directory of Open Access Journals (Sweden)

    Emma Leishman

    2017-01-01

    Full Text Available Exposure to airborne toxins can trigger headaches, but the mechanisms are not well understood. Some environmental toxins, such as acrolein, activate transient receptor potential ankyrin 1 (TRPA1, a receptor involved in pain sensation that is highly expressed in the trigeminovascular system. It has been shown in rat models that repeated exposure to acrolein induces trigeminovascular sensitization to both TRPA1 and TRP vanilloid 1 (TRPV1 agonists, a phenomenon linked to headache. In this study, we test the hypothesis that the sensitization of trigeminovascular responses in rats after acrolein exposure via inhalation is associated with changes in levels of endogenous lipids, including TRPV1 agonists, in the trigeminal ganglia, trigeminal nucleus, and cerebellum. Lipidomics analysis of 80 lipids was performed on each tissue after acute acrolein, chronic acrolein, or room air control. Both acute and chronic acrolein exposure drove widespread alterations in lipid levels. After chronic acrolein exposure, levels of all 6 N-acyl ethanolamines in the screening library, including the endogenous cannabinoid and TRPV1 agonist, N-arachidonoyl ethanolamine, were elevated in trigeminal tissue and in the cerebellum. This increase in TRPV1 ligands by acrolein exposure may indicate further downstream signaling, in that we also show here that a combination of these TRPV1 endogenous agonists increases the potency of the individual ligands in TRPV1-HEK cells. In addition to these TRPV1 agonists, 3 TRPV3 antagonists, 4 TRPV4 agonists, and 25 orphan lipids were up and down regulated after acrolein exposure. These data support the hypothesis that lipid signaling may represent a mechanism by which repeated exposure to the TRPA1 agonist and environmental toxin, acrolein, drives trigeminovascular sensitization. Keywords: Lipidomics, Endogenous cannabinoid, TRPA1, TRPV1, Lipoamine, Acrolein, Migraine

  8. Cluster headache

    Directory of Open Access Journals (Sweden)

    Ducros Anne

    2008-07-01

    Full Text Available Abstract Cluster headache (CH is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye. It affects young adults, predominantly males. Prevalence is estimated at 0.5–1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name in bouts that can occur during specific months of the year. Alcohol is the only dietary trigger of CH, strong odors (mainly solvents and cigarette smoke and napping may also trigger CH attacks. During bouts, attacks may happen at precise hours, especially during the night. During the attacks, patients tend to be restless. CH may be episodic or chronic, depending on the presence of remission periods. CH is associated with trigeminovascular activation and neuroendocrine and vegetative disturbances, however, the precise cautive mechanisms remain unknown. Involvement of the hypothalamus (a structure regulating endocrine function and sleep-wake rhythms has been confirmed, explaining, at least in part, the cyclic aspects of CH. The disease is familial in about 10% of cases. Genetic factors play a role in CH susceptibility, and a causative role has been suggested for the hypocretin receptor gene. Diagnosis is clinical. Differential diagnoses include other primary headache diseases such as migraine, paroxysmal hemicrania and SUNCT syndrome. At present, there is no curative treatment. There are efficient treatments to shorten the painful attacks (acute treatments and to reduce the number of daily attacks (prophylactic treatments. Acute treatment is based on subcutaneous administration of sumatriptan and high-flow oxygen. Verapamil, lithium, methysergide, prednisone, greater occipital nerve blocks and topiramate may be used for prophylaxis. In refractory cases, deep-brain stimulation of the

  9. Mechanism of brain tumor headache.

    Science.gov (United States)

    Taylor, Lynne P

    2014-04-01

    Headaches occur commonly in all patients, including those who have brain tumors. Using the search terms "headache and brain tumors," "intracranial neoplasms and headache," "facial pain and brain tumors," "brain neoplasms/pathology," and "headache/etiology," we reviewed the literature from the past 78 years on the proposed mechanisms of brain tumor headache, beginning with the work of Penfield. Most of what we know about the mechanisms of brain tumor associated headache come from neurosurgical observations from intra-operative dural and blood vessel stimulation as well as intra-operative observations and anecdotal information about resolution of headache symptoms with various tumor-directed therapies. There is an increasing overlap between the primary and secondary headaches and they may actually share a similar biological mechanism. While there can be some criticism that the experimental work with dural and arterial stimulation produced head pain and not actual headache, when considered with the clinical observations about headache type, coupled with improvement after treatment of the primary tumor, we believe that traction on these structures, coupled with increased intracranial pressure, is clearly part of the genesis of brain tumor headache and may also involve peripheral sensitization with neurogenic inflammation as well as a component of central sensitization through trigeminovascular afferents on the meninges and cranial vessels. © 2014 American Headache Society.

  10. Stress and headache chronification.

    Science.gov (United States)

    Houle, Timothy; Nash, Justin M

    2008-01-01

    In this special section, the concept of stress has been linked to the chronification of headache and is considered to be one of several likely mechanisms for the progression of an otherwise episodic disorder to a chronic daily phenomenon. The present review discusses the concept of stress and describes the mechanisms through which stress could influence headache progression. The hypothesized mechanisms include stress serving as a unique trigger for individual attacks, as a nociceptive activator, and as a moderator of other mechanisms. Finally, the techniques used in the screening and management of stress are mentioned in the context of employing strategies for the primary, secondary, or tertiary prevention of headache progression.

  11. National Headache Foundation

    Science.gov (United States)

    ... Headache Topic Sheets (Spanish) Headache FAQ NHF Webinars Education Modules MigrainePro™ Children’s Headache Disorders New Perspectives on Caffeine and Headache War Veterans Health Resource Initiative National Headache Foundation Brochures ...

  12. Unusual headache syndromes.

    Science.gov (United States)

    Queiroz, Luiz P

    2013-01-01

    Some headache syndromes have few cases reported in the literature. Their clinical characteristics, pathogenesis, and treatment may have not been completely defined. They may not actually be uncommon but rather under-recognized and/or underreported. A literature review of unusual headache syndromes, searching PubMed and ISI Web of Knowledge, was performed. After deciding which disorders to study, relevant publications in scientific journals, including original articles, reviews, meeting abstracts, and letters or correspondences to the editors were searched. This paper reviewed the clinical characteristics, the pathogenesis, the diagnosis, and the treatment of five interesting and unusual headache syndromes: exploding head syndrome, red ear syndrome, neck-tongue syndrome, nummular headache, and cardiac cephalgia. Recognizing some unusual headaches, either primary or secondary, may be a challenge for many non-headache specialist physicians. It is important to study them because the correct diagnosis may result in specific treatments that may improve the quality of life of these patients, and this can even be life saving. © 2013 American Headache Society.

  13. Headache And Hormones

    Directory of Open Access Journals (Sweden)

    Shukla Rakesh

    2002-01-01

    Full Text Available There are many reasons to suggest a link between headache and hormones. Migraine is three times common in women as compared to men after puberty, cyclic as well as non-cyclic fluctuations in sex hormone levels during the entire reproductive life span of a women are associated with changes in frequency or severity of migraine attack, abnormalities in the hypothalamus and pineal gland have been observed in cluster headache, oestrogens are useful in the treatment of menstrual migraine and the use of melatonin has been reported in various types of primary headaches. Headache associated with various endocrinological disorders may help us in a better understanding of the nociceptive mechanisms involved in headache disorders. Prospective studies using headache diaries to record the attacks of headache and menstrual cycle have clarified some of the myths associated with menstrual migraine. Although no change in the absolute levels of sex hormones have been reported, oestrogen withdrawal is the most likely trigger of the attacks. Prostaglandins, melatonin, opioid and serotonergic mechanisms may also have a role in the pathogenesis of menstrual migraine. Guidelines have been published by the IHS recently regarding the use of oral contraceptives by women with migraine and the risk of ischaemic strokes in migraineurs on hormone replacement therapy. The present review includes menstrual migraine, pregnancy and migraine, oral contraceptives and migraine, menopause and migraine as well as the hormonal changes in chronic migraine.

  14. Circadian variations in the clinical presentation of headaches among migraineurs: A study using a smartphone headache diary.

    Science.gov (United States)

    Park, Jeong-Wook; Cho, Soo-Jin; Park, Sang-Gue; Chu, Min Kyung

    2018-04-01

    Migraines occur within certain time frames. Nevertheless, information regarding circadian variation in the clinical presentation of migraine is limited. We investigated circadian variations in the clinical presentation of migraine using a smartphone headache diary (SHD). We enrolled adult participants with the diagnosis of migraine according to the third beta edition of the International Classification of Headache Disorders. Participants were asked to log in to the SHD every day for 90 days to record the occurrence of headaches. We compared the occurrence and clinical presentation of headaches during four 6-hour quadrants per day (00:00-05:59, 06:00-11:59, 12:00-17:59, and 18:00-23:59). Migraine-type headache was defined as a headache attack that fulfilled all criteria of migraine, except for the criterion regarding typical headache duration. Eighty-two participants kept a dairy for at least 50% of the study period and recorded 1491 headache attacks. Among the 1491 headache attacks, 474 (31.8%) were classified as migraine-type headaches and 1017 (68.2%) were classified as non-migraine-type headaches. All headaches, migraine-type headaches and non-migraine-type headaches occurred most frequently between 06:00 and 11:59, and least frequently between 18:00 and 23:59, and between 00:00 and 05:59. Migrainous headache characteristics, such as unilateral pain, pulsating quality, severe headache intensity, aggravation by movement, nausea, photophobia, and phonophobia presented most frequently between 06:00 and 11:59, and least frequently between 18:00 and 23:59, and 00:00 and 05:59 among 1491 all headache attacks. Headache clinical presentation as well as headache occurrence exhibited circadian periodicity among migraineurs. SHD: smartphone headache diary; ICHD-3 beta: the third edition beta version of the International Classification of Headache Disorders.

  15. Nausea and Vomiting

    Science.gov (United States)

    ... cancer chemotherapy or other medicines. For vomiting in children and adults, avoid solid foods until vomiting has stopped for at least six hours. Then work back to a normal diet. Drink small amounts of clear liquids to avoid dehydration. Nausea and vomiting are common. Usually, they are ...

  16. Common primary headaches in pregnancy

    Directory of Open Access Journals (Sweden)

    Anuradha Mitra

    2015-01-01

    Full Text Available Headache is a very common problem in pregnancy. Evaluation of a complaint of headache requires categorizing it as primary or secondary. Migrainous headaches are known to be influenced by fluctuation of estrogen levels with high levels improving it and low levels deteriorating the symptoms. Tension-type Headaches (TTHs are the most common and usually less severe types of headache with female to male ratio 3:1. Women known to have primary headache before conception who present with a headache that is different from their usual headache, or women not known to have primary headache before conception who present with new-onset of headache during pregnancy need neurologic assessments for potential secondary cause for their headache. In addition to proper history and physical examination, both non-contrast computed tomography (CT and Magnetic Resonance Imaging (MRI are considered safe to be performed in pregnant women when indicated. Treatment of abortive and prophylactic therapy should include non-pharmacologic tools, judicious use of drugs which are safe for mother and fetus.

  17. Gastrointestinal Headache; a Narrative Review

    Directory of Open Access Journals (Sweden)

    Majid T Noghani

    2016-08-01

    Full Text Available There are studies reporting primary headaches to be associated with gastrointestinal disorders, and some report resolution of headache following the treatment of the associated gastrointestinal disorder. Headache disorders are classified by The International Headache Society as primary or secondary; however, among the secondary headaches, those attributed to gastrointestinal disorders are not appreciated. Therefore, we aimed to review the literature to provide evidence for headaches, which originate from the gastrointestinal system. Gastrointestinal disorders that are reported to be associated with primary headaches include dyspepsia, gastro esophageal reflux disease (GERD, constipation, functional abdominal pain, inflammatory bowel syndrome (IBS, inflammatory bowel disorders (IBD, celiac disease, and helicobacter pylori (H. Pylori infection. Some studies have demonstrated remission or improvement of headache following the treatment of the accompanying gastrointestinal disorders. Hypotheses explaining this association are considered to be central sensitization and parasympathetic referred pain, serotonin pathways, autonomic nervous system dysfunction, systemic vasculopathy, and food allergy. Traditional Persian physicians, namely Ebn-e-Sina (Avicenna and Râzi (Rhazes believed in a type of headache originating from disorders of the stomach and named it as an individual entity, the "Participatory Headache of Gastric Origin". We suggest providing a unique diagnostic entity for headaches coexisting with any gastrointestinal abnormality that are improved or cured along with the treatment of the gastrointestinal disorder.

  18. Female cluster headache in the United States of America: what are the gender differences? Results from the United States Cluster Headache Survey.

    Science.gov (United States)

    Rozen, Todd D; Fishman, Royce S

    2012-06-15

    To present results from the United States Cluster Headache Survey regarding gender differences in cluster headache demographics, clinical characteristics, diagnostic delay, triggers, treatment response and personal burden. Very few studies have looked at the gender differences in cluster headache presentation. The United States Cluster Headache Survey is the largest study of cluster headache sufferers ever completed in the United States and it is also the largest study of female cluster headache patients ever presented. The total survey consisted of 187 multiple choice questions which dealt with various issues related to cluster headache including: demographics, clinical characteristics, concomitant medical conditions, family history, triggers, smoking history, diagnosis, treatment response and personal burden. A group of questions were specifically targeted to female cluster headache patients. The survey was placed on a website from October to December 2008. For all survey responders the diagnosis of cluster headache needed to be made by a neurologist but there was no validation of the headache diagnosis by the authors. 1134 individuals completed the survey (816 male, 318 female). Key Points that define the differences between female and male cluster headache include: a. Age of onset: women develop cluster headache at an earlier age than men and are more likely to develop a second peak of cluster headache onset after 50 years of age. b. Family history: woman cluster headache sufferers are more likely to have a family history of both cluster headache and migraine and have an increased familial risk of Parkinson's disease. c. Comorbid conditions: female cluster headaches sufferers are significantly more likely to experience depression and have asthma than males. d. Aura issues: aura with cluster headache is equally common in both sexes, but aura duration is shorter in women. Women are much more likely to experience sensory, language and brainstem auras. e. Pain

  19. Cluster headache

    OpenAIRE

    Leroux, Elizabeth; Ducros, Anne

    2008-01-01

    Abstract Cluster headache (CH) is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes) of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye). It affects young adults, predominantly males. Prevalence is estimated at 0.5–1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name) in bouts that can occur ...

  20. Migraine and tension-type headache triggers in a Greek population

    Directory of Open Access Journals (Sweden)

    Vasilios Constantinides

    2015-08-01

    Full Text Available Migraine and tension type headache are the two most common primary headaches. The purpose of this study was to detect differences in clinical characteristics and headache triggers and in a Greek cohort of 51 migraineurs and 12 patients with tension-type headache. (TTH Migraine patients had a significantly lower age at headache onset and frequency, higher mean visual analogue scale (VAS and greater maximum duration of headache episodes compared to TTH patients. They did not differ from (TTH patients in quality of headache, laterality of pain, way of headache installation and progression and temporal pattern of headaches. Nausea, vomiting and phonophobia were more frequent in migraine. Triggering of headaches by dietary factors was associated with migraine, whereas there was no difference between the two groups in any of the other headache triggers. Stress, both physical and psychological, were particularly common in both patient groups.

  1. Sleep-related headache and its management.

    Science.gov (United States)

    Singh, Niranjan N; Sahota, Pradeep

    2013-12-01

    apnea, which includes cluster headache, hypnic headache, and headache related to obstructive sleep apnea; and (2) headaches with high prevalence of insomnia, medication overuse, and psychiatric comorbidity including chronic migraine and chronic tension-type headache. The initial step in the management of sleep related headache is proper diagnosis with exclusion of secondary headaches. Screening for sleep disorders with the use of proper tests including polysomnography and referral to sleep clinic, when appropriate is very helpful. Control of individual episode in less than 2 hours should be the initial goal using measures to abort and prevent a relapse. Cluster headache responds very well to injectable Imitrex and oxygen. Verapamil, steroids and lithium are used for preventive treatment of cluster headache. Intractable cluster headache patients have responded to hypothalamic deep brain stimulation. Hypnic headache patients respond to nightly caffeine, indomethacin, and lithium. Paroxysmal hemicrania responds very well to indomethacin. Early morning headaches associated with obstructive sleep apnea respond to CPAP or BiPAP with complete resolution of headache within a month. Patient education and lifestyle modification play a significant role in overall success of the treatment. Chronic tension-type headache and chronic migraine have high prevalence of insomnia and comorbid psychiatric disorders, which require behavioral insomnia treatment and medication if needed along with psychiatric evaluation. Apart from the abortive treatment tailored to the headache types, - such as triptans and DHE 45 for migraine and nonsteroidal anti-inflammatory medication for chronic tension-type headache, preventive treatment with different class of medications including antiepileptics (Topamax and Depakote), calcium channel blockers (verapamil), beta blockers (propranolol), antidepressants (amitriptyline), and Botox may be used depending upon the comorbid conditions.

  2. Short-lasting headache syndromes and treatment options.

    Science.gov (United States)

    Rozen, Todd D

    2004-08-01

    A number of primary headache syndromes are marked by their short duration of pain. Many of these syndromes have their own unique treatment, so they must be recognized by practicing physicians. In this article, a number of the short-lasting headache disorders are reviewed, including chronic paroxysmal hemicrania, SUNCT syndrome, hypnic headache, exploding head syndrome, primary stabbing headache, and cough headache.

  3. Caffeine for the prevention of postoperative nausea and vomiting

    Directory of Open Access Journals (Sweden)

    Richard A Steinbrook

    2013-01-01

    Statistical analysis: Statistical comparisons were tested using bivariable linear and logistic regression for each outcome and then adjusted for high/low risk. Results: Nausea in the postanesthesia care unit (PACU was more common in the caffeine (16 of 62 patients than the placebo group (seven of 69; P = 0.02. There were no significant differences in the use of rescue antiemetics in the PACU, in the incidence of nausea or vomiting over 24 h postoperatively, nor in other outcomes (headache, fatigue, or overall satisfaction either in the PACU or at 24 h; time-to-discharge was similar for both groups. Conclusion: Caffeine was not effective in the prevention of PONV or headache, and did not improve time-to-discharge or patient satisfaction.

  4. A Recurrent Headache

    Directory of Open Access Journals (Sweden)

    Joe Dylewski

    2006-01-01

    Full Text Available Case Presentation A 43-year-old man presented to the emergency room in September 2004 with a two-day history of increasing headache, myalgias and low-grade fever. No family members had been ill recently and he denied having nausea or diarrhea. On examination, he was nontoxic, with a temperature of 37.5¡ãC, pulse of 90 beats/min and blood pressure of 146/84 mmHg. Skin rashes were not present, and the neck was supple. The patient claimed that he seldom had headaches but that he had been hospitalized in England 15 years ago for viral meningitis. He remembered receiving antibiotics at the time despite being told it was a viral meningitis. The patient underwent a computed tomography scan of the brain, which was normal, followed by a lumbar puncture. The opening pressure was not recorded, but there were 23x106/L polymorphonuclear cells and 308x106/L lymphocytes in the cerebrospinal fluid (CSF. The CSF protein was elevated at 1.26 g/L (N¡Ü0.45, with a CSF glucose of 2.9 mmol/L compared with a serum value of 5.3 mmol/L. The peripheral white blood cell count was 10.5x109/L, with 8.0x109/L neutrophils.

  5. Morning Sickness: Nausea and Vomiting of Pregnancy

    Science.gov (United States)

    ... About ACOG Morning Sickness: Nausea and Vomiting of Pregnancy Home For Patients Search FAQs Morning Sickness: Nausea ... PDF Format Morning Sickness: Nausea and Vomiting of Pregnancy Pregnancy How common is nausea and vomiting of ...

  6. Gender influences headache characteristics with increasing age in migraine patients.

    Science.gov (United States)

    Bolay, Hayrunnisa; Ozge, Aynur; Saginc, Petek; Orekici, Gulhan; Uludüz, Derya; Yalın, Osman; Siva, Aksel; Bıçakçi, Şebnem; Karakurum, Başak; Öztürk, Musa

    2015-08-01

    Migraine headache is one of the most common primary headache disorders and is three times more prevalent in women than in men, especially during the reproductive ages. The neurobiological basis of the female dominance has been partly established. The present study aimed to investigate the effect of gender on the headache manifestations in migraine patients. The study group consisted of 2082 adult patients from five different hospitals' tertiary care-based headache clinics. The relationship between headache characteristics and gender was evaluated in migraine with aura (MwA) and migraine without aura (MwoA). The duration, severity, frequency of headache and associated symptoms were evaluated in both genders and age-dependent variations and analyzed in two subgroups. Women with migraine were prone to significantly longer duration and intensity of headache attacks. Nausea, phonophobia and photophobia were more prevalent in women. Median headache duration was also longer in women than in men in MwA (p = 0.013) and MwoA (p < 0.001). Median headache intensity was higher in women than in men in MwA (p = 0.010) and MwoA (p = 0.009). The frequency of nausea was significantly higher in women than in men in MwA (p = 0.049). Throbbing headache quality and associated features (nausea, photophobia, and phonophobia) were significantly more frequent in women than in men in MwoA. The gender impact varied across age groups and significant changes were seen in female migraineurs after age 30. No age-dependent variation was observed in male migraineurs. Gender has an influence on the characteristics of the headache as well as on the associated symptoms in migraine patients, and this impact varies across the age groups, particularly in women. © International Headache Society 2014.

  7. Headaches - danger signs

    Science.gov (United States)

    Migraine headache - danger signs; Tension headache - danger signs; Cluster headache - danger signs; Vascular headache - danger signs ... and other head pain. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: ...

  8. Tension headache

    Science.gov (United States)

    ... are chronic, they can interfere with life and work. When to Contact a Medical Professional Call 911 if: You are experiencing "the worst headache of your life" You have speech, vision, or movement problems or loss of balance, especially if you have not had these symptoms ...

  9. Tension type headaches: a review

    African Journals Online (AJOL)

    Location of the pain:There is often a typical location for tension- type headaches, as ... Cranial nerve abnormalities, including papilloedema. • Signs of ... peripheral and central mechanisms underlie tension-type ... Physiotherapy has been shown to be an effective management option for .... Acupuncture in primary headache.

  10. Adolescents' medicine use for headache

    DEFF Research Database (Denmark)

    Holstein, Bjørn E; Andersen, Anette; Fotiou, Anastasios

    2015-01-01

    BACKGROUND: This study reports secular trends in medicine use for headache among adolescents in 20 countries from 1986 to 2010. METHODS: The international Health Behaviour in School-aged Children (HBSC) survey includes self-reported data about medicine use for headaches among nationally...... representative samples of 11-, 13- and 15-year-olds. We included 20 countries with data from at least three data collection waves, with a total of 380 129 participants. RESULTS: The prevalence of medicine use for headaches varied from 16.5% among Hungarian boys in 1994 to 62.9% among girls in Wales in 1998....... The prevalence was higher among girls than boys in every country and data collection year. The prevalence of medicine use for headaches increased in 12 of 20 countries, most notably in the Czech Republic, Poland, Russia, Sweden and Wales. CONCLUSION: The prevalence of medicine use for headaches among adolescents...

  11. Headache Attributed to Craniocervical Dystonia - A Little Known Headache.

    Science.gov (United States)

    Bezerra, Marcos Eugenio Ramalho; Rocha-Filho, Pedro Augusto Sampaio

    2017-02-01

    Craniocervical dystonia is a focal or segmental dystonia in its distribution, classically known as spasmodic torticollis when in its pure cervical presentation. Although craniocervical dystonia has been recognized as a possible cause of headache since the publication of the second version of International Classification of Headache Disorders, there are few studies about this entity. This was a narrative review. Craniocervical dystonia was associated with muscle pain in 67-89% of the cases. Headaches of any kind affected approximately 60% of patients with craniocervical dystonia, and were located mainly in the occipital and cervical regions. Headache attributed to craniocervical dystonia specifically was rarely found, and it was described in only one patient out of 80 in one study. Treatment with botulinum neurotoxin is considered to be the first-line treatment for focal dystonias, including craniocervical dystonia, and besides reducing clinical severity, impairment, and pain scores among the patients with craniocervical dystonia, there were also descriptions of improvements in headaches attributed to craniocervical dystonia and other headaches associated with this dystonia. Headache attributed to craniocervical dystonia has been poorly studied. There is a need for more studies to evaluate its characteristics and treatment. © 2016 American Headache Society.

  12. Alternative therapy applications for postoperative nausea and vomiting.

    Science.gov (United States)

    Chiravalle, Paulette; McCaffrey, Ruth

    2005-01-01

    The potential for postoperative nausea and vomiting is present in any patient who undergoes surgery and both are unpleasant and potentially dangerous consequences of surgery. Three types of complementary and alternative therapies that may help patients with postoperative nausea and vomiting include acupressure, acupuncture, and aromatherapy.

  13. Low Tyramine Headache Diet

    Science.gov (United States)

    ... Find A Provider Contact Membership Donate 25 Oct Low-Tyramine Diet for Migraine Posted at 17:16h ... and Diamond Headache Clinic Headache Diet Tags: headache , low tyramine diet , MAOI , tyramine No Comments Post A ...

  14. [A rarely known headache: Airplane travel headache].

    Science.gov (United States)

    Azman, Filiz; Erkılınç, Büşra; Çabalar, Murat; Çağırıcı, Sultan; Yayla, Vildan

    2017-01-01

    Recently, headache associated with airplane travel has gained importance with case reports and took its place in the classification of headache in 2013. This rare condition has different spesific characteristic from the primary headaches and its pathophysiology is not clear yet. In this case report, a 27-years-old female patient was diagnosed with the headache associated with airplane travel by history, examination and imaging findings. The possible pathophysiology and treatment were discussed.

  15. New daily persistent headache

    Directory of Open Access Journals (Sweden)

    Alok Tyagi

    2012-01-01

    Full Text Available New daily persistent headache (NDPH is a chronic headache developing in a person who does not have a past history of headaches. The headache begins acutely and reaches its peak within 3 days. It is important to exclude secondary causes, particularly headaches due to alterations in cerebrospinal fluid (CSF pressure and volume. A significant proportion of NDPH sufferers may have intractable headaches that are refractory to treatment. The condition is best viewed as a syndrome rather than a diagnosis. The headache can mimic chronic migraine and chronic tension-type headache, and it is also important to exclude secondary causes, particularly headaches due to alterations in CSF pressure and volume. A large proportion of NDPH sufferers have migrainous features to their headache and should be managed with treatments used for treating migraine. A small group of NDPH sufferers may have intractable headaches that are refractory to treatment.

  16. Headaches in Children

    Science.gov (United States)

    ... his or her head to indicate severe pain. Tension-type headache Tension-type headaches can cause: A pressing tightness ... headaches. Be alert for things that may cause stress in your child's life, such as difficulty ... Keep a headache diary. A diary can help you determine what ...

  17. Headache in sports.

    Science.gov (United States)

    Seifert, Tad

    2014-09-01

    Sports- and exercise-related headaches are not unusual. Despite their frequent occurrence in this context, there are little epidemiologic data concerning sports-related headache. The recent attention of concussive injuries and associated post-traumatic headache has renewed interest in the study of those headaches occurring after head trauma; however, any primary headache type can also occur in the setting of contact and/or collision sports. The nonspecific nature of headaches provides unique challenges to clinicians encountering this complaint. It is, therefore, imperative that physicians treating athletes are able to distinguish the various headache types and presentations often seen in this population.

  18. Headache In Children

    Directory of Open Access Journals (Sweden)

    Srinivasa R

    2002-01-01

    Full Text Available Headaches are common in children. The presentation of headache in children is varied and hence the characterization of headache is more challenging. This situation is worsened further by inadequacies in the history and the effect of maturational factors. Relevant epidemiological and limitations in the applicability of International Headache Society criteria in childhood headache and the rationale for newer criteria are discussed. Migraine and tension-type headache are the common primary headache seen in children. Although there is a paucity of clinical trials the management of childhood migraine, the important role of correct pharmacological approach has been delineated. The pivotal role of non-pharmacological treatment is emphasized.

  19. Headache care in China.

    Science.gov (United States)

    Yu, Shengyuan; Zhang, Mingjie; Zhou, Jiying; Liu, Ruozhuo; Wan, Qi; Li, Yansheng

    2014-04-01

    Headache disorders are problematic worldwide. China is no different. A population-based door-to-door survey revealed that the 1-year prevalence of primary headache disorders in China was 23.8%, constituting a major societal burden. Many headache centers and clinics have been established in China, and headache disorders (and associated stress) are receiving an increased level of expert attention. This review summarizes the outcomes of the epidemiological survey and the progress of clinical and basic research in China, describes the present situation in terms of headache diagnosis and treatment, and discusses the future of headache care in China. © 2014 American Headache Society.

  20. [Headache: classification and diagnosis].

    Science.gov (United States)

    Carbaat, P A T; Couturier, E G M

    2016-11-01

    There are many types of headache and, moreover, many people have different types of headache at the same time. Adequate treatment is possible only on the basis of the correct diagnosis. Technically and in terms of content the current diagnostics process for headache is based on the 'International Classification of Headache Disorders' (ICHD-3-beta) that was produced under the auspices of the International Headache Society. This classification is based on a distinction between primary and secondary headaches. The most common primary headache types are the tension type headache, migraine and the cluster headache. Application of uniform diagnostic concepts is essential to come to the most appropriate treatment of the various types of headache.

  1. Behavioral patterns associated with chemotherapy-induced emesis: A potential signature for nausea in musk shrews

    OpenAIRE

    Charles Christopher Horn; Charles Christopher Horn; Charles Christopher Horn; Charles Christopher Horn; Séverine eHenry; Kelly eMeyers; Magnus S. Magnusson

    2011-01-01

    Nausea and vomiting are common symptoms in patients with many diseases, including cancer and its treatments. Although the neurological basis of vomiting is reasonably well known, an understanding of the physiology of nausea is lacking. The primary barrier to mechanistic research on the nausea system is the lack of an animal model. Indeed investigating the effects of anti-nausea drugs in preclinical models is difficult because the primary readout is often emesis. It is known that animals show ...

  2. Behavioral Patterns Associated with Chemotherapy-Induced Emesis: A Potential Signature for Nausea in Musk Shrews

    OpenAIRE

    Horn, Charles C.; Henry, Séverine; Meyers, Kelly; Magnusson, Magnus S.

    2011-01-01

    Nausea and vomiting are common symptoms in patients with many diseases, including cancer and its treatments. Although the neurological basis of vomiting is reasonably well known, an understanding of the physiology of nausea is lacking. The primary barrier to mechanistic research on the nausea system is the lack of an animal model. Indeed investigating the effects of anti-nausea drugs in pre-clinical models is difficult because the primary readout is often emesis. It is known that animals show...

  3. Evaluation and management of "sinus headache" in the otolaryngology practice.

    Science.gov (United States)

    Patel, Zara M; Setzen, Michael; Poetker, David M; DelGaudio, John M

    2014-04-01

    Patients, primary care doctors, neurologists and otolaryngologists often have differing views on what is truly causing headache in the sinonasal region. This review discusses common primary headache diagnoses that can masquerade as "sinus headache" or "rhinogenic headache," such as migraine, trigeminal neuralgia, tension-type headache, temporomandibular joint dysfunction, giant cell arteritis (also known as temporal arteritis) and medication overuse headache, as well as the trigeminal autonomic cephalalgias, including cluster headache, paroxysmal hemicrania, and hemicrania continua. Diagnostic criteria are discussed and evidence outlined that allows physicians to make better clinical diagnoses and point patients toward better treatment options. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Chronorisk in cluster headache

    DEFF Research Database (Denmark)

    Barloese, Mads; Haddock, Bryan; Lund, Nunu T

    2018-01-01

    and a spectral analysis identifying oscillations in risk. Results The Gaussian model fit for the chronorisk distribution for all patients reporting diurnal rhythmicity (n = 286) had a goodness of fit R2 value of 0.97 and identified three times of increased risk peaking at 21:41, 02:02 and 06:23 hours....... In subgroups, three to five modes of increased risk were found and goodness of fit values ranged from 0.85-0.99. Spectral analysis revealed multiple distinct oscillation frequencies in chronorisk in subgroups including a dominant circadian oscillation in episodic patients and an ultradian in chronic....... Conclusions Chronorisk in cluster headache can be characterised as a sum of individual, timed events of increased risk, each having a Gaussian distribution. In episodic cluster headache, attacks follow a circadian rhythmicity whereas, in the chronic variant, ultradian oscillations are dominant reflecting...

  5. Headache associated with hemodialysis

    Directory of Open Access Journals (Sweden)

    Nikić Petar M.

    2008-01-01

    Full Text Available INTRODUCTION Hemodialysis (HD is one of the most accessible methods for the treatment of the growing number of patients suffering from terminal-stage renal insufficiency. Although headache is the most frequently encountered neurological symptom during HD, there are few studies reporting its prevalence and clinical features. OBJECTIVE The objective of this study was to examine the frequency, demographic and clinical features of headache during HD, and to compare these parameters among patients with and without headache. METHOD The study involved 126 patients (48 female and 78 male with chronic renal failure on regular HD for at least six months, at the Dialysis Unit of Nephrology Department, Kruševac. All patients were inquired about their possible problems with headache using the standardized questionnaire designed according to the diagnostic criteria of the International Headache Classification of Headache Disorders, second edition, published in 2004 (ICHD-II. Subsequently, the patients were clinically evaluated and patients with headaches were further sub classified by a neurologist with special interest in headache disorders. Patients with headache were compared to the patients without headache regarding age, sex, duration of HD, causes of end-stage renal disease, arterial diastolic and systolic blood pressure, and serum values of the most important blood parameters such as sodium, potassium, urea and creatinine. In the group of patients with headache we analyzed the characteristics of specific headache type according to ICHD-II classification. We also analyzed the most important clinical features of hemodialysis headache (HDH. RESULTS In the group of 126 evaluated patients, 41 (32.5% patients had headaches. There were no statistically significant differences between the patients with headaches and those without headaches regarding sex, age, BMI, duration of HD, causes of end-stage renal disease, arterial blood pressure, red blood cell count

  6. Unusual headaches in the elderly.

    Science.gov (United States)

    Bamford, Cynthia C; Mays, MaryAnn; Tepper, Stewart J

    2011-08-01

    Prevalence of headache lowers with age, and headaches of elderly adults tend to be different than those of the younger population. Secondary headaches, such as headaches associated with vascular disease, head trauma, and neoplasm, are more common. Also, certain headache types tend to be geriatric disorders, such as primary cough headache, hypnic headache, typical aura without headache, exploding head syndrome, and giant cell arteritis. This review provides an overview of some of the major and unusual geriatric headaches, both primary and secondary.

  7. Rare nocturnal headaches.

    Science.gov (United States)

    Cohen, Anna S; Kaube, Holger

    2004-06-01

    This review describes rare headaches that can occur at night or during sleep, with a focus on cluster headaches, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing, hypnic headache and exploding head syndrome. It is known that cluster headaches and hypnic headache are associated with rapid eye movement sleep, as illustrated by recent polysomnographic studies. Functional imaging studies have documented hypothalamic activation that is likely to be of relevance to circadian rhythms. These headache syndromes have been shown to respond to melatonin and lithium therapy, both of which have an indirect impact on the sleep-wake cycle. There is growing evidence that cluster headache and hypnic headache are chronobiological disorders.

  8. Principles of headaches evaluation

    Directory of Open Access Journals (Sweden)

    Camila Rosa Rolim de Andrade

    2011-06-01

    Full Text Available ABSTRACT However common tension-type headache is in epidemiologic population-based studies, migraine is the most common diagnosis in patients seeking treatment for headache in primary care. The appropriate evaluation of headache should be as follows: 1 To rule out the most serious underlying pathologies and to look for other secondary causes of headache, 2 To determine the type of primary headache using the patient's history as a primary diagnostic tool. Symptoms can always overlap, particularly between migraine and tension-type headache and between migraine and some secondary causes of headache (such as neurologic or systemic disease. A brief headache screen based only on anamnesis and physical examination data which direct to an underlying pathology is useful to primary care physicians in particular. An imaging study is not necessary in the vast majority of patients presenting with headache. Nevertheless, imaging (usually CT scan is warranted in the patients outlined above.

  9. Experimental headache in humans

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg

    1995-01-01

    The need for valid human experimental models of headache is obvious. Several compounds have been proposed as headache-inducing agents, but only the nitroglycerin (NTG) model has been validated. In healthy subjects, intravenous infusions of the nitric oxide (NO) donor NTG induce a dose......-dependent headache and dilatation of the temporal, radial and middle cerebral artery. NTG-induced headache, although less intense, resembles migraine in pain characteristics, but the accompanying symptoms are rarely present. Cephalic large arteries are dilated during migraine headache as well as during NTG headache....... N-acetylcysteine enhances the formation of NO and potentiates NTG-induced headache, whereas mepyramine, a H1-antagonist capable of blocking histamine-induced headache, has no effect. Thus, the headache is dependent on NO or other steps in the NO cascade. The model is useful for pharmacological...

  10. Drug therapy in headache.

    Science.gov (United States)

    Weatherall, Mark W

    2015-06-01

    All physicians will encounter patients with headaches. Primary headache disorders are common, and often disabling. This paper reviews the principles of drug therapy in headache in adults, focusing on the three commonest disorders presenting in both primary and secondary care: tension-type headache, migraine and cluster headache. The clinical evidence on the basis of which choices can be made between the currently available drug therapies for acute and preventive treatment of these disorders is presented, and information given on the options available for the emergency parenteral treatment of refractory migraine attacks and cluster headache. © Royal College of Physicians 2015. All rights reserved.

  11. Hijab (headscarf) headache.

    Science.gov (United States)

    Ansari, Huma N; Solomon, Glen D

    2015-03-01

    Hijab (headscarf) headache is well known among wearers and is a common topic of discussion. It has never previously been reported in the medical literature. Five women described bilateral headache either prompted by or worsened by donning the hijab, or headscarf. The headache always resolved soon after removal of the headscarf. Hijab headache may also be alleviated by minimal modifications in style while allowing women to maintain their moral conviction. It likely represents an extracranial etiology of headache, and recognition may prevent unnecessary evaluation and suffering in hijab wearers. © 2015 American Headache Society.

  12. Management of cluster headache

    DEFF Research Database (Denmark)

    Tfelt-Hansen, Peer C; Jensen, Rigmor H

    2012-01-01

    The prevalence of cluster headache is 0.1% and cluster headache is often not diagnosed or misdiagnosed as migraine or sinusitis. In cluster headache there is often a considerable diagnostic delay - an average of 7 years in a population-based survey. Cluster headache is characterized by very severe...... or severe orbital or periorbital pain with a duration of 15-180 minutes. The cluster headache attacks are accompanied by characteristic associated unilateral symptoms such as tearing, nasal congestion and/or rhinorrhoea, eyelid oedema, miosis and/or ptosis. In addition, there is a sense of restlessness...... and agitation. Patients may have up to eight attacks per day. Episodic cluster headache (ECH) occurs in clusters of weeks to months duration, whereas chronic cluster headache (CCH) attacks occur for more than 1 year without remissions. Management of cluster headache is divided into acute attack treatment...

  13. Headaches. More than just sinusitis

    International Nuclear Information System (INIS)

    Knauth, Michael

    2011-01-01

    Headaches are among the commonest somatic complaints seen in clinical practice. The International Headache Society differentiates about 190 types of headaches. This article focuses on the variety of secondary headaches with a radiologically identifiable cause. (orig.)

  14. Team players against headache

    DEFF Research Database (Denmark)

    Gaul, Charly; Visscher, Corine M; Bhola, Rhia

    2011-01-01

    Multidisciplinary approaches are gaining acceptance in headache treatment. However, there is a lack of scientific data about the efficacy of various strategies and their combinations offered by physiotherapists, physicians, psychologists and headache nurses. Therefore, an international platform...... for medication overuse headache. The significant value of physiotherapy, education in headache schools, and implementation of strategies of cognitive behavioural therapy was highlighted and the way paved for future studies and international collaboration....

  15. Team players against headache

    DEFF Research Database (Denmark)

    Gaul, Charly; Visscher, Corine M; Bhola, Rhia

    2011-01-01

    Multidisciplinary approaches are gaining acceptance in headache treatment. However, there is a lack of scientific data about the efficacy of various strategies and their combinations offered by physiotherapists, physicians, psychologists and headache nurses. Therefore, an international platform f...... for medication overuse headache. The significant value of physiotherapy, education in headache schools, and implementation of strategies of cognitive behavioural therapy was highlighted and the way paved for future studies and international collaboration....

  16. Headache in children

    DEFF Research Database (Denmark)

    Soee, Ann Britt L; Skov, Liselotte; Skovgaard, Lene Theil

    2013-01-01

    . Results: Fifty per cent of the children had an improvement in headache frequency above 50% at six months. By the use of repeated measurement analysis, we found a significant decrease in headache frequency in all of the six headache groups, whereas the increase in quality of life (PedsQL™ 4.0...

  17. Headache and botulinum toxin

    OpenAIRE

    Porta, M.; Camerlingo, M.

    2005-01-01

    The authors discuss clinical and international experience about botulinum toxins (BTX types A and B) in headache treatment. Data from literature suggest good results for the treatment of tensiontype headache, migraine and chronic tension–type headache. In the present paper mechanisms of action and injection sites will also be discussed.

  18. Temporomandibular disorders and headaches.

    Science.gov (United States)

    Graff-Radford, Steven B; Bassiur, Jennifer P

    2014-05-01

    Headache and temporomandibular disorders should be treated together but separately. If there is marked limitation of opening, imaging of the joint may be necessary. The treatment should then include education regarding limiting jaw function, appliance therapy, instruction in jaw posture, and stretching exercises, as well as medications to reduce inflammation and relax the muscles. The use of physical therapies, such as spray and stretch and trigger point injections, is helpful if there is myofascial pain. Tricyclic antidepressants and the new-generation antiepileptic drugs are effective in muscle pain conditions. Arthrocentesis and/or arthroscopy may help to restore range of motion. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. POSTOPERATIVE NAUSEA AND VOMITING | Yusufu | Annals of ...

    African Journals Online (AJOL)

    Antiemetics, acupuncture and other drugs are used to prevent and treat postoperative nausea and vomiting. Those that manage patients in the postoperative period should endeavour to make postoperative nausea and vomiting as unacceptable as postoperative pain. Key words: Postoperative, Nausea, Vomiting, Narcotics, ...

  20. Causality and headache triggers

    Science.gov (United States)

    Turner, Dana P.; Smitherman, Todd A.; Martin, Vincent T.; Penzien, Donald B.; Houle, Timothy T.

    2013-01-01

    Objective The objective of this study was to explore the conditions necessary to assign causal status to headache triggers. Background The term “headache trigger” is commonly used to label any stimulus that is assumed to cause headaches. However, the assumptions required for determining if a given stimulus in fact has a causal-type relationship in eliciting headaches have not been explicated. Methods A synthesis and application of Rubin’s Causal Model is applied to the context of headache causes. From this application the conditions necessary to infer that one event (trigger) causes another (headache) are outlined using basic assumptions and examples from relevant literature. Results Although many conditions must be satisfied for a causal attribution, three basic assumptions are identified for determining causality in headache triggers: 1) constancy of the sufferer; 2) constancy of the trigger effect; and 3) constancy of the trigger presentation. A valid evaluation of a potential trigger’s effect can only be undertaken once these three basic assumptions are satisfied during formal or informal studies of headache triggers. Conclusions Evaluating these assumptions is extremely difficult or infeasible in clinical practice, and satisfying them during natural experimentation is unlikely. Researchers, practitioners, and headache sufferers are encouraged to avoid natural experimentation to determine the causal effects of headache triggers. Instead, formal experimental designs or retrospective diary studies using advanced statistical modeling techniques provide the best approaches to satisfy the required assumptions and inform causal statements about headache triggers. PMID:23534872

  1. Characteristics of the first 1000 headaches in an outpatient headache clinic registry.

    Science.gov (United States)

    Guerrero, Ángel L; Rojo, Esther; Herrero, Sonia; Neri, María J; Bautista, Lourdes; Peñas, María L; Cortijo, Elisa; Mulero, Patricia; Fernández, Rosa

    2011-02-01

    To analyze the incidence and characteristics of the first 1000 headaches in an outpatient clinic. Headache is a common cause of medical consultation, both in primary care and in specialist neurology outpatient clinics. The International Classification of Headache Disorders, 2nd Edition (ICHD-II), enables headaches to be classified in a precise and reproducible manner. In January 2008, an outpatient headache clinic was set up in Hospital Clínico Universitario, a tertiary hospital in Valladolid, Spain. Headaches were classified prospectively in accordance with ICHD-II criteria. In each case we recorded age and sex, duration of headache, ancillary tests required, and previous symptomatic or prophylactic therapies. In January 2010, the registry included 1000 headaches in 682 patients. The women/men ratio was 2.46/1 and the mean age of the patients was 43.19 ± 17.1 years (range: 14-94 years). Patients were referred from primary care (53.4%), general neurology clinics (36.6%), and other specialist clinics (9%). The headaches were grouped (ICHD-II classification) as follows: group 1 (Migraine), 51.4%; group 2 (Tension-type headache), 16%; group 3 (Trigeminal autonomic cephalalgias), 2.6%; group 4 (Other primary headaches) and group 13 (Cranial neuralgias), 3.4%. The diagnostic criteria of chronic migraine were satisfied in 8.5% of migraines. Regarding secondary headaches, 1.1% of all cases were included in group 5 (Headaches attributed to trauma) and 8.3% in group 8 (Headaches attributed to a substance or its withdrawal). Only 3.4% of headaches were classified in group 14 (Unspecified or not elsewhere classified), and 5.2% were included in the groups listed in the ICHD-II research appendix. This registry outlines the characteristics of patients seen in an outpatient headache clinic in a tertiary hospital; our results are similar to those previously reported for this type of outpatient clinic. Migraine was the most common diagnosis. Most headaches can be classified using

  2. Migraine Headaches

    Science.gov (United States)

    ... migraine triggers include: stress menstruation (periods) skipping meals dehydration too much caffeine (more than 200 mg a day, such as the amount of caffeine in energy drinks) some foods (alcohol, cheese, citrus fruits, pizza, chocolate, ice cream, lunch meats and hot ...

  3. Oxygen treatment of cluster headache

    DEFF Research Database (Denmark)

    Petersen, Anja S; Barloese, Mads C J; Jensen, Rigmor H

    2014-01-01

    PURPOSE: Our aim was to review the existing literature to document oxygen's therapeutic effect on cluster headache. METHOD: A PubMed search resulted in 28 hits, and from these and their references we found in total 11 relevant studies. We included six studies that investigated the efficacy......, but not a prophylactic effect. Despite the fact that only a few high-quality RCT studies are available, oxygen treatment is close to an ideal treatment because it is effective and safe. However, sufferers of cluster headache do not always have access to oxygen because of logistic and financial concerns....

  4. Headaches During War: Analysis of Presentation, Treatment, and Factors Associated with Outcome

    Science.gov (United States)

    2011-01-01

    pathology, and cerebrovascular accidents presenting as headache; infections; low-pressure headache; headaches related to substance abuse; and psychogenic...and cerebrovascular accidents presenting as headache; infections; low-pressure headache; headaches related to substance abuse; and psychogenic...60 (9.2) 48 (14.5) 1. P values based on chi-squared testing between RTD and not RTD. 2. Includes tumours, vascular pathology, and cerebrovascular

  5. Tension-type Headache With Medication Overuse: Pathophysiology and Clinical Implications

    OpenAIRE

    Monteith, Teshamae S.; Oshinsky, Michael L.

    2009-01-01

    Tension-type headache (TTH) is the most prevalent primary headache disorder. An important factor in the long-term prognosis of TTH is the overuse of acute medications used to treat headache. There are many reasons why patients with TTH overuse acute medications, including biobehavioral influences, dependency, and a lack of patient education. Chronic daily headache occurs in 4.1% of the general population, and chronic tension-type headache and medication overuse headache (MOH) occur in approxi...

  6. Content validation of the nursing diagnosis Nausea

    Directory of Open Access Journals (Sweden)

    Daniele Alcalá Pompeo

    2014-02-01

    Full Text Available This study aimed to evaluate the content validity of the nursing diagnosis of nausea in the immediate post-operative period, considering Fehring’s model. Descriptive study with 52 nurses experts who responded an instrument containing identification and validation of nausea diagnosis data. Most experts considered the domain 12 (Comfort, Class 1 (Physical Comfort and the statement (Nausea adequate to the diagnosis. Modifications were suggested in the current definition of this nursing diagnosis. Four defining characteristics were considered primary (reported nausea, increased salivation, aversion to food and vomiting sensation and eight secondary (increased swallowing, sour taste in the mouth, pallor, tachycardia, diaphoresis, sensation of hot and cold, changes in blood pressure and pupil dilation. The total score for the diagnosis of nausea was 0.79. Reports of nausea, vomiting sensation, increased salivation and aversion to food are strong predictors of nursing diagnosis of nausea.

  7. Neurobiology and sleep disorders in cluster headache

    DEFF Research Database (Denmark)

    Barloese, Mads Christian Johannes

    2015-01-01

    Cluster headache is characterized by unilateral attacks of severe pain accompanied by cranial autonomic features. Apart from these there are also sleep-related complaints and strong chronobiological features. The interaction between sleep and headache is complex at any level and evidence suggests...... that it may be of critical importance in our understanding of primary headache disorders. In cluster headache several interactions between sleep and the severe pain attacks have already been proposed. Supported by endocrinological and radiological findings as well as the chronobiological features, predominant...... involvement of cardiac autonomic control. We conducted a questionnaire survey on 275 cluster headache patients and 145 controls as well an in-patient sleep study including 40 CH-patients and 25 healthy controls. The findings include: A distinct circannual connection between cluster occurrence and the amount...

  8. [Primary headache and depression].

    Science.gov (United States)

    Gesztelyi, Gyöngyi

    2004-11-28

    Primary headaches--mainly tension-type headache and migraine--affect a significant portion of the population. Depression is also highly prevalent. The co-existence of a primary headache and depression in the same patient therefore might be a coincidence due to the high prevalence of these conditions, but there might be a causal relationship between them, or headaches and depression might have a common background. This review of the literature summarizes the features of the relationship between primary headaches and depression. Depression is more prevalent in headache patients than in the headache-free population. Prospective epidemiological studies suggest a common genetic, biochemical or environmental background behind primary headaches and depression. This theory is supported by the role of the same neurotransmitter systems (mostly serotonin and dopamine) in headaches as well as in depression. Comorbid depression is associated with female gender, higher age, and higher frequency of headaches. Most depression inventories--questionnaires used to screen for the severity of depressive symptoms--contain transdiagnostic items, therefore their use in their original form is limited in organic diseases: due to the somatic items they might overestimate the severity of depression. When examining a headache patient special attention should be paid to the recognition of comorbid depression. The diagnosis of suspected mood disorder could be supported by using simple screening methods, such as the original or the abbreviated versions of standard depression inventories, but the final diagnosis of major depression needs psychiatric evaluation. Quality of life of the headache patient is affected not only by the characteristics of pain (frequency, duration, severity) but also by the disability caused by headache and the associating mood disorder. Recognizing coexisting mood disorder and disability helps to make the best treatment choice for the acute and preventive treatment of

  9. [PRIMARY HEADACHE IN CHILDREN AND ADOLESCENTS--DIAGNOSIS AND TREATMENT].

    Science.gov (United States)

    Matar, Amal Khourieh; Kerem, Nogah C; Srugo, Isaac; Genizi, Jacob

    2015-12-01

    Primary headaches are one of the most common disorders of childhood, with migraine and tension type headaches (TTHs) being the most frequent ones. In spite of their prevalence, there is paucity of knowledge regarding the underlying pathophysiological mechanisms that cause headaches and regarding the unique aspects of headaches in children and adolescents. To review the literature and summarize the knowledge regarding clinical features, diagnosis and management of primary headache in children and adolescents, mainly migraine and TTH. Most of our current knowledge regarding primary headaches in children and adolescents is driven from extrapolations from studies that were conducted with adult patients. Therefore, it needs to be validated for the different age groups. Migraines may be diagnosed effectively based on the 2nd edition of the International Classification of Headache Disorders (ICHD-II), however, TTH is diagnosed mainly by the absence of features found in other headache types. Treatment strategies for primary headaches vary according to patient's age, family structure, culture and beliefs, headache diagnosis, and based on the disability the headache imposes on the patient's daily living. It was shown that a multidisciplinary approach, that includes continuing counseling, education, and reassurance, in combination with pharmacological and non-pharmacological treatment, is an effective strategy for children and adolescents suffering from primary headaches. Further studies are needed to enrich our knowledge about the pathophysiological mechanisms that cause headaches in children and adolescents and to develop efficient strategies to alleviate their burden.

  10. [Headache: Otorhinolaryngological aspects].

    Science.gov (United States)

    Michel, O

    2016-01-01

    Headache is the main symptom in a wide variety of diseases of which ear, nose and throat (ENT) entities are only a small fraction but are not reflected in the number of patients. Comprehensive knowledge of the clinical signs of the most common primary headaches, e. g. migraine, is therefore essential for the ENT specialist because the few patients with secondary headache from ENT-related causes must be identified. Reasons for confusing primary headache with e. g. sinusitis are mostly symptoms mediated by the trigeminal nerve, such as nasal obstruction and rhinorrhea because branches of the trigeminal nerve also innervate the meninges. The ENT-specific origin of headaches is characterized by clinical findings of physical organ disease; therefore, from an ENT perspective imaging should be part of the diagnostic procedure as normal imaging findings are indicative of primary headache, which would not normally be treated by an ENT specialist.

  11. No Laughing Matter: Gelastic Migraine and Other Unusual Headache Syndromes.

    Science.gov (United States)

    Mathew, Paul G; Robertson, Carrie E

    2016-05-01

    Primary and secondary headache disorders have established diagnostic criteria in the International Classification of Headache Disorders IIIb, as well as classic findings, which although not part of the formal criteria are often suggestive of a particular diagnosis. At times, headache disorders can involve unusual symptoms that lack an identifiable secondary cause. This review will discuss some of these unusual symptoms, including headache associated auditory and olfactory symptoms, as well as two case reports involving gelastic migraine and migrainous thoracalgia.

  12. Harry Potter and the curse of headache.

    Science.gov (United States)

    Sheftell, Fred; Steiner, Timothy J; Thomas, Hallie

    2007-06-01

    Headache disorders are common in children and adolescents. Even young male Wizards are disabled by them. In this article we review Harry Potter's headaches as described in the biographical series by JK Rowling. Moreover, we attempt to classify them. Regrettably we are not privy to the Wizard system of classifying headache disorders and are therefore limited to the Muggle method, the International Classification of Headache Disorders, 2nd edition (ICHD-II). Harry's headaches are recurrent. Although conforming to a basic stereotype, and constant in location, throughout the 6 years of his adolescence so far described they have shown a tendency to progression. Later descriptions include a range of accompanying symptoms. Despite some quite unusual features, they meet all but one of the ICHD-II criteria for migraine, so allowing the diagnosis of 1.6 Probable migraine.

  13. Case studies of uncommon headaches.

    Science.gov (United States)

    Evans, Randolph W

    2006-05-01

    The following interesting and uncommon headache disorders are presented through case studies: exploding head syndrome, hypnic headache, neck-tongue syndrome, "Alice in Wonderland" syndrome, nummular headache, red ear syndrome, burning mouth syndrome, spontaneous intracranial hypotension syndrome, and cardiac cephalalgia.

  14. Ictal headache and visual sensitivity

    NARCIS (Netherlands)

    Piccioli, M.; Parisi, P.; Tisei, P.; Villa, M. P.; Buttinelli, C.; Kasteleijn-Nolst Trenite, D. G. A.

    Migrainous headache is reported by patients with photosensitive epilepsy, whereas their relatives complain more often about headache than the relatives of patients with other types of epilepsy. We therefore investigated whether headache itself could be an epileptic symptom related to

  15. Tension type headache

    Directory of Open Access Journals (Sweden)

    Debashish Chowdhury

    2012-01-01

    Full Text Available Tension type headaches are common in clinical practice. Earlier known by various names, the diagnosis has had psychological connotations. Recent evidence has helped clarify the neurobiological basis and the disorder is increasingly considered more in the preview of neurologists. The classification, clinical features, differential diagnosis and treatment of tension type headache are discussed in this paper.

  16. [Modifiable risk factors for primary headache. A systematic review].

    Science.gov (United States)

    Albers, L; Ziebarth, S; von Kries, R

    2014-08-01

    Strategies to prevent primary headaches could be very beneficial, especially given that primary headaches can lead to the development of chronic headache. In order to establish headache prevention strategies, the modifiable risk factors for primary headaches need to be identified. A systematic literature search on the risk factors for primary headaches was conducted independently by two persons using the databases MEDLINE and Embase. Further inclusion criteria were observational studies in adult general populations or case-control studies, where the effect sizes were reported as odds ratios or where the odds ratios could be calculated from the given data. In all, 24 studies were included in the analysis. There was a large amount of heterogeneity among the studies concerning headache acquisition, headache classification, and risk factors for headache development. Independent of headache trigger and definition of headache, the association between headache and the risk factor "stress" was very high: The meta-analysis shows an overall effect of 2.26 (odds ratio; 95 %-CI = [1.79; 2.85]). Studies evaluating neck and shoulder pain also report a strong association with headache; however, these results could not be summarized in a meta-analysis. Equally, the overall effects of smoking and coffee consumption on headaches could not be verified because the effect sizes were rather small and predominantly noticeable only at higher doses. A strong association between headache and the risk factors stress and neck and shoulder pain was confirmed. The effect sizes of smoking and coffee consumption on headaches were rather small.

  17. Gastrointestinal Headache; a Narrative Review

    OpenAIRE

    Majid T Noghani; Hossein Rezaeizadeh; Sayed Mohammad Baqer Fazljoo; Mahmoud Yousefifard; Mansoor Keshavarz

    2016-01-01

    There are studies reporting primary headaches to be associated with gastrointestinal disorders, and some report resolution of headache following the treatment of the associated gastrointestinal disorder. Headache disorders are classified by The International Headache Society as primary or secondary; however, among the secondary headaches, those attributed to gastrointestinal disorders are not appreciated. Therefore, we aimed to review the literature to provide evidence for headaches, which or...

  18. Temporomandibular disorders in headache patients

    OpenAIRE

    Mello, Christiane-Espinola-Bandeira; Oliveira, José-Luiz-Góes; Jesus, Alan-Chester-Feitosa; Maia, Mila-Leite-de Moraes; de Santana, Jonielly-Costa-Vasconcelos; Andrade, Loren-Suyane-Oliveira; Siqueira Quintans, Jullyana-de Souza; Quintans-Junior, Lucindo-José; Conti, Paulo-César-Rodrigues; Bonjardim, Leonardo-Rigoldi

    2012-01-01

    Objective: To identify the frequency of signs and symptoms of temporomandibular disorder (TMD) and its seve-rity in individuals with headache. Study Design: 60 adults divided into three groups of 20 individuals: chronic daily headache (CDH), episodic headache (EH) and a control group without headache (WH). Headache diagnosis was performed according to the criteria of International Headache Society and the signs and symptoms of TMD were achieved by using a clinical exam and an anamnestic quest...

  19. Headache yesterday in Europe

    Science.gov (United States)

    2014-01-01

    Background Surveys enquiring about burden of headache over a prior period of time (eg, 3 months) are subject to recall bias. To eliminate this as far as possible, we focused on presence and impact of headache on the preceding day (“headache yesterday”). Methods Adults (18-65 years) were surveyed from the general populations of Germany, Italy, Lithuania, Luxembourg and the Netherlands, from a work-force population in Spain and from mostly non-headache patient populations of Austria, France and UK. A study of non-responders in some countries allowed detection of potential participation bias where initial participation rates were low. Results Participation rates varied between 11% and 59% (mean 27%). Non-responder studies suggested that, because of participation bias, headache prevalence might be overestimated in initial responders by up to 2% (absolute). Across all countries, 1,422 of 8,271 participants (15-17%, depending on correction for participation bias) had headache yesterday lasting on average for 6 hours. It was bad or very bad in 56% of cases and caused absence from work or school in 6%. Among those who worked despite headache, 20% reported productivity reduced by >50%. Social activities were lost by 24%. Women (21%) were more likely than men (12%) to have headache yesterday, but impact was similar in the two genders. Conclusions With recall biases avoided, our findings indicate that headache costs at least 0.7% of working capacity in Europe. This calculation takes into account that most of those who missed work could make up for this later, which, however, means that leisure and social activities are even more influenced by headache. PMID:24884765

  20. Classification of Headache Disorders: Extending to a Multiaxial System.

    Science.gov (United States)

    Martin, Paul R

    2016-11-01

    This article argues for extending the International Classification of Headache Disorders to include information that goes beyond diagnosis. The obvious model is a multiaxial system as has been developed for other taxonomies. An axis for recording disability and impact on functioning, and an axis for recording the triggers of headache/migraine, are perhaps the strongest contenders for adding to the system, but there are other possibilities such as lifestyle factors relevant to headache. Extensions such as these would contribute to headache management, provide clear targets for change, and encourage adoption of a biopsychosocial perspective. © 2016 American Headache Society.

  1. Headache and facial pain: differential diagnosis and treatment.

    Science.gov (United States)

    Bernstein, Jonathan A; Fox, Roger W; Martin, Vincent T; Lockey, Richard F

    2013-01-01

    Headaches affect 90% of the population sometime during their life. Most are benign and fleeting, some are serious and life-threatening, and others require ongoing medical consultation and treatment. A careful history and physical is necessary to establish a differential diagnosis and to guide the choice of testing to make an accurate diagnosis. The most common types of headaches are discussed in this review. They are divided into primary and secondary headache disorders as classified by the International Headache Society. Primary headache disorders include migraine without and with aura, cluster and tension-type headaches. Secondary headaches are those that occur as a result of some other disorder and include brain tumors, rhinosinusitis, diseases of intracranial and extracranial vasculature, and temporomandibular joint disease. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  2. Rethinking headache chronification.

    Science.gov (United States)

    Turner, Dana P; Smitherman, Todd A; Penzien, Donald B; Lipton, Richard B; Houle, Timothy T

    2013-06-01

    The objective of this series is to examine several threats to the interpretation of headache chronification studies that arise from methodological issues. The study of headache chronification has extensively used longitudinal designs with 2 or more measurement occasions. Unfortunately, application of these designs, when combined with the common practice of extreme score selection as well as the extant challenges in measuring headache frequency rates (eg, unreliability, regression to the mean), induces substantive threats to accurate interpretation of findings. Partitioning the amount of observed variance in rates of chronification and remission attributable to regression artifacts is a critical yet previously overlooked step to learning more about headache as a potentially progressive disease. In this series on rethinking headache chronification, we provide an overview of methodological issues in this area (this paper), highlight the influence of rounding error on estimates of headache frequency (second paper), examine the influence of random error and regression artifacts on estimates of chronification and remission (third paper), and consider future directions for this line of research (fourth paper). © 2013 American Headache Society.

  3. Posttraumatic Headache: Basic Mechanisms and Therapeutic Targets.

    Science.gov (United States)

    Kamins, Joshua; Charles, Andrew

    2018-06-01

    Frequent or continuous headache, often refractory to medical therapy, is a common occurrence after head trauma. In addition to being the most common acute symptom after traumatic brain injury (TBI), headache is also one of the most persistent and disabling symptoms. Different studies indicate that 18-58% of those suffering a TBI will have significant headache at 1 year following the trauma. In addition to being disabling on its own, posttraumatic headache (PTH) is a predictor of overall outcome after concussion. Despite its remarkable prevalence and associated social and economic costs, many fundamental and important questions about PTH remain unanswered. The purpose of this review is to identify key questions regarding the clinical characteristics of posttraumatic headache, its basic mechanisms, and its optimal management. We discuss phenotypic features of PTH, pathophysiological mechanisms of TBI including potential overlaps with those of migraine and other primary headache disorders, and potential novel targets for treatment. We suggest different strategies to finding answers to the questions regarding PTH in order to advance the understanding of the disorder and develop more effective therapies. © 2018 American Headache Society.

  4. Pavlovian conditioning of nausea and vomiting.

    Science.gov (United States)

    Stockhorst, Ursula; Steingrueber, Hans-Joachim; Enck, Paul; Klosterhalfen, Sibylle

    2006-10-30

    Cancer patients undergoing cytotoxic drug treatment often experience side-effects, the most distressing being nausea and vomiting. Despite antiemetic drugs, 25-30% of the chemotherapy patients report these side-effects when being re-exposed to the stimuli that usually signal the chemotherapy session and its drug infusion. These symptoms are called anticipatory nausea and anticipatory vomiting. The present paper summarizes the evidence that anticipatory vomiting is acquired by Pavlovian conditioning, and, consequently, may be alleviated by conditioning techniques. To explore the mechanisms that induce and alleviate conditioned nausea and vomiting further, a conditioned nausea model was established in healthy humans using body rotation as the nausea-inducing treatment. The validity of this motion sickness model to examine conditioning mechanisms in the acquisition and alleviation of conditioned nausea was demonstrated. Cortisol and tumor-necrosis factor-alpha were elevated as endocrine and immunological correlates of nausea. Data in the rotation-induced motion sickness model indicated that gender is an important moderator variable to be considered in further studies. The paper concludes with a review of applications of the demonstrated conditioning principles as interventions to ameliorate distressing anticipatory nausea or anticipatory vomiting in cancer patients undergoing chemotherapy.

  5. Influence of headache frequency on clinical signs and symptoms of TMD in subjects with temple headache and TMD pain.

    Science.gov (United States)

    Anderson, Gary C; John, Mike T; Ohrbach, Richard; Nixdorf, Donald R; Schiffman, Eric L; Truelove, Edmond S; List, Thomas

    2011-04-01

    The relationship of the frequency of temple headache to signs and symptoms of temporomandibular joint (TMJ) disorders (TMD) was investigated in a subset of a larger convenience sample of community TMD cases. The study sample included 86 painful TMD, nonheadache subjects; 309 painful TMD subjects with varied frequency of temple headaches; and 149 subjects without painful TMD or headache for descriptive comparison. Painful TMD included Research Diagnostic Criteria for Temporomandibular Disorders diagnoses of myofascial pain, TMJ arthralgia, and TMJ osteoarthritis. Mild to moderate-intensity temple headaches were classified by frequency using criteria based on the International Classification of Headache Disorder, 2nd edition, classification of tension-type headache. Outcomes included TMD signs and symptoms (pain duration, pain intensity, number of painful masticatory sites on palpation, mandibular range of motion), pressure pain thresholds, and temple headache resulting from masticatory provocation tests. Trend analyses across the painful TMD groups showed a substantial trend for aggravation of all of the TMD signs and symptoms associated with increased frequency of the temple headaches. In addition, increased headache frequency showed significant trends associated with reduced PPTs and reported temple headache with masticatory provocation tests. In conclusion, these findings suggest that these headaches may be TMD related, as well as suggesting a possible role for peripheral and central sensitization in TMD patients. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  6. Refractory chronic cluster headache

    DEFF Research Database (Denmark)

    Mitsikostas, Dimos D; Edvinsson, Lars; Jensen, Rigmor H

    2014-01-01

    Chronic cluster headache (CCH) often resists to prophylactic pharmaceutical treatments resulting in patients' life damage. In this rare but pragmatic situation escalation to invasive management is needed but framing criteria are lacking. We aimed to reach a consensus for refractory CCH definition...... for clinical and research use. The preparation of the final consensus followed three stages. Internal between authors, a larger between all European Headache Federation members and finally an international one among all investigators that have published clinical studies on cluster headache the last five years...

  7. Management of chronic daily headache in children and adolescents.

    Science.gov (United States)

    Mack, Kenneth J; Gladstein, Jack

    2008-01-01

    Chronic daily headache (CDH) occurs in 1-2% of children and adolescents. It can evolve from either episodic tension-type headache or episodic migraine, or can appear with no previous headache history. As with other primary headache disorders, treatment is based on the level of disability. There are children and adolescents who cope well, but there are others who are markedly disabled by their chronic headaches. As in adults, children and adolescents with CDH are at risk for medication overuse. CDH is a diagnosis of exclusion, based on a thorough history, normal physical examination, and negative neuroimaging findings. Along with the chronic headaches, children with this condition may have co-morbid sleep problems, autonomic dysfunction, anxiety, and/or depression. Principles of treatment include identifying migrainous components, stopping medication overuse, stressing normalcy, using rational pharmacotherapy, and addressing co-morbid conditions. Successful outcomes often involve identifying an appropriate headache preventative, reintegration into school, and family participation in resetting realistic expectations.

  8. Functional Nausea in Children: A Review of the Literature and Need for Diagnostic Criteria

    Directory of Open Access Journals (Sweden)

    Alexandra C. Russell

    2016-03-01

    Full Text Available Nausea is common amongst children with functional gastrointestinal disorders and is associated with a high burden of somatic and psychosocial comorbidities in both the short and long-term. Current treatments including medications, phytotherapy, stress-reduction techniques, and gastric electrical stimulation for recalcitrant cases, are reviewed. Functional nausea merits its own diagnostic criteria as a pediatric functional gastrointestinal disorder.

  9. Headaches: In Depth

    Science.gov (United States)

    ... 4):199–208. Kemper KJ, Breuner CC. Complementary, holistic, and integrative medicine: headaches . Pediatrics in Review . 2010; ... based evaluation of complementary health approaches for pain management in the United States. Mayo Clinic Proceedings . September ...

  10. Epidemiology and comorbidity of headache

    DEFF Research Database (Denmark)

    Stovner, L.J.; Jensen, Rigmor Højland

    2008-01-01

    The burden associated with headache is a major public health problem, the true magnitude of which has not been fully acknowledged until now. Globally, the percentage of the adult population with an active headache disorder is 47% for headache in general, 10% for migraine, 38% for tension-type...... headache, and 3% for chronic headache that lasts for more than 15 days per month. The large costs of headache to society, which are mostly indirect through loss of work time, have been reported. On the individual level, headaches cause disability, suffering, and loss of quality of life that is on a par...

  11. Ice cream headache in students and family history of headache: a cross-sectional epidemiological study.

    Science.gov (United States)

    Zierz, Antonia Maria; Mehl, Theresa; Kraya, Torsten; Wienke, Andreas; Zierz, Stephan

    2016-06-01

    Headache attributed to ingestion of a cold stimulus (ICHD-3 beta 4.5.1) is also known as ice cream headache (ICH). This cross-sectional epidemiological study included 283 students (10-14-year-olds) attending a grammar school in Germany, their parents (n = 401), and 41 teachers. A self-administered questionnaire was used to analyze the prevalence and characteristics of ICH based on the ICHD classification. Additionally, the association between ICH and other headaches was investigated in students and parents. Prevalence of ICH in students was 62 % without gender difference. In adults, only 36 % of females and 22 % of males reported ICH. There was an increased risk for ICH in students when mother (OR 10.7) or father (OR 8.4) had ICH. Other headaches in parents had no influence on the prevalence of ICH in students. However, in the groups of students and parents itself there was a highly significant association between ICH and other headaches (students: OR 2.4, mothers: OR 2.9, fathers: OR 6.8). There was a decreased risk for ICH when parents and students had no headache at all (OR < 0.4). ICH in students clearly shows a familial disposition by both father and mother. There was also an association between ICH and other headaches within the student and adult groups. The absence of headache history seems to be a protective factor for ICH.

  12. Guidelines for the organization of headache education in Europe: the headache school II

    DEFF Research Database (Denmark)

    Jensen, Rigmor; Mitsikostas, Dimos D; Valade, Dominique

    2010-01-01

    of a similar scientific standard has been developed. To be certified for CME credits, patronage, and financial support from EHF, it is highly recommended to adhere to the suggested teaching strategies. We hereby aim to promote and professionalize the education in headache disorders and endorse the educational......In order to promote education on headache disorders, European Headache Federation (EHF) in conjunction with National Headache Societies organizes educational courses meeting uniform standards according to previous published guidelines. Based on six headache summer schools' experience, an EHF......, a day-to-day program, and a multiple-choice test battery have now been outlined. It is recommended to include practical sessions with patient interviews and hands-on demonstrations of non-pharmacological treatment strategies. For countries that want a 'low cost' education program, a Video School program...

  13. Headache as an Aura of Epilepsy: Video-EEG Monitoring Study.

    Science.gov (United States)

    Kim, Dong Wook; Sunwoo, Jun-Sang; Lee, Sang Kun

    2016-04-01

    Headache can be associated with epilepsy as a pre-ictal, ictal, or post-ictal phenomenon; however, studies of patients with headache as an epileptic aura are scarce. We performed the present study to investigate the incidence and characteristics of headache as an epileptic aura, via confirmation of electroencephalography (EEG) changes by video-EEG monitoring. Data of aura and clinical seizure episodes of 831 consecutive patients who undertook video-EEG monitoring were analyzed retrospectively. For patients who had headache as an aura, information on the detailed features of headache was acquired, including location, nature, duration, and the presence of accompanying symptoms. Video-recorded clinical seizures, EEG findings, and neuroimaging data were used to determine the ictal onset areas in the patients. Six out of 831 (0.7%) patients experienced headache as aura (age range, 25-52 years), all of whom had partial seizures. The incidence of pre-ictal headache was 6.3% (25/831), and post-ictal headache was 30.9% (257/831). In patients with headache as aura, five patients described headache as the most frequent aura, and headache was the second most frequent aura in one patient. The characteristics of headache were hemicrania epileptica in two patients, tension-type headache in another two patients, and migraine-like headache in the remaining two patients. No patient met the diagnostic criteria of ictal epileptic headache or migraine aura-triggered seizure. Our study showed that headache as an aura is uncommon in adult patients with epilepsy, and that headache can present as diverse features, including hemicrania epileptica, tension-type headache, and migraine-like headache. Further studies are necessary to characterize the features of headache as an epileptic aura in adult patients with epilepsy. © 2016 American Headache Society.

  14. Fibromyalgia and headache: an epidemiological study supporting migraine as part of the fibromyalgia syndrome.

    Science.gov (United States)

    Marcus, Dawn A; Bernstein, Cheryl; Rudy, Thomas E

    2005-11-01

    Fibromyalgia is defined by widespread body pain, tenderness to palpation of tender point areas, and constitutional symptoms. The literature reports headache in about half of fibromyalgia patients. The current epidemiological study was designed to determine the prevalence and characteristics of headache in fibromyalgia patients. Treatment-seeking fibromyalgia patients were evaluated with measures for fibromyalgia, chronic headache, quality of life, and psychological distress. Multivariate analysis of variance (MANOVA) and t-tests were used to identify significant differences, as appropriate. A total of 100 fibromyalgia patients were screened (24 fibromyalgia without headache and 76 fibromyalgia with headache). International Headache Society diagnoses included: migraine alone (n = 15 with aura, n = 17 without aura), tension-type alone (n = 18), combined migraine and tension-type (n = 16), post-traumatic (n = 4), and probable analgesic overuse headache (n = 6). Fibromyalgia tender point scores and counts and most measures of pain severity, sleep disruption, or psychological distress were not significantly different between fibromyalgia patients with and without headache. As expected, the fibromyalgia patients with headache scored higher on the Headache Impact Test (HIT-6) (62.1 +/- 0.9 vs 48.3 +/- 1.6, p 60 in 80% of fibromyalgia plus headache patients, representing severe impact from headache, and 56-58 in 4%, representing substantial impact. In summary, chronic headache was endorsed by 76% of treatment-seeking fibromyalgia patients, with 84% reporting substantial or severe impact from their headaches. Migraine was diagnosed in 63% of fibromyalgia plus headache patients, with probable analgesic overuse headache in only 8%. General measures of pain, pain-related disability, sleep quality, and psychological distress were similar in fibromyalgia patients with and without headache. Therefore, fibromyalgia patients with headache do not appear to represent a significantly

  15. New daily-persistent headache versus tension-type headache.

    Science.gov (United States)

    Robbins, Matthew S; Crystal, Sara C

    2010-12-01

    New daily-persistent headache (NDPH) and chronic tension-type headache (CTTH) are two forms of primary chronic daily headache of long duration that often are similar in their headache manifestations. NDPH distinguishes itself from CTTH and the other forms of chronic daily headache by its continuous head pain from onset. However, despite formalized criteria that specify NDPH must resemble the acute onset of a headache identical to that of CTTH, NDPH commonly has migraine features. Here, we review the available literature on NDPH and compare its clinical features, epidemiology, prognosis, inciting factors, and treatment to CTTH.

  16. Comprehensive Headache Experience in Collegiate Student-Athletes: An Initial Report From the NCAA Headache Task Force.

    Science.gov (United States)

    Seifert, Tad; Sufrinko, Alicia; Cowan, Robert; Scott Black, W; Watson, Dave; Edwards, Bill; Livingston, Scott; Webster, Keith; Akers, David; Lively, Mathew; Kontos, Anthony P

    2017-06-01

    The prevalence of primary headache disorders in the general population provides a unique challenge in the evaluation of headache occurring in the context of sport. Despite a wealth of studies exploring the epidemiology of headache in the layperson, little is known about the prevalence and nature of headaches in collegiate student-athletes. These scenarios are challenging in the return to play context, as it is often unclear whether an athlete has an exacerbation of a primary headache disorder, new onset headache unrelated to trauma, or has suffered a concussive injury. To establish the prevalence and nature of headaches in collegiate student-athletes. Retrospective cross-sectional survey. This cross-sectional survey evaluated the characteristics and prevalence of headache in 834 student-athletes from four NCAA Division-I institutions. Because headache occurrence may vary by sport (collision, contact, non-contact), by sex, and medical history, our sample included male and female athletes in a variety of sports, with differing degrees of contact exposure. The 20 question survey collected data on personal and family history of headache, as well as concussion history. A total of 23.7% (n = 198) of participants reported having a personal history of migraine, 25.2% (n = 210) history of sinus headache, and 12.3% (n = 103) history of tension type headache. Among athletes with a prior history of concussion, 46.3% (n = 25) of females reported a history of migraine, while only 32.2% of males reported history of migraine (χ 2  = 3.421, P = .064). The etiology of increased prevalence of migraine in our study is unclear. Whether this is due to increased awareness of headache disorders, a consequence of contact exposure, or a predisposition for migraine development in this age group remains unclear. Further studies are indicated. © 2017 American Headache Society.

  17. Overview of diagnosis and management of paediatric headache. Part I: diagnosis.

    Science.gov (United States)

    Ozge, Aynur; Termine, Cristiano; Antonaci, Fabio; Natriashvili, Sophia; Guidetti, Vincenzo; Wöber-Bingöl, Ciçek

    2011-02-01

    Headache is the most common somatic complaint in children and adolescents. The evaluation should include detailed history of children and adolescents completed by detailed general and neurological examinations. Moreover, the possible role of psychological factors, life events and excessively stressful lifestyle in influencing recurrent headache need to be checked. The choice of laboratory tests rests on the differential diagnosis suggested by the history, the character and temporal pattern of the headache, and the physical and neurological examinations. Subjects who have any signs or symptoms of focal/progressive neurological disturbances should be investigated by neuroimaging techniques. The electroencephalogram and other neurophysiological examinations are of limited value in the routine evaluation of headaches. In a primary headache disorder, headache itself is the illness and headache is not attributed to any other disorder (e.g. migraine, tension-type headache, cluster headache and other trigeminal autonomic cephalgias). In secondary headache disorders, headache is the symptom of identifiable structural, metabolic or other abnormality. Red flags include the first or worst headache ever in the life, recent headache onset, increasing severity or frequency, occipital location, awakening from sleep because of headache, headache occurring exclusively in the morning associated with severe vomiting and headache associated with straining. Thus, the differential diagnosis between primary and secondary headaches rests mainly on clinical criteria. A thorough evaluation of headache in children and adolescents is necessary to make the correct diagnosis and initiate treatment, bearing in mind that children with headache are more likely to experience psychosocial adversity and to grow up with an excess of both headache and other physical and psychiatric symptoms and this creates an important healthcare problem for their future life.

  18. Sleep in cluster headache

    DEFF Research Database (Denmark)

    Barloese, M C J; Jennum, P J; Lund, N T

    2015-01-01

    with rapid eye movement (REM) sleep have been suggested. Sleep in a large, well-characterized population of CH patients was investigated. METHODS: Polysomnography (PSG) was performed on two nights in 40 CH patients during active bout and one night in 25 age, sex and body mass index matched controls...... in hospital. Macrostructure and other features of sleep were analyzed and related to phenotype. Clinical headache characterization was obtained by semi-structured interview. RESULTS: Ninety-nine nights of PSG were analyzed. Findings included a reduced percentage of REM sleep (17.3% vs. 23.0%, P = 0.......0037), longer REM latency (2.0 vs. 1.2 h, P = 0.0012) and fewer arousals (7.34 vs. 14.1, P = 0.003) in CH patients. There was no difference in prevalence of sleep apnea between patients (38%) and matched controls (32%, P = 0.64) although the apnea index in patients was numerically higher (mean apnea...

  19. Headache Following Occipital Brain Lesion: A Case of Migraine Triggered by Occipital Spikes?

    Science.gov (United States)

    Vollono, Catello; Mariotti, Paolo; Losurdo, Anna; Giannantoni, Nadia Mariagrazia; Mazzucchi, Edoardo; Valentini, Piero; De Rose, Paola; Della Marca, Giacomo

    2015-10-01

    This study describes the case of an 8-year-old boy who developed a genuine migraine after the surgical excision, from the right occipital lobe, of brain abscesses due to selective infestation of the cerebrum by Entamoeba histolytica. After the surgical treatment, the boy presented daily headaches with typical migraine features, including right-side parieto-temporal pain, nausea, vomiting, and photophobia. Electroencephalography (EEG) showed epileptiform discharges in the right occipital lobe, although he never presented seizures. Clinical and neurophysiological observations were performed, including video-EEG and polygraphic recordings. EEG showed "interictal" epileptiform discharges in the right occipital lobe. A prolonged video-EEG recording performed before, during, and after an acute attack ruled out ictal or postictal migraine. In this boy, an occipital lesion caused occipital epileptiform EEG discharges without seizures, probably prevented by the treatment. We speculate that occipital spikes, in turn, could have caused a chronic headache with features of migraine without aura. Occipital epileptiform discharges, even in absence of seizures, may trigger a genuine migraine, probably by means of either the trigeminovascular or brainstem system. © EEG and Clinical Neuroscience Society (ECNS) 2014.

  20. Managing Chemotherapy Side Effects: Nausea and Vomiting

    Science.gov (United States)

    N ational C ancer I nstitute Managing Chemotherapy Side Effects U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Nausea and Vomiting “I take medicine so I won’t feel sick ...

  1. Regional cerebral blood flow in childhood headache

    International Nuclear Information System (INIS)

    Roach, E.S.; Stump, D.A.

    1989-01-01

    Regional cerebral blood flow (rCBF) was measured in 16 cranial regions in 23 children and adolescents with frequent headaches using the non-invasive Xenon-133 inhalation technique. Blood flow response to 5% carbon dioxide (CO2) was also determined in 21 patients, while response to 50% oxygen was measured in the two patients with hemoglobinopathy. Included were 10 patients with a clinical diagnosis of migraine, 4 with musculoskeletal headaches, and 3 with features of both types. Also studied were 2 patients with primary thrombocythemia, 2 patients with hemoglobinopathy and headaches, 1 patient with polycythemia, and 1 with headaches following trauma. With two exceptions, rCBF determinations were done during an asymptomatic period. Baseline rCBF values tended to be higher in these young patients than in young adults done in our laboratory. Localized reduction in the expected blood flow surge after CO2 inhalation, most often noted posteriorly, was seen in 8 of the 13 vascular headaches, but in none of the musculoskeletal headache group. Both patients with primary thrombocythemia had normal baseline flow values and altered responsiveness to CO2 similar to that seen in migraineurs; thus, the frequently reported headache and transient neurologic signs with primary thrombocythemia are probably not due to microvascular obstruction as previously suggested. These data support the concept of pediatric migraine as a disorder of vasomotor function and also add to our knowledge of normal rCBF values in younger patients. Demonstration of altered vasomotor reactivity to CO2 could prove helpful in children whose headache is atypical

  2. Temporomandibular disorders in adolescents with headache.

    Science.gov (United States)

    Sojka, Anna; Żarowski, Marcin; Steinborn, Barbara; Hedzelek, Wiesław; Wiśniewska-Spychała, Beata; Dorocka-Bobkowska, Barbara

    2018-02-01

    Headache is a common complaint in all age groups and is a frequent cause of medical consultations and hospitalization. The aim of this study was to evaluate the prevalence of bite and non-bite parafunctions as well as the signs and symptoms of temporomandibular disorder (TMD) in adolescents presenting with primary headaches. Parents of adolescents presented with headaches to the Department of Developmental Neurology within a 12-month period were asked to complete a questionnaire developed by the authors of this study. Of the 1000 patients evaluated, 19 females and 21 males, aged 13 to 17 years, met the inclusion criterion - a confirmed clinical diagnosis of migraine or a tension headache according to the International Classification of Headache Disorders, 2nd edition. The diagnostic algorithm of the study group consisted of a full medical history, an assessment of the occurrence of bite habits and a physical examination based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Bite and non-bite parafunctions were found in 36 of the study group patients. A significant difference (p = 0.0003) between the number of bite parafunctions and non-bite parafunctions was found in females but not in males. However, bite parafunctions were more frequent in boys compared to girls (p = 0.01). Our findings suggest that it may be useful for pediatricians and neurologists to include TMD dysfunctions as a part of a standard examination of adolescents presenting with persistent headaches.

  3. Nummular headache update.

    Science.gov (United States)

    Pareja, Juan A; Montojo, Teresa; Alvarez, Mónica

    2012-04-01

    Nummular headache is characterized by head pain exclusively felt in a rounded or elliptical area, typically 1 to 6 cm in diameter. The pain remains confined to the same symptomatic area, which does not change in shape or size with time. The symptomatic area may be localized in any part of the head but mostly in the parietal region. Rarely, the disorder may be multifocal, each symptomatic area keeping all the characteristics of nummular headache. The pain is generally mild or moderate, commonly described as oppressive or stabbing, and lasting minutes, hours, or days, with a remitting or unremitting pattern. Superimposed on the baseline pain, there may be spontaneous or triggered exacerbations. During and between symptomatic periods, the affected area may show variable combinations of hypoesthesia, dysesthesia, paresthesia, tenderness, and trophic changes. Nummular headache emerges as a primary disorder with a clear-cut clinical picture developed in a unique topography.

  4. The Yekaterinburg headache initiative

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Olesen, Jes; Osipova, Vera V

    2013-01-01

    for a demonstrational interventional project in Russia, undertaken within the Global Campaign against Headache. The initiative proposes three actions: 1) raise awareness of need for improvement; 2) design and implement a three-tier model (from primary care to a single highly specialized centre with academic affiliation......) for efficient and equitable delivery of headache-related health care; 3) develop a range of educational initiatives aimed at primary-care physicians, non-specialist neurologists, pharmacists and the general public to support the second action. RESULTS AND CONCLUSION: We set these proposals in a context...... of a health-care needs assessment, and as a model for all Russia. We present and discuss early progress of the initiative, justify the investment of resources required for implementation and call for the political support that full implementation requires. The more that the Yekaterinburg headache initiative...

  5. Temporomandibular dysfunction and headache disorder.

    Science.gov (United States)

    Speciali, José G; Dach, Fabíola

    2015-02-01

    It has been well established that primary headaches (especially migraine, chronic migraine, and tension-type headache) and temporomandibular dysfunction (TMD) are comorbid diseases, with the presence of one of them in a patient increasing the prevalence of the others. The relationship between the 2 diseases may involve the sharing of common physiopathological aspects. Studies about the treatment of this disease association have shown that a simultaneous therapeutic approach to the 2 diseases is more effective than the separate treatment of each. As a consequence, specialists in orofacial pain are now required to know the criteria for the diagnosis of headaches, and headache physicians are required to know the semiologic aspects of orofacial pain. Nevertheless, a headache may be attributed to TMD, instead be an association of 2 problems - TMD and primary headaches - in these cases a secondary headache, described in item 11.7 of the International Classification of Headache Disorders, is still a controversial topic. Attempts to determine the existence of this secondary headache with a specific or suggestive phenotype have been frustrated. The conclusion that can be reached based on the few studies published thus far is that this headache has a preferential unilateral or bilateral temporal location and migraine-like or tension-type headache-like clinical characteristics. In the present review, we will consider the main aspects of the TMD-headache relationship, that is, comorbidity of primary headaches and TMD and clinical aspects of the headaches attributed to TMD from the viewpoint of the International Headache Society and of a group of specialists in orofacial pain. This paper aims to explore our understanding of the association between TMD and headaches in general and migraine in particular. © 2015 American Headache Society.

  6. Psychological Risk Factors in Headache

    Science.gov (United States)

    Nicholson, Robert A.; Houle, Timothy T.; Rhudy, Jamie L.; Norton, Peter J.

    2008-01-01

    Headache is a chronic disease that occurs with varying frequency and results in varying levels of disability. To date, the majority of research and clinical focus has been on the role of biological factors in headache and headache-related disability. However, reliance on a purely biomedical model of headache does not account for all aspects of headache and associated disability. Using a biopsychosocial framework, the current manuscript expands the view of what factors influence headache by considering the role psychological (i.e., cognitive and affective) factors have in the development, course, and consequences of headache. The manuscript initially reviews evidence showing that neural circuits responsible for cognitive–affective phenomena are highly interconnected with the circuitry responsible for headache pain. The manuscript then reviews the influence cognitions (locus of control and self-efficacy) and negative affect (depression, anxiety, and anger) have on the development of headache attacks, perception of headache pain, adherence to prescribed treatment, headache treatment outcome, and headache-related disability. The manuscript concludes with a discussion of the clinical implications of considering psychological factors when treating headache. PMID:17371358

  7. [Changes introduced into the recent International Classification of Headache Disorders: ICHD-III beta classification].

    Science.gov (United States)

    Belvis, Robert; Mas, Natàlia; Roig, Carles

    2015-01-16

    The International Headache Society (IHS) has published the third edition of the International Classification of Headache Disorders (ICHD-III beta), the most commonly used guide to diagnosing headaches in the world. To review the recent additions to the guide, to explain the new entities that appear in it and to compare the conditions that have had their criteria further clarified against the criteria in the previous edition. We have recorded a large number of clarifications in the criteria in practically all the headaches and neuralgias in the classification, but the conditions that have undergone the most significant clarifications are chronic migraine, primary headache associated with sexual activity, short-lasting unilateral neuralgiform headache attacks, new daily persistent headache, medication-overuse headache, syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis. The most notable new entities that have been incorporated are external-compression headache, cold-stimulus headache, nummular headache, headache attributed to aeroplane travel and headache attributed to autonomic dysreflexia. Another point to be highlighted is the case of the new headaches (still not considered entities in their own right) included in the appendix, some of the most noteworthy being epicrania fugax, vestibular migraine and infantile colic. The IHS recommends no longer using the previous classification and changing over to the new classification (ICHD-III beta) in healthcare, teaching and research, in addition to making this new guide as widely known as possible.

  8. Myelography and headache

    International Nuclear Information System (INIS)

    Hammer, B.

    1985-01-01

    The side effects associated with the use of Metrizamide, Iopamidol and Iotrol in two double blind studies on lumbar myelography were determined. The cause of headache is explained on the one hand as the result of the distribution of the contrast substance in the CSF space (early headache) and on the other hand due to the CSF leak through the puncture lesion. Peculiar hints are given for a safe examination technique. Iotrol seems to be the safest contrast substance for intrathecal use, however it should be used in the smallest possible amount to reduce even further contrast-related effects in myelography. (Author)

  9. Temporomandibular Disorders and Headache.

    Science.gov (United States)

    Graff-Radford, Steven B; Abbott, Jeremy J

    2016-08-01

    Temporomandibular disorders (TMD) and primary headaches can be perpetual and debilitating musculoskeletal and neurological disorders. The presence of both can affect up to one-sixth of the population at any one time. Initially, TMDs were thought to be predominantly musculoskeletal disorders, and migraine was thought to be solely a cerebrovascular disorder. The further understanding of their pathophysiology has helped to clarify their clinical presentation. This article focuses on the role of the trigeminal system in associating TMD and migraine. By discussing recent descriptions of prevalence, diagnosis, and treatment of headache and TMD, we will further elucidate this relationship. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Tension-type headache

    DEFF Research Database (Denmark)

    Bendtsen, Lars; Jensen, Rigmor; Bendtsen, Lars

    2009-01-01

    The substantial societal and individual burdens associated with tension-type headache (TTH) constitute a previously overlooked major public health issue. TTH is prevalent, affecting up to 78% of the general population, and 3% suffer from chronic TTH. Pericranial myofascial nociception probably...... is important for the pathophysiology of episodic TTH, whereas sensitization of central nociceptive pathways seems responsible for the conversion of episodic to chronic TTH. Headache-related disability usually can be reduced by identification of trigger factors combined with nonpharmacologic and pharmacologic...... treatments, but effective treatment modalities are lacking. Benefits can be gained by development of specific and effective treatment strategies....

  11. Headache and pregnancy

    DEFF Research Database (Denmark)

    Negro, A; Delaruelle, Z; Ivanova, T A

    2017-01-01

    , brain MRI and MR angiography with contrast ophthalmoscopy and lumbar puncture. During pregnancy and breastfeeding the preferred therapeutic strategy for the treatment of primary headaches should always be a non-pharmacological one. Treatment should not be postponed as an undermanaged headache can lead...... to stress, sleep deprivation, depression and poor nutritional intake that in turn can have negative consequences for both mother and baby. Therefore, if non-pharmacological interventions seem inadequate, a well-considered choice should be made concerning the use of medication, taking into account all...

  12. Causes of secondary headache (image)

    Science.gov (United States)

    Temporomandibular joint, or TMJ, dysfunction, can be a cause of secondary headache. Secondary headaches result from underlying disorders which produce pain as a symptom. The TMJ may become painful and dysfunctional as a result ...

  13. Update of Inpatient Treatment for Refractory Chronic Daily Headache.

    Science.gov (United States)

    Lai, Tzu-Hsien; Wang, Shuu-Jiun

    2016-01-01

    Chronic daily headache (CDH) is a group of headache disorders, in which headaches occur daily or near-daily (>15 days per month) and last for more than 3 months. Important CDH subtypes include chronic migraine, chronic tension-type headache, hemicrania continua, and new daily persistent headache. Other headaches with shorter durations (headache and various psychiatric disorders, such as depression and anxiety. Indications of inpatient treatment for CDH patients include poor responses to outpatient management, need for detoxification for overuse of specific medications (particularly opioids and barbiturates), and severe psychiatric comorbidities. Inpatient treatment usually involves stopping acute pain, preventing future attacks, and detoxifying medication overuse if present. Multidisciplinary integrated care that includes medical staff from different disciplines (e.g., psychiatry, clinical psychology, and physical therapy) has been recommended. The outcomes of inpatient treatment are satisfactory in terms of decreasing headache intensity or frequency, withdrawal from medication overuse, reducing disability, and improving life quality, although long-term relapse is not uncommon. In conclusion, inpatient treatment may be useful for select patients with refractory CDH and should be incorporated in a holistic headache care program.

  14. Different types of headache in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Badry, Reda; Gamal, Rania M

    2015-05-01

    Headache in patients with systemic lupus erythematosus (SLE) is considered a common neurological finding, although the relationship is unclear. In this study, we aimed to evaluate frequency and characteristics of different types of headache in patients with SLE. 40 SLE patients were chosen from those referred to the out patient clinic using the American College of Rheumatology (ACR) criteria for the diagnosis of SLE. Headache classification was done regarding the ICD-II criteria in the patients. Headache severity was assessed by visual analog scale (VAS), and subjects with VAS ≥4 were included in the study. 30 patients out of 40 SLE patients (75%) have different headache types: tension type in 37.5% (n = 15) and migraine in 30% (n = 12), cluster 2.5% (n = 1), and intracranial hypertension 5% (n = 2) of all patients. Headache is frequent in SLE especially tension and migraine types, but overall, it is not associated with disease activity.

  15. Childhood headache attributed to airplane travel: a case report.

    Science.gov (United States)

    Rogers, Kirsty; Rafiq, Nadia; Prabhakar, Prab; Ahmed, Mas

    2015-05-01

    Headache attributed to airplane flights is a rare form of headache disorder. This case study describes an 11-year-old girl with recurrent, severe, frontal headaches occurring during airplane travel. The episodes were associated with dizziness and facial pallor but no additional symptoms and showed spontaneous resolution on landing. Blood tests and imaging revealed no abnormalities. The present case fulfils the criteria for airplane headache recently included in the revised edition of the International Classification of Headache Disorders (ICHD-III Beta). Only a few cases of airplane headache have been reported in children. To our knowledge, this is the fourth case. We review the current literature on this rare syndrome and discuss various proposed pathophysiological mechanisms. © The Author(s) 2014.

  16. Acute medication overuse in headache

    Directory of Open Access Journals (Sweden)

    Abouch Valenty Krymchantovscki

    2004-03-01

    Full Text Available Primary headache patients frequently overuse analgesics. Acute medication overuse plays an important role in the transformation of episodic into chronic headaches. The sudden discontinuation of analgesic and migraine prevention introduction are the main issues in the management of chronic daily headache patients. Educational strategies for those who do not overuse acute medications and an agressive approach to those overusing are fundamental for the efficacy of the primary frequent headache treatment.

  17. Headache of cervical origin

    International Nuclear Information System (INIS)

    Burguet, J.L.; Wackenheim, A.

    1984-01-01

    The authors recall cervical etiologies of headache. They distinguish on the one hand the cervico-occipital region with minor and major malformations and acquired lesions, and on the other hand the middle and inferior cervical segment. They also recall the original structuralist analysis of the cervical spine and give the example of the ''cervical triplet''. (orig.) [de

  18. Primary stabbing headache.

    Science.gov (United States)

    Pareja, Juan A; Sjaastad, Ottar

    2010-01-01

    Primary stabbing headache is characterized by transient, cephalic ultrashort stabs of pain. It is a frequent complaint with a prevalence of 35.2%, a female preponderance, and a mean age of onset of 28 years (Vågå study). Attacks are generally characterized by moderate to severe, jabbing or stabbing pain, lasting from a fraction of a second to 3s. Attack frequency is generally low, with one or a few attacks per day. The paroxysms generally occur spontaneously, during daytime. Most patients exhibit a sporadic pattern, with an erratic, unpredictable alternation between symptomatic and non-symptomatic periods. Paroxysms are almost invariably unilateral. Temporal and fronto-ocular areas are most frequently affected. Attacks tend to move from one area to another, in either the same or the opposite hemicranium. Jabs may be accompanied by a shock-like feeling and even by head movement - "jolts" -or vocalization. On rare occasions, conjunctival hemorrhage and monocular vision loss have been described as associated features. Primary stabbing headache may concur, synchronously or independently, with other primary headaches. In contrast to what is the case in adults, in childhood it is not usually associated with other headaches. Treatment is rarely necessary. Indomethacin, 75-150 mg daily, may seem to be of some avail. Celecoxib, nifedipine, melatonin, and gabapentin have been reported to be effective in isolated cases and small series of patients. The drug studies need corroboration. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. Headache of cervical origin

    Energy Technology Data Exchange (ETDEWEB)

    Burguet, J L; Wackenheim, A

    1984-08-01

    The authors recall cervical etiologies of headache. They distinguish on the one hand the cervico-occipital region with minor and major malformations and acquired lesions, and on the other hand the middle and inferior cervical segment. They also recall the original structuralist analysis of the cervical spine and give the example of the ''cervical triplet''.

  20. Headache-like Subarachnoid Hemorrhage After Digital Subtraction Angiography: A Case Report

    Directory of Open Access Journals (Sweden)

    Fettah Eren

    2018-03-01

    Full Text Available Subarachnoid hemorrhage (SAH is a clinical condition with acute-onset, sudden, and severe headache. In addition to headache, severe nausea, vomiting, dizziness, confusion, agitation, focal neurologic deficits, and hypertension can be detected. Findings of meningeal irritation may accompany to these clinical features, 6-24 hours after the hemorrhage. Digital subtraction angiography (DSA is used for surgical or endovascular treatment planning in order to identify vascular abnormalities, in addition to other imaging studies. After DSA, the frequency of all neurologic complications is between 0.2% and 4.5%. Headache may occur after DSA in an average 50% of patients. This rate is especially higher in female patients. Headache types are usually classified as migraine, tension or postoperative atypical headaches The incidence of severe headache after DSA is low. Vascular wall rupture should be considered first in severe headache after the procedure. It should also be kept in mind that after all other secondary causes are excluded; SAH-like headaches after DSA can be detected

  1. The prevalence of headache in Greece: correlations to latitude and climatological factors.

    Science.gov (United States)

    Mitsikostas, D D; Tsaklakidou, D; Athanasiadis, N; Thomas, A

    1996-03-01

    A questionnaire study on headaches, using a door-to-door survey, was carried out in a representative sample of the general Greek population, including 1737 men and 1764 women, from 15 to 75 years of age. The parameters evaluated included age, sex, education, socioeconomic status, region of domicile, frequency of headache, use of medication, medical consultation, and family history. Latitude and climatologic factors such as humidity, temperature, and atmospheric pressure were also investigated. Headaches were not classified because the interviewers were not specialists. Nineteen percent of men and 40% of women (mean 29%) suffered from headaches in the prior year. Headaches were more frequent in lower social classes, in people with less education, and in those between 45 and 64 years of age. Nineteen percent of sufferers did not take any medication and 33% used medication every time that they had a headache, while 36% sought medical consultation. Twenty-nine percent of headache sufferers had a family history of headaches. Daily headache was present in 15% of headache sufferers. Humidity and atmospheric pressure were not correlated to headache frequency. However, in the northern areas of Greece, as well as in the regions with low mean temperature, more people suffered from daily headaches. These data may explain the lower 1-year prevalence of headaches in other Greece as compared to the prevalence of headaches in other northern European countries.

  2. Team players against headache: multidisciplinary treatment of primary headaches and medication overuse headache

    NARCIS (Netherlands)

    Gaul, C.; Visscher, C.M.; Bhola, R.; Sorbi, M.J.; Galli, F.; Rasmussen, A.V.; Jensen, R.

    2011-01-01

    Multidisciplinary approaches are gaining acceptance in headache treatment. However, there is a lack of scientific data about the efficacy of various strategies and their combinations offered by physiotherapists, physicians, psychologists and headache nurses. Therefore, an international platform for

  3. Headache - what to ask your doctor

    Science.gov (United States)

    ... Migraine - what to ask your doctor; Tension-type headache - what to ask your doctor; Cluster headache - what to ask your doctor ... How can I tell if the headache I am having is dangerous? What are ... headache ? A migraine headache ? A cluster headache ? What medical ...

  4. Geranisetron versus gabapentin in preventing postoperative nausea and vomiting after middle ear surgery in adults: A double-blinded randomized clinical trial study

    Directory of Open Access Journals (Sweden)

    Morteza Heidari

    2015-01-01

    Full Text Available Background: The incidence of postoperative nausea and vomiting (PONV after middle ear surgery is high. In this study we want to compare the effects of intravenous granisetron and oral gabapentin as a premedication before surgery on the incidence and severity of PONV after middle ear surgery in adult patents. Materials and Methods: We enrolled 90 patients that were randomly divided into the three groups of 30 in each. Group I received granisetron 3 mg iv 2 minutes before induction of anesthesia; Group II received oral gabapentin 300 mg 1 hour before anesthesia and Group III received placebo. The incidence and severity of PONV were recorded each 15 minutes in the post-anesthesia care unit (PACU and each 8 hours until 24 hours after discharge from the PACU. Result: The incidence and severity of nausea and vomiting at different time intervals in Groups I and Group II was significantly lower compared with Group III (P < 0.05. There was no significant difference in the incidence of side effects of study drug administration including respiratory depression, apnea, extra pyramidal disorders, drowsiness, dizziness, vertigo and headache in three groups. Conclusion: The study was shown that using gabapentin and granisetron have equal anti-emetic effects, but significant differences were seen between these two groups compared to the control group. These submit the efficiency of these drugs in preventing PONV.

  5. Headache under simulated microgravity is related to endocrine, fluid distribution, and tight junction changes.

    Science.gov (United States)

    Feuerecker, Matthias; van Oosterhout, Willebrordus P J; Feuerecker, Benedikt; Matzel, Sandra; Schelling, Gustav; Rehm, Markus; Vein, Alla A; Choukèr, Alexander

    2016-05-01

    Head-down-tilted bed rest (HDTBR) induces headaches similar to headaches during space flights. The objective of this investigation was to study hematological, endocrinological, fluid changes and tight junctions in HDTBR-induced headaches as a proxy for space headache. The randomized crossover HDTBR design by the European Space Agency included 12 healthy, nonheadache male subjects. Before, during, and after confined HDTBR periods, epinephrine (urine), cortisol (saliva), hematological, endothelium markers, and fluid distribution parameters were measured. Headaches were assessed with a validated headache questionnaire. Compared with baseline, HDTBR in all subjects was associated with higher hematocrit, hemoglobin, and epinephrine levels, higher erythrocyte counts, and lower relative plasma volumes (all P zonulin was elevated (vs headache-free subjects in HDTBR days 1, 3, 5; P < 0.05). HDTBR induces hemoconcentration and fluid redistribution in all subjects. During headache episodes, endocrinological changes, fluid distribution, and tight junctions were more pronounced, suggesting an additional role in headache pathophysiology.

  6. Primary Headache in Yemen: Prevalence and Common Medications Used

    Directory of Open Access Journals (Sweden)

    Salah A. Abdo

    2014-01-01

    Full Text Available Background and Objective. Primary headaches is a major medical concern in certain Arabic countries, for example Oman, Jordan, and Qatar. This study was aimed at increasing understanding of the prevalence of headache in Arabic countries and identifying common medications used for treatment because of the lack of research done in this field in Yemen. Methods. This is a cross-sectional observational study conducted by recruiting case-series of adults and elderly who have primary headache within the age group from 18 to 85 years. 12640 subjects received a simple explanation for the aim of the study as ethical issue. The subjects were allowed to complete a self-conducted screening questionnaire. The data were diagnosed according to the International Headache Society’s diagnostic criteria (2004. Results. The results showed that 76.5% of the primary headache is prevalent at least once per year, 27.1% of the tension type headache (TTH was the maximum percentage of type of headache, and 14.48% of the migraine headache (MH was the minimum percentage. On the other hand, the relationship between the primary headache and age of subjects was statistically significant (P0.05. In addition, 70.15% of the subjects said that headache attacks affected their activity of daily livings (ADL. 62.26% of the subjects used the medications without medical advice regarding their headache. 37.73% of the subjects relied on medical professionals (physicians and pharmacist regarding analgesics use. The most common agent used among the medications was paracetamol (38.4%. Others included ibuprofen, aspirin, diclofenac sodium, naproxen, mefenamic acid, ergotamine and (11.45% were unknown agents. Conclusion. We concluded that absence of health attention from the Yemeni Community and education from the health system in the country regarding analgesics use and their potential risk led to abuse of such medications and could be a reason beyond high prevalence of headache in Yemen.

  7. Analysis of Trigger Factors in Episodic Migraineurs Using a Smartphone Headache Diary Applications

    Science.gov (United States)

    Park, Jeong-Wook; Chu, Min Kyung; Kim, Jae-Moon; Park, Sang-Gue; Cho, Soo-Jin

    2016-01-01

    Background Various stimuli can trigger migraines in susceptible individuals. We examined migraine trigger factors by using a smartphone headache diary application. Method Episodic migraineurs who agreed to participate in our study downloaded smartphone headache diary application, which was designed to capture the details regarding headache trigger factors and characteristics for 3 months. The participants were asked to access the smartphone headache diary application daily and to confirm the presence of a headache and input the types of trigger factors. Results Sixty-two participants kept diary entries until the end of the study. The diary data for 4,579 days were analyzed. In this data set, 1,099 headache days (336 migraines, 763 non-migraine headaches) were recorded; of these, 772 headache events had with trigger factors, and 327 events did not have trigger factors. The common trigger factors that were present on headache days included stress, fatigue, sleep deprivation, hormonal changes, and weather changes. The likelihood of a headache trigger was 57.7% for stress, 55.1% for sleep deprivation, 48.5% for fatigue, and 46.5% for any trigger. The headaches with trigger factors were associated with greater pain intensity (pSmartphone headache diary application is an effective tool to assess migraine trigger factors. The headaches with trigger factors had greater severity or migraine features. The type of triggers and the presence of preventive medication influenced the headache characteristics; hence, an investigation of trigger factors would be helpful in understanding migraine occurrences. PMID:26901341

  8. Analysis of Trigger Factors in Episodic Migraineurs Using a Smartphone Headache Diary Applications.

    Science.gov (United States)

    Park, Jeong-Wook; Chu, Min Kyung; Kim, Jae-Moon; Park, Sang-Gue; Cho, Soo-Jin

    2016-01-01

    Various stimuli can trigger migraines in susceptible individuals. We examined migraine trigger factors by using a smartphone headache diary application. Episodic migraineurs who agreed to participate in our study downloaded smartphone headache diary application, which was designed to capture the details regarding headache trigger factors and characteristics for 3 months. The participants were asked to access the smartphone headache diary application daily and to confirm the presence of a headache and input the types of trigger factors. Sixty-two participants kept diary entries until the end of the study. The diary data for 4,579 days were analyzed. In this data set, 1,099 headache days (336 migraines, 763 non-migraine headaches) were recorded; of these, 772 headache events had with trigger factors, and 327 events did not have trigger factors. The common trigger factors that were present on headache days included stress, fatigue, sleep deprivation, hormonal changes, and weather changes. The likelihood of a headache trigger was 57.7% for stress, 55.1% for sleep deprivation, 48.5% for fatigue, and 46.5% for any trigger. The headaches with trigger factors were associated with greater pain intensity (pSmartphone headache diary application is an effective tool to assess migraine trigger factors. The headaches with trigger factors had greater severity or migraine features. The type of triggers and the presence of preventive medication influenced the headache characteristics; hence, an investigation of trigger factors would be helpful in understanding migraine occurrences.

  9. Is ginger beneficial for nausea and vomiting? An update of the literature.

    Science.gov (United States)

    Marx, Wolfgang; Kiss, Nicole; Isenring, Liz

    2015-06-01

    Nausea and vomiting can pose a significant burden to patients in a variety of clinical settings. Previous evidence suggests that ginger may be an effective treatment for these symptoms; however, current evidence has been mixed. This article discusses recent clinical trials that have investigated ginger as a treatment for multiple types of nausea and vomiting. In addition, the potential mechanisms of action of ginger will be discussed. This article identified nine studies and seven reviews that investigated ginger for morning sickness, postoperative nausea and vomiting, chemotherapy-induced, and antiretroviral-induced nausea and vomiting. All studies reported that ginger provided a significant reduction in nausea and vomiting; however, the clinical relevance of some studies is less certain. Common limitations within the literature include the lack of standardized extracts, poorly controlled or blinded studies, and limited sample size. In addition, recent evidence has provided further support for 5-HT3 receptor antagonism as a mechanism by which ginger may exert its potentially beneficial effect on nausea and vomiting. The results of studies in this article suggest that ginger is a promising treatment for nausea and vomiting in a variety of clinical settings and possesses a clinically relevant mechanism. However, further studies are required to address the limitations in the current clinical literature before firm recommendations for its use can be made.

  10. Sleep and chronobiology in cluster headache

    DEFF Research Database (Denmark)

    Barloese, M; Lund, N.; Petersen, A

    2015-01-01

    BACKGROUND AND AIM: Cluster headache (CH) is the headache disorder with the strongest chronobiological traits. The severe attacks of pain occur with diurnal and annual rhythmicity but the precise rhythm and involvement of potential zeitgebers is unknown. Patients complain of poor sleep quality yet...... this has never been studied. We investigated triggers, rhythms, sleep quality and chronotypes in CH. METHODS: Patients and controls completed questionnaires and structured interviews composed of new and previously validated parts including the Pittsburgh Sleep Quality Index (PSQI) and Morningness......-Eveningness Questionnaire (MEQ). Patients were characterized by a CH index, a unified measure of headache burden. RESULTS: A total of 275 CH patients and 145 matched controls were included. The most common trigger was sleep (80%) and a relationship between clusters and daylight was identified. Of the patients, 82...

  11. Naratriptan in the Prophylactic Treatment of Cluster Headache.

    Science.gov (United States)

    Ito, Yasuo; Mitsufuji, Takashi; Asano, Yoshio; Shimazu, Tomokazu; Kato, Yuji; Tanahashi, Norio; Maruki, Yuichi; Sakai, Fumihiko; Yamamoto, Toshimasa; Araki, Nobuo

    2017-10-01

    Objective Naratriptan has been reported to reduce the frequency of cluster headache. The purpose of this study was to determine whether naratriptan is effective as a prophylactic treatment for cluster headache in Japan. Methods We retrospectively reviewed all 43 patients with cluster headache who received preventive treatment with naratriptan from April 2009 to April 2015. The International Classification of Headache Disorders, 3rd Edition (beta version) (ICHD-3 beta) was used to diagnose cluster headache. This study was conducted at 3 centers (Department of Neurology, Saitama Medical University; Saitama Neuropsychiatric Institute; Saitama Medical University International Medical Center). Patients were recruited from these specialized headache outpatient centers. Naratriptan was taken before the patient went to bed. Results The study population included 30 men (69.8%) and 13 women (30.2%). Twenty-two cases received other preventive treatments (51.2%), while 21 cases only received naratriptan (48.8%). Among the 43 cases, 37 patients (86.0%) achieved an improvement of cluster headache on naratriptan. Conclusion Naratriptan has been suggested as a preventive medicine for cluster headache because of the longer the biological half-life in comparison to other triptans. The internal use of naratriptan 2 hours before attacks appears to achieve a good response in patients with cluster headache.

  12. Surgical outcome in headache due to mucosal contact

    International Nuclear Information System (INIS)

    Goto, Fumiyuki; Yabe, Haruna; Ogawa, Kaoru

    2010-01-01

    Headaches is classified as primary and secondary, with secondary originating in head and neck conditions, the most important etiology being acute sinusitis. Headache due to mucosal contact, rarely encountered by otorhinolaryngologists, is an important secondary headache, whose criteria are defined by the International Classification of Headache Disorders to include intermittent pain localized in the periorbital and medial canthal or temporozygomatic regions, evidence that pain is attributable to mucosal contact and the presence of mucosal contact in the absence of acute rhinosinusitis, obtained using clinical examinations, nasal endoscopy, and/or computed tomography (CT). After mucosal contact is surgically corrected pain usually disappears permanently within 7 days. We reviewed mucosal contact headaches in 63 subjects undergoing nasal or paranasal surgery from April 2007 to March 2008. Of those 7 were diagnosed with headaches due to contact points in nasal mucosa, ranging from canthal to the temporozygomatic. The most common contact, between the middle turbinate and nasal septum, was seen in 6 of the 7. Surgery eliminated symptoms in 4 and ameliorated them in 3 indicating effective headache management. Subjects with severe headaches or localized periorbital and medial canthal pain regions, mucosal contact involvement is ruled out when CT allows no lesions. When mucosal contact headache is suspected, however surgery should be considered as a last resort. (author)

  13. Temporomandibular disorders in headache patients

    Science.gov (United States)

    Mello, Christiane-Espinola-Bandeira; Oliveira, José-Luiz-Góes; Jesus, Alan-Chester-Feitosa; Maia, Mila-Leite-de Moraes; de Santana, Jonielly-Costa-Vasconcelos; Andrade, Loren-Suyane-Oliveira; Siqueira Quintans, Jullyana-de Souza; Quintans-Junior, Lucindo-José; Conti, Paulo-César-Rodrigues

    2012-01-01

    Objective: To identify the frequency of signs and symptoms of temporomandibular disorder (TMD) and its seve-rity in individuals with headache. Study Design: 60 adults divided into three groups of 20 individuals: chronic daily headache (CDH), episodic headache (EH) and a control group without headache (WH). Headache diagnosis was performed according to the criteria of International Headache Society and the signs and symptoms of TMD were achieved by using a clinical exam and an anamnestic questionnaire. The severity of TMD was defined by the temporomandibular index (TMI). Results: The TMD signs and symptoms were always more frequent in individuals with headache, especially report of pain in TMJ area (CDH, n=16; EH, n=12; WH, n=6), pain to palpation on masseter (CDH, n=19; EH, n=16; WH, n=11) which are significantly more frequent in episodic and chronic daily headache. The mean values of temporomandibular and articular index (CDH patients) and muscular index (CDH and EH patients) were statistically higher than in patients of the control group, notably the articular (CDH=0.38; EH=0.25;WH=0.19) and muscular (CDH=0.46; EH=0.51; WH=0.26) indices. Conclusions: These findings allow us to speculate that masticatory and TMJ pain are more common in headache subjects. Besides, it seems that the TMD is more severe in headache patients. Key words:Temporomandibular dysfunction, headache disorders. PMID:22926473

  14. Psychological factors in childhood headaches.

    Science.gov (United States)

    Farmer, Kathleen; Dunn, David; Scott, Eric

    2010-06-01

    Recurrent headaches in children are most often migraines and are based in a genetic predisposition with a low headache threshold. As with any pain experience, there is a large emotional component associated with an attack of migraines that grows in amplitude as the headaches become more frequent and resistant to medicine, sleep, or other agents that used to work. Childhood headaches are especially complicated for 3 reasons: (1) the parents' fear (communicated to the child that serious medical pathology underlies the head pain), (2) the lack of evidence-based pharmacologic treatment, and (3) the belief that these headaches are largely psychological. This article addresses the mystery surrounding childhood headaches by delving into the influence of school, friends, and family; the impact of divorce; the coping skills required for a child to manage a migrainous nervous system; the potential secondary gain from headaches; psychiatric comorbidities and how to treat them; and the role of psychological intervention. Copyright 2010 Elsevier Inc. All rights reserved.

  15. Use of granisetron transdermal system in the prevention of chemotherapy-induced nausea and vomiting: a review

    Directory of Open Access Journals (Sweden)

    Albert Tuca

    2009-12-01

    Full Text Available Albert TucaPalliative Care Hospital Team, Palliative Care Department, Institut Català d’Oncologia, L’Hospitalet de Llobregat, Barcelona, SpainAbstract: Until now only intravenous and oral formulations of 5HT3 receptor antagonists have been available. Recently a new formulation of a 5HT3 receptor antagonist, transdermal granisetron, has been developed, and approved by the FDA. Three phase I studies to evaluate its pharmacokinetic profile have shown that granisetron administered by a transdermal delivery system is absorbed by passive diffusion and maximal concentration is reached 48 hours after patch application. The patch of 52 cm2, which contains 34.3 mg of granisetron, releases 3.3 mg of the drug every day and maintains a stable average plasma concentration of 2.2 ng/mL over 6 days, similar to levels obtained with 2 mg of oral granisetron, administered every day during the same period of time. Two randomized as yet unpublished clinical trials (phase II/III have been conducted to evaluate the antiemetic efficacy of transdermal granisetron in chemotherapy-induced nausea and vomiting, in patients receiving moderately and highly emetogenic chemotherapy, compared with 2 mg of oral granisetron. More than 800 cancer patients were included in the trials. The rate of complete control of acute emesis was 49% for the phase II trial and 60% for the phase III trial. Neither trial showed a statistically significant difference between transdermal and oral granisetron. The control of delayed emesis was observed in 46% of patients, and there were no statistically significant differences between transdermal and oral granisetron. The most common adverse effects in both trials were constipation (<7% and headache (<1%; there were no statistically significant differences between transdermal and oral granisetron. These data show that transdermal granisetron is effective and safe in controlling acute emesis induced by chemotherapy with both moderate and high

  16. Association between stress at work and primary headache among nursing staff in Taiwan.

    Science.gov (United States)

    Lin, Kao-Chang; Huang, Chin-Chang; Wu, Chiou-Chuen

    2007-04-01

    Stress, one of the most commonly identified triggers for primary headache in the workplace, usually leads to inefficient work during attacks. Stress-related primary headaches in the nursing staff of hospitals have received little attention. To realize the association between stress and headache, and the means of coping with this kind of headache. A cross-sectional, hospital-based study using a semi-structured questionnaire was administered to 900 nursing staffers in a tertiary medical center in southern Taiwan. Thirty-two items, including basic information, headache- and stress-related questions, work satisfaction, and coping strategies were measured. Headache sufferers with either migraine or episodic tension headache (attacks Headache Society (IHS) criteria were enrolled for analysis. The Student's t-test, one-way analysis of variance (ANOVA), and chi-square test were used for statistical analysis. Three hundred eighty-six out of 779 responders (49.6%) had experienced primary headaches in the previous year, and 374 (48.1%) had had episodic-type headaches (headache, 37 (4.8%) had mixed migraine and tension headache, and 11 (1.4%) had other causes of headache. There were no demographic differences between the sufferers and nonsufferers, although a statistically significant difference was noted in self-reported sources of stress (individual P values ranged from .021 to Headache sufferers had more stress at work than non-headache sufferers (P stress. The methods used to deal with headaches were sleep, taking medicine, taking a rest, visiting the doctor, and seeking psychological help. Nurses commonly used acetaminophen (panadol--500 mg) to relieve their pain. These results indicate that stress at work is associated with primary headaches among nursing staff, and that nurses rarely seek help in the beginning. Therefore, nursing staff education aimed at ameliorating the stress and coping with the headaches, thus allowing the nurses to provide better patient care, may

  17. Aromatherapy for treatment of postoperative nausea and vomiting.

    Science.gov (United States)

    Hines, Sonia; Steels, Elizabeth; Chang, Anne; Gibbons, Kristen

    2018-03-10

    Postoperative nausea and vomiting (PONV) is a common, unpleasant phenomenon and current therapies are not always effective for all patients. Aromatherapy has been suggested as an addition to the available treatment strategies. This review was originally published in 2012 and updated in 2017. The main objective was to establish the efficacy and safety of aromatherapy comparable to standard pharmacological treatments for PONV in adults and children. We searched CENTRAL; MEDLINE; Embase; CINAHL; CAM on PubMed; Informit; LILACS; and ISI Web of Science as well as grey literature sources and the reference lists of retrieved articles up to March 2017. The original search was performed in August 2011. We included all randomized controlled trials (RCTs) and controlled clinical trials (CCTs) where aromatherapy was used to treat PONV. Interventions were all types of aromatherapy compared to placebo or with standard antiemetics. Primary outcomes were severity and duration of PONV. Secondary outcomes were adverse reactions, use of rescue antiemetics and patient satisfaction. Two review authors independently assessed risk of bias in the included studies and extracted data. For dichotomous outcome variables, we used a random-effects model and calculated risk ratio (RR) with associated 95% confidence interval (95% CI). For continuous outcome variables, we used a random-effects model and calculated standardized mean difference (SMD) with associated 95% CI. We used the GRADE software to compile 'Summary of findings' tables. We included seven new studies with 663 participants in the 2017 update; five RCTs and two CCTs. These were added to the nine previously included studies (six RCTs and three CCTs with a total of 373 participants) for a total of 16 included studies and 1036 participants in this updated review. The mean age and range data for all participants were not reported for all studies. We identified two registered trials that met the inclusion criteria for this review

  18. Deep brain stimulation for cluster headache

    DEFF Research Database (Denmark)

    Grover, Patrick J; Pereira, Erlick A C; Green, Alexander L

    2009-01-01

    Cluster headache is a severely debilitating disorder that can remain unrelieved by current pharmacotherapy. Alongside ablative neurosurgical procedures, neuromodulatory treatments of deep brain stimulation (DBS) and occipital nerve simulation have emerged in the last few years as effective...... treatments for medically refractory cluster headaches. Pioneers in the field have sought to publish guidelines for neurosurgical treatment; however, only small case series with limited long-term follow-up have been published. Controversy remains over which surgical treatments are best and in which...... circumstances to intervene. Here we review current data on neurosurgical interventions for chronic cluster headache focusing upon DBS and occipital nerve stimulation, and discuss the indications for and putative mechanisms of DBS including translational insights from functional neuroimaging, diffusion weighted...

  19. Acute headache and persistent headache attributed to cervical artery dissection

    DEFF Research Database (Denmark)

    Schytz, Henrik W; Ashina, Messoud; Magyari, Melinda

    2014-01-01

    for Headache or facial or neck pain attributed to cervical carotid or vertebral artery dissection or Headache attributed to intracranial arterial dissection. Six months after dissection five of 19 patients still reported persistent headache attributed to dissection. The study demonstrates that the ICHD......The criteria for headache attributed to cervical artery dissection have been changed in the new third edition of the International Classification of Headache Disorders (ICHD-III beta). We have retrospectively investigated 19 patients diagnosed from 2001 to 2006 with cervical artery dissection......-III beta criteria for cervical artery dissection are useful for classifying patients at the first encounter. We show for the first time that persistent headache attributed to arterial dissection is frequent....

  20. Patient expectancy and post-chemotherapy nausea

    DEFF Research Database (Denmark)

    Colagiuri, Ben; Zachariae, Robert

    2010-01-01

    to determine the strength of the relationship between expectancy and post-chemotherapy nausea. METHODS: The findings from 17 relevant studies (n = 2,400) identified through systematic searches of Medline, PsycInfo, and Cinhal were analyzed using a combination of meta-analytic techniques. RESULTS: Overall...

  1. Predictors of headache before, during, and after pregnancy: a cohort study.

    Science.gov (United States)

    Turner, Dana P; Smitherman, Todd A; Eisenach, James C; Penzien, Donald B; Houle, Timothy T

    2012-03-01

    latter independent of but compounded by spinal injection. Physicians should attend to prior headache history when making decisions about pain management during and after childbirth. As the lack of formal International Classification of Headache Disorders, 2nd Edition (ICHD-II), headache diagnoses is a limitation of this study, future longitudinal studies should replicate the present design while including headache subtyping consistent with ICHD-II nosology. © 2012 American Headache Society.

  2. Primary headache diagnosis among chronic daily headache patients

    Directory of Open Access Journals (Sweden)

    Krymchantowski Abouch Valenty

    2003-01-01

    Full Text Available Chronic daily headache (CDH refers to a group of non-paroxysmal daily or near-daily headaches with peculiar characteristics that are highly prevalent in populations of neurological clinics and not uncommon among non-patient populations. Most of the patients with CDH had, as primary diagnosis, episodic migraine, which, with the time, presented a progressive frequency, pattern modification and loss of specific migraine characteristics. Other CDH patients had chronic tension-type headache, new daily persistent headache and hemicrania continua, which evolved thru the time to the daily or near-daily presentation. The objective of this study was to determine the primary headache diagnosis among a population of chronic daily headache patients attending a tertiary center for headache treatment. During a 5-year period 651 consecutive chronic daily headache patients attending a private subspecialty center were studied prospectively. The criteria adopted were those proposed by Silberstein et al (1994, revised 1996. Five hundred seventy four patients (88.1% had episodic migraine as primary headache before turning into daily presentation, 52 (8% had chronic tension-type headache, 14 (2.2% had hemicrania continua and 11 patients (1.7% had new daily persistent headache. CDH is quite frequent in patients from clinic-based studies suggesting a high degree of disability. Emphasis on education of patients suffering from frequent primary headaches with regard to measures that are able to decrease suffering and disability as well as better medical education directed to more efficient ways to handle these patients are necessary to improve outcome of such a prevalent condition.

  3. Postoperative nausea and vomiting: Validation of the Portuguese version of the Postoperative Nausea and Vomiting Intensity Score.

    Science.gov (United States)

    Dalila, Veiga; Pereira, Helder; Moreno, Carlos; Martinho, Clarisse; Santos, Cristina; Abelha, Fernando José

    2013-01-01

    The Postoperative Nausea and Vomiting (PONV) Intensity Scale was developed to define clinically important PONV. The aim of this study was to translate, retranslate and validate the PONV Intensity Scale for use in Portuguese Post Anesthetic Care Unit (PACU) settings. The PONV Intensity Scale was translated and back-translated in accordance with available guidelines. The research team conducted an observational and cohort prospective study in a PACU. One-hundred fifty-seven adult patients admiited after surgery over three weeks were evaluated for PONV. Measurements included nausea visual analogic scale (VAS) at 6 and 24 hours, postoperatively. We assessed reliability and observer disagreement using interclass correlation (ICC) and Information-Based Measure of Disagreement (IBMD). We compared VAS scores between patients with clinically significant (≥50) and not significant (<50) PONV. Thirty-nine patients (25%) had PONV at 6 hours and 54 (34%) had PONV at 24 hours. Thirty-six and 54 patients experienced nausea at 6 and 24 hours, respectively. Among patients with PONV, 6 patients (15%) and 9 patients (27%) had a clinically significant PONV intensity scale score at 6 and at 24 hours, respectively. The reliability was good both for PONV intensity scale score and for VAS and observer disagreement was slightly higher for VAS. The median nausea VAS scores were higher in patients with clinically significant PONV Intensity score. The PONV Intensity Scale appears to be an accurate and reliable assessment and monitoring instrument for PONV in the PACU settings. Copyright © 2013 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  4. Headache and Nausea after Treatment with High-Dose Subcutaneous versus Intravenous Immunoglobulin

    DEFF Research Database (Denmark)

    Markvardsen, Lars H; Christiansen, Ingelise; Andersen, Henning

    2015-01-01

    and could be an alternative in patients experiencing side effects. Fifty-nine patients diagnosed with neurological disorders (chronic inflammatory demyelinating polyneuropathy (CIDP), multi-focal motor neuropathy (MMN) or post-polio syndrome) were treated with IVIG, and 27 CIDP or MMN patients with SCIG...

  5. Orgasmic headache treated with nimodipine.

    Science.gov (United States)

    Lee, Jea Whan; Ha, Yeon Soo; Park, Seung Chol; Seo, Ill Young; Lee, Hak Seung

    2013-07-01

    Orgasmic headache (OH) is a sudden and severe headache that occurs at the time of or shortly after an orgasm. AIM.: We present the case of typical primary headache associated with sexual activity, especially during an orgasmic period. A 34-year-old man complained of sudden and severe headache during sexual activity, or orgasmic period, for 2 months. The headache developed abruptly with an orgasm and then decreased shortly over a period of 4 ≈ 8 hours. Magnetic resonance angiography revealed severe spasm of the M1 segment of both the middle cerebral arteries. He was treated with oral nimodipine (30 mg every 8 hours), which alleviated the headache and prevented its recurrence. We postulated a pathophysiological relationship between OH and migraine, especially with respect to vasoconstriction, and believe that in such cases, nimodipine may be an effective therapy. © 2013 International Society for Sexual Medicine.

  6. Does monosodium glutamate really cause headache? : a systematic review of human studies

    OpenAIRE

    Obayashi, Yoko; Nagamura, Yoichi

    2016-01-01

    Although monosodium glutamate (MSG) is classified as a causative substance of headache in the International Classification of Headache Disorders 3rd edition (ICHD-III beta), there is no literature in which causal relationship between MSG and headache was comprehensively reviewed. We performed systematic review of human studies which include the incidence of headache after an oral administration of MSG. An analysis was made by separating the human studies with MSG administration with or withou...

  7. Occipital headaches and neuroimaging in children.

    Science.gov (United States)

    Bear, Joshua J; Gelfand, Amy A; Goadsby, Peter J; Bass, Nancy

    2017-08-01

    To investigate the common thinking, as reinforced by the International Classification of Headache Disorders, 3rd edition (beta), that occipital headaches in children are rare and suggestive of serious intracranial pathology. We performed a retrospective chart review cohort study of all patients ≤18 years of age referred to a university child neurology clinic for headache in 2009. Patients were stratified by headache location: solely occipital, occipital plus other area(s) of head pain, or no occipital involvement. Children with abnormal neurologic examinations were excluded. We assessed location as a predictor of whether neuroimaging was ordered and whether intracranial pathology was found. Analyses were performed with cohort study tools in Stata/SE 13.0 (StataCorp, College Station, TX). A total of 308 patients were included. Median age was 12 years (32 months-18 years), and 57% were female. Headaches were solely occipital in 7% and occipital-plus in 14%. Patients with occipital head pain were more likely to undergo neuroimaging than those without occipital involvement (solely occipital: 95%, relative risk [RR] 10.5, 95% confidence interval [CI] 1.4-77.3; occipital-plus: 88%, RR 3.7, 95% CI 1.5-9.2; no occipital pain: 63%, referent). Occipital pain alone or with other locations was not significantly associated with radiographic evidence of clinically significant intracranial pathology. Children with occipital headache are more likely to undergo neuroimaging. In the absence of concerning features on the history and in the setting of a normal neurologic examination, neuroimaging can be deferred in most pediatric patients when occipital pain is present. © 2017 American Academy of Neurology.

  8. Overlap between Headache, Depression, and Anxiety in General Neurological Clinics: A Cross-sectional Study

    Institute of Scientific and Technical Information of China (English)

    Cui-Bai Wei; Jian-Ping Jia; Fen Wang; Ai-Hong Zhou; Xiu-Mei Zuo; Chang-Biao Chu

    2016-01-01

    Background:Many studies have reported that depression and anxiety have bidirectional relationship with headache.However,few researches investigated the roles of depression or anxiety in patients with headache.We surveyed the prevalence of depression and anxiety as a complication or cause of headache among outpatients with a chief complaint of headache at neurology clinics in general hospitals.Additional risk factors for depression and anxiety were also analyzed.Methods:A cross-sectional study was conducted at 11 general neurological clinics.All consecutive patients with a chief complaint of headache were enrolled.Diagnoses of depression and anxiety were made using the Chinese version of the Mini International Neuropsychiatric Interview,and those for headache were made according to the International Classification of Headache Disorders,2nd Edition.The headache impact test and an 11-point verbal rating scale were applied to assess headache severity and intensity.Logistic regression was used to analyze risk factors of patients with headache for depression or anxiety.Results:A total of 749 outpatients with headache were included.Among them,148 (19.7%) were diagnosed with depression and 103 (13.7%) with anxiety.Further analysis showed that 114 (15.2%) patients complaining headache due to somatic symptoms of psychiatric disorders and 82 (10.9%) had a depression or anxiety comorbidity with headache.Most patients with depression or anxiety manifested mild to moderate headaches.Poor sleep and severe headache-related disabilities were predictors for either depression or anxiety.Conclusion:Clinicians must identify the etiology of headache and recognize the effects of depression or anxiety on headache to develop specific treatments.

  9. Guidelines for the organization of headache education in Europe: the headache school II

    DEFF Research Database (Denmark)

    Jensen, Rigmor; Mitsikostas, Dimos D; Valade, Dominique

    2010-01-01

    In order to promote education on headache disorders, European Headache Federation (EHF) in conjunction with National Headache Societies organizes educational courses meeting uniform standards according to previous published guidelines. Based on six headache summer schools' experience, an EHF...

  10. The methodology of population surveys of headache prevalence, burden and cost: Principles and recommendations from the Global Campaign against Headache

    Science.gov (United States)

    2014-01-01

    The global burden of headache is very large, but knowledge of it is far from complete and needs still to be gathered. Published population-based studies have used variable methodology, which has influenced findings and made comparisons difficult. Among the initiatives of the Global Campaign against Headache to improve and standardize methods in use for cross-sectional studies, the most important is the production of consensus-based methodological guidelines. This report describes the development of detailed principles and recommendations. For this purpose we brought together an expert consensus group to include experience and competence in headache epidemiology and/or epidemiology in general and drawn from all six WHO world regions. The recommendations presented are for anyone, of whatever background, with interests in designing, performing, understanding or assessing studies that measure or describe the burden of headache in populations. While aimed principally at researchers whose main interests are in the field of headache, they should also be useful, at least in parts, to those who are expert in public health or epidemiology and wish to extend their interest into the field of headache disorders. Most of all, these recommendations seek to encourage collaborations between specialists in headache disorders and epidemiologists. The focus is on migraine, tension-type headache and medication-overuse headache, but they are not intended to be exclusive to these. The burdens arising from secondary headaches are, in the majority of cases, more correctly attributed to the underlying disorders. Nevertheless, the principles outlined here are relevant for epidemiological studies on secondary headaches, provided that adequate definitions can be not only given but also applied in questionnaires or other survey instruments. PMID:24467862

  11. [Tricyclic antidepressant therapy in headache].

    Science.gov (United States)

    Magyar, Máté; Csépány, Éva; Gyüre, Tamás; Bozsik, György; Bereczki, Dániel; Ertsey, Csaba

    2015-12-01

    The two most important representatives of the primary headaches are migraine and tension-type headache. More than 10% of the population suffer from migraine and even a greater part, approximately 30-40% from tension-type headache. These two headache types have a great effect both on the individual and on the society. There are two types of therapeutic approaches to headaches: the abortive and the prophylactic therapy. Prophylactic treatment is used for frequent and/or difficult-to-treat headache attacks. Although both migraine and tension-type headache are often associated with depression, for their treatment - in contrast to the widespread medical opinion - not all antidepressants were found to be effective. Amitriptyline, which is a tricyclic antidepressant, is used as a prophylactic therapy for headache since 1968. Its efficacy has been demonstrated in several double-blind, placebo-controlled studies. Although the newer types of antidepressant, such as selective serotonin reuptake inhibitors and selective serotonin-norepinephrine reuptake inhibitor, have a more favorable side-effect profile than tricyclic antidepressants, their headache prophylactic effect has not been proven yet.

  12. Management of chemotherapy-induced nausea and vomiting.

    LENUS (Irish Health Repository)

    Zubairi, Ishtiaq H

    2006-08-01

    Chemotherapy-induced nausea and vomiting are symptoms that cause major concern to oncology patients. This article explores the types of nausea and vomiting in the context of chemotherapy, and discusses their pathogenesis and management.

  13. Management of children and young people with headache.

    Science.gov (United States)

    Whitehouse, William P; Agrawal, Shakti

    2017-04-01

    Headache is very common in children and young people. The correct advice and treatment requires consideration of a wide differential diagnosis between primary and secondary headaches, and also of the different types of primary headache. The International Classification of Headache Disorders gives useful descriptions and diagnostic criteria that are especially useful for primary headaches. The National Institute for Health and Care Excellence (NICE) Clinical Guideline 150 provides evidence-based recommendations on treatments for adults and young people from age 12 years. However, the same principles can be applied to younger children when a specific diagnosis can be made. Key recommendations from the NICE Quality Standards include, establishing a precise diagnosis if possible, avoiding, diagnosing and treating medication overuse headache, and combining a triptan with a non-steroidal anti-inflammatory drug or paracetamol as the first-line acute/rescue treatment for migraine with or without aura. Although rare in children and young people, it is important to diagnose new daily persistent headache, as it responds poorly or not at all to medication; and paroxysmal hemicrania as it responds very well to indomethacin but not to other commonly used analgesics. When faced with difficulties in reaching a precise diagnosis or in finding effective therapies, further advice should be sought from a children's headache clinic or specialist. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Primary Headaches and School Performance-Is There a Connection?

    Science.gov (United States)

    Genizi, J; Guidetti, V; Arruda, M A

    2017-07-01

    Headache is a common complaint among children and adolescents. School functioning is one of the most important life domains impacted by chronic pain in children. This review discusses the epidemiological and pathophysiological connections between headaches and school functioning including a suggested clinical approach. The connection between recurrent and chronic headache and learning disabilities might be psychosocial (fear of failure) or anatomical (malfunctioning of the frontal and prefrontal areas). Only few population-based and clinical studies were done and good studies are still needed in order to understand the complex relationship better. However, relating to our patients' learning and school performance, history is crucial when a child with primary headaches is evaluated. Learning disabilities seem to have a high prevalence among children with primary headache syndromes especially migraine. The connection between the two is complex and might be either part of a common brain pathophysiology and/or a consequence of poor quality of life.

  15. Pain, emotion, headache.

    Science.gov (United States)

    Bussone, Gennaro; Grazzi, Licia; Panerai, Alberto E

    2012-10-01

    Pain has been considered as part of a defensive strategy whose specific role is to signal an immediate active danger to the organism. This definition fits well for acute pain. It does not work well, however, for chronic pain that is maintained even in absence of an ongoing, active threat. Currently, acute and chronic pain are considered to be separate conditions. What follows is a review of the different theories about pain and its history. Different hypotheses regarding pain mechanisms are illustrated. New data emerging from scientific research on chronic pain (migraine in particular) involving innovative imaging techniques are reported and discussed. © 2012 American Headache Society.

  16. Primary Headache Disorders- Part 2: Tension-type headache and medication overuse headache.

    Science.gov (United States)

    Jay, Gary W; Barkin, Robert L

    2017-12-01

    In Part 2 of Primary Headache disorders, we discuss the fourth Primary Headache Disorder, Tension-Type Headache (TTHA). We are again using the ICHD-III (Beta) definitions of such headaches, taking into consideration episodic and chronic TTHA, as well as the presence or absence of pericranial muscle tenderness. We discuss the pathophysiology and pharmacotherapeutic treatment of TTHA, and the aspects of the Myofascial Pain Syndrome that enhance and help the development of TTHA. We then discuss Medication Overuse Headache (MOH), itself a Secondary headache disorder, but one that is extremely important as it assists with the chronification of both migraine and TTHA. Finally we discuss how to manage and treat those patients with MOH. Chronic migraine, which is TTHA, Migraine as well as, in many patients, MOH, is discussed along with the treatment of this multifaceted disorder. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. A COMPARATIVE STUDY OF THE EFFICACY OF GRANISETRON AND ONDANSETRON IN THE PREVENTION OF POST OPERATIVE NAUSEA AND VOMITING IN LSCS PATIENTS UNDER SPINAL ANAESTHESIA

    Directory of Open Access Journals (Sweden)

    Jagadeesh Babu

    2015-08-01

    Full Text Available BACKGROUND: The most common and distressing symptoms that follow anaesthesia and surgery are pain and vomiting problems. Pain causes greater amount of suffering, but in some instances nausea and vomiting may be more distressing, particularly after minor surgery. Spinal anaesthesia has been shown to be easy, rapid and safe techniqu e for caesarean section. Nevertheless, it has some minor side effects, including nausea and vomiting in more than 66% of the cases. (Ref (Chestnut D H 1987. The abrupt diaphragmatic contractions, and protrusion of the abdominal viscera causes surgery mor e difficult, aspiration is a hazard. Hence we intended to compare the preventive and therapeutic effects of Granisetron and Ondansetron on the incidence of postoperative nausea and vomiting (PONV in patients undergoing elective Lower segment caesarian sec tion under spinal anaesthesia. OBJECTIVES: Post - operative nausea and vomiting (PONV are commonly reported adverse events after surgery and can contribute to the development of aspiration, wound dehiscence, and increased bleeding. Prophylaxis with antiemet ic has been shown to reduce the incidence of PONV as well as improve patient satisfaction. The main aim of this study is to compare the efficacy and safety of Granisetron with that of Ondansetron and placebo in the prevention of post - operative nausea and v omiting in patients undergoing lower segment caesarian section under spinal anaesthesia. This study is also intended to know the incidence of postoperative nausea and vomiting in this group of patients. Incidence of adverse effects of ondansetron and grani setron were also noted in this study. METHODS : With prior approval from the Institutional ethical committee and written informed consent, 75 patients of ASA grade I, aged between 20 – 30 years, body weight ranging from 45kg to 65 kg were studied. All the patients were subjected to elective caesarian section. RESULTS : We have studied 75 patients of ASA

  18. Headaches and Migraines: Understanding Headaches, From Mild to Migraine

    Science.gov (United States)

    ... address them. Regular exercise helps me with the stress trigger. Also, I avoid chocolate. "The point is," Eckhart declares, "medical research has really made a difference for me." Fast Fasts The most common type of headache is a tension headache. These usually are due ...

  19. Experiences and perceptions of people with headache: a qualitative study

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    Elliott Alison M

    2006-05-01

    Full Text Available Abstract Background Few qualitative studies of headache have been conducted and as a result we have little in-depth understanding of the experiences and perceptions of people with headache. The aim of this paper was to explore the perceptions and experiences of individuals with headache and their experiences of associated healthcare and treatment. Methods A qualitative study of individuals with headache, sampled from a population-based study of chronic pain was conducted in the North-East of Scotland, UK. Seventeen semi-structured interviews were conducted with adults aged 65 or less. Interviews were analysed using the Framework approach utilising thematic analysis. Results Almost every participant reported that they were unable to function fully as a result of the nature and unpredictability of their headaches and this had caused disruption to their work, family life and social activities. Many also reported a negative impact on mood including feeling depressed, aggressive or embarrassed. Most participants had formed their own ideas about different aspects of their headache and several had searched for, or were seeking, increased understanding of their headache from a variety of sources. Many participants reported that their headaches caused them constant worry and anguish, and they were concerned that there was a serious underlying cause. A variety of methods were being used to manage headaches including conventional medication, complementary therapies and self-developed management techniques. Problems associated with all of these management strategies emerged. Conclusion Headache has wide-ranging adverse effects on individuals and is often accompanied by considerable worry. The development of new interventions or educational strategies aimed at reducing the burden of the disorder and associated anxiety are needed.

  20. Effect of manual therapy techniques on headache disability in patients with tension-type headache. Randomized controlled trial.

    Science.gov (United States)

    Espí-López, G V; Rodríguez-Blanco, C; Oliva-Pascual-Vaca, A; Benítez-Martínez, J C; Lluch, E; Falla, D

    2014-12-01

    Tension-type headache (TTH) is the most common type of primary headache however there is no clear evidence as to which specific treatment is most effective or whether combined treatment is more effective than individual treatments. To assess the effectiveness of manual therapy techniques, applied to the suboccipital region, on aspects of disability in a sample of patients with tension-type headache. Randomized Controlled Trial. Specialized centre for headache treatment. Seventy-six (62 women) patients (age: 39.9 ± 10.9 years) with episodic chronic TTH. Patients were randomly divided into four treatment groups: 1) suboccipital soft tissue inhibition; 2) occiput-atlas-axis manipulation; 3) combined treatment of both techniques; 4) control. Four sessions were applied over 4 weeks and disability was assessed before and after treatment using the Headache Disability Inventory (HDI). Headache frequency, severity and the functional and emotional subscales of the questionnaire were assessed. Photophobia, phonophobia and pericranial tenderness were also monitored. Headache frequency was significantly reduced with the manipulative and combined treatment (Ptreatment groups (Ptreatment also reduced the score on the emotional subscale of the HDI (Ptreatments were combined, effectiveness was noted for all aspects of disability and other symptoms including photophobia, phonophobia and pericranial tenderness. Although individual manual therapy treatments showed a positive change in headache features, measures of photophobia, photophobia and pericranial tenderness only improved in the group that received the combined treatment suggesting that combined treatment is the most appropriate for symptomatic relief of TTH.

  1. Parkinson's disease: carbidopa, nausea, and dyskinesia.

    Science.gov (United States)

    Hinz, Marty; Stein, Alvin; Cole, Ted

    2014-01-01

    When l-dopa use began in the early 1960s for the treatment of Parkinson's disease, nausea and reversible dyskinesias were experienced as continuing side effects. Carbidopa or benserazide was added to l-dopa in 1975 solely to control nausea. Subsequent to the increasing use of carbidopa has been the recognition of irreversible dyskinesias, which have automatically been attributed to l-dopa. The research into the etiology of these phenomena has identified the causative agent of the irreversible dyskinesias as carbidopa, not l-dopa. The mechanism of action of the carbidopa and benserazide causes irreversible binding and inactivation of vitamin B6 throughout the body. The consequences of this action are enormous, interfering with over 300 enzyme and protein functions. This has the ability to induce previously undocumented profound antihistamine dyskinesias, which have been wrongly attributed to l-dopa and may be perceived as irreversible if proper corrective action is not taken.

  2. Nummular headache: diagnosis and treatment.

    Science.gov (United States)

    Pareja, Juan A; Pareja, Julia

    2003-05-01

    Nummular headache (coin-shaped cephalgia) has an unusual distinct feature: it is characterized by mild-to-moderate pressure-like pain exclusively felt in a rounded or elliptical area typically 2-6 cm in diameter. Although any region of the head may be affected, the parietal area is the common localization of nummular headache. The pain remains confined to the same symptomatic area which does not change in shape or size with time. The pain is continuous but lancinating exacerbations lasting for several seconds or gradually increasing from 10 mins to 2 h may superimpose the baseline pain. The temporal pattern is either chronic or remitting. Pseudoremissions may be observed when the pain reaches a very low grade or only discomfort (not pain) in the affected area is reported. At times, discomfort may prevail. Either during symptomatic periods or interictally, the affected area may show a variable combination of hypoethesia, dysesthesia, paresthesia or tenderness. Physical and supplementary examinations are normal. Nummular headache emerges as a primary clear-cut clinical picture. The particular topography and signs of sensory dysfunction make it reasonable to vent the idea that nummular headache is an extracranial headache, probably stemming from epicranial tissues such as terminal branches of sensitive nerves. Nummular headache may seem to be the paradigm of epicranias (group of headaches and pericranial neuralgias stemming from epicranial tissues). Nummular headache must be distinguished from head pain secondary to local processes and from tender points of more extensive headaches. Although nummular headache may frequently coexist with other primary headaches, it has an independent course. Treatment is seldom necessary and in most cases simple reassurance is sufficient.

  3. Dexmedetomidine versus Propofol in reducing postoperative nausea and vomiting in gynecologic laparoscopic surgery

    Directory of Open Access Journals (Sweden)

    Mansour Choubsaz

    2017-09-01

    Full Text Available Introduction: Post-Operative Nausea and Vomiting (PONV occurs in 20%-30% of patients, and is the second most common complaints after pain. This unpleasant complication can lead to rare but serious medical complications such as aspiration of gastric contents, suture dehiscence, esophageal rupture, subcutaneous emphysema, or pneumothorax. Annual PONV-related health care costs reach several hundred million dollars. Many interventions have been done to control PONV, but complications of drug interactions limit the use of drugs. For example, Dropridol has been placed on the Black Box Warning because of the risk of cardiac arrhythmias. Methods: This clinical trial recruited 80 patients with American Society of Anesthesiologist (ASA class I or II who were scheduled for elective gynecologic laparoscopic surgery. They were randomly divided into two groups: Propofol and Dexmedetomidine. The data was collected by the first nurse in PACUs and the second nurse in post-surgery ward, including age, weight, smoking history, nausea, vomiting and severity of vomiting. Patients and observers were blinded to the prescribed hypnotic drugs. The severity of nausea was assessed by visual analogue scale (ranging 0 to 10 in 0-2, 2-6 and 6-24 hours. The state of nausea was also recorded. Results: The incidence of nausea and the severity of vomiting significantly decreased in the dexmedetomidine group compared to the Propofol group (PV=0.001. Conclusion: The results showed that Dexmedetomidine can reduce the incidence of nausea and severity of vomiting compared to Propofol.

  4. Headache attributed to airplane travel ('airplane headache'): clinical profile based on a large case series.

    Science.gov (United States)

    Mainardi, F; Lisotto, C; Maggioni, F; Zanchin, G

    2012-06-01

    The 'headache attributed to airplane travel', also named 'airplane headache' (AH), is a recently described headache disorder that appears exclusively in relation to airplane flights, in particular during the landing phase. Based on the stereotypical nature of the attacks in all reported cases, we proposed provisional diagnostic criteria for AH in a previously published paper. Up to now 37 cases have been described in the literature. After our paper was disseminated via the Internet, we received several email messages from subjects around the world who had experienced such a peculiar headache. Their cooperation, by completing a structured questionnaire and allowing the direct observation of three subjects, enabled us to carry out a study on a total of 75 patients suffering from AH. Our survey confirmed the stereotypical nature of the attacks, in particular with regard to the short duration of the pain (lasting less than 30 minutes in up to 95% of the cases), the clear relationship with the landing phase, the unilateral pain, the male preponderance, and the absence of accompanying signs and/or symptoms. It is conceivable to consider barotrauma as one of the main mechanisms involved in the pathophysiology of AH. The observation that the pain appears inconstantly in the majority of cases, without any evident disorder affecting the paranasal sinuses, could be consistent with a multimodal pathogenesis underlying this condition, possibly resulting in the interaction between anatomic, environmental and temporary concurrent factors. This is by far the largest AH case series ever reported in the literature. The diagnostic criteria that we previously proposed proved to be valid when applied to a large number of patients suffering from this condition. We support its recognition as a new form of headache, to be included in the forthcoming update of the International Headache Society Classification, within '10. Headache attributed to disorder of homoeostasis'. Its formal

  5. Influence of temple headache frequency on physical functioning and emotional functioning in subjects with temporomandibular disorder pain.

    Science.gov (United States)

    List, Thomas; John, Mike T; Ohrbach, Richard; Schiffman, Eric L; Truelove, Edmond L; Anderson, Gary C

    2012-01-01

    To investigate the relationship of headache frequency with patient-reported physical functioning and emotional functioning in temporomandibular disorder (TMD) subjects with concurrent temple headache. The Research Diagnostic Criteria for TMD (RDC/TMD) Validation Project identified, as a subset of 614 TMD cases and 91 controls (n = 705), 309 subjects with concurrent TMD pain diagnoses (RDC/TMD) and temple headache. The temple headaches were subdivided into infrequent, frequent, and chronic headache according to the International Classification of Headache Disorders, second edition (ICHD-II). Study variables included self-report measures of physical functioning (Jaw Function Limitation Scale [JFLS], Graded Chronic Pain Scale [GCPS], Short Form-12 [SF-12]) and emotional functioning (depression and anxiety as measured by the Symptom Checklist-90R/SCL-90R). Differences among the three headache subgroups were characterized by increasing headache frequency. The relationship between ordered headache frequency and physical as well as emotional functioning was analyzed using linear regression and trend tests for proportions. Physical functioning, as assessed with the JFLS (P headache frequency. Emotional functioning, reflected in depression and anxiety, was also associated with increased frequency of headache (both P Headache frequency was substantially correlated with reduced physical functioning and emotional functioning in subjects with TMD and concurrent temple headaches. A secondary finding was that headache was precipitated by jaw activities more often in subjects with more frequent temple headaches.

  6. Postoperative nausea and vomiting following orthognathic surgery

    Science.gov (United States)

    Phillips, C.; Brookes, C. D.; Rich, J.; Arbon, J.; Turvey, T. A.

    2015-01-01

    The purpose of this study was to assess the incidence and risk factors associated with postoperative nausea (PON) and vomiting (POV) after orthognathic surgery. A review of the clinical records of consecutively enrolled subjects (2008–2012) at a single academic institution was conducted between 9/2013 and 3/2014. Data on the occurrence of PON and POV and potential patient-related, intraoperative, and postoperative explanatory factors were extracted from the medical records. Logistic models were used for the presence/absence of postoperative nausea and vomiting separately. Data from 204 subjects were analyzed: 63% were female, 72% Caucasian, and the median age was 19 years. Thirty-three percent had a mandibular osteotomy alone, 27% a maxillary osteotomy alone, and 40% had bimaxillary osteotomies. Sixty-seven percent experienced PON and 27% experienced POV. The most important risk factors for PON in this series were female gender, increased intravenous fluids, and the use of nitrous oxide, and for POV were race, additional procedures, and morphine administration. The incidence of PON and POV following orthognathic surgery in the current cohort of patients, after the introduction of the updated 2007 consensus guidelines for the management of postoperative nausea and vomiting, has not decreased substantially from that reported in 2003–2004. PMID:25655765

  7. Treatment of established postoperative nausea and vomiting: a quantitative systematic review

    Directory of Open Access Journals (Sweden)

    Tramèr Martin R

    2001-10-01

    Full Text Available Abstract Background The relative efficacy of antiemetics for the treatment of postoperative nausea and vomiting (PONV is poorly understood. Methods Systematic search (MEDLINE, Embase, Cochrane Library, bibliographies, any language, to 8.2000 for randomised comparisons of antiemetics with any comparator for the treatment of established PONV. Dichotomous data on prevention of further nausea and vomiting, and on side effects were combined using a fixed effect model. Results In seven trials (1,267 patients, 11 different antiemetics were tested without placebos; these data were not further analysed. Eighteen trials (3,809 had placebo controls. Dolasetron 12.5–100 mg, granisetron 0.1–3 mg, tropisetron 0.5–5 mg, and ondansetron 1–8 mg prevented further vomiting with little evidence of dose-responsiveness; with all regimens, absolute risk reductions compared with placebo were 20%–30%. The anti-nausea effect was less pronounced. Headache was dose-dependent. Results on propofol were contradictory. The NK1 antagonist GR205171, isopropyl alcohol vapor, metoclopramide, domperidone, and midazolam were tested in one trial each with a limited number of patients. Conclusions Of 100 vomiting surgical patients receiving a 5-HT3 receptor antagonist, 20 to 30 will stop vomiting who would not have done so had they received a placebo; less will profit from the anti-nausea effect. There is a lack of evidence for a clinically relevant dose-response; minimal effective doses may be used. There is a discrepancy between the plethora of trials on prevention of PONV and the paucity of trials on treatment of established symptoms. Valid data on the therapeutic efficacy of classic antiemetics, which have been used for decades, are needed.

  8. Headache in Systemic Lupus Erythematosus

    DEFF Research Database (Denmark)

    Hanly, John G; Urowitz, Murray B; O'Keeffe, Aidan G

    2013-01-01

    To examine the frequency and characteristics of headaches and their association with global disease activity and health-related quality of life (HRQOL) in patients with systemic lupus erythematosus (SLE).......To examine the frequency and characteristics of headaches and their association with global disease activity and health-related quality of life (HRQOL) in patients with systemic lupus erythematosus (SLE)....

  9. Hypoxic mechanisms in primary headaches

    DEFF Research Database (Denmark)

    Britze, Josefine; Arngrim, Nanna; Schytz, Henrik Winther

    2017-01-01

    and cluster headache. Methods This narrative review investigates the current level of knowledge on the relation of hypoxia in migraine and cluster headache based on epidemiological and experimental studies. Findings Epidemiological studies suggest that living in high-altitude areas increases the risk...

  10. Risk factors associated with incidence and persistence of frequent headaches.

    Science.gov (United States)

    Marklund, Susanna; Häggman-Henrikson, Birgitta; Wänman, Anders

    2014-11-01

    Headaches represent a significant public health problem, but the knowledge of factors specifically related to incidence and persistence of headaches is still limited. The aim of this study was to evaluate whether gender, self-reported bruxism and variations in the dental occlusion contribute to onset and persistence of frequent headaches. The study population comprised 280 dental students, examined annually in a 2-year prospective study with a questionnaire and a clinical examination of the jaw function. In the analysis subjects were dichotomized into cases with frequent (once a week or more) or without frequent headaches (controls). The 2-year cumulative incidence was based on subjects without frequent headaches at baseline. Cases with 2-year persistent headaches reported such symptoms at all three examinations. Self-reported bruxism and factors in the dental occlusion at baseline were used as independent variables in logistic regression analyses. The 2-year cumulative incidence of frequent headaches was 21%. Female gender (OR = 2.6; CI = 1.3-5.4), self-reported bruxism (OR = 2.3; CI = 1.2-4.4) and mandibular instability in intercuspal position (OR = 3.2; CI = 1.4-7.5) were associated with incidence of frequent headaches. Persistent headaches during the observation period were present in 12 individuals (4%) and significantly related to mandibular instability in intercuspal position (OR = 6.1; CI = 1.6-22.6). The results indicate that female gender, self-reported bruxism and mandibular instability in intercuspal position are of importance in the development of frequent headaches. In management of these patients a multidisciplinary approach including dentists may be important and, thus, advocated.

  11. Modified Valsalva test differentiates primary from secondary cough headache.

    Science.gov (United States)

    Lane, Russell J M; Davies, Paul T G

    2013-03-28

    The current definition of cough headache includes provocation of the symptom by Valsalva manoeuvre, and it is generally believed that all cough headache results from a sudden increase in intracranial pressure. We sought to question that presumption and to determine whether the Valsalva test might distinguish primary from secondary cough headache. We examined 16 consecutive cough headache patients using a modified Valsalva test (exhalation into the connecting tube of a standard anaeroid sphygmomanometer to 60 mm Hg for 10 seconds). A positive response was recorded if the manoeuvre provoked headache. All patients subsequently underwent brain MRI. None of the patients had neurological signs. Eleven had positive modified Valsalva tests. Ten were found subsequently to have posterior fossa pathologies (secondary cough headache: 8 Chiari Type 1 malformations, 2 posterior fossa meningiomas). The cough headache was relieved following surgery in all cases. One patient with a positive Valsalva test had an apparently normal brain MRI but measurements of hindbrain and posterior fossa dimensions were consistent with 'posterior fossa crowdedness'. The remaining 5 patients had negative (4 patients) or equivocal (1 patient) Valsalva tests and normal MRI scans (primary cough headache). These findings suggest that secondary cough headache results from a transient increase in intracranial CSF pressure during exertion in the presence of obstruction to normal cerebrospinal fluid dynamics. The modified Valsalva test can also determine whether tonsillar herniation found on brain MRI is symptomatic. Primary cough headache appears to be caused by a different mechanism, possibly through congestion of the orbital venous plexus in the presence of jugular venous incompetence and a reduced threshold for trigeminal sensory activation.

  12. Predictors of Headache Before, During, and After Pregnancy: A Cohort Study

    Science.gov (United States)

    Turner, Dana P.; Smitherman, Todd A.; Eisenach, James C.; Penzien, Donald B.; Houle, Timothy T.

    2011-01-01

    latter independent of but compounded by spinal injection. Physicians should attend to prior headache history when making decisions about pain management during and after childbirth. As the lack of formal ICHD-II headache diagnoses is a limitation of this study, future longitudinal studies should replicate the present design while including headache subtyping consistent with ICHD-II nosology. PMID:22268840

  13. The Sphenopalatine Ganglion: Anatomy, Pathophysiology, and Therapeutic Targeting in Headache.

    Science.gov (United States)

    Robbins, Matthew S; Robertson, Carrie E; Kaplan, Eugene; Ailani, Jessica; Charleston, Larry; Kuruvilla, Deena; Blumenfeld, Andrew; Berliner, Randall; Rosen, Noah L; Duarte, Robert; Vidwan, Jaskiran; Halker, Rashmi B; Gill, Nicole; Ashkenazi, Avi

    2016-02-01

    The sphenopalatine ganglion (SPG) has attracted the interest of practitioners treating head and face pain for over a century because of its anatomical connections and role in the trigemino-autonomic reflex. In this review, we discuss the anatomy of the SPG, as well as what is known about its role in the pathophysiology of headache disorders, including cluster headache and migraine. We then address various therapies that target the SPG, including intranasal medication delivery, new SPG blocking catheter devices, neurostimulation, chemical neurolysis, and ablation procedures. © 2015 American Headache Society.

  14. National awareness campaign to prevent medication-overuse headache in Denmark.

    Science.gov (United States)

    Carlsen, Louise Ninett; Westergaard, Maria Lurenda; Bisgaard, Mette; Schytz, Julie Brogaard; Jensen, Rigmor Højland

    2017-01-01

    Background Medication-overuse headache is prevalent, but in principle preventable. Objective To describe the Danish national awareness campaign for medication-overuse headache. Methods The Danish Headache Center, the Association of Danish Pharmacies, and headache patient organizations implemented a four-month medication-overuse headache awareness campaign in 2016. Target groups were the general public, general practitioners, and pharmacists. Key messages were: Overuse of pain-medication can worsen headaches; pain-medication should be used rationally; and medication-overuse headache is treatable. A range of communication technologies was used. A survey on the public's awareness of medication-overuse headache was conducted. Results The Danish adult population is 4.2 million. Online videos were viewed 297,000 times in three weeks. All 400 pharmacies received campaign materials. Over 28,000 leaflets were distributed. Two radio interviews were conducted. A television broadcast about headache reached an audience of 520,000. Forty articles were published in print media. Information was accessible at 32 reputable websites and five online news agencies. Three scientific papers were published. Information was available at an annual conference of general practitioners, including a headache lecture. The survey showed an increase in percentage of the public who knew about medication-overuse headache (from 31% to 38%). Conclusion A concerted campaign to prevent medication-overuse headache can be implemented through involvement of key stakeholders.

  15. Epidemiological-based childhood headache natural history study: after an interval of six years.

    Science.gov (United States)

    Ozge, Aynur; Sasmaz, Tayyar; Cakmak, Sema Erol; Kaleagasi, Hakan; Siva, Aksel

    2010-06-01

    Headache is a common problem among adolescents, and variations can be observed in headache types and characteristics. The present study aimed to reach 5562 Turkish children who were investigated six years previously in a school-based childhood headache project, and to evaluate their current headache status. Investigators interviewed the available students with structured questionnaires. New and old data were matched and analyzed. The present study included 1155 adolescents (mean age 15.2 +/- 1.1 years), with 582 boys (50.4%) and 573 girls (49.6%). The prevalence of headache was 78.7% (tension-type headache [TTH] 57.5%, migraine 18.6%, unspecified 2.6%). The prevalence of headache was 45.2% six years previously. In the intervening six years, headache prevalence increased and the headache types changed significantly (Kappa: 0.04, p < .01). The most important variation during this time was the significant increase in TTH. Analgesic use was determined in 70.2% of adolescents with headache, with this ratio being higher in migraineurs. In conclusion, there were an increase in headache prevalence and a significant change in headache types over the previous six years. It can also be suggested that new country-based management strategies are required.

  16. [Management of chronic daily headache in children and adolescents].

    Science.gov (United States)

    Cuvellier, J-C

    2009-01-01

    Chronic daily headache (CDH) affects 2 to 4% of adolescent females and 0,8 to 2% of adolescent males. CDH is diagnosed when headaches occur more than 4 hours a day, for greater than or equal to 15 headache days per month, over a period of 3 consecutive months, without an underlying pathology. It is manifested by severe intermittent headaches, that are migraine-like, as well as a chronic baseline headache. Silberstein and Lipton divided patients into four diagnostic categories: transformed migraine, chronic tension-type headache, new daily-persistent headache, and hemicrania continua. The second edition of the International Classification of Headache Disorders did not comprise any CDH category as such, but provided criteria for all four types of CDH: chronic migraine, chronic tension-type headache, new daily-persistent headache, and hemicrania continua. Evaluation of CDH needs to include a complete history and physical examination to identify any possibility of the headache representing secondary headaches. Children and adolescents with CDH frequently have sleep disturbance, pain at other sites, dizziness, medication-overuse headache and a psychiatric comorbidity (anxiety and mood disorders). CDH frequently results in school absence. CDH management plan is dictated by CDH subtype, the presence or absence of medication overuse, functional disability and presence of attacks of full-migraine superimposed. Reassuring, explaining, and educating the patient and family, starting prophylactic therapy and limiting aborting medications are the mainstay of treatment. It includes pharmacologic (acute and prophylactic therapy) and nonpharmacologic measures (biobehavioral management, biofeedback-assisted relaxation therapy, and psychologic or psychiatric intervention). Part of the teaching process must incorporate life-style changes, such as regulation of sleep and eating habits, regular exercise, avoidance of identified triggering factors and stress management. Emphasis must be

  17. Mediator Variables in Headache Research: Methodological Critique and Exemplar Using Self-Efficacy as a Mediator of the Relationship Between Headache Severity and Disability.

    Science.gov (United States)

    Peck, Kelly R; Smitherman, Todd A

    2015-09-01

    Despite advances in headache medicine, there remains little research on process-related variables that mediate relations between headache and outcomes, as well as limited dissemination of optimal statistical methodology for conducting mediation analyses. The present paper thus aims to promote and demonstrate a contemporary approach to mediation analysis as applied to headache. An overview of a contemporary path-analytic approach to mediation analysis is presented, with an empirical exemplar for illustrative purposes. In the exemplar, headache management self-efficacy (HMSE) was proposed as a mediator between headache severity and disability. The sample included 907 young adults (M age = 19.03 [SD = 2.26]; 70.8% female) with primary headache. Direct and indirect effects of headache severity on headache disability through HMSE were assessed using the espoused methods. Pain severity was positively associated with headache disability (β = 2.91, 95% confidence interval [CI; 2.62, 3.19]) and negatively associated with HMSE (β = -3.50, 95% CI [-4.24, -2.76]); HMSE was negatively associated with headache disability (β = 0.07, 95% CI [-0.09, -0.04]). A positive indirect effect of pain severity on disability through HMSE was identified (point estimate = 0.24, 95% CI [0.14, 0.34]); thus, self-efficacy mediated the association between pain severity and disability. The proposed mediation model accounted for 38% of total variance in disability (P headache literature. In one exemplar application, self-efficacy partially accounted for the disability resulting from headache. We advocate for increased attention to intervening variables in headache via dissemination of contemporary mediation analyses. © 2015 American Headache Society.

  18. Pain stress and headache.

    Science.gov (United States)

    Panerai, Alberto E

    2012-05-01

    The association between pain and stress is an old one, but still it is not really clear who comes first. Pain induces stress, and stress induces pain. Pain is part of our homeostatic system and in this way is an emotion, i.e., it tells us that something is out-of-order (control), and emotion drives our behavior and one behavior is stress response. Stress comes from ourselves: the imagination we have or would like to have of us, from the image others give of us, from the goals we assume it is necessary to reach for our well-being or the goals others want us to fulfill. Stress comes from our social condition and the condition we would like, stress comes from dangerous situations we cannot control. Headache easily fits in the picture.

  19. [Peppermint oil in the acute treatment of tension-type headache].

    Science.gov (United States)

    Göbel, H; Heinze, A; Heinze-Kuhn, K; Göbel, A; Göbel, C

    2016-06-01

    Tension-type headache is the most frequent form of headache. The local topical treatment with peppermint oil (oleum menthae piperitae) has proven to be significantly more effective than placebo in controlled studies. Peppermint oil targets headache pathophysiology in multiple ways. The efficacy is comparable to that of acetylsalicylic acid or paracetamol. Solutions of 10 % peppermint oil in ethanol are licensed for the treatment of tension-type headache in adults and children above 6 years. It is included in treatment recommendations and guidelines by the respective professional societies and is regarded as a standard treatment for the acute therapy of tension-type headaches.

  20. Chronic daily headache in U.S. soldiers after concussion.

    Science.gov (United States)

    Theeler, Brett J; Flynn, Frederick G; Erickson, Jay C

    2012-05-01

    To determine the prevalence and characteristics of, and factors associated with, chronic daily headache (CDH) in U.S. soldiers after a deployment-related concussion. A cross-sectional, questionnaire-based study was conducted with a cohort of 978 U.S. soldiers who screened positive for a deployment-related concussion upon returning from Iraq or Afghanistan. All soldiers underwent a clinical evaluation at the Madigan Traumatic Brain Injury Program that included a history, physical examination, 13-item self-administered headache questionnaire, and a battery of cognitive and psychological assessments. Soldiers with CDH, defined as headaches occurring on 15 or more days per month for the previous 3 months, were compared to soldiers with episodic headaches occurring less than 15 days per month. One hundred ninety-six of 978 soldiers (20%) with a history of deployment-related concussion met criteria for CDH and 761 (78%) had episodic headache. Soldiers with CDH had a median of 27 headache days per month, and 46/196 (23%) reported headaches occurring every day. One hundred seven out of 196 (55%) soldiers with CDH had onset of headaches within 1 week of head trauma and thereby met the time criterion for posttraumatic headache (PTHA) compared to 253/761 (33%) soldiers with episodic headache. Ninety-seven out of 196 (49%) soldiers with CDH used abortive medications to treat headache on 15 or more days per month for the previous 3 months. One hundred thirty out of 196 (66%) soldiers with CDH had headaches meeting criteria for migraine compared to 49% of soldiers with episodic headache. The number of concussions, blast exposures, and concussions with loss of consciousness was not significantly different between soldiers with and without CDH. Cognitive performance was also similar for soldiers with and without CDH. Soldiers with CDH had significantly higher average scores on the posttraumatic stress disorder (PTSD) checklist compared to soldiers with episodic headaches. Forty

  1. Self-reported efficacy of complementary and alternative medicine: the Akershus study of chronic headache.

    Science.gov (United States)

    Kristoffersen, Espen Saxhaug; Aaseth, Kjersti; Grande, Ragnhild Berling; Lundqvist, Christofer; Russell, Michael Bjørn

    2013-04-18

    Chronic headache is associated with disability and high utilisation of health care including complementary and alternative medicine (CAM). We investigated self-reported efficacy of CAM in people with chronic headache from the general population. Respondents with possible self-reported chronic headache were interviewed by physicians experienced in headache diagnostics. CAM queried included acupuncture, chiropractic, homeopathy, naprapathy, physiotherapy, psychological treatment, and psychomotor physiotherapy. Sixty-two % and 73% of those with primary and secondary chronic headache had used CAM.Self-reported efficacy of CAM ranged from 0-43% without significant differences between gender, headache diagnoses, co-occurrence of migraine, medication use or physician contact. CAM is widely used, despite self-reported efficacy of different CAM modalities is modest in the management of chronic headache.

  2. Headache in Idiopathic Intracranial Hypertension: Findings From the Idiopathic Intracranial Hypertension Treatment Trial.

    Science.gov (United States)

    Friedman, Deborah I; Quiros, Peter A; Subramanian, Prem S; Mejico, Luis J; Gao, Shan; McDermott, Michael; Wall, Michael

    2017-09-01

    To characterize the phenotype, headache-related disability, medical co-morbidities, use of symptomatic headache medications, and headache response to study interventions in the Idiopathic Intracranial Hypertension Treatment Trial (IIHTT). Patients with untreated IIH and mild vision loss enrolled in the IIHTT and randomized to acetazolamide (ACZ) and weight loss or placebo (PLB) and weight loss had prospective assessment of headache disability using the Headache Impact Test-6 (HIT-6) questionnaire. Subjects with headache at the baseline visit were assigned a headache phenotype using the International Classification for Headache Disorders version 3 beta (ICHD-3b). Medication overuse was determined using the participants' reported medication use for the preceding month and ICHD-3b thresholds for diagnosing medication overuse headache. We investigated relationships between headache disability and various other clinical characteristics at baseline and at 6 months. Headache was present in 139 (84%) of the 165 enrollees at baseline. The most common headache phenotypes were migraine (52%), tension-type headache (22%), probable migraine (16%), and probable tension-type headache (4%). Fifty-one (37%) participants overused symptomatic medications at baseline, most frequently simple analgesics. A similar amount of improvement in the adjusted mean (± standard error) HIT-6 score occurred in the ACZ (-9.56 ± 1.05) and PLB groups (-9.11 ± 1.14) at 6 months (group difference -0.45, 95% CI -3.50 to 2.60, P = .77). Headache disability did not correlate with any of the studies, variables of interest, which included: the lumbar puncture opening pressure at baseline or at 6 months, body mass index, the amount of weight lost, papilledema grade, perimetric mean deviation, or the use of hormonal contraception. Headache disability was significantly associated with patient-reported quality of life in the physical, mental, and visual domains. Headache was common, of varied

  3. The Efficacy of Aromatherapy in the Treatment of Postdischarge Nausea in Patients Undergoing Outpatient Abdominal Surgery.

    Science.gov (United States)

    Mcilvoy, Laura; Richmer, Linda; Kramer, Deborah; Jackson, Rita; Shaffer, Leslee; Lawrence, Jeffrey; Inman, Kevin

    2015-10-01

    The purpose of this study was to explore the effectiveness of the aromatherapy product QueaseEASE (QE) for decreasing postdischarge nausea (PDN) in patients undergoing outpatient abdominal surgery. Prospective exploratory study. Informed Consent was obtained preoperatively from a convenience sample of adult patients scheduled for outpatient abdominal surgery procedures. Prior to discharge, subjects were instructed in the use of QE and given instructions on how to rate their nausea on a 0-10 scale. They recorded nausea scales > 0 any time they occurred for the next 24 hours, used the QE, and recorded their nausea scales 3 minutes later. A study nurse called subjects the next day to collect the information. The sample included 70 outpatients who underwent abdominal surgery. Twenty-five participants (36%) reported experiencing PDN and their concomitant use of QE. There was a significant difference in mean age of those reporting PDN (37 years) versus those without nausea (48 years, P = .004) as well as a significant difference in mean intravenous fluid intake during hospitalization of those reporting PDN (1,310 mL) versus those without nausea (1,511 mL, P = .04). The PDN group had more female participants (72% vs 42%, P = .02), more participants that were less than 50 years of age (84% vs 53%, P = .02), and received more opioids (100% vs 76%, P = .006) than the no nausea group. The 25 PDN participants reported 47 episodes of PDN in which they used QE. For all of the 47 PDN episodes experienced, participants reported a decrease in nausea scale (0 to 10) after the use of QE; for 22 (47%) of the PDN episodes experienced, a nausea scale of 0 after using QE was reported. The mean decrease in nausea scale for all 25 participants was 4.78 (±2.12) after using QE. This study found that the aromatherapy QE was an effective treatment of PDN in select same-day abdominal surgery patients. Copyright © 2015 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc

  4. Botulinum toxin A is effective to treat tension-type headache caused by hemifacial spasm.

    Science.gov (United States)

    Mizuma, Atsushi; Nagata, Eiichiro; Yasuda, Takashi; Kouchi, Maiko; Nakayama, Taira; Honma, Kazunari; Tokuoka, Kentaro; Kitagawa, Yasuhisa; Nogawa, Shigeru; Takizawa, Shunya

    2017-10-01

    We examined the relationship between hemifacial spasm (HFS; a form of cranio-cervical dystonia) and chronic primary headache, including tension-type headache (TTH). We also examined whether botulinum toxin A (BoNT/A) therapy for HFS ameliorates concomitant TTH. Fifty-one HFS patients receiving BoNT/A therapy were recruited. Patients' characteristics (including age, gender, chronic headache history, exercise habits, stiff neck, cervical spondylolysis history), stress factors, worsening/new onset of headache associated with HFS, and dose of BoNT/A were examined. We diagnosed headache types according to The International Classification of Headache Disorders, 3rd edition, beta. Numerical Rating Scale (NRS) and Headache Impact Test-6 (HIT-6) scores for headache severity were compared between the 6-week baseline before BoNT/A therapy and 6-week follow-up after BoNT/A therapy. Of 51 patients with HFS, 17 (33.3%) reported worsening or new onset of headache (especially TTH) associated with HFS (Group-S), and 34 were not aware of headache (Group-N). Twelve patients (70.6%) in group-S reported improvement of headache after BoNT/A therapy. NRS (from 7 [5-9] to 0 [0-5], pheadache (odds ratio 28.53: 2.96-275.10, pheadache, especially TTH, is associated with HFS. BoNT/A therapy for HFS may also be indirectly effective for treatment of TTH. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. The effect of crystalloid versus Low molecular weight colloid solution on post-operative nausea and vomiting after ambulatory gynecological surgery - a prospective randomized trial

    LENUS (Irish Health Repository)

    Hayes, Ivan

    2012-07-31

    AbstractBackgroundIntravenous fluid is recommended in international guidelines to improve patient post-operative symptoms, particularly nausea and vomiting. The optimum fluid regimen has not been established. This prospective, randomized, blinded study was designed to determine if administration of equivolumes of a colloid (hydroxyethyl starch 130\\/0.4) reduced post operative nausea and vomiting in healthy volunteers undergoing ambulatory gynecologic laparoscopy surgery compared to a crystalloid solution (Hartmann’s Solution).Methods120 patients were randomized to receive intravenous colloid (N = 60) or crystalloid (N = 60) intra-operatively. The volume of fluid administered was calculated at 1.5 ml.kg-1 per hour of fasting. Patients were interviewed to assess nausea, vomiting, anti-emetic use, dizziness, sore throat, headache and subjective general well being at 30 minutes and 2, 24 and 48 hours post operatively. Pulmonary function testing was performed on a subgroup.ResultsAt 2 hours the proportion of patients experiencing nausea (38.2 % vs 17.9%, P = 0.03) and the mean nausea score were increased in the colloid compared to crystalloid group respectively (1.49 ± 0.3 vs 0.68 ± 0.2, P = 0.028). The incidence of vomiting and anti-emetic usage was low and did not differ between the groups. Sore throat, dizziness, headache and general well being were not different between the groups. A comparable reduction on post-operative FVC and FEV-1 and PEFR was observed in both groups.ConclusionsIntra-operative administration of colloid increased the incidence of early postoperative nausea and has no advantage over crystalloid for symptom control after gynaecological laparoscopic surgery.

  6. Aromatherapy for treatment of postoperative nausea and vomiting.

    Science.gov (United States)

    Hines, Sonia; Steels, Elizabeth; Chang, Anne; Gibbons, Kristen

    2012-04-18

    Postoperative nausea and vomiting is a common and unpleasant phenomenon and current therapies are not always effective for all patients. Aromatherapy has been suggested as a possible addition to the available treatment strategies. This review sought to establish what effect the use of aromatherapy has on the severity and duration of established postoperative nausea and vomiting and whether aromatherapy can be used with safety and clinical effectiveness comparable to standard pharmacological treatments. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 3); MEDLINE; EMBASE; CINAHL; CAM on PubMed; Meditext; LILACS; and ISI Web of Science as well as grey literature sources and the reference lists of retrieved articles. We conducted database searches up to August 2011. We included all randomized controlled trials (RCTs) and controlled clinical trials (CCTs) where aromatherapy was used to treat postoperative nausea and vomiting. Interventions were all types of aromatherapy. Aromatherapy was defined as the inhalation of the vapours of any substance for the purposes of a therapeutic benefit. Primary outcomes were the severity and duration of postoperative nausea and vomiting. Secondary outcomes were adverse reactions, use of rescue anti-emetics and patient satisfaction with treatment. Two review authors assessed risk of bias in the included studies and extracted data. As all outcomes analysed were dichotomous, we used a fixed-effect model and calculated relative risk (RR) with associated 95% confidence interval (95% CI). The nine included studies comprised six RCTs and three CCTs with a total of 402 participants. The mean age and range data for all participants were not reported for all studies. The method of randomization in four of the six included RCTs was explicitly stated and was adequate. Incomplete reporting of data affected the completeness of the analysis. Compared with placebo, isopropyl alcohol vapour

  7. The headache to subjects with multiple sclerosis: clinical and imaging study

    International Nuclear Information System (INIS)

    Moldovanu, Ion; Voiticovschi-Iosob, Cristina

    2011-01-01

    The present study showed clinical and imaging particularities of primary headache to subjects with multiple sclerosis. From the total number of 28 patients included in this study 22 (78,57%) had headache accuses (3 men and 19 women). Was observed a high prevalence of tension type headache, present to 10 of the 22 patients (45.45%). Migraine was diagnosed to 8 respondents (36.36 %). In 4 cases was found a combination of migraine and tension type headache (8.1%). Headache was more common to women with multiple sclerosis (MS) than to men. Neuroimaging of MS patients indicates the fact that the presence of demyelinating disease in the brainstem, midbrain, periaqueductal gray substance is associated with an increased risk of headache, migraine characteristics (migraine-like). Psychometric test have revealed a high level of depression and anxiety in patients with MS and chronic headache. (authors)

  8. Guidelines for controlled trials of drugs in tension-type headache: second edition

    DEFF Research Database (Denmark)

    Bendtsen, L; Bigal, M E; Cerbo, R

    2010-01-01

    and chronic tension-type headache have been published, providing new information on trial methodology for this disorder. Furthermore, the classification of the headaches, including tension-type headache, has been revised. These developments support the need for also revising the guidelines for drug treatments......The Clinical Trials Subcommittee of the International Headache Society published its first edition of the guidelines on controlled trials of drugs in tension-type headache in 1995. These aimed 'to improve the quality of controlled clinical trials in tension-type headache', because 'good quality...... controlled trials are the only way to convincingly demonstrate the efficacy of a drug, and form the basis for international agreement on drug therapy'. The Committee published similar guidelines for clinical trials in migraine and cluster headache. Since 1995 several studies on the treatment of episodic...

  9. Blunted autonomic response in cluster headache patients

    DEFF Research Database (Denmark)

    Barloese, Mads; Brinth, Louise; Mehlsen, Jesper

    2015-01-01

    BACKGROUND: Cluster headache (CH) is a disabling headache disorder with chronobiological features. The posterior hypothalamus is involved in CH pathophysiology and is a hub for autonomic control. We studied autonomic response to the head-up tilt table test (HUT) including heart rate variability...... (HRV) in CH patients and compared results to healthy controls. METHODS AND MATERIALS: Twenty-seven episodic and chronic CH patients and an equal number of age-, sex- and BMI-matched controls were included. We analyzed responses to HUT in the time and frequency domain and by non-linear analysis. RESULTS......: CH patients have normal cardiovascular responses compared to controls but increased blood pressure. In the frequency analysis CH patients had a smaller change in the normalized low- (LF) (2.89 vs. 13.38, p 

  10. A brief review of current scientific evidence involving aromatherapy use for nausea and vomiting.

    Science.gov (United States)

    Lua, Pei Lin; Zakaria, Noor Salihah

    2012-06-01

    The objective of this study was to compile existing scientific evidence regarding the effects of essential oils (EOs) administered via inhalation for the alleviation of nausea and vomiting. CINAHL, PubMed, and EBSCO Host and Science Direct databases were searched for articles related to the use of EOs and/or aromatherapy for nausea and vomiting. Only articles using English as a language of publication were included. Eligible articles included all forms of evidence (nonexperimental, experimental, case report). Interventions were limited to the use of EOs by inhalation of their vapors to treat symptoms of nausea and vomiting in various conditions regardless of age group. Studies where the intervention did not utilize EOs or were concerned with only alcohol inhalation and trials that combined the use of aromatherapy with other treatments (massage, relaxations, or acupressure) were excluded. Five (5) articles met the inclusion criteria encompassing trials with 328 respondents. Their results suggest that the inhaled vapor of peppermint or ginger essential oils not only reduced the incidence and severity of nausea and vomiting but also decreased antiemetic requirements and consequently improved patient satisfaction. However, a definitive conclusion could not be drawn due to methodological flaws in the existing research articles and an acute lack of additional research in this area. The existing evidence is encouraging but yet not compelling. Hence, further well-designed large trials are needed before confirmation of EOs effectiveness in treating nausea and vomiting can be strongly substantiated.

  11. Parkinson's disease: carbidopa, nausea, and dyskinesia

    Directory of Open Access Journals (Sweden)

    Hinz M

    2014-11-01

    Full Text Available Marty Hinz,1 Alvin Stein,2 Ted Cole3 1Clinical Research, NeuroResearch Clinics, Cape Coral, FL, 2Stein Orthopedic Associates, Plantation, FL, 3Cole Center for Healing, Cincinnati, OH, USA Abstract: When ʟ-dopa use began in the early 1960s for the treatment of Parkinson's disease, nausea and reversible dyskinesias were experienced as continuing side effects. Carbidopa or benserazide was added to ʟ-dopa in 1975 solely to control nausea. Subsequent to the increasing use of carbidopa has been the recognition of irreversible dyskinesias, which have automatically been attributed to ʟ-dopa. The research into the etiology of these phenomena has identified the causative agent of the irreversible dyskinesias as carbidopa, not ʟ-dopa. The mechanism of action of the carbidopa and benserazide causes irreversible binding and inactivation of vitamin B6 throughout the body. The consequences of this action are enormous, interfering with over 300 enzyme and protein functions. This has the ability to induce previously undocumented profound antihistamine dyskinesias, which have been wrongly attributed to ʟ-dopa and may be perceived as irreversible if proper corrective action is not taken. Keywords: vitamin B6, PLP, irreversible, pyridoxal 5'-phosphate

  12. Critical Evaluation of Headache Classifications.

    Science.gov (United States)

    Özge, Aynur

    2013-08-01

    Transforming a subjective sense like headache into an objective state and establishing a common language for this complaint which can be both a symptom and a disease all by itself have kept the investigators busy for years. Each recommendation proposed has brought along a set of patients who do not meet the criteria. While almost the most ideal and most comprehensive classification studies continued at this point, this time criticisims about withdrawing from daily practice came to the fore. In this article, the classification adventure of scientists who work in the area of headache will be summarized. More specifically, 2 classifications made by the International Headache Society (IHS) and the point reached in relation with the 3rd classification which is still being worked on will be discussed together with headache subtypes. It has been presented with the wish and belief that it will contribute to the readers and young investigators who are interested in this subject.

  13. Posttraumatic stress disorder and intimate partner violence in a women's headache center.

    Science.gov (United States)

    Gerber, Megan R; Fried, Lise E; Pineles, Suzanne L; Shipherd, Jillian C; Bernstein, Carolyn A

    2012-01-01

    Posttraumatic stress disorder has been linked to women's ill health, including headaches. Intimate partner violence, which may result in posttraumatic stress disorder, is often reported by women with headaches. Prior studies of intimate partner violence and headache have estimated lifetime but not 12-month prevalence. The researchers in this study examined the relationship between headache and posttraumatic stress disorder in a novel population, and estimated 12-month and lifetime prevalence rates of intimate partner violence. Patients were recruited from a women's headache center (n = 92) during 2006-07 and completed the Migraine Disability Assessment measure of headache severity. Posttraumatic stress disorder was measured using a modified Breslau scale. Twelve-month and lifetime physical intimate partner violence were measured with the Partner Violence Screen and the STaT ("slapped, threatened and throw") measure. Multivariable regression determined factors independently associated with headache severity. Among all participants, 28.3% screened positive for posttraumatic stress disorder; 9.8% and 36.9% of women endorsed recent and lifetime intimate partner violence. Posttraumatic stress disorder was strongly associated with headache severity (β = 34.12, p = 0.01). Patients reporting lifetime intimate partner violence exhibited a trend of nine additional days of disability due to headache over 90 days. Posttraumatic stress disorder and intimate partner violence occur among a sizable proportion of women referred for headache. The authors' findings reaffirm that clinicians treating women with headaches must be aware of the possibility of posttraumatic stress disorder and intimate partner violence in such patients.

  14. What clues are available for differential diagnosis of headaches in emergency settings?

    Science.gov (United States)

    Mert, Ertan; Ozge, Aynur; Taşdelen, Bahar; Yilmaz, Arda; Bilgin, Nursel G

    2008-04-01

    The correct diagnosis of headache disorders in an emergency room is important for developing early management strategies and determining optimal emergency room activities. This prospective clinical based study was performed in order to determine demographic and clinical clues for differential diagnosis of primary and secondary headache disorders and also to obtain a classification plot for the emergency room practitioners. This study included 174 patients older than 15 years of age presenting in the emergency room with a chief complaint of headache. Definite headache diagnoses were made according to ICHD-II criteria. Classification and regression tree was used as new method for the statistical analysis of the differential diagnostic process. Our 174 patients with headache were diagnosed as basically primary (72.9%) and secondary (27.1%) headaches. Univariate analysis with cross tabs showed three important results. First, unilateral pain location caused 1.431-fold increase in the primary headache risk (p = 0.006). Second, having any triggers caused 1.440-fold increase in the primary headache risk (p = 0.001). Third, having associated co-morbid medical disorders caused 4.643-fold increase in the secondary headache risk (p < 0.001). It was concluded that the presence of comorbidity, the patient's age, the existence of trigger and relaxing factors, the pain in other body parts that accompanies headache and the quality of pain in terms of location and duration were all important clues for physicians in making an accurate differentiation between primary and secondary headaches.

  15. Review of botulinum toxin type A for the prophylactic treatment of chronic daily headache

    Directory of Open Access Journals (Sweden)

    Stefan Evers

    2007-05-01

    Full Text Available Stefan EversDepartment of Neurology, University of Münster, Münster, GermanyAbstract: Botulinum toxin A is increasingly used in the treatment of idiopathic and symptomatic headache disorders. However, only few controlled trials are available and many trials can hardly be compared to each other because of different endpoints and different trial designs. In particular chronic daily headache, which is defined as an idiopathic headache occurring on more than 15 days per month for at least 3 months and a daily duration of at least 4 hours, is considered as a headache disorder with possible efficacy of botulinum toxin A. For the prophylactic treatment of chronic tension-type headache and chronic migraine, no sufficient positive evidence for a successful treatment can be obtained from randomized, double-blind, and placebo-controlled trials to date. For the treatment of chronic daily headache including medication overuse headache, there is some positive evidence for efficacy in a subgroup of patients. To date, the majority of double-blind and placebo-controlled studies do not suggest that botulinum toxin A is efficacious in the treatment of chronic idiopathic headache disorders. However, it is possible that some subgroups of patients with chronic daily headache will benefit from a long-term treatment with botulinum toxin A.Keywords: botulinum toxin A, chronic daily headache, chronic tension-type headache, chronic migraine

  16. Behavioral patterns associated with chemotherapy-induced emesis: A potential signature for nausea in musk shrews

    Directory of Open Access Journals (Sweden)

    Charles Christopher Horn

    2011-07-01

    Full Text Available Nausea and vomiting are common symptoms in patients with many diseases, including cancer and its treatments. Although the neurological basis of vomiting is reasonably well known, an understanding of the physiology of nausea is lacking. The primary barrier to mechanistic research on the nausea system is the lack of an animal model. Indeed investigating the effects of anti-nausea drugs in preclinical models is difficult because the primary readout is often emesis. It is known that animals show a behavioral profile of sickness, associated with reduced feeding and movement, and possibly these general measures are signs of nausea. Studies attempting to relate the occurrence of additional behaviors to emesis have produced mixed results. Here we applied a statistical method, t-pattern (temporal pattern analysis, to determine patterns of behavior associated with emesis. Musk shrews were injected with the chemotherapy agent cisplatin (a gold standard in emesis research to induce acute (< 24 h and delayed (> 24 h emesis. Emesis and other behaviors were coded and tracked from video files. T-pattern analysis revealed hundreds of non-random patterns of behavior associated with emesis, including sniffing, changes in body contraction, and locomotion. There was little evidence that locomotion was inhibited by the occurrence of emesis. Eating and drinking, and other larger body movements including rearing, grooming, and body rotation, were significantly less common in emesis-related behavioral patterns in real versus randomized data. These results lend preliminary evidence for the expression of emesis-related behavioral patterns, including reduced ingestive behavior, grooming and exploratory behaviors. In summary, this statistical approach to behavioral analysis in a pre-clinical emesis research model could be used to assess the more global effects and limitations of drugs used to control nausea and its potential correlates, including reduced feeding and

  17. Use of granisetron transdermal system in the prevention of chemotherapy-induced nausea and vomiting: a review

    International Nuclear Information System (INIS)

    Tuca, Albert

    2009-01-01

    Until now only intravenous and oral formulations of 5HT 3 receptor antagonists have been available. Recently a new formulation of a 5HT 3 receptor antagonist, transdermal granisetron, has been developed, and approved by the FDA. Three phase I studies to evaluate its pharmacokinetic profile have shown that granisetron administered by a transdermal delivery system is absorbed by passive diffusion and maximal concentration is reached 48 hours after patch application. The patch of 52 cm 2 , which contains 34.3 mg of granisetron, releases 3.3 mg of the drug every day and maintains a stable average plasma concentration of 2.2 ng/mL over 6 days, similar to levels obtained with 2 mg of oral granisetron, administered every day during the same period of time. Two randomized as yet unpublished clinical trials (phase II/III) have been conducted to evaluate the antiemetic efficacy of transdermal granisetron in chemotherapy-induced nausea and vomiting, in patients receiving moderately and highly emetogenic chemotherapy, compared with 2 mg of oral granisetron. More than 800 cancer patients were included in the trials. The rate of complete control of acute emesis was 49% for the phase II trial and 60% for the phase III trial. Neither trial showed a statistically significant difference between transdermal and oral granisetron. The control of delayed emesis was observed in 46% of patients, and there were no statistically significant differences between transdermal and oral granisetron. The most common adverse effects in both trials were constipation (<7%) and headache (<1%); there were no statistically significant differences between transdermal and oral granisetron. These data show that transdermal granisetron is effective and safe in controlling acute emesis induced by chemotherapy with both moderate and high emetogenic potential. Efficacy and safety of transdermal granisetron are fully comparable with that of oral granisetron. More clinical trials using regimens of 2 or 3 drugs

  18. Aprepitant: a promising antiemetic for prevention of chemotherapy-induced nausea and vomiting

    International Nuclear Information System (INIS)

    Aseeri, Mohamad A.

    2006-01-01

    Most patients who undergo chemotherapy have noted that nausea and vomiting are the most feared and distressing side-effects of cancer treatment (1). Nausea and vomiting from chemotherapy can be classified as acute, delayed, or anticipatory. Acute emesis generally occurs within 24 hours of chemotherapy administration; while delayed nausea and vomiting begin 24 hours after chemotherapy and may continue for up to one week. Anticipatory emesis occurs prior to chemotherapy in patients who anticipate another episode by sight, odors or memory of the place where acute nausea and vomiting occurred (2, 3). Different neurotransmitters found in the gastrointestinal tract (GIT) and central nervous system (CNS) mediate the pathophysiology of chemotherapy induced nausea and vomiting (CINV). These include dopamine, histamine, acetycholine, serotonin, and substance P; which act directly and indirectly on the vomiting center located in the lateral reticular formation of the medulla (1, 4). Substance P is a member of the tachykinins family of neuropeptides. The biological activity of this substance is to induce vomiting mediated by neurokinin-1 (NK1) receptors located primarily in the GIT and the CNS (5). Both Nk1 receptors and substance P play a significant role in the pathogenesis of acute and delayed CINV. (author)

  19. "WHICH Headache to Investigate, WHEN, and HOW?"

    Science.gov (United States)

    Ravishankar, K

    2016-11-01

    Headache is a common problem in medical practice. The International Classification of Headache Disorders (ICHD-3 beta) 1 divides all headaches into two broad categories. Most headaches seen in practice belong to the category of primary headaches, where there is no underlying structural cause identifiable. Less than 10% headaches in practice belong to the category of secondary headaches where there is an underlying condition, that can sometimes be ominous and life-threatening. Fear of missing a treatable serious secondary headache disorder is the most important reason why we need to investigate headache patients. There is no dilemma in investigating the patient when the clinical presentation is straightforward but when the headache presents differently or with 'red flags,' it can sometimes be quite challenging to order the right investigation and rapidly arrive at the right diagnosis. This article looks at some of the elusive headache scenarios and outlines an approach that addresses the issue of 'appropriate' investigation in the headache patient. With advancing technology and increasing expertise, the author feels it is time now to do away with the practice of ordering an exhaustive battery of tests in all headache patients. With experience, clinicians can learn to choose tests judiciously and order specific tests based on a working diagnosis. As the title suggests, knowing 'WHEN to order WHAT test in WHICH headache patient? ' forms the theme of this article. © 2016 American Headache Society.

  20. Diagnostic and Therapeutic Problems of Geriatric Headache

    Directory of Open Access Journals (Sweden)

    Kaviyan Ghandehari

    2007-07-01

    Full Text Available There is no difference in clinical characteristics of headache between old individuals and younger’s. However, differential diagnosis of migrainous aura and transient ischemic attacks may be difficult in old people who frequently have vascular risk factors. Old people have less headache than the young’s. Chronic tension headache is the most common primary type of headache in the elderly. Chronic paroxismal hemicrania and headache due to giant cell arterities are specified to the elderly, Secondary headaches; e.g headache due to cervical spondylosis and brain tumors is more common in the old people than young. Old people poorly tolerate headache drugs, i.e. Ergotamine, Triptans and Tricyclics. Trigeminal neuralgia is often seen in the elderly and is resistant to medical therapy in the old people. Headache could be the main manifestation of depression in old people. Headaches secondary to disorders of internal medicine; i.e. hypertension and chronic obstructive pulmonary disease have importance in the elderly. Subarachnoid hemorrhage is considered in every old person with sudden onset explosive headache especially in cases with decreased consciousness and neck stiffness. Old individuals use a collection of different drugs due to suffering various diseases and commonly have drug induced headaches. Neuroimaging should be performed in a geriatric patient with new onset sever headache without medical disorder or consumption of drug induced headache. Some of the old people suffer of multiple types of headache.

  1. Management of patients with headache and cervicalgia in outpatient practice

    Directory of Open Access Journals (Sweden)

    E. A. Chechet

    2015-01-01

    Full Text Available The management of patients with headache (cephalgia concurrent with neck pain (cervicalgia remains an urgent problem of modern medicine. Concurrent cervicalgia in cephalgia substantially lowers quality of life in these patients and is encountered in more than half the patients. Cervicalgia is considered as a risk factor of migraine and tension headache attacks. Cervicogenic headache is assigned to one of the most common forms of secondary cephalgias. It is shown that patients with daily headache have functional insufficiency of the antinociceptive system that plays an important role in the maintenance and chronization of neck pain. The diagnosis of different cephalgic syndromes and the identification of causes of cervicalgia commonly raise problems in a physician; the rate of misdiagnoses and hence inadequate treatment has been high so far. The detection of various comorbid conditions, including cervicalgia, in a patient with cephalgia makes it possible to use effective treatment and to achieve good results.

  2. Quantitative evaluation of headache severity before and after endoscopic transsphenoidal surgery for pituitary adenoma.

    Science.gov (United States)

    Wolf, Amparo; Goncalves, Sandy; Salehi, Fateme; Bird, Jeff; Cooper, Paul; Van Uum, Stan; Lee, Donald H; Rotenberg, Brian W; Duggal, Neil

    2016-06-01

    OBJECT The relationship between headaches, pituitary adenomas, and surgical treatment of pituitary adenomas remains unclear. The authors assessed the severity and predictors of self-reported headaches in patients referred for surgery of pituitary adenomas and evaluated the impact of endoscopic transsphenoidal surgery on headache severity and quality of life (QOL). METHODS In this prospective study, 79 patients with pituitary adenomas underwent endoscopic transsphenoidal resection and completed the Headache Impact Test (HIT-6) and the 36-Item Short Form Health Survey (SF-36) QOL questionnaire preoperatively and at 6 weeks and 6 months postoperatively. RESULTS Preoperatively, 49.4% of patients had mild headache severity, 13.9% had moderate severity, 13.9% had substantial severity, and 22.8% had intense severity. Younger age and hormone-producing tumors predisposed greater headache severity, while tumor volume, suprasellar extension, chiasmal compression, and cavernous sinus invasion of the pituitary tumors did not. Preoperative headache severity was found to be significantly associated with reduced scores across all SF-36 QOL dimensions and most significantly associated with mental health. By 6 months postoperatively, headache severity was reduced in a significant proportion of patients. Of the 40 patients with headaches causing an impact on daily living (moderate, substantial, or intense headache), 70% had improvement of at least 1 category on HIT-6 by 6 months postoperatively, while headache worsened in 7.6% of patients. The best predictors of headache response to surgery included younger age, poor preoperative SF-36 mental health score, and hormone-producing microadenoma. CONCLUSIONS The results of this study confirm that surgery can significantly improve headaches in patients with pituitary adenomas by 6 months postoperatively, particularly in younger patients whose preoperative QOL is impacted. A larger multicenter study is underway to evaluate the long

  3. Mid-cycle headaches and their relationship to different patterns of premenstrual stress symptoms.

    Science.gov (United States)

    Kiesner, Jeff; Martin, Vincent T

    2013-06-01

    Recent research has shown that affective changes associated with the menstrual cycle may follow diverse patterns, including a classic premenstrual syndrome pattern, as well as the mirror opposite pattern, referred to as a mid-cycle pattern. Test for the presence of a mid-cycle pattern of headaches, in addition to a menstrual pattern and a noncyclic pattern; test for an association between experiencing a specific pattern of headaches and a specific (previously identified) pattern of depression/anxiety; and test for mean-level differences, across headache pattern groups, in average headache index and depression/anxiety scores (averaged across 2 menstrual cycles for each participant). A sample of 213 female university students completed daily questionnaires regarding symptoms of headaches and depression/anxiety for 2 menstrual cycles. Hierarchical linear modeling, polynomial multiple regression, analyses of variance, and chi-square analyses were used to test the hypotheses. Confirmed the existence of a mid-cycle pattern of headaches (16%), in addition to a menstrual pattern (51%), and a noncyclic pattern of headaches (33%). Patterns of headaches and affective change were significantly associated (χ(2) = 21.33, P = .0003; 54% correspondence), as were the average headache index and depression/anxiety scores (r = .49; P headache pattern groups on the average headache index scores or depression/anxiety scores. A significant number of women experience a mid-cycle pattern of headaches during the menstrual cycle. Moreover, women often, but not always, demonstrate the same pattern of headaches and depression/anxiety symptoms. © 2013 American Headache Society.

  4. Risk factors for headache in the UK military: cross-sectional and longitudinal analyses.

    Science.gov (United States)

    Rona, Roberto J; Jones, Margaret; Goodwin, Laura; Hull, Lisa; Wessely, Simon

    2013-05-01

    To assess the importance of service demographic, mental disorders, and deployment factors on headache severity and prevalence, and to assess the impact of headache on functional impairment. There is no information on prevalence and risk factors of headache in the UK military. Recent US reports suggest that deployment, especially a combat role, is associated with headache. Such an association may have serious consequences on personnel during deployment. A survey was carried out between 2004 and 2006 (phase 1) and again between 2007 and 2009 (phase 2) of randomly selected UK military personnel to study the health consequences of the Iraq and Afghanistan wars. This study is based on those who participated in phase 2 and includes cross-sectional and longitudinal analyses. Headache severity in the last month and functional impairment at phase 2 were the main outcomes. Forty-six percent complained of headache in phase 2, half of whom endorsed moderate or severe headache. Severe headache was strongly associated with probable post-traumatic stress disorder (multinomial odds ratio [MOR] 9.6, 95% confidence interval [CI] 6.4-14.2), psychological distress (MOR 6.15, 95% CI 4.8-7.9), multiple physical symptoms (MOR 18.2, 95% CI 13.4-24.6) and self-reported mild traumatic brain injury (MOR 3.5, 95% CI 1.4-8.6) after adjustment for service demographic factors. Mild headache was also associated with these variables but at a lower level. Moderate and severe headache were associated with functional impairment, but the association was partially explained by mental disorders. Mental ill health was also associated with reporting moderate and severe headache at both phase 1 and phase 2. Deployment and a combat role were not associated with headache. Moderate and severe headache are common in the military and have an impact on functional impairment. They are more strongly associated with mental disorders than with mild traumatic brain injury. © 2013 American Headache Society.

  5. Tension-Type Headache - The Normal and Most Prevalent Headache.

    Science.gov (United States)

    Jensen, Rigmor Højland

    2018-02-01

    Tension-type headache (TTH) is the most prevalent form of primary headache in the general population but paradoxically the least studied headache. In this article, the epidemiology and diagnostic challenges of TTH are presented and discussed. The typical features and differential diagnosis of TTH are highlighted and the situations more likely to raise doubts are discussed. A structured approach to the patient and a better comprehension of the very frequent coexistence of migraine and medication overuse headache in the clinical population are emphasized. According to the IHS classification, several diagnoses should be applied but still some clinicians prefer to apply a single combined diagnosis in the severely affected patients, namely chronic migraine. Such uneven practice may complicate the diagnostic comparability and the entire management of TTH. The present treatment strategies for TTH are summarized and hopefully an increased awareness of TTH can translate into better quality of care and a more specific diagnosis and treatment for the numerous TTH sufferers. © 2017 American Headache Society.

  6. Anticipatory Nausea, Risk Factors, and Its Impact on Chemotherapy-Induced Nausea and Vomiting: Results From the Pan European Emesis Registry Study.

    Science.gov (United States)

    Molassiotis, Alexander; Lee, Paul H; Burke, Thomas A; Dicato, Mario; Gascon, Pere; Roila, Fausto; Aapro, Matti

    2016-06-01

    Anticipatory (prechemotherapy) nausea (AN) is a classic conditioned symptom not responding well to current antiemetics. Minimal work has been done to assess its risk factors and impact on chemotherapy-induced nausea and vomiting (CINV). To evaluate risk factors for AN and assess its impact on CINV development. We analyzed data (n = 991) from a prospective observational multisite study in eight European countries over three cycles of chemotherapy. Patient/treatment characteristics were collected before chemotherapy. History of nausea/vomiting (yes/no), patient expectation of CINV (0-100 mm visual analog scale, [VAS]), and prechemotherapy anxiety (0-100 mm VAS) also were collected before chemotherapy. A patient-completed diary during each chemotherapy cycle obtained information on AN in the 24 hours before chemotherapy administration and nausea and vomiting (episodes of vomiting and severity of nausea) daily for five days after administration of chemotherapy (0-100 mm VAS). AN was reported by 8.3%-13.8% of patients, increasing in frequency and intensity over each cycle. Every 1 mm increase in AN on the VAS was significantly associated with 2%-13% of increase in the likelihood of CINV (all P-values <0.05). Key predictors of AN in Cycle 1 included metastatic disease and prechemotherapy anxiety. However, predictors of AN in subsequent cycles included prechemotherapy anxiety and AN and CINV experience in the previous cycle, the latter being the strongest predictor (odds ratio = 3.30-4.09 for CINV outcomes over the cycles). AN is a challenging symptom, and its prevention needs to consider better CINV prevention in the previous cycles as well as managing prechemotherapy anxiety. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  7. Prediction of tension-type headache risk in adolescents

    Directory of Open Access Journals (Sweden)

    K. A. Stepanchenko

    2016-08-01

    Full Text Available Tension-type headache is the actual problem of adolescent neurology, which is associated with the prevalence of the disease, the tendency of the disease to the chronic course and a negative impact on performance in education, work capacity and quality of patients’ life. The aim. To develop a method for prediction of tension-type headache occurrence in adolescents. Materials and methods. 2342 adolescent boys and girls at the age of 13-17 years in schools of Kharkiv were examined. We used questionnaire to identify the headache. A group of adolescents with tension-type headache - 1430 people (61.1% was selected. The control group included 246 healthy adolescents. Possible risk factors for tension-type headache formation were divided into 4 groups: genetic, biomedical, psychosocial and social. Mathematical prediction of tension-type headache risk in adolescents was performed using the method of intensive indicators normalization of E.N. Shigan, which was based on probabilistic Bayesian’s method. The result was presented in the form of prognostic coefficients. Results. The most informative risk factors for tension-type headache development were the diseases, from which the teenager suffered after 1 year (sleep disorders, gastrointestinal diseases, autonomic disorders in the family history, traumatic brain injury, physical inactivity, poor adaptation of the patient in the kindergarten and school, stresses. Diagnostic scale has been developed to predict the risk of tension-type headache. It includes 23 prognostic factors with their gradation and meaning of integrated risk indicator, depending on individual factor strength influence. The risk of tension-type headache development ranged from 25,27 to 81,43 values of prognostic coefficient (low probability (25,27-43,99, the average probability (43,99-62,71 and high probability (62,71- 81,43. Conclusion. The study of tension-type headache risk factors, which were obtained by using an assessed and

  8. Benign vascular sexual headache and exertional headache: interrelationships and long term prognosis.

    OpenAIRE

    Silbert, P L; Edis, R H; Stewart-Wynne, E G; Gubbay, S S

    1991-01-01

    There is a definite relationship between the vascular type of benign sexual headache and benign exertional headache. Forty five patients with benign vascular sexual headache were reviewed. Twenty seven (60%) experienced benign vascular sexual headache alone and eighteen (40%) had experienced both benign vascular sexual headache and benign exertional headache on at least one occasion. The mean age was 34.3 years with a male:female ratio of 5.4:1. Thirty patients with a history of benign vascul...

  9. New-Onset Headache in Patients With Autoimmune Encephalitis Is Associated With anti-NMDA-Receptor Antibodies.

    Science.gov (United States)

    Schankin, Christoph J; Kästele, Fabian; Gerdes, Lisa Ann; Winkler, Tobias; Csanadi, Endy; Högen, Tobias; Pellkofer, Hannah; Paulus, Walter; Kümpfel, Tania; Straube, Andreas

    2016-06-01

    We tested the hypotheses (i) that autoimmune encephalitis is associated with new-onset headache, and (ii) that the occurrence of headache is associated with the presence of anti-N-methyl-D-aspartate (NMDA)-receptor antibodies. Autoimmune encephalitis presents with cognitive dysfunction as well as neuro-psychiatric symptoms. Its pathophysiology might involve antibody-mediated dysfunction of the glutamatergic system as indicated by the presence of anti-NMDA-receptor antibodies in some patients. In this cross-sectional study, patients with autoimmune encephalitis were assessed with a standardized interview for previous headache and headache associated with autoimmune encephalitis. Headache was classified according to the International Classification of Headache Disorders, second edition. Clinical and paraclinical findings were correlated with the occurrence of headache. Of 40 patients with autoimmune encephalitis, 19 did not have a history of headache. Of those, nine suffered from encephalitis-associated headache. Seven of these nine had anti-NMDA-receptor antibodies in contrast to only two among the remaining 10 patients without new-onset headache (P = .023, odds ratio: 14, 95% confidence interval: 1.5; 127). In most patients headache occurred in attacks on more than 15 days/month, was severe, and of short duration (less than 4 hours). International Headache Society criteria for migraine were met in three patients. New-onset headache is a relevant symptom in patients with autoimmune encephalitis who have no history of previous headache, especially in the subgroup with anti-NMDA-receptor antibodies. This indicates a thorough investigation for secondary headaches including anti-NMDA-R antibodies for patients with new-onset headache and neuropsychiatric findings. Glutamatergic dysfunction might be important for the generation of head pain but may only occasionally be sufficient to trigger migraine-like attacks in nonmigraineurs. © 2016 American Headache Society.

  10. Headache during airplane travel ("airplane headache"): first case in Greece.

    Science.gov (United States)

    Kararizou, Evangelia; Anagnostou, Evangelos; Paraskevas, George P; Vassilopoulou, Sofia D; Naoumis, Dimitrios; Kararizos, Grigoris; Spengos, Konstantinos

    2011-08-01

    Headache related to airplane flights is rare. We describe a 37-year-old female patient with multiple intense, jabbing headache episodes over the last 3 years that occur exclusively during airplane flights. The pain manifests during take-off and landing, and is located always in the left retro-orbital and frontotemporal area. It is occasionally accompanied by dizziness, but no additional symptoms occur. Pain intensity diminishes and disappears after 15-20 min. Apart from occasional dizziness, no other symptoms occur. The patient has a history of tension-type headache and polycystic ovaries. Blood tests and imaging revealed no abnormalities. Here, we present the first case in Greece. We review the current literature on this rare syndrome and discuss on possible pathophysiology and the investigation of possible co-factors such as anxiety and depression.

  11. Adherence to headache treatment and profile of previous health professional seeking among patients with chronic headache: a retrospective analysis.

    Science.gov (United States)

    Krymchantowski, Abouch Valenty; Adriano, Marcus Vinicius; de Góes, Renemilda; Moreira, Pedro Ferreira; da Cunha Jevoux, Carla

    2007-04-26

    Chronic headache is common among patients in neurology clinics. Patients may suffer important economic and social losses because of headaches, which may result in high expectations for treatment outcomes. When their treatment goals are not reached quickly, treatment may be difficult to maintain and patients may consult with numerous health professionals. This retrospective study evaluated the relationship between treatment and the profiles of previous health professionals consulted by patients in a tertiary headache center. The records were reviewed of all patients from a headache center who were seen in initial consultation between January 2000 and June 2003. Data related to patient demographic characteristics (sex and age), headache diagnosis, and the profile (quality and quantity) of previous healthcare consultations exclusively related to headache, were collected. The headache diagnoses were confirmed according to the IHS criteria (1988) and to the Silberstein criteria (1994,1996). Although adherence includes taking the prescribed medicines, discontinuing overused symptomatic medications, and changing behavior, among other things, for this study, adherence was defined as when the patient returned at least 2 times within a 3- to 3.5-month period. Patients were separated into groups depending on the number of different healthcare professionals they had consulted, from none to more than 7. Data from 495 patients were analyzed; 357 were women and 138 were men (ages 6 to 90 years; mean, 41.1 +/- 15.05 years). The headache diagnoses included migraine without aura (43.2%), chronic (transformed) migraine (40%), cluster headache (6.5%), episodic tension-type headache (0.8%), and hemicrania continua (0.4%). The 24.2% of patients who sought care from no more than 1 health professional showed a 59.8% adherence rate; 29% of the total had consulted 7 or more health professionals and showed an adherence rate of 74.3% (P = .0004). In Brazil, the belief is widespread that

  12. Psychological functioning in headache sufferers.

    Science.gov (United States)

    Andrasik, F; Blanchard, E B; Arena, J G; Teders, S J; Teevan, R C; Rodichok, L D

    1982-05-01

    The present study examined the psychological test responses of 99 headache sufferers and 30 matched nonheadache controls. Headache subjects were of four types: migraine (n = 26), muscle contraction (n = 39), combined migraine-muscle contract ion (n = 22), and cluster (n = 12). Measures consisted of the Minnesota Multiphasic Personality Inventory, a modified hostility scale derived from the MMPI, Back Depression Inventory, State-Trait Anxiety Inventory, Autonomic Perception Questionnaire, Rathus Assertiveness Schedule, Social Readjustment Rating Scale, Psychosomatic Symptom Checklist, Schalling-Sifneos Scale, Need for Achievement, and Hostile Press. Significant differences were found on five clinical scales of the MMPI--1, 2, 3, 6, and 7. Of the non-MMPI scales, only the Psychosomatic Symptom Checklist and Trait Anxiety Inventory were significant. Control subjects revealed no significant findings on any tests. The headache groups fell along a continuum, beginning with cluster subjects, who showed only minimal distress, continuing through migraine and combined migraine-muscle contraction, and ending with muscle contraction subjects, who revealed the greatest degree of psychological disturbance. However, none of the headache groups could be characterized by marked elevations on any of the psychological tests, which contrasts with past research findings. It is suggested that the present results may be more representative of the "typical" headache sufferer.

  13. Application of ICHD-II Criteria in a Headache Clinic of China

    Science.gov (United States)

    Dong, Zhao; Di, Hai; Dai, Wei; Liang, Jingyao; Pan, Meiyan; Zhang, Mingjie; Zhou, Zhibin; Li, Zheng; Liu, Ruozhuo; Yu, Shengyuan

    2012-01-01

    Background China has the huge map and the largest population in the world. Previous studies on the prevalence and classification of headaches were conducted based on the general population, however, similar studies among the Chinese outpatient population are scarce. This study aimed to analyze the characteristics of 1843 headache patients enrolled in a North China headache clinic of the General Hospital for Chinese People's Liberation Army from October 2011 to May 2012, with the International Classification of Headache Disorders, 2nd Edition (ICHD-II). Methods and Results Personal interviews were carried out and a detailed questionnaire was used to collect medical records including age, sex and headache characteristics. Patients came from 28 regions of China with the median age of 40.9 (9–80) years and the female/male ratio of 1.67/1. The primary headaches (78.4%) were classified as the following: migraine (39.1%), tension-type headache (32.5%), trigeminal autonomic cephalalgias (5.3%) and other primary headache (1.5%). Among the rest patients, 12.9% were secondary headaches, 5.9% were cranial neuralgias and 2.5% were unspecified or not elsewhere classified. Fourteen point nine percent (275/1843) were given an additional diagnosis of chronic daily headache, including medication-overuse headache (MOH, 49.5%), chronic tension-type headache (CTTH, 32.7%) and chronic migraine (CM, 13.5%). The visual analogue scale (VAS) score of TTH with MOH was significantly higher than that of CTTH (6.8±2.0 vs 5.6±2.0, Pheadache clinic outpatients in a tertiary hospital of North China that migraine is the most common diagnosis. Furthermore, most headaches in this patient population can be classified using ICHD-II criteria. PMID:23239993

  14. Cluster headache - clinical pattern and a new severity scale in a Swedish cohort.

    Science.gov (United States)

    Steinberg, Anna; Fourier, Carmen; Ran, Caroline; Waldenlind, Elisabet; Sjöstrand, Christina; Belin, Andrea Carmine

    2018-06-01

    Background The aim of this study was to investigate clinical features of a cluster headache cohort in Sweden and to construct and test a new scale for grading severity. Methods Subjects were identified by screening medical records for the ICD 10 code G44.0, that is, cluster headache. Five hundred participating research subjects filled in a questionnaire including personal, demographic and medical aspects. We constructed a novel scale for grading cluster headache in this cohort: The Cluster Headache Severity Scale, which included number of attacks per day, attack and period duration. The lowest total score was three and the highest 12, and we used the Cluster Headache Severity Scale to grade subjects suffering from cluster headache. We further implemented the scale by defining a cluster headache maximum severity subgroup with a high Cluster Headache Severity Scale score ≥ 9. Results A majority (66.7%) of the patients reported that attacks appear at certain time intervals. In addition, cluster headache patients who were current tobacco users or had a history of tobacco consumption had a later age of disease onset (31.7 years) compared to non-tobacco users (28.5 years). The Cluster Headache Severity Scale score was higher in the patient group reporting sporadic or no alcohol intake than in the groups reporting an alcohol consumption of three to four standard units per week or more. Maximum severity cluster headache patients were characterised by higher age at disease onset, greater use of prophylactic medication, reduced hours of sleep, and lower alcohol consumption compared to the non-cluster headache maximum severity group. Conclusion There was a wide variation of severity grade among cluster headache patients, with a very marked impact on daily living for the most profoundly affected.

  15. Epicrania fugax: 19 cases of an emerging headache.

    Science.gov (United States)

    Cuadrado, María Luz; Ordás, Carlos M; Sánchez-Lizcano, María; Casas-Limón, Javier; Matías-Guiu, Jordi A; García-García, María Eugenia; Fernández-Matarrubia, Marta; Barahona-Hernando, Raúl; Porta-Etessam, Jesús

    2013-05-01

    Epicrania fugax (EF) is a primary headache of recent description. We aimed to report 19 new cases of EF, and thus contribute to the characterization of this emerging headache. EF is characterized by painful paroxysms starting in a particular area of the head, and rapidly radiating forwards or backwards through the territories of different nerves. The pain is felt in quick motion along a lineal or zigzag trajectory. To date, 47 cases have been published, 34 with forward EF and 13 with backward EF. We performed a descriptive study of all EF cases attending our Headache Unit from April 2010 to December 2012. Demographic and clinical data were recorded with a structured questionnaire. Overall, there were 12 women and 7 men. Mean age at onset was 51.7 ± 16.2. Fourteen patients had forward EF, while 5 patients had backward EF. Painful paroxysms lasted 1-4 seconds. Pain intensity was usually moderate or severe, and pain quality was mostly electric. Four patients had ocular autonomic accompaniments. Pain frequency was extremely variable, and 7 patients identified some triggers. Between attacks, 13 patients had some pain or tenderness in the stemming area. Thirteen patients required therapy for their pain. Neuromodulators, indomethacin, anesthetic blockades, and steroid injections were used in different cases, with partial or complete response. EF appears as a distinct headache syndrome and could be eventually included in future editions of the International Classification of Headache Disorders. © 2013 American Headache Society.

  16. Indications for computerized tomography in the case of headache

    International Nuclear Information System (INIS)

    Huk, W.J.

    1987-01-01

    Of the large number of patients with headache only very few suffer from an intracranial tumor. On the other hand, brain tumors may grow silently for a long period of time. Clinical analysis of patients with headache has demonstrated that a CT-scan is not indicated in cases where an adequate cause can be found and when the headache disappears together with the underlaying cause in a reasonable amount of time. A CT-scan, however, should be performed when an adequate cause is missing, when the headache recurs with increasing frequency, intensity and duration, when it is accentuated in the morning and in certain positions, and when it is associated with personality chances, dizziness and blurred vision. In chronic headache a CT-scan is indicated when a change in the character of the headache and its various qualities (location, frequency and duration of attacks, temporal coincidence etc.) can be detected. A thorough history, including the family history, of the complains together with an accurate clinical examination will deliver the criteria to avoid unnecessary CT-scanning. (orig.) [de

  17. Headache impact of chronic and episodic migraine: results from the American Migraine Prevalence and Prevention study.

    Science.gov (United States)

    Buse, Dawn; Manack, Aubrey; Serrano, Daniel; Reed, Michael; Varon, Sepideh; Turkel, Catherine; Lipton, Richard

    2012-01-01

    The Headache Impact Test-6 (HIT-6) has been demonstrated to be a reliable and valid measure that assesses the impact of headaches on the lives of persons with migraine. Originally used in studies of episodic migraine (EM), HIT-6 is finding increasing applications in chronic migraine (CM) research. (1) To examine the headache-impact on persons with migraine (EM and CM) using HIT-6 in a large population sample; (2) to identify predictors of headache-impact in this sample; (3) to assess the magnitude of effect for significant predictors of headache-impact in this sample. The American Migraine Prevalence and Prevention study is a longitudinal, population-based study that collected data from persons with severe headache from 2004 to 2009 through annual, mailed surveys. Respondents to the 2009 survey who met International Classification of Headache Disorders 2 criteria for migraine reported at least 1 headache in the preceding year, and completed the HIT-6 questionnaire were included in the present analysis. Persons with migraine were categorized as EM (average headache days per month) or CM (average ≥15 headache days per month). Predictors of headache-impact examined include: sociodemographics; headache days per month; a composite migraine symptom severity score (MSS); an average pain severity rating during the most recent long-duration headache; depression; and anxiety. HIT-6 scores were analyzed both as continuous sum scores and using the standard, validated categories: no impact; some impact; substantial impact; and severe impact. Group contrasts were based on descriptive statistics along with linear regression models. Multiple imputation techniques were used to manage missing data. There were 7169 eligible respondents (CM = 373, EM = 6554). HIT-6 scores were normally distributed. After converting sum HIT-6 scores to the standard categories, those with CM were significantly more likely to experience "severe" headache impact (72.9% vs 42.3%) and had higher odds of

  18. The Association Between Headaches and Temporomandibular Disorders is Confounded by Bruxism and Somatic Symptoms.

    Science.gov (United States)

    van der Meer, Hedwig A; Speksnijder, Caroline M; Engelbert, Raoul H H; Lobbezoo, Frank; Nijhuis-van der Sanden, Maria W G; Visscher, Corine M

    2017-09-01

    The objective of this observational study was to establish the possible presence of confounders on the association between temporomandibular disorders (TMD) and headaches in a patient population from a TMD and Orofacial Pain Clinic. Several subtypes of headaches have been diagnosed: self-reported headache, (probable) migraine, (probable) tension-type headache, and secondary headache attributed to TMD. The presence of TMD was subdivided into 2 subtypes: painful TMD and function-related TMD. The associations between the subtypes of TMD and headaches were evaluated by single regression models. To study the influence of possible confounding factors on this association, the regression models were extended with age, sex, bruxism, stress, depression, and somatic symptoms. Of the included patients (n=203), 67.5% experienced headaches. In the subsample of patients with a painful TMD (n=58), the prevalence of self-reported headaches increased to 82.8%. The associations found between self-reported headache and (1) painful TMD and (2) function-related TMD were confounded by the presence of somatic symptoms. For probable migraine, both somatic symptoms and bruxism confounded the initial association found with painful TMD. The findings of this study imply that there is a central working mechanism overlapping TMD and headache. Health care providers should not regard these disorders separately, but rather look at the bigger picture to appreciate the complex nature of the diagnostic and therapeutic process.

  19. Chronic daily headache with analgesics overuse in professional women breath-hold divers.

    Science.gov (United States)

    Choi, Jay Chol; Lee, Jung Seok; Kang, Sa-Yoon; Kang, Ji-Hoon; Bae, Jong-Myon

    2008-07-01

    The object of this study is to investigate the prevalence and characteristics of headache in Korean professional women breath-hold divers, including their overuse of analgesics. Headache is a common problem encountered in clinical practice, and undersea divers exhibit unique causes of headache in addition to other common primary headaches. Many scuba divers are known to use various types of drugs to overcome dive-related symptoms or to enhance their underwater performance. The target population of this study was women divers in the northern district of Jeju Island who were registered in the divers' union. Data were collected using telephone interviews with a structured questionnaire. Headache was diagnosed and classified according to criteria of the International Headache Society. Nine hundred and eleven (80.3%) divers responded to the telephone interview. The prevalence rates of headache were 21.4% for tension-type headache and 9.1% for migraine. One hundred and four divers (11.4%) fulfilled the criteria for chronic daily headache (CDH). Overuse of combination analgesics was reported by 70.7% of divers. Women divers with CDH were significantly older and they complained more of tinnitus and dizziness, and had a greater history of hypertension than divers without headache. The prevalence of CDH is high in Korean professional women breath-hold divers, with many of them being combination-analgesics overusers.

  20. The influence of excessive chewing gum use on headache frequency and severity among adolescents.

    Science.gov (United States)

    Watemberg, Nathan; Matar, Manar; Har-Gil, Miki; Mahajnah, Muhammad

    2014-01-01

    Excessive gum-chewing is underreported as a headache precipitant in children and adolescents. We evaluated the influence of daily excessive gum-chewing in older children and teenagers with chronic headache, emphasizing the impact of habit discontinuation and its reintroduction. Patients with chronic headache and excessive gum-chewing were consecutively recruited and asked to fill questionnaire pertaining headache characteristics, potential triggers, family history of headaches, and gum-chewing habits. These individuals were classified into four groups depending on the number of daily hours of gum-chewing. All children discontinued chewing for 1 month, reintroduced the habit, and were reinterviewed after 2 to 4 weeks. Thirty patients (25 girls) were recruited. Median age was 16 years. Most had migraine-like headaches. Following gum-chewing discontinuation, 26 reported significant improvement, including headache resolution in 19. All 20 patients reinstituting the habit reported symptom relapse within days. Duration of headache before discontinuation and the number of daily hours of chewing had no influence on the response to habit discontinuation. Excessive daily gum-chewing may be associated with chronic headache and should get more attention in the medical literature. Physician and patient awareness of this association could have a meaningful impact on the quality of life of children and adolescents with chronic headache who chew gum excessively. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Effect of Flunarizine on Serum Glutamate Levels and its Correlation with Headache Intensity in Chronic Tension-Type Headache Patients.

    Science.gov (United States)

    Surbakti, Khairul Putra; Sjahrir, Hasan; Juwita-Sembiring, Rosita; Mutiara, Erna

    2017-10-15

    Some of the excitatory neurotransmitters including glutamate have been suggested to be involved in headache pathophysiology. To our knowledge, there is a lack of publication about flunarizine efficacy in chronic tension-type headache (CTTH) treatments and the roles of glutamate in CTTH pathophysiology. This study aimed to investigate the flunarizine effect on serum levels of glutamate and its correlation with headache intensity based on the Numeric Rating Scale for pain (NRS) scores in CTTH patients. In a prospective randomised, double-blind study with pre and post-test design, seventy-three CTTH patients were randomly allocated with flunarizine 5 mg, flunarizine 10 mg and amitriptyline 12.5 mg groups. The serum levels of glutamate and NRS scores were measured before and after 15-day treatment. Flunarizine 5 mg was more effective than flunarizine 10 mg and amitriptyline 12.5 mg in reducing serum glutamate levels, whereas amitriptyline 12.5 mg was the most effective in reducing headache intensity. There was found nonsignificant, but very weak negative correlation between headache intensity and serum glutamate levels after flunarizine 5 mg administration (r = -0.062; P = 0.385), nonsignificant very weak negative correlation after flunarizine 10 mg administration (r = -0.007; P = 0.488) and there was found a significant moderate positive correlation (r = 0.508; P = 0.007) between headache intensity and serum glutamate levels after amitriptyline 12.5 mg administration. Since there was no significant correlation found between serum glutamate and headache intensity after treatment with flunarizine, it is suggested that decreasing of headache intensity after flunarizine treatment occurred not through glutamate pathways in CTTH patients.

  2. Improvement in headaches with continuous positive airway pressure for obstructive sleep apnea: a retrospective analysis.

    Science.gov (United States)

    Johnson, Karin G; Ziemba, Alexis M; Garb, Jane L

    2013-02-01

    We aimed to identify clinical features in patients with severe headaches that predicted obstructive sleep apnea (OSA) and determine clinical and sleep study characteristics that predicted headache improvement with continuous positive airway pressure (CPAP). Many patients with headaches complain of sleep symptoms and have OSA. There is often improvement of headaches with CPAP treatment. We conducted a retrospective chart review of all patients referred to adult neurology clinic for headaches and sent for polysomnography between January 2008 and December 2009. Follow-up ranged from 18 to 42 months. Eighty-two headache patients (70 females, 12 males) were studied. Mean age was 45±13 years (females 45±13, males 43±11) and mean body mass index was 32±9. Headache types included 17% chronic migraine without aura, 22% episodic migraine without aura, 32% migraine with aura, 21% tension-type headache, 6% chronic post-traumatic headache, 11% medication overuse headache, and 7% other types. All patients were receiving standard treatment for their headaches by their neurologist. Fifty-two patients (63%) had OSA. Increasing age, female gender, and chronic migraine without aura were predictive of OSA. Of the patients with OSA, 33 (63%) used CPAP and 27 (82%) were adherent to CPAP. Headache improvement was reported by 40 patients (49%) due to either standard medical therapy or CPAP. Patients with OSA who were CPAP adherent (21/27) were more likely to have improvement in headaches than patients intolerant of CPAP (2/6), those that did not try CPAP (8/19), and those who did not have OSA (16/30) (P=.045). Of the 33 patients who used CPAP, 13 reported improvement in headaches specifically due to CPAP therapy and 10 additional patients noted benefit in sleep symptoms. The presence of witnessed apneas (P=.045) and male gender (P=.021) predicted improvement in headaches due to CPAP. Headache patients should be evaluated for the presence of OSA. Treating OSA improves headaches in some

  3. Analysis of Trigger Factors in Episodic Migraineurs Using a Smartphone Headache Diary Applications.

    Directory of Open Access Journals (Sweden)

    Jeong-Wook Park

    Full Text Available Various stimuli can trigger migraines in susceptible individuals. We examined migraine trigger factors by using a smartphone headache diary application.Episodic migraineurs who agreed to participate in our study downloaded smartphone headache diary application, which was designed to capture the details regarding headache trigger factors and characteristics for 3 months. The participants were asked to access the smartphone headache diary application daily and to confirm the presence of a headache and input the types of trigger factors.Sixty-two participants kept diary entries until the end of the study. The diary data for 4,579 days were analyzed. In this data set, 1,099 headache days (336 migraines, 763 non-migraine headaches were recorded; of these, 772 headache events had with trigger factors, and 327 events did not have trigger factors. The common trigger factors that were present on headache days included stress, fatigue, sleep deprivation, hormonal changes, and weather changes. The likelihood of a headache trigger was 57.7% for stress, 55.1% for sleep deprivation, 48.5% for fatigue, and 46.5% for any trigger. The headaches with trigger factors were associated with greater pain intensity (p<0.001, headache-related disability (p<0.001, abortive medication use (p = 0.02, and the proportion of migraine (p < 0.001, relative to those without trigger factors. Traveling (odd ratios [OR]: 6.4, hormonal changes (OR: 3.5, noise (OR: 2.8, alcohol (OR: 2.5, overeating (OR: 2.4, and stress (OR:1.8 were significantly associated with migraines compared to non-migraine headaches. The headaches that were associated with hormonal changes or noise were more often migraines, regardless of the preventive medication. The headaches due to stress, overeating, alcohol, and traveling were more often migraines without preventive medication, but it was not evident with preventive medication.Smartphone headache diary application is an effective tool to assess migraine

  4. Tinnitus Patients with Comorbid Headaches: The Influence of Headache Type and Laterality on Tinnitus Characteristics

    Directory of Open Access Journals (Sweden)

    Berthold Langguth

    2017-08-01

    Full Text Available BackgroundBoth clinical experience and clinical studies suggest a relationship between tinnitus and headache. Here, we aimed to investigate the influence of comorbid headache type and headache laterality on tinnitus characteristics.MethodThe Tinnitus Research Initiative database was screened for patients of the Tinnitus Center of the University Regensburg who reported comorbid headaches. These patients were contacted to complete additional validated questionnaires. Based on these data, patients were categorized according to headache type and headache laterality, and their clinical characteristics were compared with tinnitus patients, who did not report comorbid headaches.ResultsData from 193 patients with tinnitus and comorbid headaches were compared with those from 765 tinnitus patients without comorbid headaches. Tinnitus patients with comorbid headache have higher scores in tinnitus questionnaires, a lower quality of life and more frequently comorbidities such as painful sensation to loud sounds, vertigo, pain (neck, temporomandibular, and general, and depressive symptoms when compared with tinnitus patients without headaches. Both headache laterality and headache type interact with the degree of comorbidity with higher impairment in patients with left-sided and bilateral headaches as well as in patients with migraine or cluster headache.ConclusionThe observed increased impairment in tinnitus patients with comorbid headache can be explained as an additive effect of both disorders on health-related quality of life. The more frequent occurrence of further comorbidities suggests a generally increased amplification of sensory signals in a subset of tinnitus patients with comorbid headaches.

  5. Headache in children with Chiari I malformation.

    Science.gov (United States)

    Toldo, Irene; Tangari, Marta; Mardari, Rodica; Perissinotto, Egle; Sartori, Stefano; Gatta, Michela; Calderone, Milena; Battistella, Pier Antonio

    2014-05-01

    Headache is the most common symptom of Chiari 1 malformation, a condition characterized by the herniation of cerebellar tonsils through the foramen magnum. However, the headache pattern of cases with Chiari 1 malformations is not well defined in the literature, especially in children. The aim of this retrospective chart review was to evaluate the frequency and the characteristics of headache in children with Chiari 1 malformation at initial evaluation and during follow up. Forty-five cases with tonsillar ectopia were selected among 9947 cases under 18 years of age who underwent neuroimaging between 2002 and 2010. A semistructured clinical interview (mean follow-up: 5.2 years) was conducted. Headache was classified according to the second edition of the International Classification of Headache Disorders. Possible associations between clinical picture, in particular headache pattern, but also other signs and symptoms attributable to Chiari 1 malformation, and the extent of tonsillar ectopia were found for 3 different groups: those with borderline (headache, and 9/33 (27%) of those patients (5 with mild and 4 with severe tonsillar ectopia) reported headache attributed to Chiari 1 malformation. In our studied pediatric population, the most common symptom for cases diagnosed with Chiari 1 malformation was headache, and headache attributed to Chiari 1 malformation was the most common headache pattern in patients with Chiari 1 malformation. The presence of headache attributed to Chiari 1 malformation along with 3 other signs or symptoms of Chiari 1 malformation were highly predictive of severe tonsillar ectopia. © 2014 American Headache Society.

  6. Headache triggers in the US military.

    Science.gov (United States)

    Theeler, Brett J; Kenney, Kimbra; Prokhorenko, Olga A; Fideli, Ulgen S; Campbell, William; Erickson, Jay C

    2010-05-01

    Headaches can be triggered by a variety of factors. Military service members have a high prevalence of headache but the factors triggering headaches in military troops have not been identified. The objective of this study is to determine headache triggers in soldiers and military beneficiaries seeking specialty care for headaches. A total of 172 consecutive US Army soldiers and military dependents (civilians) evaluated at the headache clinics of 2 US Army Medical Centers completed a standardized questionnaire about their headache triggers. A total of 150 (87%) patients were active-duty military members and 22 (13%) patients were civilians. In total, 77% of subjects had migraine; 89% of patients reported at least one headache trigger with a mean of 8.3 triggers per patient. A wide variety of headache triggers was seen with the most common categories being environmental factors (74%), stress (67%), consumption-related factors (60%), and fatigue-related factors (57%). The types of headache triggers identified in active-duty service members were similar to those seen in civilians. Stress-related triggers were significantly more common in soldiers. There were no significant differences in trigger types between soldiers with and without a history of head trauma. Headaches in military service members are triggered mostly by the same factors as in civilians with stress being the most common trigger. Knowledge of headache triggers may be useful for developing strategies that reduce headache occurrence in the military.

  7. Epileptic seizures and headache/migraine: a review of types of association and terminology.

    Science.gov (United States)

    Cianchetti, Carlo; Pruna, Dario; Ledda, Mariagiuseppina

    2013-11-01

    There are different possible temporal associations between epileptic seizures and headache attacks which have given rise to unclear or controversial terminologies. The classification of the International League Against Epilepsy does not refer to this type of disorder, while the International Classification of Headache Disorders (ICHD-2) defines three kinds of association: (1) migraine-triggered seizure ("migralepsy"), (2) hemicrania epileptica, and (3) post-ictal headache. We performed an extensive review of the literature, not including "post-ictal" and "inter-ictal" headaches. On the basis of well-documented reports, the following clinical entities may be identified: (A) "epileptic headache (EH)" or "ictal epileptic headache (IEH)": in this condition headache (with or without migrainous features) is an epileptic manifestation per se, with onset, and cessation if isolated, coinciding with the scalp or deep EEG pattern of an epileptic seizure. EH maybe followed by other epileptic manifestations (motor/sensory/autonomic); this condition should be differentiated from "pure" or "isolated" EH, in which headache/migraine is the sole epileptic manifestation (requiring differential diagnosis from other headache forms). "Hemicrania epileptica" (if confirmed) is a very rare variant of EH, characterized by ipsilateral location of headache and ictal EEG paroxysms. (B) "Pre-ictal migraine" and "pre-ictal headache": when a headache attack is followed during, or shortly after, by a typical epileptic seizure. The migraine attack may be with or without aura, and its seizure-triggering role ("migraine-triggered seizure") is still a subject of debate. A differentiation from occipital epilepsy is mandatory. The term "migralepsy" has not been used uniformly, and may therefore led to misinterpretation. On the basis of this review we suggest definitions and a terminology which may become the basis of a forthcoming classification of headaches associated with epileptic seizures. Copyright

  8. Air movement, gender and risk of sick building headache among employees in a Jakarta office

    Directory of Open Access Journals (Sweden)

    Margaretha Winarti

    2003-09-01

    Full Text Available Even though office buildings are usually equipped with ventilation system or air conditioning to create a comfortable working environment, yet there is still found a number of sick building syndrome (SBS symptoms. One of the symptoms of SBS is SBS headache. Therefore, it is crucial to identify risk factors related to SBS headache. Cases were subjects who have suffered SBS headache, and controls were subjects who did not suffered headache for the last one month. Cases and controls were selected through a survey on all of employees in the said office during the period of May to August 2002. Total respondents were 240 employees including 36 people suffered SBS headache (15%. Compared to the normal air movement, faster air movement decreased the risk of SBS headache by 57% [adjusted odds ratio (OR = 0.43; 95% confidence intervals (CI: 0.19-0.95]. Female employees, compared to the males ones, had a higher risk of getting SBS headache by almost three times (adjusted OR = 2.96: 95% CI: 1.29-6.75. Employees who had breakfast irregularly, had a lower risk to SBS headache than those who have breakfast regularly (adjusted OR=0.31; 95% CI: 0.09-0.84. Temperature, humidity and smoking habits were not noted correlated to SBS headache. Female workers had greater risk of suffering SBS headache. In addition slower air movement increased the risk of SBS headache. Therefore, it is recommended to improve the progress of air in order to reduce the risk of SBS headache, especially for female workplace. (Med J Indones 2003; 12: 171-7Keywords: sick building syndrome headache, gender, air movement

  9. Haloperidol for the treatment of nausea and vomiting in palliative care patients.

    Science.gov (United States)

    Murray-Brown, Fay; Dorman, Saskie

    2015-11-02

    Nausea and vomiting are common symptoms in patients with terminal, incurable illnesses. Both nausea and vomiting can be distressing. Haloperidol is commonly prescribed to relieve these symptoms. This is an updated version of the original Cochrane review published in Issue 2, 2009, of Haloperidol for the treatment of nausea and vomiting in palliative care patients. To evaluate the efficacy and adverse events associated with the use of haloperidol for the treatment of nausea and vomiting in palliative care patients. For this updated review, we performed updated searches of CENTRAL, EMBASE and MEDLINE in November 2013 and in November 2014. We searched controlled trials registers in March 2015 to identify any ongoing or unpublished trials. We imposed no language restrictions. For the original review, we performed database searching in August 2007, including CENTRAL, MEDLINE, EMBASE, CINAHL and AMED, using relevant search terms and synonyms. Handsearching complemented the electronic searches (using reference lists of included studies, relevant chapters and review articles) for the original review. We considered randomised controlled trials (RCTs) of haloperidol for the treatment of nausea or vomiting, or both, in any setting, for inclusion. The studies had to be conducted with adults receiving palliative care or suffering from an incurable progressive medical condition. We excluded studies where nausea or vomiting, or both, were thought to be secondary to pregnancy or surgery. We imported records from each of the electronic databases into a bibliographic package and merged them into a core database where we inspected titles, keywords and abstracts for relevance. If it was not possible to accept or reject an abstract with certainty, we obtained the full text of the article for further evaluation. The two review authors independently assessed studies in accordance with the inclusion criteria. There were no differences in opinion between the authors with regard to the

  10. Evidence of Diplopia in Children's Headache Drawings Helps to Differentiate Pseudotumor Cerebri From Migraine.

    Science.gov (United States)

    Lee, Erica B; Edelman, Fredrick S; Stafstrom, Carl E

    2018-02-01

    This study aimed to determine whether children's headache drawings can distinguish between pseudotumor cerebri and migraine. Headache features associated with pseudotumor cerebri (pseudotumor; idiopathic intracranial hypertension) are nonspecific and are difficult to distinguish clinically from migraines. Children's headache drawings have a high predictive value for migraine versus nonmigraine headaches. We hypothesized that drawings could help to differentiate pediatric headaches due to pseudotumor cerebri from those associated with migraines. Children aged six to 18 years old attending university hospital pediatric neurology clinics were asked to draw a picture of how their headache feels. From our database of children's headache drawings, pictures by children with clinically diagnosed pseudotumor were compared with migraine drawings. Headache drawings of 21 children (16 females) with pseudotumor were compared with those of 518 children with migraine. Pseudotumor drawings depicted a variety of symptoms including pounding pain (n = 11), pressure-like pain (n = 3), photophobia (3), dizziness (1), and recumbency (1). Severe pain indicators included hammers, bombs, anvil, and vise grip. Positive visual phenomena included scintillations, scotomata, or blurring (n = 8). Negative visual phenomena included field defects (n = 2). Pseudotumor drawings were similar to migraine drawings except that 6 of 21 pseudotumor drawings (28.6%) depicted diplopia (crossed eyes, double images), whereas only three of 518 migraine drawings (0.6%) depicted diplopia (P drawings than migraine drawings. In all other respects, headache drawings by children with pseudotumor cerebri were similar to those drawn by children with migraine. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. The relationship between primary headache and constipation in children and adolescents

    OpenAIRE

    Park, Mi-Na; Choi, Min-Gyu; You, Su Jeong

    2015-01-01

    Purpose Many patients presenting with headache also complain of constipation; the relationship between these two symptoms has not been explored in detail. The aim of this study was to investigate the association between primary headache and constipation. Methods This retrospective study included all children who attended the Inje University Sanggye Paik Hospital complaining of headache, and who had been followed up for at least 100 days. Patients were divided into 2 groups: group A, in whom t...

  12. Tension-Type Headache - The Normal and Most Prevalent Headache

    DEFF Research Database (Denmark)

    Jensen, Rigmor Højland

    2018-01-01

    diagnosis of TTH are highlighted and the situations more likely to raise doubts are discussed. POTENTIAL SOLUTION: A structured approach to the patient and a better comprehension of the very frequent coexistence of migraine and medication overuse headache in the clinical population are emphasized. According...

  13. Headaches and Migraines: Headache Symptoms, Diagnosis, and Treatment

    Science.gov (United States)

    ... are thought to involve abnormal functioning of the brain's blood vessels. Migraines cause severe pain on one or both ... migraines. Toxic: The second most common type of vascular headache, toxic ... They are brought on by stressful events and involve the tightening or tensing of facial ...

  14. Carbon monoxide inhalation induces headache in a human headache model

    DEFF Research Database (Denmark)

    Arngrim, Nanna; Schytz, Henrik Winther; Britze, Josefine

    2018-01-01

    , double-blind, placebo-controlled crossover design, 12 healthy volunteers were allocated to inhalation of CO (carboxyhemoglobin 22%) or placebo on two separate days. Headache was scored on a verbal rating scale from 0-10. We recorded mean blood velocity in the middle cerebral artery (VMCA) by transcranial...

  15. A Cross-Sectional Clinic-Based Study in Patients With Side-Locked Unilateral Headache and Facial Pain.

    Science.gov (United States)

    Prakash, Sanjay; Rathore, Chaturbhuj; Makwana, Prayag; Dave, Ankit

    2016-07-01

    To undertake the epidemiological evaluation of the patients presenting with side-locked headache and facial pain in a tertiary neurology outpatient clinic. Side-locked unilateral headache and facial pain include a large number of primary and secondary headaches and cranial neuropathies. A diagnostic approach for the patients presenting with strictly unilateral headaches is important as many of these headache disorders respond to a highly selective drug. Epidemiological data may guide us to formulate a proper approach for such patients. However, the literature is sparse on strictly unilateral headache and facial pain. We prospectively recruited 307 consecutive adult patients (>18 years) with side-locked headache and facial pain presenting to a neurology outpatient clinic between July 2014 and December 2015. All patients were subjected to MRI brain and other investigations to find out the different secondary causes. The diagnosis was carried out by at least two headache specialists together. All patients were classified according to the International Classification of Headache Disorder-third edition (ICHD-3β). The mean age at the time of examination was 42.4 ± 13.6 years (range 18-80 years). Forty-eight percent of patients were male. Strictly unilateral headaches accounted for 19.2% of the total headaches seen in the clinic. Headaches were classified as primary in 58%, secondary in 18%, and cranial neuropathies and other facial pain in 16% patients. Five percent of patients could not be classified. Three percent of patients were classified as per the Appendix section of ICHD-3β. The prevalence of secondary headaches and painful cranial neuropathies increased with age. A total of 36 different diagnoses were made. Only two diseases (migraine and cluster headache) had a prevalence of more than 10%. The prevalence of 13 diseases varied between 6 and 9%. The prevalence of other 14 groups was ≤1%. Migraine was the most common diagnosis (15%). Cervicogenic headache

  16. Altitude, Acute Mountain Sickness and Headache

    Science.gov (United States)

    ... impact during MHAM What is Migraine and Headache Awareness Month? June is Migraine and Headache Awareness Month, ... approved last week, which is called erenumab, the brand name of which is Aimovig, is a monoclonal ...

  17. Hair Transplantation in Migraine Headache Patients

    Directory of Open Access Journals (Sweden)

    Safvet Ors, MD

    2017-09-01

    Conclusions:. This report details 6 patients who experienced abatement of migraine headache symptoms following hair transplantation. The positive effects of hair transplantation on migraine headache and potential mechanisms of action are also discussed.

  18. Headaches and Migraines: Migraine 101 Quiz

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Headaches and Migraines Migraine 101 Quiz Past Issues / Spring 2009 Table of ... the facts when it comes to headaches and migraines? Test your knowledge with this quick quiz. True/ ...

  19. Cluster-like headache aura status

    NARCIS (Netherlands)

    Langedijk, M; van der Naalt, J; Luijckx, GJ; De Keyser, J

    We describe a patient with successive attacks (40 to 90 minutes) of cluster-like headache associated with aphasia, and contralateral hemihypesthesia and hemiplegia. The condition can best be described as cluster-like headache aura status.

  20. Comorbidities associated with epilepsy and headaches

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    Thalles P. Ferreira

    2012-04-01

    Full Text Available Comorbidities are often associated with chronic neurological diseases, such as headache and epilepsy. OBJECTIVES: To identify comorbidities associated with epilepsy and headaches, and to determine possible drug interactions. METHODS: A standardized questionnaire with information about type of epilepsy/headache, medical history, and medication was administered to 80 adult subjects (40 with epilepsy and 40 with chronic headache. RESULTS: Patients with epilepsy had an average of two comorbidities and those with headache of three. For both groups, hypertension was the most prevalent. On average, patients with epilepsy were taking two antiepileptic medications and those with headache were taking only one prophylactic medication. Regarding concomitant medications, patients with epilepsy were in use, on average, of one drug and patients with headache of two. CONCLUSIONS: Patients with chronic neurological diseases, such as epilepsy and headaches, have a high number of comorbidities and they use many medications. This may contribute to poor adherence and interactions between different medications.

  1. Headaches. More than just sinusitis; Kopfschmerzen. Mehr als nur Sinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Knauth, Michael [Universitaetsklinikum Goettingen (Germany). Abt. Neuroradiologie

    2011-09-15

    Headaches are among the commonest somatic complaints seen in clinical practice. The International Headache Society differentiates about 190 types of headaches. This article focuses on the variety of secondary headaches with a radiologically identifiable cause. (orig.)

  2. Headaches: Treatment Depends on Your Diagnosis and Symptoms

    Science.gov (United States)

    ... keep a headache diary to help diagnose your headache type. Write down when your headaches occur, accompanying symptoms, and any potential triggers such as food, changes in sleep or stress. Tension-type headaches, the most common variety of ...

  3. Postoperative nausea and vomiting in pediatric anesthesia.

    Science.gov (United States)

    Höhne, Claudia

    2014-06-01

    Postoperative nausea and vomiting (PONV) has a high incidence in children and requires prophylactic and therapeutic strategies. PONV can be reduced by the avoidance of nitrous oxide, volatile anesthetics, and the reduction of postoperative opioids. The use of dexamethasone, 5-HT3 antagonists, or droperidol alone is potent, but combinations are even more effective to reduce PONV. Droperidol has a Food and Drug Administration warning. Hence, dexamethasone and 5-HT3 antagonists should be preferred as prophylactic drugs. It is further reasonable to adapt PONV prophylaxis to different risk levels. Prolonged surgery time, inpatients, types of surgery (e.g. strabismus and ear-nose-throat surgery), and patients with PONV in history should be treated as high risk, whereas short procedures and outpatients are to be treated as low risk. Concluding from the existing guidelines and data on the handling of PONV in children at least 3 years, the following recommendations are given: outpatients undergoing small procedures should receive a single prophylaxis, outpatients at high risk a double prophylaxis, inpatients with surgery time of more than 30 min and use of postoperative opioids should get double prophylaxis, and inpatients receiving a high-risk surgical procedure or with other risk factors a triple prophylaxis (two drugs and total intravenous anesthesia). Dimenhydrinate can be used as a second choice, whereas droperidol and metoclopramide can only be recommended as rescue therapy.

  4. Intractable nausea caused by zolpidem withdrawal: a case report.

    Science.gov (United States)

    Baruch, Edward; Vernon, Leonard F; Hasbun, Rafael J

    2007-03-01

    First launched in France in 1988, zolpidem (Ambien®) is a short-acting hypnotic agent. Early studies reported that that the development of physical dependence and tolerance to sedative-hypnotic drugs, such as the depressant and anticonvulsant effects evidenced with benzodiazepines, is not found with zolpidem. Direct to consumer advertising by the manufacturer continues to state that the risk for dependency is low; however, recent publications seem to contradict this. Additionally, adverse drug reactions affecting the central nervous system, gastrointestinal tract, and respiratory system have been reported. Other studies have examined the interactions of selective serotonin reuptake inhibitors and zolpidem as a possible cause of hallucinations. With continued physician marketing efforts touting the safety and efficacy of zolpidem, there is a high likelihood to overlook the risk of dependency and the symptoms related to zolpidem withdrawal. We report a case of a 41-year-old female who developed a dependency to zolpidem, who on her own decided to decrease her dosage, resulting in intractable nausea requiring hospitalization. Reported cases of zolpidem withdrawal have occurred with doses in excess of 160 mg per day, none of these have reported with intractable nausea as the sole symptom. In our reported case, although exceeding recommended dosage withdrawal phenomenon seemed to be severe after withdrawal from a comparatively low dose of zolpidem. Before zolpidem is prescribed, patient education should include warnings about the potential problems associated with dependency and abrupt discontinuation. Education about this common and likely underrecognized clinical phenomenon will help prevent future episodes and minimize the risk of misdiagnosis.

  5. Considerations in the treatment of tension-type headache in the elderly.

    Science.gov (United States)

    Wrobel Goldberg, Stephanie; Silberstein, Stephen; Grosberg, Brian M

    2014-11-01

    Tension-type headache (TTH) is the most prevalent headache type in all age groups worldwide, including patients with advanced age. Because of its high prevalence and possible association with medical and psychiatric co-morbidities, TTH has a major socioeconomic impact. The lifetime prevalence of TTH ranges between 30 and 78 %, and the 1-year prevalence in individuals over the age of 55 years is 35.8 % (27.8 % in men, 42.4 % in women). Since the prevalence of secondary headache disorders increases in the elderly, the initial evaluation of this group of patients with a new-onset headache or a change in a pre-existing headache pattern should be directed towards their exclusion. This article reviews the diagnostic and treatment dilemmas encountered in elderly patients with tension-type headaches, highlighting both pharmacological and non-pharmacological interventions.

  6. Temporomandibular disorders, facial pain, and headaches.

    Science.gov (United States)

    Bender, Steven D

    2012-05-01

    Headaches and facial pain are common in the general population. In many cases, facial pain can be resultant from temporomandibular joint disorders. Studies have identified an association between headaches and temporomandibular joint disorders suggesting the possibility of shared pathophysiologic mechanisms of these 2 maladies. The aim of this paper is to elucidate potential commonalities of these disorders and to provide a brief overview of an examination protocol that may benefit the headache clinician in daily practice. © 2012 American Headache Society.

  7. Diclofenac with or without an antiemetic for acute migraine headaches in adults

    Science.gov (United States)

    Derry, Sheena; Rabbie, Roy; Moore, R Andrew

    2014-01-01

    Background Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter (OTC) analgesics. Diclofenac is an established analgesic, and new formulations using the potassium or epolamine salts, which can be dissolved in water, have been developed for rapid absorption, which may be beneficial in acute migraine. Co-therapy with an antiemetic should help to reduce the nausea and vomiting commonly associated with migraine. Objectives To determine the efficacy and tolerability of diclofenac, alone or in combination with an antiemetic, compared to placebo and other active interventions in the treatment of acute migraine headaches in adults. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, the Oxford Pain Relief Database, ClinicalTrials.gov, and reference lists for studies through 27 September 2011. Selection criteria We included randomised, double-blind, placebo- and/or active-controlled studies using self administered diclofenac to treat a migraine headache episode, with at least 10 participants per treatment arm. Data collection and analysis Two review authors independently assessed trial quality and extracted data. We used numbers of participants achieving each outcome to calculate relative risk (or ‘risk ratio’) and numbers needed to treat to benefit (NNT) or harm (NNH) compared to placebo or a different active treatment. Main results Five studies (1356 participants) compared oral diclofenac with placebo, and one also compared it with sumatriptan; none combined diclofenac with a self administered antiemetic. Four studies treated attacks with single doses of medication, and two allowed an optional second dose for inadequate response. Only two studies, with three active treatment arms, provided data for pooled analysis of primary outcomes. For single doses of diclofenac

  8. The relationship between migraine headache and asthma features.

    Science.gov (United States)

    Dirican, Nigar; Demirci, Seden; Cakir, Munire

    2017-06-01

    Migraine and asthma are comorbid chronic disorders with episodic attacks thought to involve inflammatory and neurological mechanisms. The objective of the present study is to investigate the relationship of asthma features between the asthma patients with migraine and those without migraine headache. A cross-sectional study was conducted from October 2015 to June 2016. Physician-diagnosed asthma patients aged 18 years and above were included. Demographic data, pulmonary function test and treatment of asthma were recorded. Asthma control was assessed using the asthma control test (ACT) and asthma control questionnaire (ACQ). The diagnosis of migraine was made by the neurologist with face-to face examinations based on the International Classification of Headache Disorders, third edition beta (ICHD-III-beta) criteria. Data about the age at onset, frequency of headache attacks, duration of headache attack, the presence of aura, and severity of headache were recorded. The severity of headache was evaluated using visual analogue scale (VAS). Overall 121 asthma patients were included in this study. Migraine was found to be present in 32 (26.4%) of patients. No statistically significant difference was found between asthma group and asthma with migraine groups in terms of pulmonary function test parameters. The mean ACT score in asthma with migraine patients group was significantly lower than the asthma groups. Morever, in the group asthma with migraine, a negative significant correlations were found between ACT scores with VAS scores. This study demonstrates that migraine headache may be associated with poor asthma control. On the other hand, it should not be forgotten that ACT is a subjective test and can be affected from by many clinical parameters.

  9. Development of Foot Massage Program on Nausea and Vomiting for Cancer Patients: A Literature Review

    Directory of Open Access Journals (Sweden)

    Ni Ketut Guru Prapti

    2012-08-01

    Full Text Available Objective: This study aims to develop a foot massage program to support care activity in reducing nausea and vomiting for cancer patients undergoing chemotherapy. Two phases, a literature review and the development of a foot massage program were conducted. The literature review was to analyze state of the art massage techniques by reviewing problems, related theories and supporting evidence. Method: Eight published studies in the English language were reviewed. A massage can be performed for different durations, from 10 minutes up to 60 minutes for three to six weeks and can be applied on various body areas. We found that the soft stroke/effleurage seems to be the best method and is most suitable for patients with cancer. It is also evident that foot massaging can be applied as a modality to reduce nausea and vomiting for cancer patients undergoing chemotherapy. Result: We developed a foot massage program specifically for patients with cancer. The foot massage program comprised of three sessions, including 1 education session, 2 preparation session, and 3 foot massage session. In the education session, patients obtain brief information about the definition of a foot massage, the benefits and contraindication of foot massaging. During the preparation phase, foot soaking and warming up are performed. Subsequently, the foot massage is applied and should last for 30 minutes. Further research is recommended to test the effectiveness of the proposed foot massage program for nausea and vomiting in cancer patients across countries including Indonesia. Key Words: Foot massage program, chemotherapy, nausea and vomiting

  10. Acute treatment of migraine headaches.

    Science.gov (United States)

    Taylor, Frederick R

    2010-04-01

    Optimum acute treatment of migraine requires prevention of headache as a top priority. Recognition of the multitude of migraine presentations, the frequency of total headache attacks, and number of days of headache disability are critical. Successful treatment requires excellent patient-clinician communication enhancing confidence and mutual trust based on patient needs and preferences. Optimum management of acute migraine nearly always requires pharmacologic treatment for rapid resolution. Migraine-specific triptans, dihydroergotamine, and several antiinflammatories have substantial empirical clinical efficacy. Older nonspecific drugs, particularly butalbital and opioids, contribute to medication overuse headache and are to be avoided. Clinicians should utilize evidence-based acute migraine-specific therapy stressing the imperative acute treatment goal of early intervention, but not too often with the correct drug, formulation, and dose. This therapy needs to provide cost-effective fast results, meaningful to the patient while minimizing the need for additional drugs. Migraine-ACT evaluates 2-hour pain freedom with return to normal function, comfort with treatment, and consistency of response. Employ a thoroughly educated patient, formulary, testimonials, stratification, and rational cotherapy against the race to central sensitization for optimum outcomes. Thieme Medical Publishers.

  11. AUTOGENIC THERAPY IN TENSION HEADACHE

    Science.gov (United States)

    Amruthraj, Brunda; Mishra, H.; Kumaraiah, V.

    1987-01-01

    SUMMARY Ten subjects diagnosed as Psychalgia were taken for study. A multiple baseline design was adapted and clients were subjected to 30 sessions of autogenic training. They were assessed using physiological (EMG and thermal change) and behavioural measures (Visual analogue scale and behavioural symptom checklist). Findings revealed autogenic therapy to be effective in reducing tension headache. PMID:21927245

  12. Rare primary headaches: clinical insights.

    Science.gov (United States)

    Casucci, G; d'Onofrio, F; Torelli, P

    2004-10-01

    So-called "rare" headaches, whose prevalence rate is lower than 1% or is not known at all and have been reported in only a few dozen cases to date, constitute a very heterogeneous group. Those that are best characterised from the clinical point of view can be classified into forms with prominent autonomic features and forms with sparse or no autonomic features. Among the former are trigeminal autonomic cephalalgias (TACs) and hemicrania continua, while the latter comprise classical trigeminal neuralgia, hypnic headache, primary thunderclap headache, and exploding head syndrome. The major clinical discriminating factor for the differential diagnosis of TACs is the relationship between duration and frequency of attacks: the forms in which pain is shorter lived are those with the higher frequency of daily attacks. Other aspects to be considered are the time pattern of symptoms, intensity and timing of attacks, the patient's behaviour during the attacks, the presence of any triggering factors and of the refractory period after an induced attack, and response to therapy, especially with indomethacin. Often these are little known clinical entities, which are not easily detected in clinical practice. For some of them, e. g., thunderclap headache, it is always necessary to perform instrumental tests to exclude the presence of underlying organic diseases.

  13. Blunt Head Trauma and Headache

    Directory of Open Access Journals (Sweden)

    Ana B Chelse

    2015-04-01

    Full Text Available Investigators from New York Presbyterian Morgan Stanley Children’s Hospital examined whether having an isolated headache following minor blunt head trauma was suggestive of traumatic brain injury (TBI among a large cohort of children 2-18 years of age.

  14. AUTOGENIC THERAPY IN TENSION HEADACHE

    OpenAIRE

    Amruthraj, Brunda; Mishra, H.; Kumaraiah, V.

    1987-01-01

    SUMMARY Ten subjects diagnosed as Psychalgia were taken for study. A multiple baseline design was adapted and clients were subjected to 30 sessions of autogenic training. They were assessed using physiological (EMG and thermal change) and behavioural measures (Visual analogue scale and behavioural symptom checklist). Findings revealed autogenic therapy to be effective in reducing tension headache.

  15. Headaches and Hormones: What's the Connection?

    Science.gov (United States)

    Headaches and hormones: What's the connection? Being female has some real health advantages, but not when it comes to headaches — particularly ... a relationship between headaches and hormonal changes. The hormones estrogen (ES-truh-jen) and progesterone (pro-JES- ...

  16. Headache associated with cough : a review

    NARCIS (Netherlands)

    Cordenier, Ann; De Hertogh, Willem; De Keyser, Jacques; Versijpt, Jan

    2013-01-01

    Headache only triggered by coughing is a rather uncommon condition. The aim of the present review is to present an overview of the diagnosis, clinical characteristics, pathophysiology and treatment of both primary and symptomatic cough headache and discuss other relevant headache disorders affected

  17. Ice massage on chemotherapy induced nausea and vomiting

    Directory of Open Access Journals (Sweden)

    Mehdi Sadeghi Shermeh

    2012-05-01

    Full Text Available Background and Aim: Nausea and vomiting are the most common side effects of chemotherapy. The aim of the current study was to assess the effect of ice massage applied to the pericardium 6 (P6 or Neigaun acupuncture point on nausea– vomiting due to chemotherapy in cancer patient. Materials and Methods: In a randomized clinical trial one- blind, 114 patients were randomly divided into three groups. Ice massage group were massaged gently on the skin around P6 point of the hand with ice cube into a wet gauze pad for 7 minutes twice a day with 12-hours interval for 24 hours by the patient. Placebo group were massaged with wooden cube and the control group received no interventions. Nausea and vomiting in three groups rated by Morrow Assessment of Nausea and Emesis (MANE Questionnaire in 4 periods of time in 24 hours was used for the assessment of nausea and vomiting. Results: There were significant decreases in the frequency of nausea (P<0.01 and vomiting (P<0.03 and a decrease in the intensity of nausea (P=0.63 and vomiting (P=0.34 in the case group. Frequency of nausea was significantly lower among placebo group than the control group (P<0.02. Conclusion: Ice massage on Neigaun point is effective on reducing the frequency of chemotherapy induced nausea and vomiting in cancer patients. Placebos, patient-practitioner relationship, suggestion, and the patient's view on nausea and vomiting and the role of interaction between the therapist and the patient is effective to some extent.

  18. Headache in the parturient: Pathophysiology and management of post-dural puncture headache

    Directory of Open Access Journals (Sweden)

    Gita Nath

    2011-01-01

    Full Text Available Headache in the postpartum period is common and multifactorial in origin. Apart from primary causes such as tension headaches and migraine, secondary headaches such as post-dural puncture headache (PDPH are increasingly common because of increasing use of regional anaesthesia and analgesia during childbirth. Preventive measures for PDPH include the use of smaller gauge pencil-point needles for spinal blocks; epidural needles of 18 G or less; using saline rather than air for epidural space identification and the use of ultrasound guidance, especially for difficult cases such as morbid obesity and spinal deformities. In case of accidental dural puncture (ADP, the choice is between inserting the catheter in an adjacent space or intrathecal catheterization. Current evidence seems to be in favour of inserting the epidural catheter into the subarachnoid space and using the intrathecal catheter for analgesia/anaesthesia after prominently labelling it as intrathecal, to prevent misuse. It should be removed after at least 24 hours and a 10 ml bolus of saline injected before removal of catheter may be helpful. Either way, having written protocols for the management of accidental dural puncture helps to reduce the incidence of PDPH. PDPH can be disabling in severity and can mar the whole experience of childbirth. In addition, severe untreated PDPH can cause complications such as nerve palsies, subdural hematoma and cerebral venous thrombosis. Conservative methods of treatment should be tried first such as adequate hydration, paracetamol, caffeine, sumatriptan or ACTH/hydrocortisone. Epidural blood patching is the most effective treatment for PDPH. It is more effective if done 24-48 hours after dural puncture. It is an invasive procedure with its own complications as well as a failure rate of up to 30%, so that a second or even third patch may be necessary. Both these facts should be intimated to the patient beforehand. Meticulous follow-up and evaluation

  19. Stress and Sleep Duration Predict Headache Severity in Chronic Headache Sufferers

    OpenAIRE

    Houle, Timothy T.; Butschek, Ross A.; Turner, Dana P.; Smitherman, Todd A.; Rains, Jeanetta C.; Penzien, Donald B.

    2012-01-01

    The objective of this study was to evaluate the time-series relationships between stress, sleep duration, and headache pain among patients with chronic headaches. Sleep and stress have long been recognized as potential triggers of episodic headache (< 15 headache days/month), though prospective evidence is inconsistent and absent in patients diagnosed with chronic headaches (≥ 15 days/month). We reanalyzed data from a 28-day observational study of chronic migraine (n = 33) and chronic tension...

  20. Natural course of untreated cluster headache: A retrospective cohort study.

    Science.gov (United States)

    Lee, Mi Ji; Choi, Hyun Ah; Shin, Jong Hwa; Park, Hea Ree; Chung, Chin-Sang

    2018-04-01

    Objective To determine the natural course of cluster headache. Methods We screened patients with cluster headache who were diagnosed at Samsung Medical Center and lost to follow-up for ≥5 years. Eligible patients were interviewed by phone about the longitudinal changes in headache characteristics and disease course. Remission was defined as symptom-free 1) for longer than twice the longest between-bout period and 2) for ≥5 years. Results Forty-two patients lost to follow-up for mean 7.5 (range, 5.0-15.7) years were included. The length of the last bout did not differ from the first one, while the last between-bout period was longer than the first one ( p = 0.012). Characteristics of cluster headache decreased over time: Side-locked unilaterality (from 92.9% to 78.9%), seasonal and circadian rhythmicity (from 63.9% to 60.9% and from 62.2 to 40.5%, respectively), and autonomic symptoms (from 95.2% to 75.0%). Remission occurred in 14 (33.3%) patients at a mean age of 42.3 (range, 27-65) years, which was not different from the age of last bouts in active patients ( p = 0.623). There was a trend for more seasonal and circadian predilection at baseline in the active group ( p = 0.056 and 0.063, respectively) and fewer lifetime bouts and shorter disease duration in patients in remission ( p = 0.063 and 0.090). Conclusions This study first shows the natural courses of cluster headache. Features of cluster headache become less prominent over time. Remission occurred regardless of age. Although no single predictor of remission was found, our data suggest that remission of cluster headache might not be a consequence of more advanced age, longer duration of disease, or accumulation of lifetime bouts.

  1. OnabotulinumtoxinA for the treatment of headache.

    Science.gov (United States)

    Ashkenazi, Avi; Blumenfeld, Andrew

    2013-09-01

    Botulinum toxin, a potent muscle relaxant, has been found to have analgesic effects in patients with various pain syndromes. Both in vitro and in vivo studies showed the ability of the toxin to block the release of pain neurotransmitters, such as substance P, glutamate, and calcitonin gene-related peptide. The effect of the toxin, and specifically of one of its serotypes, botulinum neurotoxin type A, on headaches, has been extensively studied. This serotype is available in the United States in 3 forms, including as onabotulinumtoxinA. Data from clinical trials confirmed the efficacy, safety, and tolerability of onabotulinumtoxinA in the prophylactic treatment of chronic migraine, the most severe and debilitating type of migraine, in adults. The drug was approved by the Food and Drug Administration for this indication in 2010. The drug was not found to be effective for episodic migraine or tension-type headache. Noncontrolled studies suggest the efficacy of the toxin for headache associated with craniocervical dystonia. Proper injection technique and appropriate patient selection are essential for achieving positive results after treatment with onabotulinumtoxinA. The recommended injection paradigm combines a fixed site/fixed dose and follow the pain approaches, with the toxin injected to multiple sites of the head and neck, at a total dose of 155U-195U. The treatment is given at intervals of 12 weeks on average. The efficacy of onabotulinumtoxinA for some headaches, its long duration of action, and its favorable adverse effect profile make it a viable treatment option for the appropriate headache patients. The drug may be particularly suitable for patients who cannot tolerate, or are not compliant with, the daily intake of oral headache preventive drugs. © 2013 American Headache Society.

  2. The effects of healing touch on pain, nausea, and anxiety following bariatric surgery: a pilot study.

    Science.gov (United States)

    Anderson, Joel G; Suchicital, Liliana; Lang, Maria; Kukic, Azra; Mangione, Lucrezia; Swengros, Diane; Fabian, Jennifer; Friesen, Mary Ann

    2015-01-01

    Given the growth in the number of bariatric surgeries, it is important for healthcare practitioners to maximize symptom management for these patients, including the option of complementary therapies such as Healing Touch. A quasi-experimental study was conducted to determine the feasibility of a Healing Touch intervention for reducing pain, nausea, and anxiety in patients undergoing laparoscopic bariatric surgery. Following surgery, a nurse administered the Healing Touch intervention once daily. Study participants reported levels of pain, nausea, and anxiety immediately before and after the Healing Touch intervention using separate numeric rating scales. Significant decreases in pain, nausea, and anxiety were observed immediately following the intervention on post-operative days one and two, and in pain and anxiety on post-operative day three compared with pre-intervention levels. These findings indicate that the Healing Touch intervention is feasible and acceptable to patients undergoing bariatric surgery, and significantly improved pain, nausea, and anxiety in these patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Ginger-Mechanism of action in chemotherapy-induced nausea and vomiting: A review.

    Science.gov (United States)

    Marx, Wolfgang; Ried, Karin; McCarthy, Alexandra L; Vitetta, Luis; Sali, Avni; McKavanagh, Daniel; Isenring, Liz

    2017-01-02

    Despite advances in antiemetic therapy, chemotherapy-induced nausea and vomiting (CINV) still poses a significant burden to patients undergoing chemotherapy. Nausea, in particular, is still highly prevalent in this population. Ginger has been traditionally used as a folk remedy for gastrointestinal complaints and has been suggested as a viable adjuvant treatment for nausea and vomiting in the cancer context. Substantial research has revealed ginger to possess properties that could exert multiple beneficial effects on chemotherapy patients who experience nausea and vomiting. Bioactive compounds within the rhizome of ginger, particularly the gingerol and shogaol class of compounds, interact with several pathways that are directly implicated in CINV in addition to pathways that could play secondary roles by exacerbating symptoms. These properties include 5-HT 3 , substance P, and acetylcholine receptor antagonism; antiinflammatory properties; and modulation of cellular redox signaling, vasopressin release, gastrointestinal motility, and gastric emptying rate. This review outlines these proposed mechanisms by discussing the results of clinical, in vitro, and animal studies both within the chemotherapy context and in other relevant fields. The evidence presented in this review indicates that ginger possesses multiple properties that could be beneficial in reducing CINV.

  4. Cluster headache as a first manifestation of multiple sclerosis: case report and literature review

    Directory of Open Access Journals (Sweden)

    Mijajlović MD

    2014-11-01

    Full Text Available Milija D Mijajlović,* Vuk M Aleksić,* Nadežda M Čovičković Šternić Department for Cerebrovascular Disorders and Headaches, Neurology Clinic, Clinical Center of Serbia, School of Medicine, University of Belgrade, Belgrade, Serbia *These authors contributed equally to this work Abstract: Cluster headache (CH is estimated to be the most common primary trigeminal autonomic headache, although it is a rare disabling medical condition. Dominant symptoms of CH include severe unilateral orbital, supraorbital, and/or temporal pain, lasting from 15 to 180 minutes if untreated, associated with at least one of various autonomic symptoms during the headache, such as conjunctival injection, lacrimation, nasal congestion and rhinorrhea, facial sweating, miosis, ptosis, and eyelid edema. Headache is not frequently a symptom of multiple sclerosis (MS. The most commonly reported primary headaches are migraine without aura and a tension-type headache. Several described cases involved complicated migraine, ophthalmoplegic migraine-like headache, and finally cluster-like headache. We present a case of a 45-year-old male patient who had typical CH attacks as the initial and only clinical manifestation of MS, which was diagnosed after cerebrospinal fluid (CSF isoelectric focusing and brain magnetic resonance imaging (MRI investigation. He presented as a typical cluster-like headache patient since in the background of the CH symptoms and signs, were MS demyelinating lesions. In a patient with CH symptoms one should always think about the possibility of cluster-like-headache, which presents the CH patient with different underlying diseases, so we proposed a protocol to evaluate such patients and exclude diseases that could be in the background of CH symptoms. Keywords: demyelinating disease, headache, trigeminal autonomic cephalalgia, diagnosis

  5. Association between headache and temporomandibular disorder.

    Science.gov (United States)

    Abouelhuda, Amira Mokhtar; Kim, Hyun-Seok; Kim, Sang-Yun; Kim, Young-Kyun

    2017-12-01

    Headaches are one of the most common conditions associated with temporomandibular disorder (TMD). In the present paper, we evaluated the relationship between headache and TMD, determined whether headache influences the symptoms of TMD, and reported two cases of TMD accompanied by headache. Our practical experience and a review of the literature suggested that headache increases the frequency and intensity of pain parameters, thus complicating dysfunctional diseases in both diagnostic and treatment phases. Therefore, early and multidisciplinary treatment of TMD is necessary to avoid the overlap of painful events that could result in pain chronicity.

  6. New Investigator and Trainee Task Force Survey on the Recruitment and Retention of Headache Specialists.

    Science.gov (United States)

    Minen, Mia T; Monteith, Tesha; Strauss, Lauren D; Starling, Amaal

    2015-09-01

    We sought to survey the New Investigators and Trainees Section (NITS) members of the American Headache Society (AHS) to better understand their exposure to headache medicine during training and to determine their perceptions and attitudes about the field and the future of headache medicine. Despite the high prevalence of headache disorders in the general population, only about 2% of neurology residents pursue headache medicine fellowships. Furthermore, there is a paucity of United Council of Neurologic Subspecialties headache specialists in the country to meet the population demands. Thus, there needs to be a focus on how to recruit and retain more headache specialists. A survey was distributed via SurveyMonkey to the NITS listserv. It remained online for 60 days, during which reminder emails were sent to members of the listserv. In addition, the survey was available on laptops at NITS-related events at an annual AHS meeting. Descriptive analyses were then conducted using SurveyMonkey and Excel. Of the 93 members of NITS, 64 of the 96 (68.8%) clicked to initiate the survey and 52.7% successfully completed it. Attendings made up the majority of respondents (62.5%), followed by fellows (10.9%), and residents (7.8%). Key highlights of the survey included the following: just under 10% reported no exposure to a headache center during any time in their training (medical school, residency, or fellowship); less than 2% had exposure to a headache center during medical school; less than half of participants reported exposure to a headache center in residency (45.3%) and during fellowship (43.4%). Having a mentor in the field, liking the patient population, and working in a headache center, 64.7%, 52.9%, and 41.2%, respectively, were the top ways in which participants became interested in headache. The journal Headache (56.9%), attendings (56.3%), and the AHS/American Academy of Neurology guidelines for migraine management (52.0%) are the resources cited as being used all

  7. A Survey of Headache Medicine Physicians on the Likeability of Headaches and Their Personal Headache History.

    Science.gov (United States)

    Evans, Randolph W; Ghosh, Kamalika

    2016-03-01

    Two prior studies have shown an increased prevalence of migraine among physicians who are headache medicine specialists (HMS). There have been no studies of the prevalence of other headache disorders among HMS. A prior survey showed that neurologists like to treat some headaches more than others but there has not been a similar survey of HMS. The aim of the survey was to learn more about the prevalence of headaches among HMS and which headache disorders they like to treat. An email survey was sent to 749 physician members of the American Headache Society who were asked to respond to the following statement using a 5-point Likert scale (from 1, strongly disagree to 5, strongly agree): "I like to treat patients with the following types of headaches or syndromes." They were asked, "Have you personally suffered from any of the following at any time during your life: episodic migraine (EM), chronic migraine (CM), refractory migraine (RM), episodic cluster (EC), chronic cluster (CC), new daily persistent headache (NDPH), and postconcussion syndrome (PCS)." The response rate was 15.8% (n = 118) with a mean age of 51.4 years, 64.4% males, and 85.6% neurologists. HMS reported likeability for treating disorders in rank order as follows: EM (mean = 4.69, SD = 0.61); CM (mean = 4.20, SD = 0.94); RM (mean = 3.62, SD = 1.17); EC (mean = 4.37, SD = 0.80); CC (mean = 3.68, SD = 1.10); NDPH (mean = 3.52, SD = 1.21); and PCS (mean = 3.66, SD = 1.18). The lifetime prevalence of disorders was as follows: EM, 69.5% (85.7% in females and 60.5% in males); CM, 13.6% (19% in females and 10.5% in males); RM, .9% (2.4% females and 0% males); EC, 1.7% (0% females and 2.6% males); CC, 0%; NDPH, 0%, and PCS, 4.2% (7.1% females and 2.6% males). HMS with a personal history of EM (mean = 4.73, SD = 0.51) showed a significant preference (t130  = 7.30, P headaches (mean = 3.90, SD = 0.77). HMS preferred to treat some

  8. Nausea and vomiting in fractionated radiotherapy: a prospective on-demand trial of tropisetron rescue for non-responders to metoclopramide

    International Nuclear Information System (INIS)

    Miralbell, R.; Behrouz, F.; Coucke, P.

    1995-01-01

    A prospective trial was performed to better assess the risk of nausea and vomiting and the rescue value of tropisetron (TRO), a 5-HT 3 receptor antagonist, in 88 patients undergoing fractionated radiotherapy to the abdomen or to large supradiaphragmatic fields and failing a first anti-emetic trial with metoclopramide (MET). Nausea was graded 0 (absent), 1 (mild), 2 (moderate) and 3 (severe). Nausea requiring anti-emetics (≥ grade 2) was present in 64% of the patients. MET was able to control nausea (≤ grade 1) in 26 of 58 patients (45%) who developed ≥ grade 2 nausea during radiation treatment (2 patients vomiting without nausea included). 34 patients required TRO, and 31 experienced immediate relief. However, nausea (≥ grade 2) recurred in 7 patients from 1 to 3 weeks after starting TRO. Sex, age, field type and field size (cm 2 ) did not influence the incidence and severity of nausea and vomiting. Only 24/88 patients vomited after starting radiotherapy. MET helped to eliminate emesis in one third of these patients. TRO helped to control vomiting in 73% of the salvaged patients. Constipation was observed in 8 patients on TRO and was a reason to stop the medication in 4 cases. (author)

  9. Optimal use of acute headache medication: a qualitative examination of behaviors and barriers to their performance.

    Science.gov (United States)

    Seng, Elizabeth K; Holroyd, Kenneth A

    2013-10-01

    This study aims to qualitatively examine the behaviors required to optimally use acute headache medication and the barriers to successful performance of these behaviors. The efficacy of drug treatment is partly determined by medication adherence. The adherence literature has focused almost exclusively on the behaviors required to optimally use medications that are taken on a fixed schedule, as opposed to medications taken on an as needed basis to treat acute episodes of symptoms, such as headaches. Twenty-one people with headache and 15 health care providers participated in qualitative phenomenological interviews that were transcribed and coded by a multidisciplinary research team using phenomenological analysis. Interviews revealed 8 behaviors required to optimally use acute headache medication, including cross-episode behaviors that people with headache regularly perform to ensure optimal acute headache medication use, and episode-specific behaviors used to treat an individual headache episode. Interviews further revealed 9 barriers that hinder successful performance of these behaviors. Behaviors required to optimally use acute headache medication were numerous, often embedded in a larger chain of behaviors, and were susceptible to disruption by numerous barriers. © 2013 American Headache Society.

  10. Influence of psychological stress on headache in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Vargas-Hitos, José Antonio; Sabio, José Mario; Martínez-Egea, Isabel; Jiménez-Jáimez, Enrique; Rodríguez-Guzmán, Manuel; Navarrete-Navarrete, Nuria; López-Lozano, Esther; Romero-Alegría, Ángela; de la Calle, Cristina; Jáimez-Gámiz, Laura; Baños-Piñero, Pilar; Nebrera-Navarro, Fernando; Fidalgo, Alba; Caminal, Luis; de Ramón Garrido, Enrique; Ortego-Centeno, Norberto; Expósito, Manuela; Zamora-Pasadas, Mónica; Jiménez-Alonso, Juan

    2014-03-01

    To compare the prevalence and disability of headache in patients with systemic lupus erythematosus (SLE) with the general population and to assess the role of chronic psychological stress (CPS) in headache development. One hundred seventy patients with SLE and 102 control subjects matched for age, sex, and level of education were included in this multicenter, cross-sectional study. CPS, headache-related disability, and chronic analgesic intake (CAI) were evaluated in all participants. No statistical differences in the prevalence of headache between both groups were observed but headache disability was significantly higher in patients with SLE. In addition, a higher average score in the Cohen Perceived Stress Scale (CPSS) and a higher prevalence of patients with CAI were observed in patients with SLE. In multivariate analysis, CPSS score was positively (OR 1.09; 95% CI: 1.03-1.14; p = 0.001) and CAI negatively (OR 0.43; 95% CI: 0.19-0.99; p = 0.049) associated with headache in patients with SLE. Despite the prevalence of headache in patients with SLE and the general population being similar, headache-related disability may be higher in patients with SLE. Moreover, CPS might play a role in the pathogenesis of SLE headache, whereas CAI might have a protective effect against it.

  11. Nausea, Vomiting and Diarrhea: An Unusual Presentation of Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Andrew Szilagyi

    1997-01-01

    Full Text Available The case of a young woman who presented with nausea, vomiting and diarrhea is outlined; the etiology turned out to be a first attack of multiple sclerosis. Plausible mechanisms are discussed.

  12. Risk Factors for Postoperative Nausea and Vomiting in Pediatric ...

    African Journals Online (AJOL)

    2018-05-22

    May 22, 2018 ... nausea and vomiting (PONV) in children receiving dental treatment under general anesthesia .... For pediatric patients undergoing dental treatment under general anesthesia ..... Consensus guidelines for the management.

  13. Challenges in developing drugs for primary headaches

    DEFF Research Database (Denmark)

    Schytz, Henrik Winther; Hargreaves, Richard; Ashina, Messoud

    2017-01-01

    This review considers the history of drug development in primary headaches and discusses challenges to the discovery of innovative headache therapeutics. Advances in headache genetics have yet to translate to new classes of therapeutics and there are currently no clear predictive human biomarkers...... for any of the primary headaches that can guide preventative drug discovery and development. Primary headache disorder subtypes despite common phenotypic presentation are undoubtedly heterogeneous in their pathophysiology as judged by the variability of response to headache medicines. Sub......, despite having promising effects in basic pain models, have not delivered efficacy in the clinic. Future efforts may triage novel physiological mediators using human experimental models of headache pain to support drug discovery strategies that target active pathways pharmacologically....

  14. Associations between Nausea, Vomiting, Fatigue and Health-Related Quality of Life of Women in Early Pregnancy: The Generation R Study.

    Directory of Open Access Journals (Sweden)

    Guannan Bai

    Full Text Available The objective of this study was to evaluate the independent associations between nausea, vomiting, fatigue and health-related quality of life of women in early pregnancy in the Generation R study, which is a prospective mother and child cohort. Analyses were based on 5079 women in early pregnancy in the Rotterdam area, the Netherlands. The information on nausea, vomiting and fatigue in the previous three months was measured in the questionnaire at enrollment, as well as potential confounders (i.e., maternal/gestational age, ethnic background, educational level, parity, marital status, body mass index, tobacco and alcohol use, chronic/infectious conditions, uro-genital conditions/symptoms, sleep quality, headache, anxiety, and depression. Health-related quality of life was assessed by the 12-item Short Form Health Survey and physical and mental component summary scores were calculated. Multivariate regression models were performed to evaluate the independent associations of the presence of nausea, vomiting and fatigue with health-related quality of life, adjusting for potential confounders. 33.6% of women experienced daily presence of nausea, 9.6% for vomiting and 44.4% for fatigue. Comparing with women who never reported nausea, vomiting and fatigue, women with daily presence of at least one of these symptoms had significantly lower scores of physical component summary and mental component summary, after adjusting for potential confounders. Our study shows how common nausea, vomiting and fatigue are among women in early pregnancy and how much each of these symptoms negatively impact on health-related quality of life. We call for awareness of this issue from health care professionals, pregnant women and their families.

  15. Thunderclap headache: Diagnostic considerations and neuroimaging features

    International Nuclear Information System (INIS)

    Mortimer, A.M.; Bradley, M.D.; Stoodley, N.G.; Renowden, S.A.

    2013-01-01

    Thunderclap headache (TCH) is an acute and severe headache that has maximum intensity at onset; TCH can be primary or secondary. Primary TCH is diagnosed when no underlying cause is discovered; however, imaging is crucial in distinguishing secondary causes, which are wide-ranging. The radiologist should be aware of the list of potential diagnoses. Subarachnoid haemorrhage (SAH) is the most common cause of secondary TCH. Aneurysmal SAH accounts for the majority of cases, although other causes should also be considered and these include perimesencephalic haemorrhage, arteriovenous malformations, and dural arteriovenous fistula as well as reversible cerebral vasoconstriction syndrome. Conditions that may present with TCH, with or without SAH include cervical artery dissection and cerebral venous sinus thrombosis. Ischaemic stroke, pituitary apoplexy, and posterior reversible leucoencephalopathy are other potential causes, whereas non-vascular causes include colloid cysts of the third ventricle and spontaneous intracranial hypotension. Imaging features are reviewed with reference to clues gleaned from initial imaging using computed tomography, as well as characteristics that should be sought using magnetic resonance imaging or angiographic imaging

  16. Headache and pregnancy: a systematic review.

    Science.gov (United States)

    Negro, A; Delaruelle, Z; Ivanova, T A; Khan, S; Ornello, R; Raffaelli, B; Terrin, A; Reuter, U; Mitsikostas, D D

    2017-10-19

    This systematic review summarizes the existing data on headache and pregnancy with a scope on clinical headache phenotypes, treatment of headaches in pregnancy and effects of headache medications on the child during pregnancy and breastfeeding, headache related complications, and diagnostics of headache in pregnancy. Headache during pregnancy can be both primary and secondary, and in the last case can be a symptom of a life-threatening condition. The most common secondary headaches are stroke, cerebral venous thrombosis, subarachnoid hemorrhage, pituitary tumor, choriocarcinoma, eclampsia, preeclampsia, idiopathic intracranial hypertension, and reversible cerebral vasoconstriction syndrome. Migraine is a risk factor for pregnancy complications, particularly vascular events. Data regarding other primary headache conditions are still scarce. Early diagnostics of the disease manifested by headache is important for mother and fetus life. It is especially important to identify "red flag symptoms" suggesting that headache is a symptom of a serious disease. In order to exclude a secondary headache additional studies can be necessary: electroencephalography, ultrasound of the vessels of the head and neck, brain MRI and MR angiography with contrast ophthalmoscopy and lumbar puncture. During pregnancy and breastfeeding the preferred therapeutic strategy for the treatment of primary headaches should always be a non-pharmacological one. Treatment should not be postponed as an undermanaged headache can lead to stress, sleep deprivation, depression and poor nutritional intake that in turn can have negative consequences for both mother and baby. Therefore, if non-pharmacological interventions seem inadequate, a well-considered choice should be made concerning the use of medication, taking into account all the benefits and possible risks.

  17. Prenatal and Postnatal Cell Phone Exposures and Headaches in Children.

    Science.gov (United States)

    Sudan, Madhuri; Kheifets, Leeka; Arah, Onyebuchi; Olsen, Jorn; Zeltzer, Lonnie

    2012-12-05

    Children today are exposed to cell phones early in life, and may be at the greatest risk if exposure is harmful to health. We investigated associations between cell phone exposures and headaches in children. The Danish National Birth Cohort enrolled pregnant women between 1996 and 2002. When their children reached age seven years, mothers completed a questionnaire regarding the child's health, behaviors, and exposures. We used multivariable adjusted models to relate prenatal only, postnatal only, or both prenatal and postnatal cell phone exposure to whether the child had migraines and headache-related symptoms. Our analyses included data from 52,680 children. Children with cell phone exposure had higher odds of migraines and headache-related symptoms than children with no exposure. The odds ratio for migraines was 1.30 (95% confidence interval: 1.01-1.68) and for headache-related symptoms was 1.32 (95% confidence interval: 1.23-1.40) for children with both prenatal and postnatal exposure. In this study, cell phone exposures were associated with headaches in children, but the associations may not be causal given the potential for uncontrolled confounding and misclassification in observational studies such as this. However, given the widespread use of cell phones, if a causal effect exists it would have great public health impact.

  18. Fibromuscular dysplasia: an update for the headache clinician.

    Science.gov (United States)

    O'Connor, Sarah C; Poria, Neil; Gornik, Heather L

    2015-05-01

    Fibromuscular dysplasia (FMD) is an uncommon vascular disease that presents with stenosis, aneurysm, dissection, beading, and tortuosity of medium-sized arteries. It primarily manifests in the renal and extracranial carotid and vertebral arteries, and is associated with major vascular events such as carotid artery dissection, renal artery dissection, ruptured aneurysm, transient ischemic attack, stroke, and myocardial infarction (due to coronary artery dissection). There is a wide spectrum of disease severity among FMD patients. Symptoms of FMD are related to the vascular beds involved and the severity of arterial stenoses. Headache is an extremely common and important symptom reported by patients with FMD, although the precise mechanism of headache in this population is not yet known. This review summarizes the most recent literature regarding FMD, including epidemiology, clinical manifestations, imaging practices, and treatment. Special attention will be paid to the association of headaches and FMD. Correct diagnosis, optimal medical management, and appropriate referral for vascular intervention are vital elements of the treatment of patients with FMD. There is a great need for more clinical research regarding the epidemiology, pathophysiology, and optimal treatment of headache in the FMD patient population. © 2015 American Headache Society.

  19. Development and psychometric validation of the headache screening questionnaire – Dutch Version

    NARCIS (Netherlands)

    van der Meer, Hedwig A.; Visscher, Corine M.; Engelbert, Raoul H.H.; Mulleners, Wim M.; Nijhuis-van der Sanden, Maria W. G.; Speksnijder, Caroline M.

    2017-01-01

    Background Headache is a common disorder which may lead to substantial socio-economic loss. Treatment options include self-management strategies, medication and physiotherapy. Physiotherapists need to be able to screen for the presence of migraine and tension-type headache (TTH), so they can adjust

  20. Headache following intracranial neuroendovascular procedures.

    Science.gov (United States)

    Baron, Eric P; Moskowitz, Shaye I; Tepper, Stewart J; Gupta, Rishi; Novak, Eric; Hussain, Muhammad Shazam; Stillman, Mark J

    2012-05-01

    Predicting who will develop post-procedure headache (PPH) following intracranial endovascular procedures (IEPs) would be clinically useful and potentially could assist in reducing the excessive diagnostic testing so often obtained in these patients. Although limited safety data exist, the use of triptans or dihydroergotamine (DHE) often raise concern when used with pre/post-coiled aneurysms. We sought to determine risk factors for PPH following IEP, to evaluate the utility of diagnostic testing in patients with post-coil acute headache (HA), and to record whether triptans and DHE have been used safely in this clinical setting. We conducted a retrospective chart review of adult patients undergoing IEPs. Bivariate analyses were conducted to compare patients who did and did not develop PPH. We reviewed records pertaining to 372 patients, of whom 263 underwent intracranial coil embolizations, 21 acrylic glue embolizations, and 88 stent placements. PPH occurred in 72% of coil patients, 33% of glue patients, and 14% of stent patients. Significant risk factors for post-coil HA were female gender, any pre-coil HA history, smoking, and anxiety/depression. A pre-stent history of HA exceeding 1 year's duration, and smoking were risk factors for post-stent HA. A pre-glue history of HA exceeding 1 year was the only risk factor for post-glue HA. In the small subgroup available for study, treatment with triptans or DHE was not associated with adverse events in pre/post-coiled aneurysms. Diagnostic testing was low yield. Occurrence of PPH was common after IEPs and especially so with coiling and in women, smokers, and those with anxiety/depression, and was often of longer duration than allowed by current International Classification of Headache Disorders-II criteria. The yield of diagnostic testing was low, and in a small subgroup treatment with triptans or DHE did not cause adverse events in pre/post-coiled aneurysms. Prospective studies are needed to confirm these findings.

  1. Critical Evaluation of Headache Classifications

    OpenAIRE

    ?ZGE, Aynur

    2013-01-01

    Transforming a subjective sense like headache into an objective state and establishing a common language for this complaint which can be both a symptom and a disease all by itself have kept the investigators busy for years. Each recommendation proposed has brought along a set of patients who do not meet the criteria. While almost the most ideal and most comprehensive classification studies continued at this point, this time criticisims about withdrawing from daily practice came to the fore. I...

  2. Factors Associated With Medication-Overuse Headache in Patients Seeking Treatment for Primary Headache.

    Science.gov (United States)

    Peck, Kelly R; Roland, Malcolm M; Smitherman, Todd A

    2018-03-09

    Although risk factors for medication-overuse headache have been identified within the general population, most studies have neglected clinical samples. The present study examined the relative and combined associations of these factors with medication-overuse headache in a sample of US adults seeking treatment for primary headache disorders. Treatment-seeking headache patients provided data on demographics, headache variables, psychiatric variables, use of headache medications, and use of other prescription medications and substances. A classification tree selection strategy was utilized within this cross-sectional study to differentiate between those with and without medication-overuse headache, and a final multivariable model assessed their combined utility. Forty-three of 164 participants (26.2%) met diagnostic criteria for medication-overuse headache. Relative to non-medication-overuse headache participants, participants with medication-overuse headache reported greater headache-related disability (odds ratio = 1.09, 95% confidence interval = 1.01-1.18), escape and avoidance responses indicative of fear of pain (odds ratio = 1.07, 95% confidence interval = 1.00-1.15), and use of combination medications for headache (odds ratio = 3.10, 95% confidence interval = 1.51-6.36). The final multivariable model differentiated well between the 2 groups (area under the receiver operating characteristic curve = .78; 95% confidence interval = .71-.86). Items that assess headache-related disability, use of combination medications, and fear of pain help identify patients who are currently overusing acute headache medications and may serve as indicators of treatment progress. Future studies should apply similar analytic approaches longitudinally to identify headache sufferers at risk for medication-overuse headache prior to headache progression. © 2018 American Headache Society.

  3. Role of Acupuncture in the Treatment or Prevention of Migraine, Tension-Type Headache, or Chronic Headache Disorders.

    Science.gov (United States)

    Coeytaux, Remy R; Befus, Deanna

    2016-07-01

    To summarize the current evidence that evaluates the effectiveness of acupuncture for the treatment or prevention of migraine, tension-type headache, and chronic headache disorders. Findings from selected systematic reviews and meta-analyses are summarized. Recently published systematic reviews and meta-analyses demonstrate that acupuncture is associated with improved clinical outcomes compared to routine care only, medical management, and sham acupuncture 2 months after randomization. The evidence in support of acupuncture's comparative effectiveness at longer follow-up periods is mixed. Cost effectiveness analyses conducted in the United Kingdom and Germany suggest that acupuncture is a cost-effective treatment option in those countries. There are few or no cost-effectiveness studies of acupuncture in the United States. This brief review of the current, published evidence does not include a discussion of potential risks or adverse events associated with acupuncture. There is also the question of the extent to which placebo effects might contribute to acupuncture's clinical effectiveness. From a purely comparative effectiveness perspective, however, the evidence from clinical trials and meta-analyses makes a compelling case in support of a potentially important role for acupuncture as part of a treatment plan for patients with migraine, tension-type headache, and several different types of chronic headache disorders. © 2016 American Headache Society.

  4. Temporomandibular disorders dysfunction in headache patients.

    Science.gov (United States)

    Melo, Christiane-Espinola-Bandeira; Oliveira, José-Luiz-Góes; Jesus, Alan-Chester-Feitosa; Maia, Mila-Leite-de Moraes; de Santana, Jonielly-Costa-Vasconcelos; Andrade, Loren-Suyane-Oliveira; Quintans, Jullyana-de Souza Siqueira; Quintans-Junior, Lucindo-José; Conti, Paulo-César-Rodrigues; Bonjardim, Leonardo-Rigoldi

    2012-11-01

    To identify the frequency of signs and symptoms of temporomandibular disorder (TMD) and its severity in individuals with headache. 60 adults divided into three groups of 20 individuals: chronic daily headache (CDH), episodic headache (EH) and a control group without headache (WH). Headache diagnosis was performed according to the criteria of International Headache Society and the signs and symptoms of TMD were achieved by using a clinical exam and an anamnestic questionnaire. The severity of TMD was defined by the temporomandibular index (TMI). The TMD signs and symptoms were always more frequent in individuals with headache, especially report of pain in TMJ area (CDH, n=16; EH, n=12; WH, n=6), pain to palpation on masseter (CDH, n=19; EH, n=16; WH, n=11) which are significantly more frequent in episodic and chronic daily headache. The mean values of temporomandibular and articular index (CDH patients) and muscular index (CDH and EH patients) were statistically higher than in patients of the control group, notably the articular (CDH=0.38; EH=0.25;WH=0.19) and muscular (CDH=0.46; EH=0.51; WH=0.26) indices. These findings allow us to speculate that masticatory and TMJ pain are more common in headache subjects. Besides, it seems that the TMD is more severe in headache patients.

  5. Acute headache diagnosis in pregnant women

    Science.gov (United States)

    Farmakidis, Constantine; Dayal, Ashlesha K.; Lipton, Richard B.

    2015-01-01

    Objective: To characterize demographic and clinical features in pregnant women presenting with acute headache, and to identify clinical features associated with secondary headache. Methods: We conducted a 5-year, single-center, retrospective study of consecutive pregnant women presenting to acute care with headache receiving neurologic consultation. Results: The 140 women had a mean age of 29 ± 6.4 years and often presented in the third trimester (56.4%). Diagnoses were divided into primary (65.0%) and secondary (35.0%) disorders. The most common primary headache disorder was migraine (91.2%) and secondary headache disorders were hypertensive disorders (51.0%). The groups were similar in demographics, gestational ages, and most headache features. In univariate analysis, secondary headaches were associated with a lack of headache history (36.7% vs 13.2%, p = 0.0012), seizures (12.2% vs 0.0%, p = 0.0015), elevated blood pressure (55.1% vs 8.8%, p headache history (OR 4.9, 95% CI 1.7–14.5) had an increased association with secondary headache, while psychiatric comorbidity (OR 0.13, 95% CI 0.021–0.78) and phonophobia (OR 0.29, 95% CI 0.09–0.91) had a reduced association with secondary headache. Conclusions: Among pregnant women receiving inpatient neurologic consultation, more than one-third have secondary headache. Diagnostic vigilance should be heightened in the absence of a headache history and if seizures, hypertension, or fever are present. Attack features may not adequately distinguish primary vs secondary disorders, and low thresholds for neuroimaging and monitoring for preeclampsia are justified. PMID:26291282

  6. Simulated airplane headache: a proxy towards identification of underlying mechanisms.

    Science.gov (United States)

    Bui, Sebastian Bao Dinh; Petersen, Torben; Poulsen, Jeppe Nørgaard; Gazerani, Parisa

    2017-12-01

    Airplane Headache (AH) occurs during flights and often appears as an intense, short lasting headache during take-off or landing. Reports are limited on pathological mechanisms underlying the occurrence of this headache. Proper diagnosis and treatments would benefit from identification of potential pathways involved in AH pathogenesis. This study aimed at providing a simulated airplane headache condition as a proxy towards identification of its underlying mechanisms. Fourteen participants including 7 volunteers suffering from AH and 7 healthy matched controls were recruited after meeting the diagnostic and safety criteria based on an approved study protocol. Simulation of AH was achieved by entering a pressure chamber with similar characteristics of an airplane flight. Selected potential biomarkers including salivary prostaglandin E 2 (PGE 2 ), cortisol, facial thermo-images, blood pressure, pulse, and saturation pulse oxygen (SPO) were defined and values were collected before, during and after flight simulation in the pressure chamber. Salivary samples were analyzed with ELISA techniques, while data analysis and statistical tests were handled with SPSS version 22.0. All participants in the AH-group experienced a headache attack similar to AH experience during flight. The non-AH-group did not experience any headaches. Our data showed that the values for PGE 2 , cortisol and SPO were significantly different in the AH-group in comparison with the non-AH-group during the flight simulation in the pressure chamber. The pressure chamber proved useful not only to provoke AH-like attack but also to study potential biomarkers for AH in this study. PGE 2 , and cortisol levels together with SPO presented dysregulation during the simulated AH-attack in affected individuals compared with healthy controls. Based on these findings we propose to use pressure chamber as a model to induce AH, and thus assess new potential biomarkers for AH in future studies.

  7. Headache in military service members with a history of mild traumatic brain injury: A cohort study of diagnosis and classification.

    Science.gov (United States)

    Finkel, Alan G; Yerry, Juanita A; Klaric, John S; Ivins, Brian J; Scher, Ann; Choi, Young S

    2017-05-01

    Introduction Headaches after concussion are highly prevalent, relatively persistent and are being treated like primary headaches, especially migraine. Methods We studied all new patients seen between August 2008 and December 2009 assessed by a civilian headache specialist at the TBI Center at Womack Army Medical Center, Fort Bragg, NC. We report sample demographics, injuries and headache characteristics, including time from injury to headache onset, detailed descriptions and International Classification of Headache Disorders second edition primary headache diagnosis type. Results A total of 95 soldiers reported 166 headaches. The most common injury cited was a blast (53.7%). Most subjects (76.8%) recalled the onset of any headache within 7 days of injury. The most commonly diagnosed headache was a continuous type with migraine features ( n = 31 (18.7%)), followed by chronic migraine (type 1.5.1, n = 14 (8.4%)), migraine with aura (type 1.2.1, n = 10 (6.0%)), hemicrania continua (type 4.7, n = 12 (7.2%)), chronic cluster (type 3.1.2, n = 6 (3.6%)) and headaches not otherwise classifiable (type 14.1, n = 5 (3.0%)) also present. The most clinically important was a continuous headache with migraine features. Conclusion We present a series of patients seen in a military treatment facility for headache diagnosis after concussion in whom we found migraine, as well as uncommon primary headache types, at frequencies that were much higher than expected.

  8. Whiplash headache is transitory worsening of a pre-existing primary headache.

    Science.gov (United States)

    Stovner, L J; Obelieniene, D

    2008-07-01

    Acute and chronic whiplash headache are new diagnostic entities in the ICHD-2 (5.3, 5.4). In a prospective cohort study, 210 rear-end collision victims were identified consecutively from police records and asked about head and neck pain in questionnaires after 2 weeks, 3 months and 1 year. The results were compared with those of matched controls who were also followed for 1 year. Of 210 accident victims, 75 developed headache within 7 days. Of these, 37 had also neck pain and complied with the criteria for acute whiplash headache. These 37 had the same headache diagnoses, headache features, accompanying symptoms and long-term prognosis as the 38 without initial neck pain who therefore did not comply with the acute whiplash headache diagnosis. Previous headache was a major risk factor for headache both in the acute and chronic stage. Compared with the non-traumatized controls, headache in the whiplash group had the same prevalence, the same diagnoses and characteristic features, and the same prognosis. Both acute and chronic whiplash headache lack specificity compared with the headache in a control group, and have the same long-term prognosis, indicating that such headaches are primary headaches, probably elicited by the stress of the situation.

  9. Developmental trajectories of paediatric headache - sex-specific analyses and predictors.

    Science.gov (United States)

    Isensee, Corinna; Fernandez Castelao, Carolin; Kröner-Herwig, Birgit

    2016-01-01

    Headache is the most common pain disorder in children and adolescents and is associated with diverse dysfunctions and psychological symptoms. Several studies evidenced sex-specific differences in headache frequency. Until now no study exists that examined sex-specific patterns of change in paediatric headache across time and included pain-related somatic and (socio-)psychological predictors. Latent Class Growth Analysis (LCGA) was used in order to identify different trajectory classes of headache across four annual time points in a population-based sample (n = 3 227; mean age 11.34 years; 51.2 % girls). In multinomial logistic regression analyses the influence of several predictors on the class membership was examined. For girls, a four-class model was identified as the best fitting model. While the majority of girls reported no (30.5 %) or moderate headache frequencies (32.5 %) across time, one class with a high level of headache days (20.8 %) and a class with an increasing headache frequency across time (16.2 %) were identified. For boys a two class model with a 'no headache class' (48.6 %) and 'moderate headache class' (51.4 %) showed the best model fit. Regarding logistic regression analyses, migraine and parental headache proved to be stable predictors across sexes. Depression/anxiety was a significant predictor for all pain classes in girls. Life events, dysfunctional stress coping and school burden were also able to differentiate at least between some classes in both sexes. The identified trajectories reflect sex-specific differences in paediatric headache, as seen in the number and type of classes extracted. The documented risk factors can deliver ideas for preventive actions and considerations for treatment programmes.

  10. Headache cessation by an educational intervention in grammar schools: a cluster randomized trial.

    Science.gov (United States)

    Albers, L; Heinen, F; Landgraf, M; Straube, A; Blum, B; Filippopulos, F; Lehmann, S; Mansmann, U; Berger, U; Akboga, Y; von Kries, R

    2015-02-01

    Headache is a common health problem in adolescents. There are a number of risk factors for headache in adolescents that are amenable to intervention. The aim of the study was to assess the effectiveness of a low-level headache prevention programme in the classroom setting to prevent these risk factors. In all, 1674 students in 8th-10th grade at 12 grammar schools in greater Munich, Germany, were cluster randomized into intervention and control groups. A standardized 60-min prevention lesson focusing on preventable risk factors for headache (physical inactivity, coffee consumption, alcohol consumption and smoking) and providing instructions on stress management and neck and shoulder muscle relaxation exercises was given in a classroom setting. Seven months later, students were reassessed. The main outcome parameter was headache cessation. Logistic regression models with random effects for cluster and adjustment for baseline risk factors were calculated. Nine hundred students (intervention group N = 450, control group N = 450) with headache at baseline and complete data for headache and confounders were included in the analysis. Headache cessation was observed in 9.78% of the control group compared with 16.22% in the intervention group (number needed to treat = 16). Accounting for cluster effects and confounders, the probability of headache cessation in the intervention group was 1.77 (95% confidence interval = [1.08; 2.90]) higher than in the control group. The effect was most pronounced in adolescents with tension-type headache: odds ratio = 2.11 (95% confidence interval = [1.15; 3.80]). Our study demonstrates the effectiveness of a one-time, classroom-based headache prevention programme. © 2014 EAN.

  11. The Use of Cannabis for Headache Disorders

    Science.gov (United States)

    Lochte, Bryson C.; Beletsky, Alexander; Samuel, Nebiyou K.; Grant, Igor

    2017-01-01

    Abstract Headache disorders are common, debilitating, and, in many cases, inadequately managed by existing treatments. Although clinical trials of cannabis for neuropathic pain have shown promising results, there has been limited research on its use, specifically for headache disorders. This review considers historical prescription practices, summarizes the existing reports on the use of cannabis for headache, and examines the preclinical literature exploring the role of exogenous and endogenous cannabinoids to alter headache pathophysiology. Currently, there is not enough evidence from well-designed clinical trials to support the use of cannabis for headache, but there are sufficient anecdotal and preliminary results, as well as plausible neurobiological mechanisms, to warrant properly designed clinical trials. Such trials are needed to determine short- and long-term efficacy for specific headache types, compatibility with existing treatments, optimal administration practices, as well as potential risks. PMID:28861505

  12. Acetate causes alcohol hangover headache in rats.

    Directory of Open Access Journals (Sweden)

    Christina R Maxwell

    2010-12-01

    Full Text Available The mechanism of veisalgia cephalgia or hangover headache is unknown. Despite a lack of mechanistic studies, there are a number of theories positing congeners, dehydration, or the ethanol metabolite acetaldehyde as causes of hangover headache.We used a chronic headache model to examine how pure ethanol produces increased sensitivity for nociceptive behaviors in normally hydrated rats.Ethanol initially decreased sensitivity to mechanical stimuli on the face (analgesia, followed 4 to 6 hours later by inflammatory pain. Inhibiting alcohol dehydrogenase extended the analgesia whereas inhibiting aldehyde dehydrogenase decreased analgesia. Neither treatment had nociceptive effects. Direct administration of acetate increased nociceptive behaviors suggesting that acetate, not acetaldehyde, accumulation results in hangover-like hypersensitivity in our model. Since adenosine accumulation is a result of acetate formation, we administered an adenosine antagonist that blocked hypersensitivity.Our study shows that acetate contributes to hangover headache. These findings provide insight into the mechanism of hangover headache and the mechanism of headache induction.

  13. CGRP in human models of primary headaches

    DEFF Research Database (Denmark)

    Ashina, Håkan; Schytz, Henrik Winther; Ashina, Messoud

    2018-01-01

    experiments are likely due to assay variation; therefore, proper validation and standardization of an assay is needed. To what extent CGRP is involved in tension-type headache and cluster headache is unknown. CONCLUSION: Human models of primary headaches have elucidated the role of CGRP in headache...... pathophysiology and sparked great interest in developing new treatment strategies using CGRP antagonists and antibodies. Future studies applying more refined human experimental models should identify biomarkers of CGRP-induced primary headache and reveal whether CGRP provocation experiments could be used......OBJECTIVE: To review the role of CGRP in human models of primary headaches and to discuss methodological aspects and future directions. DISCUSSION: Provocation experiments demonstrated a heterogeneous CGRP migraine response in migraine patients. Conflicting CGRP plasma results in the provocation...

  14. Medication overuse headache in Europe and Latin America

    DEFF Research Database (Denmark)

    Find, Ninett Louise; Terlizzi, Rossana; Munksgaard, Signe Bruun

    2016-01-01

    painkillers distribution in several European and Latin American (LA) Countries. Methods: This descriptive cross-sectional observational study included 669 patients with MOH referred to headache-centers in Europe and LA as a part of the COMOESTAS project. Information about acute medication and healthcare...

  15. A Comparison of Cerebral Blood Flow in Migraineurs During Headache, Headache-Free and Treatment Periods

    National Research Council Canada - National Science Library

    Bednarczyk, Edward

    1999-01-01

    ...: Otherwise healthy patients with a minimum of one migraine headache per month (IHS criteria) were scanned using H215O, and positron emission tomography, within 24 hours of the onset of migraine headache...

  16. Pain sensitivity mediates the relationship between stress and headache intensity in chronic tension-type headache.

    Science.gov (United States)

    Cathcart, Stuart; Bhullar, Navjot; Immink, Maarten; Della Vedova, Chris; Hayball, John

    2012-01-01

    A central model for chronic tension-type headache (CTH) posits that stress contributes to headache, in part, by aggravating existing hyperalgesia in CTH sufferers. The prediction from this model that pain sensitivity mediates the relationship between stress and headache activity has not yet been examined. To determine whether pain sensitivity mediates the relationship between stress and prospective headache activity in CTH sufferers. Self-reported stress, pain sensitivity and prospective headache activity were measured in 53 CTH sufferers recruited from the general population. Pain sensitivity was modelled as a mediator between stress and headache activity, and tested using a nonparametric bootstrap analysis. Pain sensitivity significantly mediated the relationship between stress and headache intensity. The results of the present study support the central model for CTH, which posits that stress contributes to headache, in part, by aggravating existing hyperalgesia in CTH sufferers. Implications for the mechanisms and treatment of CTH are discussed.

  17. Laboratory tests of headache disorders - Dawn of a new era?

    DEFF Research Database (Denmark)

    Schytz, Henrik Winther; Olesen, Jes

    2016-01-01

    secondary headaches. Background In this narrative review we present and discuss published tests that might be useful in phenotyping and/or diagnosis of long-lasting headache disorders such as migraine, tension-type headache, trigeminal autonomic cephalalgias, trigeminal neuralgia and persisting secondary...... headaches. Aim The palpometer test, quantitative sensory testing, nociceptive blink reflex and autonomic tests may be valuable to phenotype and/or diagnose subforms of migraine, tension-type headache, cluster headache, trigeminal neuralgia and medication-overuse headache. Provocation tests with glyceryl...... if well-reputed tertiary headache centers commence developing and implementing laboratory tests in order to improve the classification and treatment of headache patients....

  18. The prevention and treatment of radiotherapy induced nausea and vomiting

    International Nuclear Information System (INIS)

    Van Zyl, A.J.

    1992-11-01

    Nausea and vomiting are side-effects that are associated with chemo- and radiotherapy. A single-blind study to compare the efficacy and safety of intravenous granisetron (G) with metoclopramide (M) plus dexamethasone (D) in the prophylaxis and control of nausea and emesis in patients undergoing hemi-body irradiation (HBI) was performed. G (3 mg) or M (20 mg) plus D (12 mg) were given intravenously, thirty minutes prior to the start of radiotherapy. Patients were monitored for nausea, vomiting and side-effects. Thirty-five patients were treated, 28 men and 7 women. A total of 21 (60%) patients did not vomit during the first 24 hours after the start of radiotherapy. Both G and M plus D offer safe and effective anti-emetic regimes for the prophylaxis and control of radiotherapy induced nausea and vomiting. However, granisetron was found to be more effective than metoclopramide plus dexamethasone in preventing nausea and vomiting. 101 refs., 40 tabs., 8 figs

  19. Headache in recent onset hypothyroidism: Prevalence, characteristics and outcome after treatment with levothyroxine.

    Science.gov (United States)

    Lima Carvalho, Marise de Farias; de Medeiros, Josian Silva; Valença, Marcelo Moraes

    2017-09-01

    Objective The objective of this article is to analyze the features of headache attributed to hypothyroidism (HAH), evaluate the differences between groups with and without HAH, between "overt" and "subclinical" hypothyroidism groups, and evaluate outcomes after levothyroxine treatment. Methods Patients with hypothyroidism were selected in a cross-sectional study, followed prospectively for 12 months, and classified as subclinical or overt hypothyroidism. The patients were divided into two groups: with and without HAH. Results HAH was reported by 73/213 (34%) patients, involving the following areas: fronto-orbital (49%), temporal (37%), and posterior part of the head (15%). The HAH features were as follows: pulsatile (63%), four to 72 hours' duration (78%), unilateral (47%), nausea/vomiting (60%), and moderate-severe intensity (72%). Hypothyroidism symptomatology was similar in both groups, except for a greater frequency of hoarseness in the group with HAH. Migraine history was more frequent in the patients with HAH (53% vs 38%, p hypothyroidism. After levothyroxine treatment 78% reported a decrease in HAH frequency. Subclinical and overt hypothyroid patients reported a similar alleviation of their headaches. Conclusion Patients with HAH may present with unilateral, pulsatile, episodic pattern, and nausea/vomiting, which is at odds with the criteria for HAH established by ICHD 3 beta. Not all individuals responded to levothyroxine, and patients with the subclinical form of hypothyroidism benefit from this treatment.

  20. Headaches of otolaryngological interest: current status while awaiting revision of classification. Practical considerations and expectations.

    Science.gov (United States)

    Farri, A; Enrico, A; Farri, F

    2012-04-01

    In 1988, diagnostic criteria for headaches were drawn up by the International Headache Society (IHS) and is divided into headaches, cranial neuralgias and facial pain. The 2(nd) edition of the International Classification of Headache Disorders (ICHD) was produced in 2004, and still provides a dynamic and useful instrument for clinical practice. We have examined the current IHC, which comprises 14 groups. The first four cover primary headaches, with "benign paroxysmal vertigo of childhood" being the forms of migraine of interest to otolaryngologists; groups 5 to 12 classify "secondary headaches"; group 11 is formed of "headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth or other facial or cranial structures"; group 13, consisting of "cranial neuralgias and central causes of facial pain" is also of relevance to otolaryngology. Neither the current classification system nor the original one has a satisfactory collocation for migraineassociated vertigo. Another critical point of the classification concerns cranio-facial pain syndromes such as Sluder's neuralgia, previously included in the 1988 classification among cluster headaches, and now included in the section on "cranial neuralgias and central causes of facial pain", even though Sluder's neuralgia has not been adequately validated. As we have highlighted in our studies, there are considerable similarities between Sluder's syndrome and cluster headaches. The main features distinguishing the two are the trend to cluster over time, found only in cluster headaches, and the distribution of pain, with greater nasal manifestations in the case of Sluder's syndrome. We believe that it is better and clearer, particularly on the basis of our clinical experience and published studies, to include this nosological entity, which is clearly distinct from an otolaryngological point of view, as a variant of cluster headache. We agree with experts in the field of headaches, such as

  1. Granisetron plus dexamethasone for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery: A meta-analysis.

    Science.gov (United States)

    Zhu, Min; Zhou, Chengmao; Huang, Bing; Ruan, Lin; Liang, Rui

    2017-06-01

    Objective This study was designed to compare the effectiveness of granisetron plus dexamethasone for preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic surgery. Methods We searched the literature in the Cochrane Library, PubMed, EMBASE, and CNKI. Results In total, 11 randomized controlled trials were enrolled in this analysis. The meta-analysis showed that granisetron in combination with dexamethasone was significantly more effective than granisetron alone in preventing PONV in patients undergoing laparoscopy surgery. No significant differences in adverse reactions (dizziness and headache) were found in association with dexamethasone. Conclusion Granisetron in combination with dexamethasone was significantly more effective than granisetron alone in preventing PONV in patients undergoing laparoscopic surgery, with no difference in adverse reactions between the two groups. Granisetron alone or granisetron plus dexamethasone can be used to prevent PONV in patients undergoing laparoscopic surgery.

  2. Development of chronic daily headache : A clinical study

    NARCIS (Netherlands)

    Spierings, E.L.H.; Schroevers, M.; Honkoop, P.C.; Sorbi, M.

    1998-01-01

    We studied the development of chronic daily headache in 258 headache practice patients, 50 men and 208 women. Chronic daily headache was defined as headaches occurring at least 5 days per week for at least 1 year. Twenty-two percent of the patients had daily headaches from the onset, and 78%

  3. CPD: The patient with daily headaches. | Maizels | South African ...

    African Journals Online (AJOL)

    The term "chronic daily headache" (CDH) describes a variety of headache types, of which chronic migraine is the most common. Daily headaches often are disabling and may be challenging to diagnose and treat. Medication overuse, or drug rebound headache, is the most treatable cause of refractory daily headache.

  4. Post-myelogram headache - physiological or psychological?

    International Nuclear Information System (INIS)

    Lee, T.; Maynard, N.; Briggs, M.; Anslow, P.; McPherson, K.; Northover, J.

    1991-01-01

    Psychological aspects of post-lumbar puncture headache have hitherto received little attention. A hundred consecutive patients admitted for elective myelography were studied. Post-myelogram headache was assessed by an independent observer and found to be strongly associated with normality of the test (P<0.001). Psychological testing showed a trend between Hospital Anxiety Depression score and normality of myelogram as well as development of headache, although this did not achieve statistical significance. This study suggestet that there is a large psychological as well as organic component to post-myelogram headache. (orig.)

  5. Cerebral blood flow changes in cluster headache

    International Nuclear Information System (INIS)

    Norris, J.W.; Hachinski, V.C.; Cooper, P.W.

    1976-01-01

    Serial cerebral blood flod studies performed by the intra-carotid 133 Xenon method were fortuitously determined during the course of a cluster headache in a 32 year old man. The initial study was performed about 10 min after the headache began and showed values at the upper limit of normal. Twenty min after the headache started a second procedure showed that the autoregulatory response on hyperventilation was normal. Ergotamine tartrate was given intra-muscularly 23 min after the headache began and there was partial relief. A third cerebral blood flow estimation showed abnormally high values. The probable reasons for this are discussed. (author)

  6. Radiological diagnosis and differential diagnosis of headache

    International Nuclear Information System (INIS)

    Langner, S.; Kirsch, M.

    2015-01-01

    Headache is very common and affects almost everyone at some point. It is one of the most common disorders that leads patients to see their physician. All different forms have the nociception via trigeminal nerve fibers in common. Beside the clinical course headaches are classified as either primary or secondary, with the latter having an identifiable structural or biochemical cause. Imaging has a low diagnostic yield in primary headache but play an important role in the differential diagnosis of secondary forms. An overview of different forms of secondary headache is given, outlining diagnostic procedures and the morphologic imaging features of each syndrome.

  7. Young adults' medicine use for headache

    DEFF Research Database (Denmark)

    Koushede, Vibeke; Hansen, Ebba Holme; Andersen, Anette

    2012-01-01

    Over-the-counter analgesic (OTCA) use is increasingly common and may have potential harmful side effects. The primary reason for using analgesics is headache symptoms. Whether OTCA use for headache is sensitive to psychosocial and social circumstances is an understudied topic.......Over-the-counter analgesic (OTCA) use is increasingly common and may have potential harmful side effects. The primary reason for using analgesics is headache symptoms. Whether OTCA use for headache is sensitive to psychosocial and social circumstances is an understudied topic....

  8. Pain Sensitivity Mediates The Relationship between Stress and Headache Intensity in Chronic Tension-Type Headache

    OpenAIRE

    Stuart Cathcart; Navjot Bhullar; Maarten Immink; Chris Della Vedova; John Hayball

    2012-01-01

    BACKGROUND: A central model for chronic tension-type headache (CTH) posits that stress contributes to headache, in part, by aggravating existing hyperalgesia in CTH sufferers. The prediction from this model that pain sensitivity mediates the relationship between stress and headache activity has not yet been examined.OBJECTIVE: To determine whether pain sensitivity mediates the relationship between stress and prospective headache activity in CTH sufferers.METHOD: Self-reported stress, pain sen...

  9. Psilocybin dose-dependently causes delayed, transient headaches in healthy volunteers.

    Science.gov (United States)

    Johnson, Matthew W; Sewell, R Andrew; Griffiths, Roland R

    2012-06-01

    Psilocybin is a well-characterized classic hallucinogen (psychedelic) with a long history of religious use by indigenous cultures, and nonmedical use in modern societies. Although psilocybin is structurally related to migraine medications, and case studies suggest that psilocybin may be efficacious in treatment of cluster headache, little is known about the relationship between psilocybin and headache. This double-blind study examined a broad range of psilocybin doses (0, 5, 10, 20, and 30 mg/70 kg) on headache in 18 healthy participants. Psilocybin frequently caused headache, the incidence, duration, and severity of which increased in a dose-dependent manner. All headaches had delayed onset, were transient, and lasted no more than a day after psilocybin administration. Possible mechanisms for these observations are discussed, and include induction of delayed headache through nitric oxide release. These data suggest that headache is an adverse event to be expected with the nonmedical use of psilocybin-containing mushrooms as well as the administration of psilocybin in human research. Headaches were neither severe nor disabling, and should not present a barrier to future psilocybin research. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  10. Joint hypermobility and headache: the glue that binds the two together--part 2.

    Science.gov (United States)

    Martin, Vincent T; Neilson, Derek

    2014-09-01

    Past studies have reported that connective tissue disorders (CTDs) are more common in patients with specific types of headache disorders. The objectives of this study are (1) to review and critique the clinical studies reporting an association between joint hypermobility, CTDs and headache and (2) to postulate mechanisms though which CTDs might predispose to headache disorders. PubMed was searched for relevant articles with search terms that included joint hypermobility, Ehlers-Danlos syndrome, Marfan syndrome, and specific headache disorders. A narrative review was performed of these articles as well as those identified from the bibliography of these articles. Case reports and case control studies confirm an association between CTDs and migraine, coat-hanger headaches, carotid arterial dissections, intracranial hypotension, Arnold Chiari malformations-type 1, cervical spine disorders, and temporomandibular joint disorders. Observational cross-sectional studies suggest that the prevalence of CTDs is increased in patients with specific types of headache disorders. It is unknown if the CTDs directly cause these headaches disorders or are associated with them through other mechanisms. © 2014 American Headache Society.

  11. One-day behavioral intervention in depressed migraine patients: effects on headache.

    Science.gov (United States)

    Dindo, Lilian; Recober, Ana; Marchman, James; O'Hara, Michael W; Turvey, Carolyn

    2014-03-01

    To determine whether a 1-day behavioral intervention, aimed at enhancing psychological flexibility, improves headache outcomes of migraine patients with comorbid depression. Migraine is often comorbid with depression, with each disorder increasing the risk for onset and exacerbation of the other. Managing psychological triggers, such as stress and depression, may result in greater success of headache management. Sixty patients with comorbid migraine and depression were assigned to a 1-day Acceptance and Commitment Training plus Migraine Education workshop (ACT-ED; N = 38) or to treatment as usual (TAU; N = 22). Patients completed a daily headache diary prior to, and for 3 months following, the intervention. Clinical variables examined included headache frequency/severity, medication use, disability, and visit to a health care professional. Comparisons were made between baseline findings and findings at the 3-month follow up. Participants assigned to the ACT-ED condition exhibited significant improvements in headache frequency, headache severity, medication use, and headache-related disability. In contrast, the TAU group did not exhibit improvements. The difference in headache outcomes between ACT-ED and TAU was not statistically significant over time (ie, the treatment by time interaction was nonsignificant). These results complement those of a previous report showing effects of ACT-ED vs TAU on depression and disability. A 1-day ACT-ED workshop targeting psychological flexibility may convey benefit for patients with comorbid migraine and depression.These pilot study findings merit further investigation using a more rigorously designed large-scale trial.

  12. Concepts leading to the definition of the term cervicogenic headache: a historical overview.

    Science.gov (United States)

    Antonaci, Fabio; Bono, Giorgio; Mauri, Marco; Drottning, Monica; Buscone, Simona

    2005-12-01

    The idea that headache may originate from a problem at the neck or cervical spine level has fascinated and stimulated researchers for centuries. Contributions and reports seeking to clarify this issue have multiplied in the past 80 or 90 years. Bärtschi-Rochaix reported what seems to have been the first clinical description of cervicogenic headache, but it was not until 1983 that Sjaastad and his school defined diagnostic criteria for this syndrome. The current, revised International Headache Society Classification (ICHD-II) includes the term cervicogenic headache, but the diagnostic criteria it gives differ from those of the International Association for the Study of Pain (IASP), and also from the most recent Cervicogenic Headache International Study Group (CHISG) definition (1998).

  13. [A role of treatment of autonomic syndrome in patients with tension-type headache].

    Science.gov (United States)

    Duma, S N

    2015-01-01

    The study aims to evaluate the effect of correction of psycho-vegetative violations anxiolitikami on the frequency and intensity of headache. the study included 50 women (average age - 37,4 years) with confirmed diagnosis: frequent episodic headache and chronic headache no factor abuses. Patients of the main group received ibuprofen to 200-400 mg/day for headaches in combination with tizanidine (2-4 mg/day) and anvifen 750 mg a day for 8 weeks. Patients in the comparison group received ibuprofen and tizanidine in the same mode, but did not take anvifen. Evaluated the severity of headaches by visual analogue scale, the level of anxiety on the Hamilton depression rating scale, vegetative disorders on questionnaire ( Wayne), the quality of sleep before treatment and 60 days. In addition, 60 day therapy was conducted subjective assessment of the General state on a scale GGI. The conclusion about expediency of inclusion of, anvifen in the complex treatment of the condition.

  14. MIGRAINE AND TENSION-TYPE HEADACHE IN CHILDREN: THE APPROACH TO EFFECTIVE TREATMENT. PART 2

    Directory of Open Access Journals (Sweden)

    A. V. Sergeev

    2012-01-01

    Full Text Available Pediatric neurologists often have to prescribe drugs off-label in children, according to individual approach to every patient and weighing possible benefits and risk of side-effects. Multidisciplinary approach to migraine and tension-type headache treatment in children, including correction of comorbid psychiatric and somatic disorders, is a critical point in decrease of frequency and severity of headaches and normalization of everyday children’s activity. In the second part of the article the authors discuss the problems of symptomatic (episodic drugs taking in order to arrest a headache attack and preventive (regular prolonged drug taking directed on decrease of frequency and severity of headaches medical treatment of migraine and tension-type headaches in pediatric practice.

  15. The methodology of population surveys of headache prevalence, burden and cost

    DEFF Research Database (Denmark)

    Stovner, Lars Jacob; Al Jumah, Mohammed; Birbeck, Gretchen L

    2014-01-01

    The global burden of headache is very large, but knowledge of it is far from complete and needs still to be gathered. Published population-based studies have used variable methodology, which has influenced findings and made comparisons difficult. Among the initiatives of the Global Campaign against...... to include experience and competence in headache epidemiology and/or epidemiology in general and drawn from all six WHO world regions. The recommendations presented are for anyone, of whatever background, with interests in designing, performing, understanding or assessing studies that measure or describe...... the burden of headache in populations. While aimed principally at researchers whose main interests are in the field of headache, they should also be useful, at least in parts, to those who are expert in public health or epidemiology and wish to extend their interest into the field of headache disorders. Most...

  16. Application of ICHD-II criteria in a headache clinic of China.

    Directory of Open Access Journals (Sweden)

    Zhao Dong

    Full Text Available China has the huge map and the largest population in the world. Previous studies on the prevalence and classification of headaches were conducted based on the general population, however, similar studies among the Chinese outpatient population are scarce. This study aimed to analyze the characteristics of 1843 headache patients enrolled in a North China headache clinic of the General Hospital for Chinese People's Liberation Army from October 2011 to May 2012, with the International Classification of Headache Disorders, 2nd Edition (ICHD-II.Personal interviews were carried out and a detailed questionnaire was used to collect medical records including age, sex and headache characteristics. Patients came from 28 regions of China with the median age of 40.9 (9-80 years and the female/male ratio of 1.67/1. The primary headaches (78.4% were classified as the following: migraine (39.1%, tension-type headache (32.5%, trigeminal autonomic cephalalgias (5.3% and other primary headache (1.5%. Among the rest patients, 12.9% were secondary headaches, 5.9% were cranial neuralgias and 2.5% were unspecified or not elsewhere classified. Fourteen point nine percent (275/1843 were given an additional diagnosis of chronic daily headache, including medication-overuse headache (MOH, 49.5%, chronic tension-type headache (CTTH, 32.7% and chronic migraine (CM, 13.5%. The visual analogue scale (VAS score of TTH with MOH was significantly higher than that of CTTH (6.8±2.0 vs 5.6±2.0, P<0.001. The similar result was also observed in VAS score between migraine with MOH and CM (8.0±1.5 vs 7.0±1.5, P = 0.004. The peak age at onset of TTH for male and female were both in the 3(rd decade of life. However, the age distribution at onset of migraine shows an obvious sex difference, i.e. the 2(nd decade for females and the 1(st decade for males.This study revealed the characteristics of the headache clinic outpatients in a tertiary hospital of North China that migraine is

  17. Headaches

    Science.gov (United States)

    ... Development Infections Diseases & Conditions Pregnancy & Baby Nutrition & Fitness Emotions & Behavior School & Family Life First Aid & Safety Doctors & Hospitals ... blood vessels swell, tighten, or go through other changes that stimulate the ... nerves send a rush of pain messages to the brain, and this brings on a ...

  18. Headache

    Science.gov (United States)

    ... Migraines may be triggered by foods, such as chocolate, certain cheeses, or monosodium glutamate (MSG). Caffeine withdrawal, ... while chewing, or weight loss. You have a history of cancer or immune system problem (such as ...

  19. Rounding behavior in the reporting of headache frequency complicates headache chronification research.

    Science.gov (United States)

    Houle, Timothy T; Turner, Dana P; Houle, Thomas A; Smitherman, Todd A; Martin, Vincent; Penzien, Donald B; Lipton, Richard B

    2013-06-01

    To characterize the extent of measurement error arising from rounding in headache frequency reporting (days per month) in a population sample of headache sufferers. When reporting numerical health information, individuals tend to round their estimates. The tendency to round to the nearest 5 days when reporting headache frequency can distort distributions and engender unreliability in frequency estimates in both clinical and research contexts. This secondary analysis of the 2005 American Migraine Prevalence and Prevention study survey characterized the population distribution of 30-day headache frequency among community headache sufferers and determined the extent of numerical rounding ("heaping") in self-reported data. Headache frequency distributions (days per month) were examined using a simplified version of Wang and Heitjan's approach to heaping to estimate the probability that headache sufferers round to a multiple of 5 when providing frequency reports. Multiple imputation was used to estimate a theoretical "true" headache frequency. Of the 24,000 surveys, headache frequency data were available for 15,976 respondents diagnosed with migraine (68.6%), probable migraine (8.3%), or episodic tension-type headache (10.0%); the remainder had other headache types. The mean number of headaches days/month was 3.7 (standard deviation = 5.6). Examination of the distribution of headache frequency reports revealed a disproportionate number of responses centered on multiples of 5 days. The odds that headache frequency was rounded to 5 increased by 24% with each 1-day increase in headache frequency (odds ratio: 1.24, 95% confidence interval: 1.23 to 1.25), indicating that heaping occurs most commonly at higher headache frequencies. Women were more likely to round than men, and rounding decreased with increasing age and increased with symptoms of depression. Because of the coarsening induced by rounding, caution should be used when distinguishing between episodic and chronic

  20. Aromatherapy as treatment for postoperative nausea: a randomized trial.

    Science.gov (United States)

    Hunt, Ronald; Dienemann, Jacqueline; Norton, H James; Hartley, Wendy; Hudgens, Amanda; Stern, Thomas; Divine, George

    2013-09-01

    Postoperative nausea (PON) is a common complication of anesthesia and surgery. Antiemetic medication for higher-risk patients may reduce but does not reliably prevent PON. We examined aromatherapy as a treatment for patients experiencing PON after ambulatory surgery. Our primary hypothesis was that in comparison with inhaling a placebo, PON will be reduced significantly by aromatherapy with (1) essential oil of ginger, (2) a blend of essential oils of ginger, spearmint, peppermint, and cardamom, or (3) isopropyl alcohol. Our secondary hypothesis was that the effectiveness of aromatherapy will depend upon the agent used. A randomized trial of aromatherapy with patients who reported nausea in the postanesthesia care unit was conducted at one ambulatory surgical center. Eligibility criteria were adult, able to give consent, and no history of coagulation problems or allergy to the aromatherapy agents. Before surgery, demographic and risk factors were collected. Patients with a nausea level of 1 to 3 on a verbal descriptive scale (0-3) received a gauze pad saturated with a randomly chosen aromatherapy agent and were told to inhale deeply 3 times; nausea (0-3) was then measured again in 5 minutes. Prophylactic and postnausea antiemetics were given as ordered by physicians or as requested by the patient. A total of 1151 subjects were screened for inclusion; 303 subjects reporting nausea were enrolled (26.3%), and 301 meeting protocol were analyzed (26.2%). The change in nausea level was significant for the blend (P aromatherapy was also significantly reduced with ginger or blend aromatherapy versus saline (P = 0.002 and P aromatherapy would be effective as a treatment for PON was supported. On the basis of our results, future research further evaluating aromatherapy is warranted. Aromatherapy is promising as an inexpensive, noninvasive treatment for PON that can be administered and controlled by patients as needed.

  1. Ambulatory anesthesia and postoperative nausea and vomiting: predicting the probability

    Directory of Open Access Journals (Sweden)

    Hegarty AT

    2016-08-01

    Full Text Available Aoife T Hegarty,1 Muiris A Buckley,1 Conan L McCaul1–3 1Department of Anaesthesia, The Rotunda Hospital, 2Mater Misericordiae University Hospital, 3School of Medicine and Medical Science, University College Dublin, Dublin, Ireland Abstract: Nausea and vomiting are distinctly unpleasant symptoms that may occur after surgery and anesthesia, and high priority is given to their prevention by patients. Research in this area is plentiful and has focused on event prediction and pharmacological prophylaxis but despite this, postoperative nausea and vomiting (PONV typically occurs in 20%–30% of patients in contemporary practice. Prediction of postoperative and postdischarge nausea and vomiting is particularly important in the ambulatory surgical population as these symptoms may occur following discharge from hospital and continue for up to one week when access to antiemetic therapies is limited. Many of the existing predictive scoring systems are based on data from inpatient populations and limited to the first 24 hours after surgery. Scoring systems based on data from ambulatory surgical populations to predict PONV are only moderately good. The best-performing systems in ambulatory patients are those of Sinclair and Sarin with an area under the receiver operating characteristic curve of 0.78 and 0.74, respectively, but are limited by the short duration of follow-up and a greater emphasis on nausea than vomiting. Given that the ability to predict both PONV and postdischarge nausea and vomiting is clearly limited, emphasis has been placed on prophylactic strategies that incorporate antiemetic medication, intravenous hydration, and nonnarcotic analgesia. PONV has been reduced to <10% in institutions using multimodal approaches. Scoring systems may facilitate “risk tailoring” in which patient risk profile is used as a stratification method for pharmacointervention. Keywords: postoperative nausea and vomiting, prediction, antiemetics, anesthesia

  2. Nausea and vomiting after exposure to non-ionic contrast media: incidence and risk factors focusing on preparatory fasting.

    Science.gov (United States)

    Kim, Yeon Soo; Yoon, Soon Ho; Choi, Young Hun; Park, Chang Min; Lee, Whal; Goo, Jin Mo

    2018-04-25

    To prospectively evaluate the incidence of nausea and vomiting after exposure to non-ionic iodinated contrast media (ICM), and to identify potential risk factors, with a focus on fasting duration for solid food and fluids, separately. From January to March 2017, 1175 patients (605 males, 570 females; median age, 60 years; range, 20-91 years) undergoing ICM-enhanced CT were included in this study. Patients received instructions for a 6 h preparatory fast from solid food. Nausea and vomiting after ICM exposure were assessed on a 3-point scale (mild, moderate, severe). Patients' characteristics and the fasting duration were evaluated to identify risk factors using logistic regression analysis. Of the 1175 patients, 34 (2.9%; 95% CI, 2.0-4.0%) experienced mild nausea. No patients experienced vomiting (95% CI, 0.0000-0.0005%). 1173 (99.8%) carried out a 6 h fast, and the median fasting durations were 14 h for solid food (IQR, 12.5-15.5 h) and 11 h for fluid (IQR, 0-13.5 h), respectively. Fasting durations for solid food and fluids were not associated with nausea on uni-variate regression analyses (p = 0.282-1.000 andP=0.146-1.000, respectively). Multi-variate regression analysis revealed that a history of drug hypersensitivity (OR = 4.33; 95% CI, 1.85-17.52; p = .039) was independent risk factors for nausea, whereas iobitridol was less nauseous (OR = 0.32; 95% CI, 0.11-0.90; p = .032). Mild nausea occurred in 2.9% of patients and none vomited in our study population with a 6 h preparatory fast from solid food. Many patients underwent excessive fasting for fluids as well as solid food and their fasting durations were not associated with nausea. Advances in knowledge: We firstly evaluated fasting durations for solid food and fluids, and their impacts on vomiting or nausea after ICM exposure with an instruction of 6 h preparatory fast for solid food: many patients underwent excessive fasting for fluids and the fasting duration was unrelated to

  3. Headache in Patients With Pituitary Lesions: A Longitudinal Cohort Study.

    Science.gov (United States)

    Rizzoli, Paul; Iuliano, Sherry; Weizenbaum, Emma; Laws, Edward

    2016-03-01

    Headache is a presenting feature in 37% to 70% of patients with pituitary tumor. Other pituitary lesions may also present with headache, and together these lesions account for about 20% of all primary brain lesions. Although pituitary lesions have been associated with headache, the exact nature of the relationship remains undefined. It is not always clear whether the presenting headache is an unrelated primary headache, a lesion-induced aggravation of a preexisting primary headache, or a separate secondary headache related to the lesion. To characterize headache in patients referred to a multidisciplinary neuroendocrine clinic with suspected pituitary lesions and to assess changes in headache in those who underwent surgery. We used a self-administered survey of headache characteristics completed by patients upon presentation and after any pituitary surgical procedure. One hundred thirty-three participants completed the preoperative questionnaire (response rate of 99%). The overall prevalence of headache was 63%. Compared to patients without headache, the group with headache was more likely to be female (P = .001), younger (P = .001), and to have had a prior headache diagnosis (P headache localized to the anterior region of the head. Fifty-one patients with headache underwent transsphenoidal pituitary surgery. Headache was not associated with increased odds of having surgery (odds ratio, 0.90). At 3 months, 81% of surgically treated patients with headache who completed the postoperative questionnaire (21/26) reported improvement or resolution of headaches. No patient who completed the postoperative questionnaire (44/84) reported new or worsened headache. Frequent, disabling headaches are common in patients with pituitary lesions referred for neuroendocrine consultation, especially in younger females with a preexisting headache disorder. Surgery in this group was associated with headache improvement or resolution in the majority and was not found to cause or worsen

  4. Headache Attributed to Airplane Travel: A Review of Literature.

    Science.gov (United States)

    Nierenburg, Hida; Jackfert, Katelin

    2018-06-14

    Headaches due to airplane travel are rare but documented in the literature. We aim to provide a review of diagnostic criteria and treatment for this condition. Several cases of this syndrome have been reported since it was first described in 2004. Airplane headache is classified as unilateral, stabbing, orbito-frontal pain, lasting under 30 min, and occurs during ascent or descent of a plane. Patients with this condition can develop anxiety and fear of flying given the intensity and severity of the pain. The pathophysiology of this syndrome is unknown, but theories include suspected barotrauma given changes in barometric pressure during ascent and descent. There are no randomized controlled trials regarding treatment, but case reports suggest headache prevention with pre-treatment with naproxen, decongestants, and triptans prior to air travel. Some non-pharmacological therapies reported include Valsalva maneuvers, chewing, relaxation techniques, and pressure at the pain area. As more cases of headache attributed to airplane travel are reported, epidemiological data can be obtained to further understand the incidence and prevalence of this condition, which can lead to improved treatment options for patients.

  5. The anterior hypothalamus in cluster headache.

    Science.gov (United States)

    Arkink, Enrico B; Schmitz, Nicole; Schoonman, Guus G; van Vliet, Jorine A; Haan, Joost; van Buchem, Mark A; Ferrari, Michel D; Kruit, Mark C

    2017-10-01

    Objective To evaluate the presence, localization, and specificity of structural hypothalamic and whole brain changes in cluster headache and chronic paroxysmal hemicrania (CPH). Methods We compared T1-weighted magnetic resonance images of subjects with cluster headache (episodic n = 24; chronic n = 23; probable n = 14), CPH ( n = 9), migraine (with aura n = 14; without aura n = 19), and no headache ( n = 48). We applied whole brain voxel-based morphometry (VBM) using two complementary methods to analyze structural changes in the hypothalamus: region-of-interest analyses in whole brain VBM, and manual segmentation of the hypothalamus to calculate volumes. We used both conservative VBM thresholds, correcting for multiple comparisons, and less conservative thresholds for exploratory purposes. Results Using region-of-interest VBM analyses mirrored to the headache side, we found enlargement ( p cluster headache compared to controls, and in all participants with episodic or chronic cluster headache taken together compared to migraineurs. After manual segmentation, hypothalamic volume (mean±SD) was larger ( p cluster headache compared to controls (1.72 ± 0.15 ml) and migraineurs (1.68 ± 0.19 ml). Similar but non-significant trends were observed for participants with probable cluster headache (1.82 ± 0.19 ml; p = 0.07) and CPH (1.79 ± 0.20 ml; p = 0.15). Increased hypothalamic volume was primarily explained by bilateral enlargement of the anterior hypothalamus. Exploratory whole brain VBM analyses showed widespread changes in pain-modulating areas in all subjects with headache. Interpretation The anterior hypothalamus is enlarged in episodic and chronic cluster headache and possibly also in probable cluster headache or CPH, but not in migraine.

  6. Clinical roundtable monograph: New data in emerging treatment options for chemotherapy-induced nausea and vomiting.

    Science.gov (United States)

    Morrow, Gary R; Navari, Rudolph M; Rugo, Hope S

    2014-03-01

    Chemotherapy-induced nausea and vomiting (CINV) has long been one of the most troublesome adverse effects of chemotherapy, leading to significant detriments in quality of life and functioning, increased economic costs, and, in some cases, the discontinuation of effective cancer therapy. The past 2 decades have witnessed a dramatic increase in the number of effective antiemetic agents, with the introduction of the serotonin (5-hydroxytryptamine [5-HT₃]) receptor antagonists (ondansetron, granisetron, and palonosetron), the neurokinin-1 (NK₁) receptor antagonists (aprepitant and fosaprepitant), and the identification of other agents that have demonstrated efficacy against CINV, including corticosteroids. These agents often provide excellent control of emesis. Nausea, however, has proven more intractable, particularly in the days after administration of chemotherapy. Newer antiemetic agents under study may provide additional CINV control, particularly against delayed nausea. New agents undergoing review by the US Food and Drug Administration for the prevention of CINV include the novel NK₁ receptor antagonist rolapitant and a fixed-dose combination consisting of the novel NK₁ receptor antagonist netupitant and palonosetron (NEPA). Adherence to clinical practice guidelines has been shown to significantly improve CINV control. As antiemetic therapy continues to evolve, it will be important for clinicians to stay informed of new developments and changes in guidelines.

  7. Clinical aspects of perimenstrual headaches.

    Science.gov (United States)

    Taylor, Frederick R

    2009-02-01

    Menstrual migraine (MM) is either pure, if attacks are limited solely during the perimenstrual window (PMW), or menstrually related (MRM), if two of three PMWs are associated with attacks with additional migraine events outside the PMW. Acute migraine specific therapy is equally effective in MM and non-MM. Although the International Classification of Headache Disorders-II classifies MM without aura, data suggest this needs revision. The studies on extended-cycle oral contraceptives suggest benefits for headache-prone individuals. Triptan mini-prophylaxis outcomes are positive, but a conclusion of "minimal net benefit compared to placebo" is not entirely unwarranted. In a 2008 evidence-based review, grade B recommendations exist for sumatriptan (50 and 100 mg), mefenamic acid (500 mg), and riza-triptan (10 mg) for the acute treatment of MRM. For the preventive mini-prophylactic treatment of MRM, grade B recommendations are provided for transcutaneous estrogen (1.5 mg), frovatriptan (2.5 mg twice daily), and naratriptan (1 mg twice daily).

  8. Headache in 25 consecutive patients with atrial septal defects before and after percutaneous closure--a prospective case series.

    Science.gov (United States)

    Riederer, Franz; Baumgartner, Helmut; Sándor, Peter S; Wessely, Peter; Wöber, Christian

    2011-09-01

    In contrast to patent foramen ovale that is highly prevalent in the general population, atrial septal defect (ASD) is a rare congenital heart defect. The effect of ASD closure on headache and migraine remains a matter of controversy. The objectives of our study were (1) to determine headache prevalence in consecutive patients with ASD scheduled for percutaneous closure for cardiologic indications, using the International Classification of Headache Disorders and (2) to compare headache characteristics before and after closure of ASD. In this observational case series no a priori power analysis was performed. Twenty-five consecutive patients were prospectively included over 27 months. Median duration of follow-up was 12 months [interquartile range 0]. Prevalence of active headache seemed to be higher compared with the general population: any headaches 88% (95% confidence interval 70-96), migraine without aura 28% (14-48), migraine with aura 16% (6-35). After ASD closure, we observed a slightly lower headache frequency (median frequency 1.0 [2.6] vs. 0.3 [1.5] headaches per month; P = .067). In patients with ongoing headaches, a significant decrease in headache intensity (median VAS 7 [3] vs. 5 [4]; P = .036) was reported. Three patients reporting migraine with aura before the intervention noted no migraine with aura attacks at follow-up, 2 of them reported ongoing tension-type headache, 1 migraine without aura. In summary, this prospective observational study confirms the high prevalence of headache, particularly migraine, in ASD patients and suggests a possible small beneficial effect of ASD closure. © 2011 American Headache Society.

  9. Evaluation of headache severity after aneurysmal subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Rachel Swope, PharmD, BCPS

    2014-12-01

    Conclusions: Headache after SAH is persistent and treatment refractory. There may be an association with development of vasospasm and worsening of headache. Novel treatment strategies to attenuate headache in this population are needed.

  10. Prostacyclin (epoprostenol) induces headache in healthy subjects

    DEFF Research Database (Denmark)

    Wienecke, Troels; Olesen, Jes; Oturai, Peter S

    2008-01-01

    on the placebo day (p=0.002). During epoprostenol (0-30 min) and in the post-infusion phase (30-90 min), the area under the curve (AUC) for headache score was significantly larger than during and after placebo (p=0.005). PGI(2) caused headache associated with the dilatation of STA (AUC, p

  11. Some opthalmological aspects of headache | Macgregor | South ...

    African Journals Online (AJOL)

    The ophthalmologist is often consulted about headaches being due to 'the eyes', but although interference with clear vision may occasionally cause headaches, by far the commonest cause of pain in and around rhe eyes is some type of neuralgia affecting rhe first division of the fifth cranial nerve, or one of the variants of ...

  12. Clinical aspects of headache in HIV.

    Science.gov (United States)

    Sheikh, Huma U; Cho, Tracey A

    2014-05-01

    Headaches are commonly seen in those patients with human immunodeficiency virus (HIV) and are the most common form of pain reported among HIV patients. There have been relatively few studies attempting to determine the rates and phenotypes of the headaches that occur in patients with HIV. Patients with HIV are susceptible to a much broader array of secondary headache causes, sometimes with atypical manifestations due to a dampened inflammatory response. The investigation of a headache in the HIV patient should be thorough and focused on making sure that secondary and HIV-specific causes are either ruled out or treated if present. An effective treatment plan should incorporate the use of appropriate pharmacological agents along with the integration of non-pharmacological therapies, such as relaxation and lifestyle regulation. When treating for headaches in patients with HIV, it is important to keep in mind comorbidities and other medications, especially combination antiretroviral therapy. For those with complicated headache histories, referral to a specialized headache center may be appropriate. © 2014 American Headache Society.

  13. Prevalence and Clinical Characteristics of Headaches among ...

    African Journals Online (AJOL)

    2018-01-24

    Jan 24, 2018 ... headache on students' daily physical activity, whether they have seen a doctor on ... Table 3: Comparison of some clinical characteristics by headache .... the prevalence was 3.4% in women and 1.5% in men. The findings of ...

  14. Headache among medical and psychology students.

    Science.gov (United States)

    Ferri-de-Barros, João Eliezer; Alencar, Mauricio José de; Berchielli, Luis Felipe; Castelhano Junior, Luis Carlos

    2011-06-01

    Headaches occur frequently and thus are a key component of sociocentric medical education. To study headaches among students of medicine and psychology in a single university. This was a questionnaire-based survey of a cohort of students of medicine and psychology. The overall lifetime prevalence of headache was 98% and over the last year, 91%. Tensional headache accounted for 59% and migraine 22% in medicine; and 48.5% and 32% respectively in psychology. Forty-five percent reported that headaches had a variable sporadic impact on their productivity. The self-medication rate was 77%. Thirty-six percent reported worsening since admission to the university. The prevalence of headaches was very high. Tension-type headaches predominated in males and migraine in females. Tension-type was more frequent among medical students than among psychology students; migraine was more frequent in psychology (more females) than in medicine. Both kinds of students reported that headaches caused low interference with daily activities. The students reported that their symptoms had worsened since admission to the university.

  15. Pre-attack signs and symptoms in cluster headache: Characteristics and time profile.

    Science.gov (United States)

    Snoer, Agneta; Lund, Nunu; Beske, Rasmus; Jensen, Rigmor; Barloese, Mads

    2018-05-01

    Introduction In contrast to the premonitory phase of migraine, little is known about the pre-attack (prodromal) phase of a cluster headache. We aimed to describe the nature, prevalence, and duration of pre-attack symptoms in cluster headache. Methods Eighty patients with episodic cluster headache or chronic cluster headache, according to ICHD-3 beta criteria, were invited to participate. In this observational study, patients underwent a semi-structured interview where they were asked about the presence of 31 symptoms/signs in relation to a typical cluster headache attack. Symptoms included previously reported cluster headache pre-attack symptoms, premonitory migraine symptoms and accompanying symptoms of migraine and cluster headache. Results Pre-attack symptoms were reported by 83.3% of patients, with an average of 4.25 (SD 3.9) per patient. Local and painful symptoms, occurring with a median of 10 minutes before attack, were reported by 70%. Local and painless symptoms and signs, occurring with a median of 10 minutes before attack, were reported by 43.8% and general symptoms, occurring with a median of 20 minutes before attack, were reported by 62.5% of patients. Apart from a dull/aching sensation in the attack area being significantly ( p cluster headache. Since the origin of cluster headache attacks is still unresolved, studies of pre-attack symptoms could contribute to the understanding of cluster headache pathophysiology. Furthermore, identification and recognition of pre-attack symptoms could potentially allow earlier abortive treatment.

  16. Association between tension-type headache and migraine with sleep bruxism: a systematic review.

    Science.gov (United States)

    De Luca Canto, Graziela; Singh, Vandana; Bigal, Marcelo E; Major, Paul W; Flores-Mir, Carlos

    2014-10-01

    To evaluate the association between tension-type headache and migraine with sleep bruxism (SB). The association between SB and headaches has been discussed in both children and adults. Although several studies suggested a possible association, no systematic analysis of the available published studies exists to evaluate the quantity, quality, and risk of bias among those studies. A systematic review was undertaken, including articles that classified the headaches according to the International Classification of Headache Disorders and SB according to the criteria of the American Association of Sleep Medicine. Only articles in which the objective was to investigate the association between primary headaches (tension-type and migraine) and SB were selected. Detailed individual search strategies for The Cochrane Library, MEDLINE, EMBASE, PubMed, and LILACS were developed. The reference lists from selected articles were also checked. A partial grey literature search was taken by using Google Scholar. The methodology of selected studies was evaluated using the quality in prognosis studies tool. Of 449 identified citations, only 2 studies, both studying adults, fulfilled the inclusion criteria. The presence of SB significantly increased the odds (study 1: odds ratio [OR] 3.12 [1.25-7.7] and study 2: OR 3.8; 1.83-7.84) for headaches, although studies reported different headache type. There is not enough scientific evidence to either support or refute the association between tension-type headache and migraine with SB in children. Adults with SB appear to be more likely to have headache. © 2014 American Headache Society.

  17. Chronic Daily Headache in a Patient With Nasopharyngeal Carcinoma

    Directory of Open Access Journals (Sweden)

    Jiann-Jy Chen

    2010-12-01

    Full Text Available Chronic daily headache (CDH among nasopharyngeal carcinoma (NPC patients is a multidisciplinary challenge. Although imaging studies are recommended to identify skull-base invasion, intracranial metastasis or skull-base osteoradionecrosis, a headache diary is also a practical approach. A 42-year-old woman had been bothered with CDH since she was diagnosed with T3N1M0 stage III NPC 2 years earlier. Although the imaging studies did not show any abnormality, the attending doctor informed her that there remained the possibility of an intracranial or skull-base lesion. She was regularly taking painkillers. Eventually, when her headache diary was examined, the diagnosis of chronic migraine superimposed on medication overuse headache was made according to the ICHD-IIR. The CDH abated after 1 week of outpatient detoxification. The following half year was uneventful. In reporting this case, we suggest that it would be of interest to a number of disciplines including otorhinolaryngologists, oncologists and radio-oncologists. By avoiding medication overuse in similar patients, we hope to improve the quality of life of these individuals.

  18. Neurostimulation for neck pain and headache.

    Science.gov (United States)

    Hong, Jennifer; Ball, Perry A; Fanciullo, Gilbert J

    2014-03-01

    Patients with medically refractory headache disorders are a rare and challenging-to-treat group. The introduction of peripheral neurostimulation (PNS) has offered a new avenue of treatment for patients who are appropriate surgical candidates. The utility of PNS for headache management is actively debated. Preliminary reports suggested that 60-80% of patients with chronic headache who have failed maximum medical therapy respond to PNS. However, complications rates for PNS are high. Recent publication of 2 large randomized clinical trials with conflicting results has underscored the need for further research and careful patient counseling. In this review, we summarize the current evidence for PNS in treatment of chronic migraine, trigeminal autonomic cephalagias and occipital neuralgia, and other secondary headache disorders. © 2014 American Headache Society.

  19. Efficacy of topical Rose (Rosa damascena Mill.) oil for migraine headache: A randomized double-blinded placebo-controlled cross-over trial.

    Science.gov (United States)

    Niazi, Maria; Hashempur, Mohammad Hashem; Taghizadeh, Mohsen; Heydari, Mojtaba; Shariat, Abdolhamid

    2017-10-01

    To evaluate the effect of topical formulation of Rosa damascena Mill. (R. damascena) oil on migraine headache, applying syndrome diffrentiation model. Forty patients with migraine headache were randomly assigned to 2 groups of this double-blind, placebo-controlled cross-over trial. The patients were treated for the first 2 consecutive migraine headache attacks by topical R. damascena oil or placebo. Then, after one week of washout period, cross-over was done. Pain intensity of the patients' migraine headache was recorded at the beginnig and ten-sequence time schadule of attacks up to 24h. In addition, photophobia, phonophobia, and nausea and/or vomitting (N/V) of the patients were recorded as secondary outcomes. Finally, gathered data were analysed in a syndrome differentiation manner to assess the effect of R. damascena oil on Hot- and Cold-type migraine headache. Mean pain intensity of the patients' migraine headache in the different time-points after R. damascena oil or placebo use, was not significantly different. Additionally, regarding mean scores of N/V, photophobia, and phonophobia severity of the patients, no significant differences between the two groups were observed. Finally, applying syndrome differentiation model, the mean score of migraine headache pain intensity turned out to be significantly lower in patients with "hot" type migraine syndrome at in 30, 45, 60, 90, and 120min after R. damascena oil application compared to "cold" types (P values: 0.001, 0.001, <0.001, <0.001, and 0.02; respectively). It seems that syndrome differentiation can help in selection of patients who may benefit from the topical R. damascena oil in short-term relief of pain intensity in migraine headache. Further studies of longer follow-up and larger study population, however, are necessitated for more scientifically rigorous judgment on efficacy of R. damascena oil for patients with migraine headache. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Significantly Elevated Serum Lipase in Pregnancy with Nausea and Vomiting: Acute Pancreatitis or Hyperemesis Gravidarum?

    Directory of Open Access Journals (Sweden)

    Amanda Johnson

    2015-01-01

    Full Text Available Hyperemesis gravidarum is a severe manifestation of nausea and vomiting of pregnancy and it is associated with weight loss and metabolic abnormalities. It is known that abnormal laboratory values, including mildly elevated serum lipase level, could be associated with hyperemesis gravidarum. However, in this case report details of two women with hyperemesis gravidarum but with significantly elevated serum lipase levels were discussed. These patients presented with severe nausea and vomiting but without abdominal pain. They were found to have severely elevated lipase levels over 1,000 units/liter. In the absence of other findings of pancreatitis, they were treated with conservative measures for hyperemesis gravidarum, with eventual resolution to normal lipase levels. Although significantly elevated lipase level in pregnant patients with nausea and vomiting is a concern for acute pancreatitis, these two cases of significantly elevated serum lipase without other clinical findings of pancreatitis led to this report that serum lipase could be quite elevated in hyperemesis gravidarum and that it might not be an accurate biochemical marker for acute pancreatitis. Imaging studies are thus necessary to establish the diagnosis of acute pancreatitis.

  1. Stress and sleep duration predict headache severity in chronic headache sufferers.

    Science.gov (United States)

    Houle, Timothy T; Butschek, Ross A; Turner, Dana P; Smitherman, Todd A; Rains, Jeanetta C; Penzien, Donald B

    2012-12-01

    The objective of this study was to evaluate the time-series relationships between stress, sleep duration, and headache pain among patients with chronic headaches. Sleep and stress have long been recognized as potential triggers of episodic headache (headache days/month), though prospective evidence is inconsistent and absent in patients diagnosed with chronic headaches (≥15 days/month). We reanalyzed data from a 28-day observational study of chronic migraine (n=33) and chronic tension-type headache (n=22) sufferers. Patients completed the Daily Stress Inventory and recorded headache and sleep variables using a daily sleep/headache diary. Stress ratings, duration of previous nights' sleep, and headache severity were modeled using a series of linear mixed models with random effects to account for individual differences in observed associations. Models were displayed using contour plots. Two consecutive days of either high stress or low sleep were strongly predictive of headache, whereas 2 days of low stress or adequate sleep were protective. When patterns of stress or sleep were divergent across days, headache risk was increased only when the earlier day was characterized by high stress or poor sleep. As predicted, headache activity in the combined model was highest when high stress and low sleep occurred concurrently during the prior 2 days, denoting an additive effect. Future research is needed to expand on current findings among chronic headache patients and to develop individualized models that account for multiple simultaneous influences of headache trigger factors. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  2. Does smoking have an influence on postoperative nausea and ...

    African Journals Online (AJOL)

    Background Smoking is considered a risk factor not only for anaesthesia, but for general health. On the other hand, it was demonstrated that smoking reduces postoperative nausea and vomiting. In our study, we have investigated this effect in patients undergoing laparoscopic cholecystectomy. Moreover, we have looked to ...

  3. A survey of postoperative nausea and vomiting in Enugu, Nigeria ...

    African Journals Online (AJOL)

    To achieve a representative sample of everyday surgery, data were collected from 8 types of common surgical procedures in 4 different operating theatres and departments: general surgery, gynecology, ophthalmology and otolaryngology. Results: In the recovery room, the incidence of nausea and vomiting was 15% and ...

  4. postoperative nausea and vomiting in korle bu teach- ing hospital

    African Journals Online (AJOL)

    DOfori-Adjei

    2007-12-01

    Dec 1, 2007 ... SUMMARY. Objective: Postoperative nausea and vomiting (PONV) is one of the most distressing morbidities associated with surgery. Even though the incidence can be as high as 30% elsewhere no work has been done to assess the incidence in any health facility in Ghana. This study was carried out to ...

  5. Intraoperative Gastric Suctioning and Postoperative Nausea, Retching, and Vomiting.

    Science.gov (United States)

    1984-07-01

    of Anesthesiologists CTZ -chemoreceptor trigger zone IV - intravenous kg. - kilogram LES - lower esophageal sphincter Mzg. -milligram ml. -milliliter...the stomach or duedenum * . -= provides the strongest stimulus for vomiting" (Guyton, 1981). Sensory impulses originating in the upper gastro ...duodenum may cause nausea and can result in intestinal contraction during gastric relax- ... , ation allowing reflux of intestinal contents into the

  6. Migraine-like headache in cerebral venous sinus thrombosis.

    Science.gov (United States)

    Tan, Funda Uysal; Tellioglu, Serdar; Koc, Rabia Soylu; Leventoglu, Alev

    2015-01-01

    A 20-year-old female, university student presented with severe, throbbing, unilateral headache, nausea and vomiting that started 2 days ago. The pain was aggravated with physical activity and she had photophobia. She had been taking contraceptive pills due to polycystic ovary for 3 months. Cranial computed tomography was uninformative and she was considered to have the first attack of migraine. She did not benefit from triptan treatment and as the duration of pain exceeded 72 h further imaging was done. Cranial MRI and MR venography revealed a central filling defect and lack of flow in the left sigmoid sinus caused by venous sinus thrombosis. In search for precipitating factors besides the use of contraceptive pills, plasma protein C activity was found to be depressed (42%, normal 70-140%), homocystein was minimally elevated (12.7 μmol/L, normal 0-12 μmol/L) and anti-cardiolipin IgM antibody was close to the upper limit. Copyright © 2015 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  7. The Course of Headache in Patients With Moderate-to-Severe Headache Due to Aneurysmal Subarachnoid Hemorrhage: A Retrospective Cross-Sectional Study.

    Science.gov (United States)

    Hong, Chang-Ki; Joo, Jin-Yang; Kim, Yong Bae; Shim, Yu Shik; Lim, Yong Cheol; Shin, Yong Sam; Chung, Joonho

    2015-01-01

    The purpose of this study was to evaluate the course of headache in patients with moderate-to-severe headache due to aneurysmal subarachnoid hemorrhage (aSAH) and to identify its predisposing factors. Little is known about the long-term course of headache in patients with aSAH. Since September 2009, patients with aSAH have had their headaches prospectively rated using a numeric rating scale (NRS). From this database containing 838 patients, 217 were included and all included patients met the following criteria: (1) presence of ruptured intracranial aneurysms on computed tomography angiography or magnetic resonance angiography; (2) alert consciousness (Glasgow Coma Scale 15); (3) newly onset moderate-to-severe headache (NRS ≥ 4) due to ruptured intracranial aneurysms; and (4) good clinical outcome at discharge (modified Rankin Scale 0, 1, or 2). We observed the changes in NRS scores from initial to 12-month follow-up and identified the predisposing factors of NRS changes. Of the 217 patients, 182 (83.9%) experienced improvement in NRS score ≤ 3 upon discharge. The NRS scores at discharge were significantly lower than those on admission (P headache improvement included previous stroke (odds ratio [OR] = 0.141; 95% CI 0.051-0.381; P headache treated with medication (OR = 0.079; 95% CI 0.010-0.518; P = .008), and endovascular treatment (EVT; OR = 2.531; 95% CI 1.141-5.912; P = .026). The NRS scores tended to decrease continuously until the 12-month follow-up. EVT and symptomatic vasospasm were independently associated with a decrease of NRS in the follow-up periods. The course of headache in patients with aSAH continuously improved during the 12 months of follow-up. Headache improvement might be expected in patients who were treated with EVT and in those who did not have previous stroke or headache. © 2015 American Headache Society.

  8. Noninvasive neuromodulation in cluster headache

    DEFF Research Database (Denmark)

    Láinez, Miguel J A; Jensen, Rigmor

    2015-01-01

    PURPOSE OF REVIEW: Neuromodulation is an alternative in the management of medically intractable cluster headache patients. Most of the techniques are invasive, but in the last 2 years, some studies using a noninvasive device have been presented. The objective of this article is to review the data...... using this approach. RECENT FINDINGS: Techniques as occipital nerve stimulation or sphenopalatine ganglion stimulation are recommended as first-line therapy in refractory cluster patients, but they are invasive and maybe associated with complications. Noninvasive vagal nerve stimulation with an external...... device has been tried in cluster patients. Results from clinical practice and a single randomized clinical trial have been presented showing a reduction of the number of cluster attacks/week in the patients treated with the device. The rate of adverse events was low and most of them were mild. SUMMARY...

  9. A new biomarker of hedonic eating? A preliminary investigation of cortisol and nausea responses to acute opioid blockade.

    Science.gov (United States)

    Daubenmier, Jennifer; Lustig, Robert H; Hecht, Frederick M; Kristeller, Jean; Woolley, Josh; Adam, Tanja; Dallman, Mary; Epel, Elissa

    2014-03-01

    Overweight and obese individuals differ in their degree of hedonic eating. This may reflect adaptations in reward-related neural circuits, regulated in part by opioidergic activity. We examined an indirect, functional measure of central opioidergic activity by assessing cortisol and nausea responses to acute opioid blockade using the opioid antagonist naltrexone in overweight/obese women (mean BMI=31.1±4.8) prior to the start of a mindfulness-based intervention to reduce stress eating. In addition, we assessed indices of hedonic-related eating, including eating behaviors (binge eating, emotional eating, external eating, restraint) and intake of sweets/desserts and carbohydrates (Block Food Frequency); interoceptive awareness (which is associated with dysregulated eating behavior); and level of adiposity at baseline. Naltrexone-induced increases in cortisol were associated with greater emotional and restrained eating and lower interoceptive awareness. Naltrexone-induced nausea was associated with binge eating and higher adiposity. Furthermore, in a small exploratory analysis, naltrexone-induced nausea predicted treatment response to the mindfulness intervention, as participants with more severe nausea at baseline maintained weight whereas those with little or no nausea responses tended to gain weight. These preliminary data suggest that naltrexone-induced cortisol release and nausea may help identify individuals who have greater underlying food reward dependence, which leads to an excessive drive to eat. Future research is needed to confirm this finding and to test if these markers of opioidergic tone might help predict success in certain types of weight management programs. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Does menopause influence nocturnal awakening with headache?

    Science.gov (United States)

    Lucchesi, L M; Hachul, H; Yagihara, F; Santos-Silva, R; Tufik, S; Bittencourt, L

    2013-06-01

    The aim of the present study was to assess whether menopausal status influences the occurrence of nocturnal awakening with headache (NAH) in the female population of Sao Paulo, Brazil. We also examined the relationship of this complaint to sociodemographic determinants, hot flushes, sleep quality and parameters, anxiety and depressive symptoms, somnolence and fatigue according to menopausal status. The female population of the Sao Paulo Epidemiologic Sleep Study (EPISONO) (n = 576) was divided according to menopausal status (pre-, peri-, early and late menopause) based on questionnaires and hormonal blood measures. The complaint of waking up because of a headache at least once a week was assessed by the UNIFESP Sleep questionnaire. Additionally, hot flushes, sleep complaints, anxiety and depressive symptoms, somnolence and fatigue were assessed by specific questionnaires. A full-night polysomnography assessed sleep parameters. The prevalence of NAH in women in the Sao Paulo population was 13.3%. Perimenopause was associated with a higher risk of having NAH (odds ratio 13.9; 95% confidence interval 4.3-45.2). More complaints of NAH were observed in obese women. All the groups with NAH showed more hot flushes, worse subjective sleep quality, more complaints of insomnia, anxiety symptoms and fatigue. We observed a constellation of symptoms in women according to menopausal status and NAH that included hot flushes, sleep complaints, more anxiety symptoms and fatigue. Moreover, some of these symptoms were more frequent in perimenopausal women with NAH. Therefore, we concluded that menopausal status influences NAH and the women in perimenopause presented a high risk of having this complaint.

  11. Late-Onset N-Acetylglutamate Synthase Deficiency: Report of a Paradigmatic Adult Case Presenting with Headaches and Review of the Literature

    Science.gov (United States)

    Cavicchi, Catia; Chilleri, Chiara; Fioravanti, Antonella; Ferri, Lorenzo; Ripandelli, Francesco; Costa, Cinzia; Calabresi, Paolo; Prontera, Paolo; Pochiero, Francesca; Pasquini, Elisabetta; Funghini, Silvia; la Marca, Giancarlo; Donati, Maria Alice

    2018-01-01

    N-acetylglutamate synthase deficiency (NAGSD) is an extremely rare urea cycle disorder (UCD) with few adult cases so far described. Diagnosis of late-onset presentations is difficult and delayed treatment may increase the risk of severe hyperammonemia. We describe a 52-year-old woman with recurrent headaches who experienced an acute onset of NAGSD. As very few papers focus on headaches in UCDs, we also report a literature review of types and pathophysiologic mechanisms of UCD-related headaches. In our case, headaches had been present since puberty (3–4 days a week) and were often accompanied by nausea, vomiting, or behavioural changes. Despite three previous episodes of altered consciousness, ammonia was measured for the first time at 52 years and levels were increased. Identification of the new homozygous c.344C>T (p.Ala115Val) NAGS variant allowed the definite diagnosis of NAGSD. Bioinformatic analysis suggested that an order/disorder alteration of the mutated form could affect the arginine-binding site, resulting in poor enzyme activation and late-onset presentation. After optimized treatment for NAGSD, ammonia and amino acid levels were constantly normal and prevented other headache bouts. The manuscript underlies that headache may be the presenting symptom of UCDs and provides clues for the rapid diagnosis and treatment of late-onset NAGSD. PMID:29364180

  12. Late-Onset N-Acetylglutamate Synthase Deficiency: Report of a Paradigmatic Adult Case Presenting with Headaches and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Catia Cavicchi

    2018-01-01

    Full Text Available N-acetylglutamate synthase deficiency (NAGSD is an extremely rare urea cycle disorder (UCD with few adult cases so far described. Diagnosis of late-onset presentations is difficult and delayed treatment may increase the risk of severe hyperammonemia. We describe a 52-year-old woman with recurrent headaches who experienced an acute onset of NAGSD. As very few papers focus on headaches in UCDs, we also report a literature review of types and pathophysiologic mechanisms of UCD-related headaches. In our case, headaches had been present since puberty (3–4 days a week and were often accompanied by nausea, vomiting, or behavioural changes. Despite three previous episodes of altered consciousness, ammonia was measured for the first time at 52 years and levels were increased. Identification of the new homozygous c.344C>T (p.Ala115Val NAGS variant allowed the definite diagnosis of NAGSD. Bioinformatic analysis suggested that an order/disorder alteration of the mutated form could affect the arginine-binding site, resulting in poor enzyme activation and late-onset presentation. After optimized treatment for NAGSD, ammonia and amino acid levels were constantly normal and prevented other headache bouts. The manuscript underlies that headache may be the presenting symptom of UCDs and provides clues for the rapid diagnosis and treatment of late-onset NAGSD.

  13. Serial headache drawings by children with migraine: correlation with clinical headache status.

    Science.gov (United States)

    Stafstrom, Carl E; Goldenholz, Shira R; Dulli, Douglas A

    2005-10-01

    Children's artistic self-depictions of headache provide valuable insights into their experience of pain and aid in the diagnostic differentiation of headache types. In a previous study, we compared the clinical diagnosis (gold standard) and artistic diagnosis of headaches in 226 children. In approximately 90% of cases, the drawing predicted the clinical diagnosis of migraine versus nonmigraine headache correctly. In the present study, we explored whether headache drawings correlate with clinical improvement after treatment in children with migraine headaches followed longitudinally. Children seen in the Pediatric Neurology Clinic with the chief complaint of headache were asked to draw a picture of what their headache feels like. On subsequent clinic visits, children with the clinical diagnosis of migraine were asked to draw another picture depicting their current headache. The two drawings were compared to assess whether there was improvement; this "artistic response" was then correlated with the child's clinical status (ie, whether the headaches were improved clinically). One hundred eleven children (66 girls, 45 boys) participated in the study, with a mean interval of 5.3 +/- 2.3 (standard error of the mean) months between the first and second visits. The mean age at the first visit was 11.6 +/- 3.1 years. The raters agreed that serial drawings were both improved or both not improved in 99 of the 111 cases (89%; interrater reliability kappa score of 0.767). Fifty-three children had improvements in their headaches and drawings, 3 children had an improved drawing but no clinical headache improvement, 32 children had no improvement in either their drawing or clinical headaches, and 11 children had improved headaches but no improvement in their drawing. The sensitivity of the drawings for clinical improvement was 0.83, and the specificity was 0.91. The predictive value of an improved headache drawing for an improved clinical response was 0.946. There was no

  14. Occipital Headaches in Children: Are They a Red Flag?

    Science.gov (United States)

    Genizi, Jacob; Khourieh-Matar, Amal; Assaf, Nurit; Chistyakov, Irena; Srugo, Isaac

    2017-10-01

    Occipital headache is considered a risk factor for serious secondary headache pathology. The purpose of our study was to assess the etiology of occipital headaches among children visiting the emergency department. Subjects were children aged 5 to 18 years who were referred to the emergency department due to headaches during the years 2013 to 2014. A total of 314 patients with headaches were seen at our emergency department. Thirty-nine patients had occipital headaches. Viral infections were the most prevalent final diagnosis (97; 31%), followed by migraine (37; 11.8%). None of our patients had a brain tumor. There was no difference in final diagnosis between the occipital and nonoccipital groups. The most common causes of occipital headaches are viral infections and primary headaches. Serious intracranial disorders presenting solely as occipital headaches and not accompanied by other neurologic signs are uncommon. Thus, occipital headaches should be evaluated in the same manner as other headache locations.

  15. Cognitive, Personality, and Family Factors in Patients with Migraine Headache

    Directory of Open Access Journals (Sweden)

    Reza Johari-Fard

    2014-01-01

    Full Text Available Migraine is a disorder that has debilitating pain, and affects all aspects of life, including the academic, social, and family life of patients. In addition, studies show the effects of migraine on patient's relationships with family members such as spouse, children, and other family members. In addition to physical pain, migraines are tied to significant psychological and economic costs. Migraineurs tend to have high levels of depression and anxiety, and migraine headaches have a profoundly negative impact on sufferers’ quality of life. In the present research, we investigated the correlations and regressions of cognitive, personality, and family factors with migraine headache, to find predictor factors of migraine. In this study, the following questionnaires were used: For migraine: six-item Headache Impact Test (HIT-6, and Specific Quality of Life Questionnaire Version 2.1.; for cognitive factors: Irrational Beliefs Test and Dysfunctional Attitudes Scale; for personality factors: NEO Personality Inventory; and for family factors: Family Assessment Device. This project was on 58 women with migraine headaches, diagnosed by neurologist. The findings show that, there is a significant regression between cognitive, personality, and family factors and HIT-6. In cognitive factors, frustration reactivity and anxious overconcern, in personality factors, extraversion trait, and in family factors, affective involvement are significant. Moreover, there is a significant regression between cognitive, personality, and family factors and MSQ. In cognitive factors, frustration reactivity, anxious overconcern, and helplessness, in personality factors, agreeableness and consciousness, and in family factors, affective involvement and general functioning are significant. This project showed that cognitive, personality, and family factors have a correlation with migraine headache.

  16. Obesity and headache: part I--a systematic review of the epidemiology of obesity and headache.

    Science.gov (United States)

    Chai, Nu Cindy; Scher, Ann I; Moghekar, Abhay; Bond, Dale S; Peterlin, B Lee

    2014-02-01

    Individually, both obesity and headache are conditions associated with a substantial personal and societal impact. Recent data support that obesity is comorbid with headache in general and migraine specifically, as well as with certain secondary headache conditions such as idiopathic intracranial hypertension. In the current manuscript, we first briefly review the epidemiology of obesity and common primary and secondary headache disorders individually. This is followed by a systematic review of the general population data evaluating the association between obesity and headache in general, and then obesity and migraine and tension-type headache disorders. Finally, we briefly discuss the data on the association between obesity and a common secondary headache disorder that is associated with obesity, idiopathic intracranial hypertension. Taken together, these data suggest that it is important for clinicians and patients to be aware of the headache/migraine-obesity association, given that it is potentially modifiable. Hypotheses for mechanisms of the obesity-migraine association and treatment considerations for overweight and obese headache sufferers are discussed in the companion manuscript, as part II of this topic. © 2014 American Headache Society.

  17. HIT-6 and MIDAS as measures of headache disability in a headache referral population.

    Science.gov (United States)

    Sauro, Khara M; Rose, Marianne S; Becker, Werner J; Christie, Suzanne N; Giammarco, Rose; Mackie, Gordon F; Eloff, Arnoldas G; Gawel, Marek J

    2010-03-01

    The objective of this study was to compare the headache impact test (HIT-6) and the migraine disability assessment scale (MIDAS) as clinical measures of headache-related disability. The degree of headache-related disability is an important factor in treatment planning. Many quality of life and headache disability measures exist but it is unclear which of the available disability measures is the most helpful in planning and measuring headache management. We compared HIT-6 and MIDAS scores from 798 patients from the Canadian Headache Outpatient Registry and Database (CHORD). Correlation and regression analyses were used to examine the relationships between the HIT-6 and MIDAS total scores, headache frequency and intensity, and Beck Depression Inventory (BDI-II) scores. A positive correlation was found between HIT-6 and MIDAS scores (r = 0.52). The BDI-II scores correlated equally with the HIT-6 and the MIDAS (r = 0.42). There was a non-monotonic relationship between headache frequency and the MIDAS, and a non-linear monotonic relationship between headache frequency and the HIT-6 (r = 0.24). The correlation was higher between the intensity and the HIT-6 scores (r = 0.46), than MIDAS (r = 0.26) scores. Seventy-nine percent of patients fell into the most severe HIT-6 disability category, compared with the 57% of patients that fell into the most severe MIDAS disability category. Significantly more patients were placed in a more severe category with the HIT-6 than with the MIDAS (McNemar chi-square = 191 on 6 d.f., P MIDAS appear to measure headache-related disability in a similar fashion. However, some important differences may exist. Headache intensity appears to influence HIT-6 score more than the MIDAS, whereas the MIDAS was influenced more by headache frequency. Using the HIT-6 and MIDAS together may give a more accurate assessment of a patient's headache-related disability.

  18. Refractory migraine in a headache clinic population

    Directory of Open Access Journals (Sweden)

    Fernandez-Torron Roberto

    2011-08-01

    Full Text Available Abstract Background Many migraineurs who seek care in headache clinics are refractory to treatment, despite advances in headache therapies. Epidemiology is poorly characterized, because diagnostic criteria for refractory migraine were not available until recently. We aimed to determine the frequency of refractory migraine in patients attended in the Headache Unit in a tertiary care center, according to recently proposed criteria. Methods The study population consisted of a consecutive sample of 370 patients (60.8% females with a mean age of 43 years (range 14-86 evaluated for the first time in our headache unit over a one-year period (between October 2008 and October 2009. We recorded information on clinical features, previous treatments, Migraine Disability Assessment Score (MIDAS, and final diagnosis. Results Overall migraine and tension-type headache were found in 46.4% and 20.5% of patients, respectively. Refractory migraine was found in 5.1% of patients. In refractory migraineurs, the mean MIDAS score was 96, and 36.8% were medication-overusers. Conclusions Refractory migraine is a relatively common and very disabling condition between the patients attended in a headache unit. The proposed operational criteria may be useful in identifying those patients who require care in headache units, the selection of candidates for combinations of prophylactic drugs or invasive treatments such as neurostimulation, but also to facilitate clinical studies in this patient group.

  19. Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults.

    Science.gov (United States)

    Derry, Sheena; Moore, R Andrew

    2013-04-30

    This is an updated version of the original Cochrane review published in Issue 11, 2010 (Derry 2010). Migraine is a common, disabling condition and a burden for the individual, health services and society. Many sufferers choose not to, or are unable to, seek professional help and rely on over-the-counter analgesics. Co-therapy with an antiemetic should help to reduce nausea and vomiting, which are commonly associated with migraine. To determine the efficacy and tolerability of paracetamol (acetaminophen), alone or in combination with an antiemetic, compared with placebo and other active interventions in the treatment of acute migraine in adults. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and the Oxford Pain Relief Database for studies through 4 October 2010 for the original review, and to 13 February 2013 for the update. Two clinical trials registers (ClinicalTrials.gov and gsk-clinicalstudyregister.com) were also searched on both occasions. We included randomised, double-blind, placebo- or active-controlled studies using self-administered paracetamol to treat a migraine headache episode, with at least 10 participants per treatment arm. Two review authors independently assessed trial quality and extracted data. Numbers of participants achieving each outcome were used to calculate relative risk and numbers needed to treat (NNT) or harm (NNH) compared with placebo or other active treatment. Searches for the update identified one additional study for inclusion. Eleven studies (2942 participants, 5109 attacks) compared paracetamol 1000 mg, alone or in combination with an antiemetic, with placebo or other active comparators, mainly sumatriptan 100 mg. For all efficacy outcomes paracetamol was superior to placebo, with NNTs of 12 (19% response with paracetamol, 10% with placebo), 5.0 (56% response with paracetamol, 36% with placebo) and 5.2 (39% response with paracetamol, 20% with placebo) for 2-hour pain-free and 2- and 1

  20. Effects of Anger Awareness and Expression Training versus Relaxation Training on Headaches: A Randomized Trial

    Science.gov (United States)

    Slavin-Spenny, Olga; Lumley, Mark A.; Thakur, Elyse R.; Nevedal, Dana C.; Hijazi, Alaa M.

    2013-01-01

    Background and purpose Stress contributes to headaches, and effective interventions for headaches routinely include relaxation training (RT) to directly reduce negative emotions and arousal. Yet, suppressing negative emotions, particularly anger, appears to augment pain, and experimental studies suggest that expressing anger may reduce pain. Therefore, we developed and tested anger awareness and expression training (AAET) on people with headaches. Methods Young adults with headaches (N = 147) were randomized to AAET, RT, or a wait-list control. We assessed affect during sessions, and process and outcome variables at baseline and 4 weeks after treatment. Results On process measures, both interventions increased self-efficacy to manage headaches, but only AAET reduced alexithymia and increased emotional processing and assertiveness. Yet, both interventions were equally effective at improving headache outcomes relative to controls. Conclusions Enhancing anger awareness and expression may improve chronic headaches, although not more than RT. Researchers should study which patients are most likely to benefit from emotional expression versus emotional reduction approaches to chronic pain. PMID:23620190

  1. Headache in patients with chronic obstructive pulmonary disease: effects of chronic hypoxaemia.

    Science.gov (United States)

    Ozge, Aynur; Ozge, Cengiz; Kaleagasi, Hakan; Yalin, Osman Ozgür; Unal, Ozgür; Ozgür, Eylem S

    2006-02-01

    The frequency and characteristics of headache in patients with chronic obstructive pulmonary disease (COPD) are not clear and there are only a few studies that have assessed the relationship between chronic hypoxaemia and headache. We performed this study in order to evaluate the frequency and characteristics of headache in COPD patients. A total of 119 patients, with a mean age of 63.4 +/- 8.2 years, diagnosed with moderate or severe stable COPD were included in the study. Overall 31.9% of the patients complained of headache and 45.4% were reported to have sleep disorders. There were significant effects of family history of COPD, having other systemic disorders or sleep disorders (snoring, bruxism, restless leg syndrome, etc.) and laboratory data of chronic hypoxaemia and airway obstruction on headache co-morbidity. In conclusion, possibly being a specific subtype of elderly headache, headache in patients with moderate or severe COPD is a common problem and future studies are needed to obtain more knowledge about its pathophysiological and clinical basis.

  2. Long-term effects of octreotide on pituitary gigantism: its analgesic action on cluster headache.

    Science.gov (United States)

    Otsuka, Fumio; Mizobuchi, Satoshi; Ogura, Toshio; Sato, Kenji; Yokoyama, Masataka; Makino, Hirofumi

    2004-10-01

    We report the case of 19-year-old man with pituitary gigantism due to growth hormone-producing pituitary macroadenoma. The patient complained of recurrent headache and excessive growth spurt since age 15. Octreotide administration was initiated following transsphenoidal pituitary adenomectomy. Octreotide injection for 4 years efficaciously reduced the size of remnant adenoma as well as serum growth hormone levels. Notably, octreotide exhibited a potent analgesic effect on his intractable cluster headache that has continued even after reduction of the adenoma volume. The analgesic effect lasted 2 to 6 hours after each injection and no tachyphylaxis to octreotide appeared during 4-year treatment. To characterize the headache and the pain intensity, analgesic drugs including octreotide, lidocaine, morphine and thiopental were tested using a visual analogue scale (VAS) evaluation, with the result that octreotide exhibited a prompt and complete disappearance of the headache. Headache relief was in part reproduced by morphine injection (56% reduction) but not by lidocaine or thiopental. The present case suggests that the intractable headache associated with pituitary gigantism is possibly related to the endogenous opioid system. Thus, the headache control by octreotide is clinically helpful for continuation of the self-injection regimen.

  3. Evaluation of headache service quality indicators

    DEFF Research Database (Denmark)

    Katsarava, Zaza; Gouveia, Raquel Gil; Jensen, Rigmor

    2015-01-01

    that deficiencies in headache care worldwide might be recognized and rectified. These indicators themselves require evaluation and proof of fitness for purpose. This pilot study begins this process. METHODS: We tested the quality indicators in the tertiary headache centres of the University of Duisburg...... of ensuring equal access to the services); and over protocols for reporting serious adverse events. CONCLUSION: This pilot study to assess feasibility of the methods and acceptability of the instruments of headache service quality evaluation was successful. The project is ready to be taken into its next...

  4. Associations between headache and stress, alcohol drinking, exercise, sleep, and comorbid health conditions in a Japanese population.

    Science.gov (United States)

    Yokoyama, Masako; Yokoyama, Tetsuji; Funazu, Kazuo; Yamashita, Takeshi; Kondo, Shuji; Hosoai, Hiroshi; Yokoyama, Akira; Nakamura, Haruo

    2009-06-01

    We conducted a cross-sectional survey of 12,988 subjects aged 20-79 years (5,908 men and 7,090 women) receiving health checkups at a Tokyo clinic. They filled out a self-administered structured questionnaire, and 5.4% of the men and 15.4% of the women reported having headaches. Younger subjects were more prone to having headaches. The likelihood of having headaches increased with stress level and decreased ability to relieve stress in both genders. There was an inverse dose-response relationship between having headaches and alcohol consumption, and less walking/exercise and sleep problems increased the likelihood of headaches in both genders. Headache sufferers of both genders were more likely to report multiple additional poor health conditions. A multivariate stepwise logistic analysis showed that age, self-estimated degree of stress, reported number of additional poor health conditions, and less alcohol consumption were independently correlated with having headaches. In conclusion, although women were more susceptible to headache, Japanese men and women in Tokyo shared factors associated with headache, including age, stress, having other poor health conditions, alcohol consumption, sleep, and exercise.

  5. Sensitizing Effects of Pretreatment Measures on Cancer Chemotherapy Nausea and Vomiting.

    Science.gov (United States)

    Gard, Diane; And Others

    1988-01-01

    Explored sensitizing effects of pretreatment assessment on posttreatment chemotherapy nausea and vomiting and interactive effects of personal dispositions for information seeking. Oncology patients rated side effects experienced previously (experimental condition), or parking conditions (control). Posttreatment, nausea of experimentals was…

  6. Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting: A Comparative Study From Sudan

    Directory of Open Access Journals (Sweden)

    Alaa A.M. Osman

    2018-05-01

    Full Text Available Purpose: Chemotherapy-induced nausea and vomiting (CINV is a distressing adverse effect. Neurokinin-1 receptor antagonist (NK1RA–containing regimens are the standard regimens for CINV prophylaxis in patients with cancer receiving highly or moderately emetogenic chemotherapy (HEC or MEC. NK1RA agents are expensive and were not registered in Sudan. Recently, regimens containing olanzapine, the available and affordable medication in Sudan, were introduced as another option. This study aimed to compare the efficacy of an olanzapine-containing regimen with the antiemetic regimen that was currently used in our institute for CINV prophylaxis in HEC/MEC settings. Patients and Methods: The study prospectively compared an olanzapine-containing regimen (acute phase: olanzapine, ondansetron, dexamethasone; delayed phase: olanzapine, ondansetron with an ondansetron/dexamethasone regimen (acute phase: ondansetron, dexamethasone; delayed phase: ondansetron in adult patients with cancer receiving HEC or MEC. The study outcomes were complete response (CR; no emesis and no rescue medications and nausea control (no nausea, which were assessed in the acute (0 to 24 hours, delayed (24 to 120 hours, and overall (0 to 120 hours phases. Results: The study included 131 patients (olanzapine-containing: 50 patients; ondansetron/dexamethasone: 81 patients. CR and nausea control were higher in the olanzapine-containing than in the ondansetron/dexamethasone regimen (CR: acute phase, 86% v 71.6%; P = .086; delayed phase, 72% v 30.9%; P < .001; overall phase, 66% v 25.9%; P < .001; nausea control: acute phase, 86% v 74.1%; P = .127; delayed phase, 76% v 34.6%; P < .001; overall phase, 72% v 29.6%; P < .001. The major toxicity of olanzapine was grade 1 and 2 sedation or drowsiness (25 patients. Conclusion: An olanzapine-containing regimen has better efficacy for prevention of CINV in the HEC/MEC setting. Oncologists working in a limited-resource setting should be familiar

  7. Long-term occipital nerve stimulation for drug-resistant chronic cluster headache.

    Science.gov (United States)

    Leone, Massimo; Proietti Cecchini, Alberto; Messina, Giuseppe; Franzini, Angelo

    2017-07-01

    Introduction Chronic cluster headache is rare and some of these patients become drug-resistant. Occipital nerve stimulation has been successfully employed in open studies to treat chronic drug-resistant cluster headache. Data from large group of occipital nerve stimulation-treated chronic cluster headache patients with long duration follow-up are advantageous. Patients and methods Efficacy of occipital nerve stimulation has been evaluated in an experimental monocentric open-label study including 35 chronic drug-resistant cluster headache patients (mean age 42 years; 30 men; mean illness duration: 6.7 years). The primary end-point was a reduction in number of daily attacks. Results After a median follow-up of 6.1 years (range 1.6-10.7), 20 (66.7%) patients were responders (≥50% reduction in headache number per day): 12 (40%) responders showed a stable condition characterized by sporadic attacks, five responders had a 60-80% reduction in headache number per day and in the remaining three responders chronic cluster headache was transformed in episodic cluster headache. Ten (33.3%) patients were non-responders; half of these have been responders for a long period (mean 14.6 months; range 2-48 months). Battery depletion (21 patients 70%) and electrode migration (six patients - 20%) were the most frequent adverse events. Conclusions Occipital nerve stimulation efficacy is confirmed in chronic drug-resistant cluster headaches even after an exceptional long-term follow-up. Tolerance can occur years after improvement.

  8. In-Depth Review of Symptoms, Triggers, and Treatment of Occipital Migraine Headaches (Site IV).

    Science.gov (United States)

    Ascha, Mona; Kurlander, David E; Sattar, Abdus; Gatherwright, James; Guyuron, Bahman

    2017-06-01

    This study reports the surgical technique and efficacy of deactivation of occipital-triggered migraine headaches. In addition, it reports the effect of surgical deactivation of occipital-triggered migraine headaches on migraine triggers and associated symptoms other than pain. One hundred ninety-five patients undergoing surgery for occipital-triggered migraine headaches performed by a single surgeon, and followed for at least 1 year, were analyzed. Median regression adjusted for age, sex, and follow-up time was used to determine postoperative reduction in occipital-specific Migraine Headache Index, which is the product of migraine duration, frequency, and severity. Reduction in migraine-days was also measured. The association between symptom or trigger resolution and occipital-specific Migraine Headache Index reduction was studied by logistic regression. Details of surgical treatment are discussed and complication rates reported. Eighty-two percent of patients (n = 160) reported successful surgery at least 12 months postoperatively (mean follow-up, 3.67 years). Eighty-six percent (n = 168) had successful surgery as measured by migraine-days. Fifty-two percent reported complete occipital-triggered migraine headaches elimination. Symptoms resolving with successful surgery beyond headache include being bothered by light and noise, feeling lightheaded, difficulty concentrating, vomiting, blurred/double vision, diarrhea, visual aura, numbness and tingling, speech difficulty, and limb weakness (p occipital-triggered migraine headaches provides long-lasting migraine relief. Successful site IV surgery is associated with changes in specific symptoms and triggers. This can assist in trigger avoidance and aid occipital-triggered migraine headache trigger-site identification. Therapeutic, IV.

  9. Cluster Headache Clinical Phenotypes: Tobacco Nonexposed (Never Smoker and No Parental Secondary Smoke Exposure as a Child) versus Tobacco-Exposed: Results from the United States Cluster Headache Survey.

    Science.gov (United States)

    Rozen, Todd D

    2018-05-01

    To present results from the United States Cluster Headache Survey comparing the clinical presentation of tobacco nonexposed and tobacco-exposed cluster headache patients. Cluster headache is uniquely tied to a personal history of tobacco usage/cigarette smoking and, if the individual cluster headache sufferer did not smoke, it has been shown that their parent(s) typically did and that individual had significant secondary smoke exposure as a child. The true nontobacco exposed (no personal or secondary exposure) cluster headache sufferer has never been fully studied. The United States Cluster Headache Survey consisted of 187 multiple choice questions related to cluster headache including: patient demographics, clinical headache characteristics, family history, triggers, smoking history (personal and secondary), and headache-related disability. The survey was placed on a website from October through December 2008. One thousand one hundred thirty-four individuals completed the survey. One hundred thirty-three subjects or 12% of the surveyed population had no personal smoking/tobacco use history and no secondary smoke exposure as an infant/child, thus a nontobacco exposed population. In the nonexposed population, there were 87 males and 46 females with a gender ratio of 1.9:1. Episodic cluster headache occurred in 80% of nonexposed subjects. One thousand and one survey responders or 88% were tobacco-exposed (729 males and 272 females) with a gender ratio of 2.7:1. Eighty-three percent had a personal smoking history, while only 17% just had parents who smoked with secondary smoke exposure. Eighty-five percent of smokers had double exposure with a personal smoking history and secondary exposure as a child. Nonexposed cluster headache subjects are significantly more likely to develop cluster headache at ages 40 years and younger, while the exposed sufferers are significantly more likely to develop cluster headache at 40 years of age and older. Nonexposed patients have a

  10. Are headache and temporomandibular disorders related? A blinded study.

    Science.gov (United States)

    Ballegaard, V; Thede-Schmidt-Hansen, P; Svensson, P; Jensen, R

    2008-08-01

    To investigate overlaps between headache and temporomandibular disorders (TMD) in a clinical headache population and to describe the prevalence of TMD in headache patients, 99 patients referred to a specialized headache centre were diagnosed according to Research Diagnostic Criteria for TMD (RDC/TMD) and classified in headache groups according to the International Classification of Headache Disorders, second edition for headache diagnoses in a blinded design. The prevalence of TMD in the headache population was 56.1%. Psychosocial dysfunction caused by TMD pain was observed in 40.4%. No significant differences in TMD prevalence were revealed between headache groups, although TMD prevalence tended to be higher in patients with combined migraine and tension-type headache. Moderate to severe depression was experienced by 54.5% of patients. Patients with coexistent TMD had a significantly higher prevalence of depression-most markedly in patients with combined migraine and tension-type headache. Our studies indicate that a high proportion of headache patients have significant disability because of ongoing chronic TMD pain. The trend to a higher prevalence of TMD in patients with combined migraine and tension-type headache suggests that this could be a risk factor for TMD development. A need for screening procedures and treatment strategies concerning depression in headache patients with coexistent TMD is underlined by the overrepresentation of depression in this group. Our findings emphasize the importance of examination of the masticatory system in headache sufferers and underline the necessity of a multidimensional approach in chronic headache patients.

  11. Selective attention of students suffering from primary headaches in a ...

    African Journals Online (AJOL)

    Background: Headache patients frequently complain about difficulties in attention and concentration, even when they are headache-free and psychometric studies concerning attentional deficits in headache patients between attacks are scarce. Objective: To evaluate selective attention of headache patients in a pain free ...

  12. Presentation of chronic daily headache : A clinical study

    NARCIS (Netherlands)

    Spierings, E L H; Schroevers, M.; Honkoop, P.C.; Sorbi, M.

    We studied the presentation of chronic daily headache in 258 patients from a private headache practice, 50 men and 208 women. Chronic daily headache was defined as headaches, occurring at least 5 days per week for at least 1 year. Seventy-seven percent of the patients experienced the onset of

  13. Psychological issues in the evaluation and treatment of tension-type headache.

    Science.gov (United States)

    Rosen, Noah L

    2012-12-01

    Tension-type headache is the most common headache disorder, affecting approximately 40 % of Americans within a one-year span. Although the most common form, episodic tension-type headache, is rarely impairing, more frequent tension-type headache can occur with significant disability and psychological comorbidity. Appreciating the psychological impact, assessing the associated biopsychosocial issues, and understanding patients' coping styles are important in forming an appropriate treatment plan and maximizing treatment outcomes. A range of psychological therapies including relaxation training, cognitive behavioral therapy, biofeedback and mindfulness have demonstrated utility in treating chronic pain conditions and reducing the associated disability. This may be particularly applicable to special populations, including pediatric patients, pregnant patients and geriatric. Psychological assessment and treatment may be done conjointly with medication management and expands treatment options. There is great need to continue researching the effects of psychological treatments, standardizing interventions and making them available to the wider population.

  14. Heat stress disorders and headache: a case of new daily persistent headache secondary to heat stroke

    OpenAIRE

    Di Lorenzo, C; Ambrosini, A; Coppola, G; Pierelli, F

    2009-01-01

    Headache is considered as a common symptom of heat stress disorders (HSD), but no forms of secondary headache from heat exposure are reported in the International Classification of Headache Disorders-2 Edition (ICHD-II). Heat-stroke (HS) is the HSD most severe condition, it may be divided into two forms: classic (due to a long period environmental heat exposure) and exertional (a severe condition caused by strenuous physical exercises in heat environmental conditions). Here we report the case...

  15. Disability, anxiety and depression associated with medication-overuse headache can be considerably reduced by detoxification and prophylactic treatment

    DEFF Research Database (Denmark)

    Bendtsen, L; Munksgaard, Sb; Tassorelli, C

    2014-01-01

    OBJECTIVE: The objective of this article is to investigate whether headache-related disability, depression and anxiety can be reduced by detoxification and prophylactic treatment in patients with medication-overuse headache (MOH). METHODS: Patients with MOH were included from six centres in Europ...

  16. Headache and Vascular Events with Brain Tumors

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2013-05-01

    Full Text Available Investigators at the Children's Hospital of Philadelphia, PA, performed a retrospective study of 265 children with brain tumors who received cranial irradiation and developed severe recurrent headache.

  17. Neurobiology and sleep disorders in cluster headache

    DEFF Research Database (Denmark)

    Barloese, Mads Christian Johannes

    2015-01-01

    of daylight, substantially poorer sleep quality in patients compared to controls which was present not only inside the clusters but also outside, affected REM-sleep in patients without a particular temporal connection to nocturnal attacks, equal prevalence of sleep apnea in both patient and control groups......Cluster headache is characterized by unilateral attacks of severe pain accompanied by cranial autonomic features. Apart from these there are also sleep-related complaints and strong chronobiological features. The interaction between sleep and headache is complex at any level and evidence suggests...... that it may be of critical importance in our understanding of primary headache disorders. In cluster headache several interactions between sleep and the severe pain attacks have already been proposed. Supported by endocrinological and radiological findings as well as the chronobiological features, predominant...

  18. Noninvasive neuromodulation in migraine and cluster headache.

    Science.gov (United States)

    Starling, Amaal

    2018-06-01

    The purpose of this narrative review is to provide an overview of the currently available noninvasive neuromodulation devices for the treatment of migraine and cluster headache. Over the last decade, several noninvasive devices have undergone development and clinical trials to evaluate efficacy and safety. Based on this body of work, single-pulse transcranial magnetic stimulation, transcutaneous supraorbital neurostimulation, and noninvasive vagal nerve stimulation devices have been cleared by the United States Food and Drug Administration and are available for clinical use for the treatment of primary headache disorders. Overall, these novel noninvasive devices appear to be safe, well tolerated, and have demonstrated promising results in clinical trials in both migraine and cluster headache. This narrative review will provide a summary and update of the proposed mechanisms of action, evidence, safety, and future directions of various currently available modalities of noninvasive neuromodulation for the treatment of migraine and cluster headache.

  19. Neurostimulation therapies for primary headache disorders

    DEFF Research Database (Denmark)

    Magis, Delphine; Jensen, Rigmor; Schoenen, Jean

    2012-01-01

    Most pharmacological treatments of primary headache disorders are partially effective and have cumbersome side effects. Therapies with better efficacy and tolerance are needed. Neurostimulation techniques may have this potential. This is an attempt to summarize the latest clinical trial results...

  20. Young adolescents' use of medicine for headache:

    DEFF Research Database (Denmark)

    Holstein, Bjørn E; Andersen, Anette; Krølner, Rikke

    2008-01-01

    OBJECTIVE: Use of medicines for headache is common among young adolescents but little is known about their sources of supply and access to medicines. The purpose was to describe sources of supply, availability and accessibility at home and to examine if supply, availability and accessibility were...... associated with medicine use. METHODS: Cross-sectional study in eight schools where all fifth and seventh grade students (11- and 13-year-olds) answered a questionnaire about socio-demographic factors, health and medicine use. Response rate: 84.0%, n = 595. RESULTS: The reported prevalence of headache...... at least monthly was 45.0%, and 42.5% had used medicines for headache during the past month. 68.2% reported that medicines for headache were always available at home, and 22.2% were allowed to use these without asking for permission. Most pupils received medicine from their parents (73.1%) and physicians...

  1. Sinking Brain: Unusual Cause of Orthostatic Headache

    Directory of Open Access Journals (Sweden)

    Raina R

    2015-04-01

    Full Text Available We report a case presenting with an orthostatic headache. Brain magnetic resonance imaging (MRI revealed typical pachymeningeal enhancement. CT myelography revealed leakage at the thoracic level. Patient was successfully treated by lumbar epidural blood patch (EBP.

  2. Obesity and Headache: Part I – A Systematic Review of the Epidemiology of Obesity and Headache

    Science.gov (United States)

    Chai, Nu Cindy; Scher, Ann I.; Moghekar, Abhay; Bond, Dale S.; Peterlin, B. Lee

    2014-01-01

    Individually, both obesity and headache are conditions associated with a substantial personal and societal impact. Recent data support that obesity is comorbid with headache in general and migraine specifically, as well as with certain secondary headache conditions such as idiopathic intracranial hypertension. In the current manuscript, we first briefly review the epidemiology of obesity and common primary and secondary headache disorders individually. This is followed by a systematic review of the general population data evaluating the association between obesity and headache in general, and then obesity and migraine and tension-type headache disorders. Finally, we briefly discuss the data on the association between obesity and a common secondary headache disorder that is associated with obesity, idiopathic intracranial hypertension. Taken together, these data suggest that it is important for clinicians and patients to be aware of the headache/migraine-obesity association, given that it is potentially modifiable. Hypotheses for mechanisms of the obesity-migraine association and treatment considerations for overweight and obese headache sufferers are discussed in the companion manuscript, as part II of this topic. PMID:24512574

  3. The role of muscles in tension-type headache

    DEFF Research Database (Denmark)

    Bendtsen, Lars; Fernández-de-la-Peñas, César

    2011-01-01

    The tenderness of pericranial myofascial tissues and number of myofascial trigger points are considerably increased in patients with tension-type headache (TTH). Mechanisms responsible for the increased myofascial pain sensitivity have been studied extensively. Peripheral activation...... to prolonged nociceptive stimuli from pericranial myofascial tissues seem to be responsible for the conversion of episodic to chronic TTH. Treatment directed toward muscular factors include electromyography biofeedback, which has a documented effect in patients with TTH, as well as physiotherapy and muscle...

  4. Cognitive, Personality, and Family Factors in Patients with Migraine Headache

    OpenAIRE

    Reza Johari-Fard; Farzad Goli; Amirreza Boroumand

    2014-01-01

    Migraine is a disorder that has debilitating pain, and affects all aspects of life, including the academic, social, and family life of patients. In addition, studies show the effects of migraine on patient's relationships with family members such as spouse, children, and other family members. In addition to physical pain, migraines are tied to significant psychological and economic costs. Migraineurs tend to have high levels of depression and anxiety, and migraine headaches have a profoundly ...

  5. Hair Transplantation in Migraine Headache Patients.

    Science.gov (United States)

    Ors, Safvet

    2017-09-01

    Migraine headache is a primary neurologic disease affecting millions of people worldwide. As a consequence, quality of life is diminished, productivity suffers (through loss of work force), and treatment costs are substantial. The occurrence rate in the general population is quite high, with women accounting for 3 of every 4 cases. Between January 2011 and May 2012, a total of 221 patients received hair transplants. Another 590 patients underwent hair transplantation between June 2012 and December 2016. Initially (first interval), patients were not questioned on migraine headaches in preoperative visits, but questioning was regularly done thereafter. Overall, 150 patients given transplants in the first period were surveyed by phone regarding preoperative migraine headaches. Aside from the 1 incidental discovery, no other instances of migraine emerged. Headache origins were occipital-frontal in 2 patients, occipital-temporal in 2 patients, and occipital-temporal-frontal in the 2 others. Donor/receiver areas in hair transplantation and migraine trigger zones shared locations. Headache frequencies ranged from 4 to 8 days per month (average, 6 days), and pain scores were 5-8 (10 being highest). Duration of pain was 3-5 hours (average, 4 hours). All six patients had used various medications, such as triptans, ergot, and nonsteroidal anti-inflammatory drugs, before hair transplantation. The 1 female patient was a 32-year-old seeking treatment for alopecia, with a 6-year history of migraine headaches. The male patients presenting with androgenetic alopecia (grade 4-5 by Norwood classification) had 6- to 20-year migrainous histories. After hair transplantation, each migraine sufferer was checked once in the first month and then once every 3 months. Those who could not appear in person after the first year were evaluated by phone every 3 months. Migraine headaches had ceased in all 6 patients, none of whom used medical treatments for migraines thereafter. The postoperative

  6. Chemotherapy- and cancer-related nausea and vomiting

    OpenAIRE

    Warr, D.G.

    2008-01-01

    Approximately one half of cancer patients will experience nausea or vomiting during the course of their disease either because of the cancer itself or because of their treatment. Emesis attributable to cancer warrants a careful investigation to determine whether a treatable underlying cause is responsible. Interventions using dexamethasone and octreotide may reduce vomiting attributable to bowel obstruction. In the absence of a bowel obstruction or a correctable cause, the usual approach is a...

  7. The temporomandibular opening index, report of headache and TMD, and implications for screening in general practice: an initial study.

    Science.gov (United States)

    Miller, Victor J; Karic, Vesna V; Ofec, Ronen; Nehete, Swati R; Smidt, Ami

    2014-01-01

    The cardinal signs and symptoms of temporomandibular disorder (TMD) are pain in joints and/or muscles, joint sounds, and limitation of movement. They are also associated with other complaints, one of which is headache. Myogenous TMD patients can be divided into those with a high and low temporomandibular opening index (TOI). These two subgroups appear to vary in several ways, including symptom severity. The objective was to assess the relationship between reported headache and TMD patients and a control group with no TMD and to compare the report of headache in high- and low-TOI myogenous TMD patients. Sixty-six patients with TMD were included in the study. Fortythree were diagnosed with myogenous TMD, 23 with arthrogenous TMD, and 20 with no TMD were included as a control. Patients reported a history of headache using a four-point Verbal Rating Scale for both severity and frequency. Multiple logistic regression analysis was performed, after adjusting for confounders of sex and age. This helped investigate the association between the study groups and reported headache. Seventeen of the myogenous TMD patients were studied further. Seven were assigned to the high and 10 to the low-TOI group. Mean ages were 38.43 years and 33.00 years respectively. The Mann Whitney test was used to examine the difference in report of headache between these two groups. 76.7% of the myogenous group, 26.1% of the arthrogenous group, and 35% of the control group reported headache. Age and myogenous TMD were significantly associated with reported headache (P = .001 and .01, respectively). Myogenous TMD is a significant risk factor (OR = 5.20, P = .01) for reported headache while arthrogenous TMD is not (OR = 0.75, P = .69) A significant difference in report of headache between the two myogenous TMD groups was found (P = .0067). The risk for reported headache is 5.20-times greater for myogenous TMD patients compared to the control group, but no difference was noted between the arthrogenous

  8. Spontaneous Intracranial Hypotension without Orthostatic Headache

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    Tülay Kansu

    2009-03-01

    Full Text Available We report 2 cases of spontaneous intracranial hypotension that presented with unilateral abducens nerve palsy, without orthostatic headache. While sixth nerve palsies improved without any intervention, subdural hematoma was detected with magnetic resonance imaging. We conclude that headache may be absent in spontaneous intracranial hypotension and spontaneous improvement of sixth nerve palsy can occur, even after the development of a subdural hematoma

  9. Therapeutic Strategy for Chronic Headache in Children

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    H.O. Lezhenko

    2016-05-01

    Full Text Available The therapeutic efficacy of a combined homeopathic preparation Cefavora, which consists of alcoholic extracts of Ginkgo biloba, hawthorn (Crataegus and white mistletoe (Viscum album, has been studied in the treatment of chronic tension-type headache in children. It has been shown that alongside with elimination of headache manifestations, the use of homeopathic medicine has contributed to the normalization of adaptive mechanisms of autonomic regulation in children indicating its high therapeutic efficacy.

  10. Two reports of flight-related headache.

    Science.gov (United States)

    Nagatani, Kazuhiko

    2013-07-01

    Airplane headache is flight-related and appears during airplane landing and/or takeoff without accompanying symptoms. Intracranial and paranasal imaging studies reveal no abnormalities. The etiology is still uncertain, although sinus barotrauma has been proposed as a possible mechanism. 1) A 26-yr-old woman presented with recurring headache during each air travel since she was 22 yr old. Severe bursting pain suddenly manifested in the bilateral orbits and temples during airplane descent, with no accompanying additional symptoms. She had no unusual medical history. X-ray computed tomography (CT) scans showed no abnormalities except thickening of the nasal mucosa. Effective pain relief was obtained with over-the-counter nasal decongestant spray. 2) A 49-yr-old man presented with a 3-yr history of flight-related headache that appeared at airplane touchdown, when he had mental stress, or when he was suffering from a lack of sleep. Pain was of a severe jabbing quality, localized over the forehead with no additional accompanying symptoms. He had a past history of episodic tension-type headache. Intracranial and paranasal CT scan revealed no abnormalities. Headache ceased spontaneously within 40 min of the end of the flight and nonsteroidal anti-inflammatory drug premedication did not prevent the headache. Sinus barotrauma was thought to be a plausible explanation for the headache in Case 1. In Case 2, an anxiety disorder could be considered as an underlying etiology. The etiology of so-called airplane headache is probably protean and this should be taken into account when assessing cases of in-flight cephalalgia.

  11. Translating Romans: some persistent headaches

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    A.B. du Toit

    2010-07-01

    Full Text Available Translating Romans: some persistent headaches Gone are the days when it was axiomatic that expertise in biblical languages automatically qualified one as a Bible translator. In 1949, Ronald Knox, who for nine years conscientiously struggled with translating the Bible for his generation, published a booklet under the title The trials of a translator. At that stage Bible translation as the subject of scientific study was still in its infancy. Since then, research into the intricacies of communicating the biblical message in an authentic but understandable manner, has made significant progress (cf. Roberts, 2009. However, the frustrations of Bible translators, first of all to really understand what the biblical authors wanted to convey to their original addressees, and then to commu-nicate that message to their own targeted readers in a meaningful way, have not disappeared. In fact, the challenge to meet the vary-ing requirements of the multiple kinds of translation that are present-ly in vogue, has only increased.

  12. Alternative Therapies for the Prevention of Postoperative Nausea and Vomiting.

    Science.gov (United States)

    Stoicea, Nicoleta; Gan, Tong J; Joseph, Nicholas; Uribe, Alberto; Pandya, Jyoti; Dalal, Rohan; Bergese, Sergio D

    2015-01-01

    Postoperative nausea and vomiting (PONV) is a complication affecting between 20 and 40% of all surgery patients, with high-risk patients experiencing rates of up to 80%. Recent studies and publications have shed light on the uses of alternative treatment for PONV through their modulation of endogenous opioid neuropeptides and neurokinin ligands. In addition to reducing PONV, hypnosis was reported to be useful in attenuating postoperative pain and anxiety, and contributing to hemodynamic stability. Music therapy has been utilized to deepen the sedation level and decrease patient anxiety, antiemetic and analgesic requirements, hospital length of stay, and fatigue. Isopropyl alcohol and peppermint oil aromatherapy have both been used to reduce postoperative nausea. With correct training in traditional Chinese healing techniques, acupuncture (APu) at the P6 acupoint has also been shown to be useful in preventing early PONV, postdischarge nausea and vomiting, and alleviating of pain. Electro-acupuncture (EAPu), as with APu, provided analgesic and antiemetic effects through release and modulation of opioid neuropeptides. These non-pharmacological modalities of treatment contribute to an overall patient wellbeing, assisting in physical and emotional healing.

  13. Alternative Therapies for the Prevention of Postoperative Nausea and Vomiting

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    Nicoleta eStoicea

    2015-12-01

    Full Text Available Post-operative nausea and vomiting (PONV is a complication affecting between 20% and 40% of all surgery patients, with high-risk patients experiencing rates of up to 80%. Recent studies and publications have shed light on the uses of alternative treatment for PONV, through their modulation of endogenous opioid neuropeptides and neurokinin ligands. In addition to reducing PONV, hypnosis was reported to be useful in attenuating postoperative pain, anxiety, and contributing to hemodynamic stability. Music therapy has been utilized to deepen the sedation level and decrease patient anxiety, antiemetic and analgesic requirements, hospital length of stay, and fatigue. Isopropyl alcohol and peppermint oil aromatherapy have both been used to reduce postoperative nausea. With correct training in traditional Chinese healing techniques, acupuncture (APu at the P6 acupoint has also been shown to be useful in preventing early PONV, post-discharge nausea and vomiting, and alleviating of pain. Electro-acupuncture (EAPu, as with APu, provided analgesic and antiemetic effects through release of opioid neuropeptides and modulation. These non-pharmacological modalities of treatment contribute to an overall patient wellbeing, assisting in physical and emotional healing.

  14. Use of the Emergency Department for Severe Headache. A population-based study

    Science.gov (United States)

    Friedman, Benjamin W.; Serrano, Daniel; Reed, Michael; Diamond, Merle; Lipton, Richard B.

    2008-01-01

    Background Although headache is a common emergency department (ED) chief complaint, the role of the ED in the management of primary headache disorders has rarely been assessed from a population perspective. We determined frequency of ED use and risk factors for use among patients suffering severe headache. Methods As part of the American Migraine Prevalence and Prevention study, a validated self-administered questionnaire was mailed to 24,000 severe headache sufferers, who were randomly drawn from a larger sample constructed to be socio-demographically representative of the US population. Participants were asked a series of questions on headache management, healthcare system use, socio-demographic features, and number of ED visits for management of headache in the previous 12 months. In keeping with the work of others, “frequent” ED use was defined as a particpants report of four or more visits to the ED for treatment of a headache in the previous 12 months. Headaches were categorized into specific diagnoses using a validated methodology. Results Of 24,000 surveys, 18,514 were returned, and 13,451 (56%) provided complete data on ED use. Socio-demographic characteristics did not differ substantially between responders and non-responders. Among the 13,451 responders, over the course of the previous year, 12,592 (94%) did not visit the ED at all, 415 (3%) visited the ED once, and 444 (3%) visited the ED more than once. Patients with severe episodic tension-type headache were less likely to use the ED than patients with severe episodic migraine (OR 0.4 [95%CI 0.3, 0.6]). Frequent ED use was reported by 1% of the total sample or 19% (95%CI: 17, 22%) of subjects who used the ED in the previous year, though frequent users accounted for 51% (95%CI: 49, 53) of all ED visits. Predictors of ED use included markers of disease severity, elevated depression scores, low socio-economic status, and a predilection for ED use for conditions other than headache. Conclusions Most

  15. Headache in Schoolchildren : Epidemiology, Pain Comorbidity and Psychosocial Factors

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    Laurell, Katarina

    2005-01-01

    Headache is the most frequently reported pain in children and is associated with missed schooldays, anxiety, depressive symptoms and various physical symptoms. A secular trend of increasing headache prevalence has been suggested. Few studies have focused on tension-type headache among children from the general population. The aims of this thesis were to describe the prevalence, incidence and prognosis of tension-type headache, migraine and overall headache in schoolchildren, to identify medi...

  16. Pathophysiology of Headaches with a Prominent Vascular Component

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    Juan A Pareja

    1996-01-01

    Full Text Available Vascular changes, whether preliminary or secondary, seem to accompany most headaches. The literature concerning pathophysiological mechanisms in headaches where vascular phenomena are a major, integral part, ie, migraine and cluster headache syndrome, is reviewed and the most common forms of headache associated with cerebrovascular disease are discussed. Emphasis is placed on the vascular phenomena and on the abundant hypotheses and theories regarding headache mechanisms. This review also presents alternative explanatory models, and compares the available anatomical, physiological and biochemical results.

  17. Olanzapine and Betamethasone Are Effective for the Treatment of Nausea and Vomiting due to Metastatic Brain Tumors of Rectal Cancer

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    M. Suzuki

    2014-01-01

    Full Text Available Brain lesions originating from metastasis of colorectal cancer represent 3-5% of all brain metastases and are relatively rare. Of all distant metastases of colorectal cancer, those to the liver are detected in 22-29% of cases, while those to the lungs are detected in 8-18% of cases. In contrast, brain metastasis is quite rare, with a reported incidence ranging from 0.4 to 1.8%. Treatments for metastatic brain tumors include surgery, radiotherapy, chemotherapy and supportive care with steroids, etc. Untreated patients exhibit a median survival of only approximately 1 month. The choice of treatment for brain metastasis depends on the number of lesions, the patient's general condition, nerve findings and presence of other metastatic lesions. We herein report the case of a 78-year-old male who presented with brain metastases originating from rectal carcinoma. He suffered from nausea, vomiting, anorexia and vertigo during body movement. He received antiemetics, glycerol and whole brain radiation therapy; however, these treatments proved ineffective. Olanzapine therapy was started at a dose of 1.25 mg every night. The persistent nausea disappeared the next day, and the frequency of vomiting subsequently decreased. The patient was able to consume solid food. Olanzapine is an antipsychotic that has recently been used as palliative therapy for refractory nausea and vomiting in patients receiving chemotherapy. We consider that olanzapine was helpful as a means of supportive care for the treatment of nausea and vomiting due to brain metastasis.

  18. Can granisetron injection used as primary prophylaxis improve the control of nausea and vomiting with low- emetogenic chemotherapy?

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    Keat, Chan Huan; Phua, Gillian; Abdul Kassim, Mohd Shainol; Poh, Wong Kar; Sriraman, Malathi

    2013-01-01

    The purpose of this study is to examine the risk of uncontrolled chemotherapy-induced nausea and vomiting (CINV) among patients receiving low emetogenic chemotherapy (LEC) with and without granisetron injection as the primary prophylaxis in addition to dexamethasone and metochlopramide. This was a single-centre, prospective cohort study. A total of 96 patients receiving LEC (52 with and 42 without granisetron) were randomly selected from the full patient list generated using the e-Hospital Information System (e-His). The rates of complete control (no CINV from days 1 to 5) and complete response (no nausea or vomiting in both acute and delayed phases) were identified through patient diaries which were adapted from the MASCC Antiemesis Tool (MAT). Selected covariates including gender, age, active alcohol consumption, morning sickness and previous chemotherapy history were controlled using the multiple logistic regression analyses. Both groups showed significant difference with LEC regimens (pgranisetron group indicated a higher complete response rate in acute emesis (adjusted OR: 0.1; 95%CI 0.02-0.85; p=0.034) than did the non-granisetron group. Both groups showed similar complete control and complete response rates for acute nausea, delayed nausea and delayed emesis. Granisetron injection used as the primary prophylaxis in LEC demonstrated limited roles in CINV control. Optimization of the guideline-recommended antiemetic regimens may serve as a less costly alternative to protect patients from uncontrolled acute emesis.

  19. Does monosodium glutamate really cause headache? : a systematic review of human studies.

    Science.gov (United States)

    Obayashi, Yoko; Nagamura, Yoichi

    2016-01-01

    Although monosodium glutamate (MSG) is classified as a causative substance of headache in the International Classification of Headache Disorders 3rd edition (ICHD-III beta), there is no literature in which causal relationship between MSG and headache was comprehensively reviewed. We performed systematic review of human studies which include the incidence of headache after an oral administration of MSG. An analysis was made by separating the human studies with MSG administration with or without food, because of the significant difference of kinetics of glutamate between those conditions (Am J Clin Nutr 37:194-200, 1983; J Nutr 130:1002S-1004S, 2000) and there are some papers which report the difference of the manifestation of symptoms after MSG ingestion with or without food (Food Chem Toxicol 31:1019-1035, 1993; J Nutr 125:2891S-2906S, 1995). Of five papers including six studies with food, none showed a significant difference in the incidence of headache except for the female group in one study. Of five papers including seven studies without food, four studies showed a significant difference. Many of the studies involved administration of MSG in solution at high concentrations (>2 %). Since the distinctive MSG is readily identified at such concentrations, these studies were thought not to be properly blinded. Because of the absence of proper blinding, and the inconsistency of the findings, we conclude that further studies are required to evaluate whether or not a causal relationship exists between MSG ingestion and headache.

  20. The Role of Headache in the Classification and Management of Hypertensive Disorders in Pregnancy.

    Science.gov (United States)

    Sperling, Jeffrey D; Dahlke, Joshua D; Huber, Warren J; Sibai, Baha M

    2015-08-01

    Hypertensive disorders of pregnancy remain among the leading causes of maternal morbidity and mortality. The onset of headaches in patients with hypertensive disorders of pregnancy has been considered as a premonitory symptom for eclampsia and other adverse maternal outcomes. Headaches are very common symptoms during pregnancy and the postpartum period with a reported incidence of 39%; however, headache is absent in 30-50% of women before the onset of eclampsia and is a poor predictor of eclampsia and adverse maternal outcomes. If included in the definition of cerebral or visual disturbances, headache may be considered a symptom of preeclampsia, a diagnostic feature of preeclampsia with severe features, a premonitory symptom of eclampsia, and an indication for delivery. Inclusion of this nonspecific symptom in the diagnosis and management of hypertensive disorders of pregnancy in the absence of an evidence basis may lead to unintended consequences including excessive testing, visits to outpatient offices or emergency departments, additional hospitalization, and iatrogenic preterm delivery without proven benefit. If a cerebral disturbance such as severe or persistent headache presents for the first time during pregnancy or postpartum, an evaluation should be performed that considers a broad differential diagnosis, including but not limited to hypertensive disorders of pregnancy, and the diagnostic evaluation is similar to that in nonpregnant adults. This commentary draws attention to the implications of considering the cerebral disturbance of headache as a symptom that portends adverse pregnancy outcome in the current recommendations for diagnosing and managing hypertensive disorders of pregnancy.

  1. Early Maladaptive Schemas in Patients with and without Migraine and Tension Headaches

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    Ebrahim Rezaei Dogaheh

    2015-12-01

    Methods:  The present study was of cross sectional and correlational studies. The measures included  Headache Disability Inventory and Young Early Maladaptive Schemas Questionnaire (Short Form. The  population of the study was Tehran adult patients with migraine and tension headache aged 18 to 55  years. The final study sample included 69 participants with migraine or tension headaches and 86 non- clinical samples of both genders. After referring by psychiatrists, they were selected by convenient and  targeted sampling. The two groups were matched based on sex and education. Results: Migraine and tension headache sufferers and non-clinical participants were significantly  different in 9 schemas including Emotional deprivation, Abandonment/instability, Mistrust/abuse, Social  isolation/alienation, Failure to achieve, Enmeshment/Undeveloped Self, Subjugation, Self-sacrifice and  Emotional inhibition. In addition, a series of EMSs could significantly predict 61 percent of the total  change in position of tension headaches or migraine group correctly. Discussion: It seems that EMSs are important factors influencing migraine and tension headaches. The  recognition and manipulation of these schemas along with other medical therapies can result in reducing  the symptoms of the disorder. 

  2. Ginger effects on control of chemotherapy induced nausea and vomiting

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    Seyyed Meisam Ebrahimi

    2013-09-01

    Full Text Available Background : Chemotherapy-induced nausea (CIN in the anticipatory and acute phase is the most common side effect in cancer therapy. The purpose of this study was to investigate the effect of ginger capsules on the alleviation of this problem. Methods : This randomized, double-blind, placebo-controlled clinical trial was performed on 80 women with breast cancer between August till December 2009 in Imam Khomeini Hospital, Tehran, Iran. These patients underwent one-day chemotherapy regime and suffering from chemotherapy-induced nausea. After obtaining written consent, samples were randomly assigned into intervention and control groups. Two groups were matched based on the age and emetic effects of chemotherapy drugs used. The intervention group received ginger capsules (250 mg, orally four times a day (1 gr/d and the same samples from the placebo group received starch capsules (250 mg, orally for three days before to three days after chemotherapy. To measure the effect of capsules a three-part questionnaire was used, so the samples filled every night out these tools. After collecting the information, the gathered data were analyzed by statistical tests like Fisher’s exact, Kruskal-Wallis and Chi-square using version 8 of STATA software. Results : The mean ± SD of age in the intervention and placebo groups were 41.8 ± 8.4 and 45.1 ± 10 years, respectively. Results indicated that the severity and number of nausea in the anticipatory phase were significantly lower in the ginger group compared with placebo group (P=0.0008, P=0.0007, respectively. Also, the intensity (P=0.0001 and number (P=0.0001 of nausea in the acute phase were significantly lower in the ginger group. On the other hand, taking ginger capsules compared with placebo did not result in any major complications. Conclusion: Consuming ginger root powder capsules (1 gr/d from three days before chemotherapy till three days after it in combination with the standard anti-emetic regimen can

  3. A pilot study to assess the pharmacy impact of implementing a chemotherapy-induced nausea or vomiting collaborative disease therapy management in the outpatient oncology clinics.

    Science.gov (United States)

    Jackson, Kasey; Letton, Cathy; Maldonado, Andy; Bodiford, Andrew; Sion, Amy; Hartwell, Rebekah; Graham, Anastasia; Bondarenka, Carolyn; Uber, Lynn

    2018-01-01

    Background Collaborative drug therapy management is a formal partnership between a pharmacist and physician to allow the pharmacist to manage a patient's drug therapy. Literature supports collaborative disease therapy management can improve patient outcomes, improve medication adherence, enhance medication safety, and positively influence healthcare expenditures. Chemotherapy induced nausea or vomiting is considered one of the most distressing and feared adverse events among patients receiving chemotherapy. Chemotherapy induced nausea or vomiting can impact a patient's quality of life and may affect compliance with the treatment plan. Purpose The objective of this pilot study was to determine the pharmacy impact of implementing a chemotherapy induced nausea or vomiting collaborative disease therapy management protocol in the outpatient oncology clinics at a National Cancer Institute (NCI)-designated cancer center associated with an academic medical center. The primary endpoint was to determine the number and type of chemotherapy induced nausea or vomiting clinical interventions made by the oncology pharmacists. Secondary endpoints included comparing patient's Multinational Association for Supportive Care in Cancer scores and revenue of pharmacists' services. Methods The credentialed oncology pharmacists were consulted by an oncologist to manage chemotherapy induced nausea or vomiting. Patients were included in the chemotherapy induced nausea or vomiting collaborative disease therapy management if they were seen in an outpatient oncology clinic from October 2016 to January 2017 and had a referral from a qualified provider to help manage chemotherapy induced nausea or vomiting. Patients admitted to the hospital at the time of consult were excluded from the study. The pharmacists interviewed patients and provided recommendations. The pharmacists followed up with the patient via a telephone call or during the next scheduled clinic visit to assess their symptoms

  4. Orofacial pain: a guide for the headache physician.

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    Shephard, Martina K; Macgregor, E Anne; Zakrzewska, Joanna M

    2014-01-01

    Orofacial pain represents a significant burden in terms of morbidity and health service utilization. It includes very common disorders such as toothache and temporomandibular disorders, as well as rare orofacial pain syndromes. Many orofacial pain conditions have overlapping presentations, and diagnostic uncertainty is frequently encountered in clinical practice. This review provides a clinically orientated overview of common and uncommon orofacial pain presentations and diagnoses, with an emphasis on conditions that may be unfamiliar to the headache physician. A holistic approach to orofacial pain management is important, and the social, cultural, psychological and cognitive context of each patient needs to be considered in the process of diagnostic formulation, as well as in the development of a pain management plan according to the biopsychosocial model. Recognition of psychological comorbidities will assist in diagnosis and management planning. © 2013 American Headache Society.

  5. Rhinologic headache caused by mucosal contact with a surgical solution. A case report

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    Ignacio ALCALÁ-RUEDA

    2016-03-01

    Full Text Available Introduction and objective: Rhinologic headache caused by mucosal contact is a difficult definition condition with good response to surgical approach. Description: We present a case of a 31 year-old male with rhinologic headache criteria. We decided to offer a surgical approach, successfully. Discussion: Rhinologic headache is included in the group of “Headache caused by disorders of the nasal mucosa, turbinates or septum”. There is no agreement about its cause because the prevalence of mucosal nasal contact is similar in patients with and without facial pain. There is evidence in the resolution of facial pain with a surgical approach. Conclusions: Despite the evidence of success in the surgical approach, some doubts still persist about the causes of this entity.

  6. "All the World Is Gone to the Assembly": Elizabeth Carter's Headaches, Nerves, and (In)Sociability.

    Science.gov (United States)

    Hansen, Mascha

    Elizabeth Carter suffered from severe headaches all her life. Her letters are peppered with references to fits of "head-ach" so bad they made her bold enough to demand her own room wherever she visited, and to cherish a preference for solitude contrary to the ideal of Bluestocking sociability. Following her friends and physicians, she bowed to fashionable diagnoses in considering these headaches the result of a nervous constitution, and she was prescribed the usual remedies, including sociable trips to fashionable watering places. While positioning her sufferings within the frame of fashionable diseases, Carter tried to dissociate herself from fashionable sensibility, and struggled to gain acceptance for her pain as part of her body's "mechanism" by using a more old-fashioned, religious interpretative frame. This case study of Carter's headaches thus charts Carter's own understanding of her constitution, her body, and her pain within-and without-the framework of eighteenth-century fashionable diseases.

  7. Headache associated with sexual activity: From the benign to the life threatening

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    Frank Aiwansoba Imarhiagbe

    2016-01-01

    Full Text Available Background: Neurologic syndromes like headache may on occasion complicate sexual activity. Though largely benign, the headache may seldom be a symptom of an underlying sinister and life threatening neurologic disorder such as aneurysmal subarachnoid heamorrhage. Method: Relevant published materials on the subject of headache associated with sexual intercourse and their cross references from Pubmed Medline, Cochrane Library, International Headache society, EMBASE and other relevant bibliographic repositories were ferreted since 1980 till date. Result: HAS is mainly a diagnosis of exclusion. The secondary or malignant form has a course that is dictated by its underlying cause. HAS in the primary or benign form is amenable to treatment with drugs including indomethacin, propranolol and calcium channel blockers (nimodipine, verapamil and diltiazem with excellent prognosis. Conclusion: Early evaluation for underlying cause of HAS and institution of appropriate treatment is recommended.

  8. Factors contributing to migraine headache surgery failure and success.

    Science.gov (United States)

    Larson, Kelsey; Lee, Michelle; Davis, Janine; Guyuron, Bahman

    2011-11-01

    The purpose of this study was to identify factors that contribute to migraine headache surgery failure and success. A retrospective chart review was conducted of patients who underwent surgery for migraine headaches performed by the senior author (B.G.) and had at least 11 months of follow-up. The study population included three groups: migraine surgery success, improvement, and failure. Thirty-six unique data points were collected for each patient. A total of 169 patients met inclusion criteria. Of these, 66 patients comprised the migraine surgery success group (S, complete elimination of migraine headaches); 67 comprised the migraine surgery improvement group (I, >50 percent reduction in migraine frequency, intensity, or duration); and 36 comprised the migraine surgery failure group (F, I, p=0.02), migraine frequency (SI, p=0.003; S>F, p=0.04), history of head or neck injury (SI, p=0.02), increased intraoperative bleeding (SF, p=0.0006; I>F, p=0.0004), site II (S>F, p=0.015), single operative site (SI, p=0.05; S>F, p=0.04). Factors associated with migraine surgery failure include increased intraoperative bleeding and surgery on fewer trigger sites. Factors associated with migraine surgery success are older age of migraine onset, higher rate of visual symptoms versus improvement group, surgery at site I or II, and deactivating all four operative sites. Risk, III.

  9. Characteristics of headaches in Japanese elementary and junior high school students: A school-based questionnaire survey.

    Science.gov (United States)

    Goto, Masahide; Yokoyama, Koji; Nozaki, Yasuyuki; Itoh, Koichi; Kawamata, Ryou; Matsumoto, Shizuko; Yamagata, Takanori

    2017-10-01

    Few studies have investigated pediatric headaches in Japan. Thus, we examined the lifetime prevalence and characteristics of headaches among elementary and junior high school students in Japan. In this school-based study, children aged 6-15years completed a questionnaire based on the diagnostic criteria of the International Classification of Headache Disorders-3β to assess headache characteristics and related disability. Of the 3285 respondents, 1623 (49.4%) experienced headaches. Migraine and tension-type headaches (TTH) were reported by 3.5% and 5.4% of elementary school students, respectively, and by 5.0% and 11.2% of junior high school students. Primary headaches increased with age. Compared with TTH sufferers, the dominant triggers in migraine sufferers were hunger (odds ratio=4.7), sunny weather (3.3), and katakori (neck and shoulder pain) (2.5). Compared with TTH, migraine caused higher headache-related frustration (P=0.010) as well as difficulty concentrating (P=0.017). Migraine-related disability was greater among junior high school students (feeling fed up or irritated, P=0.028; difficulty concentrating, P=0.016). TTH-related disability was also greater among junior high school students (feeling fed up or irritated, P=0.035). Approximately half of the students who complained of headache-related disability were not receiving medical treatment. This is the first detailed study of headaches in Japanese children to include elementary school students. Nearly 50% of the school children reported headaches and the disruption of daily activities caused by migraine was higher among junior high students than elementary school students. Copyright © 2017 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  10. A cohort study examining headaches among veterans of Iraq and Afghanistan wars: Associations with traumatic brain injury, PTSD, and depression.

    Science.gov (United States)

    Jaramillo, Carlos A; Eapen, Blessen C; McGeary, Cindy A; McGeary, Donald D; Robinson, Jedediah; Amuan, Megan; Pugh, Mary Jo

    2016-03-01

    To describe the prevalence and persistence of headache and associated conditions in an inception cohort of U.S. veterans of Iraq and Afghanistan wars. Iraq and Afghanistan war veterans (IAV) suffer from persistent and difficult-to-treat headaches that have been found to co-occur with traumatic brain injury (TBI) and other deployment related comorbidities. This longitudinal retrospective cohort study used data from the national Veterans Health Administration (VA) data repository for IAV who first received VA care in 2008 (baseline) and also received care each year in 2009, 2010, and 2011. We used ICD-9-CM codes, to identify those treated for headache each year (2008-2011). Individuals with headache diagnosed each year were classified as having persistent headache. We also identified comorbidities that may be associated with baseline headache using algorithms validated for use with ICD-9-CM codes. Comorbidities included TBI, posttraumatic stress disorder (PTSD), depression, and conditions associated with these diagnoses (anxiety, memory/attention/cognition, neck pain, tinnitus/hyperacusis, photosensitivity/photo blurring, insomnia, malaise/fatigue, and vertigo/dizziness). Multivariable logistic regression analysis was used to determine characteristics associated with baseline headache as well as those associated with persistent headache. Among all IAV, 38,426 received their first year of VA care in 2008 and had care each year 2009-2011: 13.7% of these were diagnosed with headache in 2008. Veterans diagnosed with headache in 2008 were more likely than those without a headache diagnosis to also have a diagnosis of TBI alone (adjusted odds ratios [AOR] 6.75; 95% CI 5.79-7.86), TBI + depression (AOR 7.09; 95% CI 5.23-9.66), TBI + PTSD (AOR 10.16; 95% CI 8.96-11.53), TBI + PTSD + depression (AOR 9.40; 95% CI 8.12-10.09), and neck pain (AOR 2.44; 95% CI 2.14-2.77). Among those with headache diagnosis in 2008, 24.3% had a headache diagnosis each of the

  11. Headache Attributed to Masticatory Myofascial Pain: Clinical Features and Management Outcomes.

    Science.gov (United States)

    Costa, Yuri Martins; Porporatti, André Luís; Stuginski-Barbosa, Juliana; Bonjardim, Leonardo Rigoldi; Speciali, José Geraldo; Rodrigues Conti, Paulo César

    2015-01-01

    To describe the characteristics of headaches attributed to temporomandibular disorders (TMD) and assess the effects of two management strategies used for the management of TMD on headache intensity and frequency. The initial sample (n=60) of this randomized controlled trial comprised patients with masticatory myofascial pain according to the Research Diagnostic Criteria for TMD (RDC/TMD), and headache. The patients were divided into two groups: group 1 received only counseling for behavioral changes, and group 2 received counseling and an occlusal appliance. A 5-month follow-up period included three assessments. TMD-related headache characteristics, eg, headache intensity (scored on a visual analog scale [VAS]) and frequency were measured by a questionnaire. Two-way analysis of variance, chi-square, Friedman, and Mann-Whitney tests were used to test for differences considering a 5% significance level. The main clinical features of headache attributed to masticatory myofascial pain were the long duration (≥4 hours), frontotemporal bilateral location, and a pressing/tightening quality. Forty-one subjects (group 1, 17 subjects; group 2, 24 subjects) were included in the final analysis. There was a reduction in headache intensity and frequency, with no significant differences between groups (P>.05). The mean (±SD) baseline VAS was 7.6 (±2.2) for group 1 and 6.5 (±1.6) for group 2; final values were 3.1 (±2.2) (PHeadache attributed to masticatory myofascial pain was mainly characterized by long duration, frontotemporal bilateral location, and a pressing/tightening quality. Also, counseling and behavioral management of masticatory myofascial pain improved headache, regardless of the use of an occlusal appliance.

  12. Parenting Stress and Emotional/Behavioral Problems in Adolescents with Primary Headache.

    Science.gov (United States)

    Operto, Francesca Felicia; Craig, Francesco; Peschechera, Antonia; Mazza, Roberta; Lecce, Paola Alessandra; Margari, Lucia

    2017-01-01

    Primary headache is a frequent and disabling disorder, common among children and adolescents, and it is a painful syndrome often accompanied by functional impairment and associated with emotional and behavior problems. The aim of this study was to investigate parenting stress and emotional/behavioral problems in adolescents affected by primary headache compared with healthy adolescents. The study population consisted of 35 adolescents and a control group of 23 healthy subjects. The assessment included the administration of clinical standardized scales such as Parent Stress Index-Short Form, Pediatric Migraine Disability Assessment Score Questionnaire, and Child Behavior Checklist (CBCL). Headache group and control group did not differ in terms of parenting stress ( p  = 0.29). On the contrary, headache group showed more internalizing problems ( p  = 0.023), affective problems ( p  = 0.01), anxious ( p  = 0.001), and somatic complaints ( p  headache group. The findings emphasize the need for expanded intervention in the clinical treatment of pediatric headache, a treatment that may also include the family members. Further research is needed.

  13. Prevalence and impact of headache and migraine among secondary school students in Nigeria.

    Science.gov (United States)

    Ofovwe, Gabriel E; Ofili, Antoinette N

    2010-11-01

    A cross-sectional descriptive study to determine the overall, age and gender specific prevalence, trigger factors and impact of headache and migraine on quality of life of students attending secondary schools in Benin City, Nigeria. Six secondary schools were randomly selected from which students were randomly selected. A self-administered questionnaire was used to screen those with frequent headache, defined as at least 2 episodes of headache unrelated to fever or any underlying disease within the last 12 months or at least 1 episode in the last 6 months preceding the date questionnaire was administered. Another questionnaire based on the ICHD-2 criteria for diagnosis of migraine was then administered to those with frequent headaches. Data analysis was with SPSS 13.0 for Windows. One thousand six hundred and seventy-nine students aged 11-18 years were recruited. The overall prevalence of headache was 19.5%. The prevalence of migraine was 13.5%. Migraine was more common in girls than in boys at all ages. The most common trigger factors included emotional stress, sunlight or bright light, sleep deprivation, and hunger. Inability to participate in outdoor activities, household chores, and school absenteeism were the common impacts on the quality of life of among 76.8% of the migraineurs. Migraine is common and underdiagnosed among secondary school students in Benin City, Nigeria, and negatively impacts on the quality of life including school absenteeism. © 2010 American Headache Society.

  14. Neuromodulation of chronic headaches: position statement from the European Headache Federation

    Science.gov (United States)

    2013-01-01

    The medical treatment of patients with chronic primary headache syndromes (chronic migraine, chronic tension-type headache, chronic cluster headache, hemicrania continua) is challenging as serious side effects frequently complicate the course of medical treatment and some patients may be even medically intractable. When a definitive lack of responsiveness to conservative treatments is ascertained and medication overuse headache is excluded, neuromodulation options can be considered in selected cases. Here, the various invasive and non-invasive approaches, such as hypothalamic deep brain stimulation, occipital nerve stimulation, stimulation of sphenopalatine ganglion, cervical spinal cord stimulation, vagus nerve stimulation, transcranial direct current stimulation, repetitive transcranial magnetic stimulation, and transcutaneous electrical nerve stimulation are extensively published although proper RCT-based evidence is limited. The European Headache Federation herewith provides a consensus statement on the clinical use of neuromodulation in headache, based on theoretical background, clinical data, and side effect of each method. This international consensus further gives recommendations for future studies on these new approaches. In spite of a growing field of stimulation devices in headaches treatment, further controlled studies to validate, strengthen and disseminate the use of neurostimulation are clearly warranted. Consequently, until these data are available any neurostimulation device should only be used in patients with medically intractable syndromes from tertiary headache centers either as part of a valid study or have shown to be effective in such controlled studies with an acceptable side effect profile. PMID:24144382

  15. Parenteral treatment of episodic tension-type headache: a systematic review.

    Science.gov (United States)

    Weinman, Danielle; Nicastro, Olivia; Akala, Olabiyi; Friedman, Benjamin W

    2014-02-01

    Tension-type headache is highly prevalent in the general population and is a consistent if not frequent cause of visits to acute care settings. Analgesics such as nonsteroidal anti-inflammatory drugs, acetaminophen, and salicylates are considered first-line therapy for treatment of tension-type headache. For patients who present to an acute care setting with persistent tension-type headache despite analgesic therapy, it is not clear which parenteral agent should be administered. We performed a systematic review of the medical literature to determine whether parenteral therapies other than salicylates or nonsteroidals are efficacious for acute tension-type headache. We performed a systematic review of Medline, EMBASE, CINAHL, Google scholar, and the Cochrane Central Registry of Controlled Trials from inception through August, 2012 using the search terms "tension-type headache" and "parenteral or subcutaneous or intramuscular or intravenous." Our goal was to identify randomized trials in which one parenteral treatment was compared to another active comparator or to placebo for the acute relief of tension-type headache. Parenteral was defined as intravenous, intramuscular, or subcutaneous administration. We only included studies that distinguished tension-type headache from other primary headache disorders, such as migraine. The primary outcome for this review was measures of efficacy one hour after medication administration. Data abstraction was performed by two authors. Disagreements were resolved by a third author. We assessed the internal validity of trials using the Cochrane Collaboration risk of bias tool. Because of the small number of trials identified, and the substantial heterogeneity among study design and medications, we decided that combining data and reporting summary statistics would serve no useful function. The results of individual studies are presented using Number Needed to Treat (NNT) with 95%CI when dichotomous outcomes were available and

  16. Cardiovascular Risk Factors in Cluster Headache.

    Science.gov (United States)

    Lasaosa, S Santos; Diago, E Bellosta; Calzada, J Navarro; Benito, A Velázquez

    2017-06-01

     Patients with cluster headache tend to have a dysregulation of systemic blood pressure such as increased blood pressure variability and decreased nocturnal dipping. This pattern of nocturnal nondipping is associated with end-organ damage and increased risk of cardiovascular disease.  To determine if cluster headache is associated with a higher risk of cardiovascular disease.  Cross-sectional study of 33 cluster headache patients without evidence of cardiovascular disease and 30 age- and gender-matched healthy controls. Ambulatory blood pressure monitoring was performed in all subjects. We evaluate anthropometric, hematologic, and structural parameters (carotid intima-media thickness and ankle-brachial index).  Of the 33 cluster headache patients, 16 (48.5%) were nondippers, a higher percentage than expected. Most of the cluster headache patients (69.7%) also presented a pathological ankle-brachial index. In terms of the carotid intima-media thickness values, 58.3% of the patients were in the 75th percentile, 25% were in the 90th percentile, and 20% were in the 95th percentile. In the control group, only five of the 30 subjects (16.7%) had a nondipper pattern ( P  =   0.004), with 4.54% in the 90th and 95th percentiles ( P  =   0.012 and 0.015).  Compared with healthy controls, patients with cluster headache presented a high incidence (48.5%) of nondipper pattern, pathological ankle-brachial index (69.7%), and intima-media thickness values above the 75th percentile. These findings support the hypothesis that patients with cluster headache present increased risk of cardiovascular disease. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  17. Post-traumatic headache: is it for real? Crossfire debates on headache: pro.

    Science.gov (United States)

    Obermann, Mark; Keidel, Matthias; Diener, Hans-Christoph

    2010-04-01

    Mild traumatic brain injury is very common in Western societies, affecting approximately 1.8 million individuals in the USA. Even though between 30% and 90% of patients develop post-traumatic headache, post-traumatic headache remains a very controversial disorder. Particularly when it comes to chronic post-traumatic headache following mild closed head injury and headache attributed to whiplash injury. Some experts are disputing its existence as a genuine disorder. Indistinct disease classification, unresolved pathophysiological mechanism, and the role of accident-related legal issues further fuel this controversy. The complex combination of pain and neuropsychological symptoms needs further research in understanding the underlying pathophysiological mechanisms associated with the acute headache following trauma but more so the mechanisms associated with the development of chronic pain in some patients. Investigators should refrain from oversimplifying these complex mechanisms as hysteric exaggeration of everyday complains and from implying greed as motivation for this potentially very disabling disease.

  18. The linear trend of headache prevalence and some headache features in school children.

    Science.gov (United States)

    Ozge, Aynur; Buğdayci, Resul; Saşmaz, Tayyar; Kaleağasi, Hakan; Kurt, Oner; Karakelle, Ali; Siva, Aksel

    2007-04-01

    The objectives of this study were to determine the age and sex dependent linear trend of recurrent headache prevalence in schoolchildren in Mersin. A stratified sample composed of 5562 children; detailed characteristics were previously published. In this study the prevalence distribution of headache by age and sex showed a peak in the female population at the age of 11 (27.2%) with a plateau in the following years. The great stratified random sample results suggested that, in addition to socio-demographic features, detailed linear trend analysis showed headache features of children with headache have some specific characteristics dependent on age, gender and headache type. This study results can constitute a basis for the future epidemiological based studies.

  19. Headache classification and aspects of reproductive life in young women.

    Science.gov (United States)

    Melhado, Eliana M; Bigal, Marcelo E; Galego, Andressa R; Galdezzani, João P; Queiroz, Luiz P

    2014-01-01

    To classify headaches as a function of the menstrual cycle and to contrast aspects relating to the reproductive cycle as a function of headache type. Participants responded to a structured questionnaire consisting of 44 questions. Detailed headache information, enabling the classification of headaches, and questions relating to the menstrual cycle were obtained. The sample consisted of 422 students. Menstrual headaches were experienced by 31.8%. Migraine without aura (MO) occurred in 13.3%, migraine with aura (MA) in 7.8%, and probable migraine in 6.4%. Women with MA were significantly more likely to have reached menarche at earlier ages than women without headaches (p=0.03). Use of a hormonal contraceptive was related to the function of having MA headaches or not. Most female college students are affected by menstrual headaches. Although the vast majority experience MO, other headaches also occur. Women with MA are equally likely to receive hormonal contraceptives as others.

  20. Vestibular migraine in multicenter neurology clinics according to the appendix criteria in the third beta edition of the International Classification of Headache Disorders.

    Science.gov (United States)

    Cho, Soo-Jin; Kim, Byung-Kun; Kim, Byung-Su; Kim, Jae-Moon; Kim, Soo-Kyoung; Moon, Heui-Soo; Song, Tae-Jin; Cha, Myoung-Jin; Park, Kwang-Yeol; Sohn, Jong-Hee

    2016-04-01

    Vestibular migraine (VM), the common term for recurrent vestibular symptoms with migraine features, has been recognized in the appendix criteria of the third beta edition of the International Classification of Headache Disorders (ICHD-3β). We applied the criteria for VM in a prospective, multicenter headache registry study. Nine neurologists enrolled consecutive patients visiting outpatient clinics for headache. The presenting headache disorder and additional VM diagnoses were classified according to the ICHD-3β. The rates of patients diagnosed with VM and probable VM using consensus criteria were assessed. A total of 1414 patients were enrolled. Of 631 migraineurs, 65 were classified with VM (10.3%) and 16 with probable VM (2.5%). Accompanying migraine subtypes in VM were migraine without aura (66.2%), chronic migraine (29.2%), and migraine with aura (4.6%). Probable migraine (75%) was common in those with probable VM. The most common vestibular symptom was head motion-induced dizziness with nausea in VM and spontaneous vertigo in probable VM. The clinical characteristics of VM did not differ from those of migraine without VM. We diagnosed VM in 10.3% of first-visit migraineurs in neurology clinics using the ICHD-3β. Applying the diagnosis of probable VM can increase the identification of VM. © International Headache Society 2015.

  1. Diagnostic criteria for headache attributed to temporomandibular disorders.

    Science.gov (United States)

    Schiffman, Eric; Ohrbach, Richard; List, Thomas; Anderson, Gary; Jensen, Rigmor; John, Mike T; Nixdorf, Donald; Goulet, Jean-Paul; Kang, Wenjun; Truelove, Ed; Clavel, Al; Fricton, James; Look, John

    2012-07-01

    We assessed and compared the diagnostic accuracy of two sets of diagnostic criteria for headache secondary to temporomandibular disorders (TMD). In 373 headache subjects with TMD, a TMD headache reference standard was defined as: self-reported temple headache, consensus diagnosis of painful TMD and replication of the temple headache using TMD-based provocation tests. Revised diagnostic criteria for Headache attributed to TMD were selected using the RPART (recursive partitioning and regression trees) procedure, and refined in half of the data set. Using the remaining half of the data, the diagnostic accuracy of the revised criteria was compared to that of the International Headache Society's International Classification of Headache Diseases (ICHD)-II criteria A to C for Headache or facial pain attributed to temporomandibular joint (TMJ) disorder. Relative to the TMD headache reference standard, ICHD-II criteria showed sensitivity of 84% and specificity of 33%. The revised criteria for Headache attributed to TMD had sensitivity of 89% with improved specificity of 87% (p headache that is changed with jaw movement, function or parafunction and (2) provocation of that headache by temporalis muscle palpation or jaw movement. Having significantly better specificity than the ICHD-II criteria A to C, the revised criteria are recommended to diagnose headache secondary to TMD.

  2. Osteopathy for primary headache patients: a systematic review

    Directory of Open Access Journals (Sweden)

    Cerritelli F

    2017-03-01

    Full Text Available Francesco Cerritelli,1–3 Eleonora Lacorte,4 Nuria Ruffini,1 Nicola Vanacore4 1Clinical-based Human Research Department, Centre for Osteopathic Medicine Collaboration, 2Department of Neuroscience, Imaging and Clinical Sciences, 3ITAB – Institute for Advanced Biomedical Technologies, G. D’Annunzio University of Chieti, Pescara, 4National Centre for Epidemiology, Surveillance and Health Promotion, National Institute of Health, Rome, Italy Objective: This systematic review aimed to assess the efficacy, effectiveness, safety, and tolerability of osteopathic manipulative treatment (OMT in patients with headache. Background: Migraine is one of the most common and disabling medical conditions. It affects more than 15% of the general population, causing high global socioeconomic costs, and the currently available treatment options are inadequate.Methods: We systematically reviewed all available studies investigating the use of OMT in patients with migraine and other forms of headache.Results: The search of literature produced six studies, five of which were eligible for review. The reviewed papers collectively support the notion that patients with migraine can benefit from OMT. OMT could most likely reduce the number of episodes per month as well as drug use. None of the included studies, however, was classified as low risk of bias according to the Cochrane Collaboration’s tool for assessing risk of bias.Conclusion: The results from this systematic review show a preliminary low level of evidence that OMT is effective in the management of headache. However, studies with more rigorous designs and methodology are needed to strengthen this evidence. Moreover, this review suggests that new manual interventions for the treatment of acute migraine are available and developing. Keywords: osteopathic manipulative treatment, tension type headache, pain, migraine, disability 

  3. Effects of Modification of Pain Protocol on Incidence of Post Operative Nausea and Vomiting.

    Science.gov (United States)

    Schwarzkopf, Ran; Snir, Nimrod; Sharfman, Zachary T; Rinehart, Joseph B; Calderon, Michael-David; Bahn, Esther; Harrington, Brian; Ahn, Kyle

    2016-01-01

    A Perioperative Surgical Home (PSH) care model applies a standardized multidisciplinary approach to patient care using evidence-based medicine to modify and improve protocols. Analysis of patient outcome measures, such as postoperative nausea and vomiting (PONV), allows for refinement of existing protocols to improve patient care. We aim to compare the incidence of PONV in patients who underwent primary total joint arthroplasty before and after modification of our PSH pain protocol. All total joint replacement PSH (TJR-PSH) patients who underwent primary THA (n=149) or TKA (n=212) in the study period were included. The modified protocol added a single dose of intravenous (IV) ketorolac given in the operating room and oxycodone immediate release orally instead of IV Hydromorphone in the Post Anesthesia Care Unit (PACU). The outcomes were (1) incidence of PONV and (2) average pain score in the PACU. We also examined the effect of primary anesthetic (spinal vs . GA) on these outcomes. The groups were compared using chi-square tests of proportions. The incidence of post-operative nausea in the PACU decreased significantly with the modified protocol (27.4% vs . 38.1%, p=0.0442). There was no difference in PONV based on choice of anesthetic or procedure. Average PACU pain scores did not differ significantly between the two protocols. Simple modifications to TJR-PSH multimodal pain management protocol, with decrease in IV narcotic use, resulted in a lower incidence of postoperative nausea, without compromising average PACU pain scores. This report demonstrates the need for continuous monitoring of PSH pathways and implementation of revisions as needed.

  4. [Preventive treatment of tension headache in children and adolescents].

    Science.gov (United States)

    Shypilova, E M; Zavadenko, N N; Nesterovskiy, Yu E

    To assess the efficacy of noophen (γ-amino-β-phenylbutyric acid hydrochloride) in the preventive treatment of tension-type headache (TTH) in children and adolescents. The study included 30 patients with TTH, aged from 8 to 16 years, treated with noophen in dose of 15-20 mg/kg per day (2-3 times perorally) during 2 month. Before and during the treatment characteristics of headache, its influence on daily activities were assessed with HIT-6 and PedMIDAS, anxiety disorders were assessed with SCAS, the dynamics of sleep disturbances in children were evaluated. A significant decrease in the frequency, duration and intensity of TTH as well as positive changes in daily life activities and reduction of anxiety and sleep disorders manifestations, which are the risk factors for TTH, were demonstrated during the treatment with noophen. Starting from the first month of treatment, there was a significant decrease in the number of days completely lost because of headache and days with the reduced activity (a decrease in the productivity by >50%).

  5. THE PREVALENCE AND CLINICAL CHARACTERISTICS OF PRIMARY HEADACHE IN IRRITABLE BOWEL SYNDROME: a subgroup of the functional somatic syndromes

    Directory of Open Access Journals (Sweden)

    Rosa LS SOARES

    2013-12-01

    Full Text Available Context The irritable bowel syndrome and primary headache are two chronic diseases characterized by symptoms of recurring pain and affect approximately 10%-20% of the general population. Objectives To study the prevalence of primary headache in volunteers with irritable bowel syndrome in a Brazilian urban community. Methods It was evaluated the prevalence of primary headache associated with irritable bowel syndrome in adult volunteers 330 no patients.The protocol included the Rome III criteria, international classification of Headaches, later divided into four groups: I- Irritable bowel syndrome (n = 52, II- Primary headache (n = 45, III-Irritable bowel syndrome (n = 26 and headache, and IV- Controls (207. Results We not found significant difference in the average age of the four groups and the diagnosis of irritable bowel syndrome, primary headache and their association was more frequent in females. The frequent use of analgesics was greater in groups II and III. Conclusion Our results suggest that irritable bowel syndrome and primary headache are also common in third world countries. The frequency in use of analgesics in association between the two entities was relevant. The identification of irritable bowel syndrome patients with different clinical sub-types could improve the therapeutics options and the prevention strategies.

  6. Multimodal Physiotherapy Based on a Biobehavioral Approach as a Treatment for Chronic Tension-Type Headache: A Case Report.

    Science.gov (United States)

    Beltran-Alacreu, Hector; Lopez-de-Uralde-Villanueva, Ibai; La Touche, Roy

    2015-12-01

    Tension-type headache (TTH) is the most common primary headache affecting the general population, which is characterized by bilateral headache and mild to moderate pain. This disorder causes high levels of disability and recent scientific evidence suggests that manual therapy (MT) and therapeutic exercise are effective in reducing medication intake and decreasing the frequency and intensity of headaches in patients with TTH. A 34-year-old woman was known to have chronic TTH. Initially, the patient presented moderate headaches 5 days per week, mechanical neck pain and no positive response to analgesics. A battery of self-reports was given to the patient to assess disability (using the Spanish versions of the Headache Impact Test-6 and the neck disability index), pain (visual analogue scale) and psychosocial issues (Spanish version of the pain catastrophizing scale) involved in the headaches. All measurements were taken four times during 161 days. Eleven sessions of treatment including MT, motor control therapeutic exercise (MCTE) and therapeutic patient education (TPE) were applied. This biobehavioral-based multimodal physical rehabilitation treatment combining MT, TPE and MCTE produced a substantial reduction in pain intensity, pain catastrophizing, disability and the impact of headaches on patient's life.

  7. Identification of clinical and paraclinical findings predictive for headache occurrence during spontaneous subarachnoid hemorrhage.

    Science.gov (United States)

    Ljubisavljevic, Srdjan; Milosevic, Vuk; Stojanov, Aleksandar; Ljubisavljevic, Marina; Dunjic, Olivera; Zivkovic, Miroslava

    2017-07-01

    Headache is recognized as the main but unwarranted symptom of subarachnoid hemorrhage (SAH). There are no enough findings identified as predictive for headache occurrence in SAH. We evaluated the clinical and paraclinical factors predictive for headache occurrence in SAH. We retrospectively analyzed medical records of 431 consecutive non traumatic SAH patients (264 females and 167 males), ages from 19 to 91 years, presenting with headache (70.3%) and without headache (29.7%) during period of 11years. Among all tested parameters, as negative predictors for headache occurrence were recognized: patients' ages (OR 0.97 [95%CI: 0.96-0.99], p=0.025), persistence of coagulation abnormality (OR 0.23 [95%CI: 0.08-0.67], p=0.006), atrial fibrilation (OR 0.23 [95%CI: 0.09-0.59], p=0.002), chronic renal failure (OR 0.26 [95%CI: 0.09-0.76], p=0.014) and more diseases (OR 0.11 [95%CI: 0.04-0.32], p<0.0001), as higher clinical score (OR 0.94 [95%CI: 0.90-0.99], p=0.018) including positive neurological findings (OR 0.34 [95%CI: 0.21-0.55], p<0.001) and loss of consciousness (OR 0.22 [95%CI: 0.12-0.39], p<0.001) at the SAH onset, while the complaint of neck stiffness was identified as its positive predictor (OR 1.93 [95%CI: 1.19-3.10], p=0.007). Although diagnosis based solely on clinical presentation is not reliable and speculative, our findings could provide physicians with evidence to consider SAH not only in conditions of its headache occurrence but also in those with headache absence. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. A randomized trial of telemedicine efficacy and safety for nonacute headaches.

    Science.gov (United States)

    Müller, Kai I; Alstadhaug, Karl B; Bekkelund, Svein I

    2017-07-11

    To evaluate long-term treatment efficacy and safety of one-time telemedicine consultations for nonacute headaches. We randomized, allocated, and consulted nonacute headache patients via telemedicine (n = 200) or in a traditional manner (n = 202) in a noninferiority trial. Efficacy endpoints, assessed by questionnaires at 3 and 12 months, included change from baseline in Headache Impact Test-6 (HIT-6) (primary endpoint) and pain intensity (visual analogue scale [VAS]) (secondary endpoint). The primary safety endpoint, assessed via patient records, was presence of secondary headache within 12 months after consultation. We found no differences between telemedicine and traditional consultations in HIT-6 ( p = 0.84) or VAS ( p = 0.64) over 3 periods. The absolute difference in HIT-6 from baseline was 0.3 (95% confidence interval [CI] -1.26 to 1.82, p = 0.72) at 3 months and 0.2 (95% CI -1.98 to 1.58, p = 0.83) at 12 months. The absolute change in VAS was 0.4 (95% CI -0.93 to 0.22, p = 0.23) after 3 months and 0.3 (95% CI -0.94 to 0.29, p = 0.30) at 12 months. We found one secondary headache in each group at 12 months. The estimated number of consultations needed to miss one secondary headache with the use of telemedicine was 20,200. Telemedicine consultation for nonacute headache is as efficient and safe as a traditional consultation. NCT02270177. This study provides Class III evidence that a one-time telemedicine consultation for nonacute headache is noninferior to a one-time traditional consultation regarding long-term treatment outcome and safety. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

  9. Monthly variation in pediatric visits for headache to US emergency departments.

    Science.gov (United States)

    Caperell, Kerry; Rominger, Anna

    2017-08-01

    Headache is a common pediatric symptom often associated with stress and fatigue which may be more common during the school year. The purpose of this study is to determine if visits for headache are more common during the months of the school year. This study is a secondary analysis of the National Hospital Ambulatory Medical Care Survey (NHAMCS) database from 2001 to 2010. Patient visits in those aged 18 years or younger not associated with injury were examined. Only visits with an International Classification of Diseases, ninth revision (ICD-9) code consistent with headache were included. Data were analyzed using cumulative binomial probabilities. This statistic was used to establish the chance of seeing up to the observed number of visits for headache in a given month assuming that all months have an equal number of visits. A total of 660 unweighted visits representing 3.2 million patient encounters met the inclusion and exclusion criteria. Visits for headache were more common during the months of January, September, and October and less common in March, April, July, and November. Subgroup analysis was performed for children aged 13-18 years. In this subgroup, headaches were more common in January, September, and October. They were less common in July and December. Headache is more common during the first 2 months back to school in the fall as well as after the winter break in January. While we are not able to establish causality, we propose that children with headache require additional attention during the school year, particularly in the months following summer and winter breaks. Copyright © 2017 American Federation for Medical Research.

  10. Management of headache disorders in the Emergency Department setting.

    Science.gov (United States)

    Pari, Elisa; Rinaldi, Fabrizio; Gipponi, Stefano; Venturelli, Elisabetta; Liberini, Paolo; Rao, Renata; Padovani, Alessandro

    2015-07-01

    Headache is a common presenting complaint in the Emergency Department. The aim of this study was to delineate the demographic profile of patients presenting a chief complaint of headache and to assess the application of diagnostic algorithms for the management of these patients. We examined patients admitted to the Spedali Civili Hospital ED between January 2005 and December 2009 who complained of headache not related to trauma and all patients hospitalized for headache in Neurological Clinic, from ED, between January 2008 and December 2009. 7495 patients were examined at ED for headaches. 72 % of patients were discharged, 22 % were admitted. From 2005 to 2009, there was a definite decrease in the rate of hospitalization due to headache (15 vs 9.9 % in Department of Neurology and 26 vs 18.9 % in all Departments). Considering the decrease year by year, this reduction was significant from 2007 to 2008, when the algorithms were adopted. The most common diagnosis in the ED was "Non-specific headache" (41 %), followed by "Primary headaches and complications of primary headaches" (20.8 %), "Secondary headaches not associated with risk of serious disease" (20.4 %) and "Secondary headache associated with risk of serious disease" (5 %). Over 2-year period (2008-2009) we found an increase in the diagnosis of "Primary headaches and complications of primary headaches" and "Secondary headaches associated with risk of serious disease" compared with a decrease of "nonspecific headache" and "secondary headaches not associated with risk of serious disease". The use of the diagnostic algorithms and collaborative network between the ED and the Headache Center can improve the management of patients with headache in ED.

  11. The role of fear of pain in headache.

    Science.gov (United States)

    Black, Anna Katherine; Fulwiler, Joshua C; Smitherman, Todd A

    2015-05-01

    Recurrent headache sufferers are often fearful of pain, which disrupts thought processes, interferes with daily activities, and may maintain headache-related disability through avoidance and associated negative reinforcement. The aim of this cross-sectional study was to (1) examine differences in fear of pain (FOP) between headache sufferers and non-headache controls; (2) examine differences in FOP across primary headache diagnostic groups; (3) assess the extent to which FOP predicts headache variables (eg., severity, frequency, disability); and (4) determine whether FOP mediates the relationship between pain severity and headache-related disability. The sample consisted of 908 young adults (M age = 19.5 years; 64.9% female). Of those, 237 (26.1%) met the diagnostic criteria for episodic tension-type headache (TTH), 232 (25.6%) for episodic migraine (167 [18.4%] without aura and 65 [7.2%] with aura), 38 (4.2%) for chronic migraine, and 19 (2.1%) for chronic TTH; 382 (42.1%) served as non-headache controls. FOP differed among groups, with headache sufferers reporting greater FOP than those without headache; migraineurs typically endorsed greater FOP than those with TTH. Among those with headache, FOP significantly predicted headache severity (R(2)  = 6.1%) and frequency (R(2)  = 4.5%), and accounted for more variance in disability (R(2)  = 17.5%) than gender, anxiety, and depression combined (13.8%). Pain severity and disability were strongly associated (r = 0.61, P headache and plays a significant role in primary headache, particularly in headache-related disability. Findings build upon and extend those from previous chronic pain studies and highlight the need for longitudinal and experimental studies to further explore this construct in headache. © 2015 American Headache Society.

  12. Diagnosis, pathophysiology, and management of cluster headache.

    Science.gov (United States)

    Hoffmann, Jan; May, Arne

    2018-01-01

    Cluster headache is a trigeminal autonomic cephalalgia characterised by extremely painful, strictly unilateral, short-lasting headache attacks accompanied by ipsilateral autonomic symptoms or the sense of restlessness and agitation, or both. The severity of the disorder has major effects on the patient's quality of life and, in some cases, might lead to suicidal ideation. Cluster headache is now thought to involve a synchronised abnormal activity in the hypothalamus, the trigeminovascular system, and the autonomic nervous system. The hypothalamus appears to play a fundamental role in the generation of a permissive state that allows the initiation of an episode, whereas the attacks are likely to require the involvement of the peripheral nervous system. Triptans are the most effective drugs to treat an acute cluster headache attack. Monoclonal antibodies against calcitonin gene-related peptide, a crucial neurotransmitter of the trigeminal system, are under investigation for the preventive treatment of cluster headache. These studies will increase our understanding of the disorder and perhaps reveal other therapeutic targets. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. BIOFEEDBACK TRAINING AND TENSION-TYPE HEADACHE.

    Science.gov (United States)

    Šecić, Ana; Cvjeticanin, Timon; Kes, Vanja Bašić

    2016-03-01

    Biofeedback is a training method, which connects physiological and psychological processes in a person for the purposes of improving his/her physical, emotional, mental and spiritual health. In biofeedback treatment, an active role of the patient is stressed for him/her to be able to actively control the physiological and emotional processes. The aim of biofeedback is to improve the conscious control of the individual's involuntary physiological activity. Research has shown that biofeedback, either applied alone or in combination with other behavioral therapies (techniques), is an effective treatment for various medical and psychological disorders, from headache and hypertension to temporomandibular and attention deficit disorders. More than 90% of adults experience headache once a year, which makes headache one of the most common symptoms and diagnoses in medicine. Tension-type headaches occur in at least 40% of the population and their impact on the health insurance costs and diminished productivity is significant. Studies have shown that clinical biofeedback training is effective in treating headaches. Moreover, the authors stress the need for additional research and further development of methodology for this kind of research.

  14. Headache diagnoses among Iraq and Afghanistan war veterans enrolled in VA: a gender comparison.

    Science.gov (United States)

    Carlson, Kathleen F; Taylor, Brent C; Hagel, Emily M; Cutting, Andrea; Kerns, Robert; Sayer, Nina A

    2013-01-01

    To examine the prevalence and correlates of headache diagnoses, by gender, among Iraq and Afghanistan War Veterans who use Department of Veterans Affairs (VA) health care. Understanding the health care needs of recent Veterans, and how these needs differ between women and men, is a priority for the VA. The potential for a large burden of headache disorders among Veterans seeking VA services exists but has not been examined in a representative sample. We conducted a historical cohort study using national VA inpatient and outpatient data from fiscal year 2011. Participants were all (n = 470,215) Iraq and Afghanistan War Veteran VA users in 2011; nearly 13% were women. We identified headache diagnoses using International Classification of Diseases (ICD-9) diagnosis codes assigned during one or more VA inpatient or outpatient encounters. Descriptive analyses included frequencies of patient characteristics, prevalence and types of headache diagnoses, and prevalence of comorbid diagnoses. Prevalence ratios (PR) with 95% confidence intervals (CI) were used to estimate associations between gender and headache diagnoses. Multivariate models adjusted for age and race. Additional models also adjusted for comorbid diagnoses. In 2011, 56,300 (11.9%) Veterans received a headache-related diagnosis. While controlling for age and race, headache diagnoses were 1.61 times more prevalent (95% CI = 1.58-1.64) among women (18%) than men (11%). Most of this difference was associated with migraine diagnoses, which were 2.66 times more prevalent (95% CI = 2.59-2.73) among women. Cluster and post-traumatic headache diagnoses were less prevalent in women than in men. These patterns remained the same when also controlling for comorbid diagnoses, which were common among both women and men with headache diagnoses. The most prevalent comorbid diagnoses examined were depression (46% of women with headache diagnoses vs 40% of men), post-traumatic stress disorder (38% vs 58%), and back

  15. Ondansetron versus granisetron in the prevention of chemotherapy induced nausea and vomiting in children with acute lymphoblastic leukemia.

    Science.gov (United States)

    Siddique, R; Hafiz, M G; Rokeya, B; Jamal, C Y; Islam, A

    2011-10-01

    Effect of ondansetron and granisetron were evaluated in sixty (60) children (age 4-11 years) irrespective of sex, diagnosed case of acute lymphoblastic leukemia (ALL) who received high dose methotrexate and did not receive any antiemetic 24 hours prior to HDMTX. This was a prospective, randomized, double-blind, single center study. Of 60 children, 30 received oral ondansetron (4mg) and rest 30 granisetron (1mg) half an hour before therapy. Drugs were randomly allocated with appropriate code. The patients were followed up from day 1 to day 5 of therapy. Episodes of nausea and vomiting were recorded and scorings was done every 24 hours following chemotherapy. No significant difference was found between two groups according to acute emesis (Day-1) (p=0.053). In day two and day three it was significant (pgranisetron and 70% in children who received ondansetron. Delayed (Day 2-4) CINV were controlled in 80% of children who received granisetron and 43.4% who received ondansetron (pGranisetron group required additional doses only 3.3% cases and ondanseton group 30% cases on the second day (pgranisetron group due to adverse effects of antiemetic drug itself (p=0.001). Maximum episodes of vomiting were found on the second day in ondansetron group 33.3% and in granisetron group 3.3% (p=0.003). Though adverse effects like headache, constipation, abdominal pain and loose motion were common in both group of children but their number was much less in children who received granisetron. On second day of therapy score of nausea and vomiting was maximum in ondansetron and minimum in granisetron treated on day 4 and the result was significant. So, to prevent acute and delayed CINV in children with ALL, oral graniseteron can be considered as more effective and well tolerated with minimum adverse effects compared with ondansetrons.

  16. Are signs of temporomandibular disorders stable and predictable in adolescents with headache?

    Science.gov (United States)

    Liljeström, M-R; Le Bell, Y; Laimi, K; Anttila, P; Aromaa, M; Jämsä, T; Metsähonkala, L; Vahlberg, T; Viander, S; Alanen, P; Sillanpää, M

    2008-06-01

    The aim of the present study was to study changes in signs and symptoms of temporomandibular disorders (TMD) and factors predicting TMD signs in adolescents with and without headache. A population-based sample (n = 212) of 13-year-olds with and without headache was re-examined at the age of 16. The study included a questionnaire, face-to-face interview and somatic examination. In addition, a neurological examination, a muscle evaluation and a stomatognathic examination were performed. Significant changes were seen in TMD signs during the follow-up, but TMD signs at the end of the follow-up could not be predicted by baseline headache, sleeping difficulties, depression or muscle pain. TMD signs at the age of 16 were associated with female gender and muscle pain. We conclude that considerable changes in TMD signs occur in the follow-up of adolescents with and without headache. Headache-related TMD are not predictable in adolescents with and without headache.

  17. Headache attributed to airplane travel: diagnosis, pathophysiology, and treatment - a systematic review.

    Science.gov (United States)

    Bui, Sebastian Bao Dinh; Gazerani, Parisa

    2017-08-16

    Headache attributed to airplane travel, also named "airplane headache" (AH) is a headache that occurs during take-off and landing. Today, there are still uncertainties about the pathophysiology and treatment of AH. This systematic review was performed to facilitate identification of the existing literature on AH in order to discuss the current evidence and areas that remain to be investigated in AH. The systematic literature search was performed in 3 relevant medical databases; PubMed, Scopus, and Embase. The search yielded 220 papers and the papers were sorted based on inclusion and exclusion criteria established for this study. This systematic review included 39 papers. Main findings revealed that AH attacks are clinically stereotyped and appear mostly during landing phases. The headache presents as a severe painful headache that often disappears within 30 min. The pain is unilateral and localized in the fronto-orbital region. Sinus barotrauma has been considered as the main cause of AH. Nonsteroidal anti-inflammatory drugs and triptans have been taken by passengers with AH, to relieve the headache. Based on this systematic review, further studies seem required to investigate underlying mechanisms in AH and also to investigate the biological effects of nonsteroidal anti-inflammatory drugs and triptans for alleviating of AH. These studies would advance our understanding of AH pathogenesis and potential use of treatments that are not yet established.

  18. Level of headaches after surgical aneurysm clipping decreases significantly faster compared to endovascular coiled patients

    Directory of Open Access Journals (Sweden)

    Athanasios K. Petridis

    2017-04-01

    Full Text Available In incidental aneurysms, endovascular treatment can lead to post-procedural headaches. We studied the difference of surgical clipping vs. endovascular coiling in concern to post-procedural headaches in patients with ruptured aneurysms. Sixtyseven patients with aneurysmal subarachnoidal haemorrhage were treated in our department from September 1st 2015 - September 1st 2016. 43 Patients were included in the study and the rest was excluded because of late recovery or highgrade subarachnoid bleedings. Twenty-two were surgical treated and twenty-one were interventionally treated. We compared the post-procedural headaches at the time points of 24 h, 21 days, and 3 months after treatment using the visual analog scale (VAS for pain. After surgical clipping the headache score decreased for 8.8 points in the VAS, whereas the endovascular treated population showed a decrease of headaches of 3.3 points. This difference was highly statistical significant and remained significant even after 3 weeks where the pain score for the surgically treated patients was 0.68 and for the endovascular treated 1.8. After 3 months the pain was less than 1 for both groups with surgically treated patients scoring 0.1 and endovascular treated patients 0.9 (not significant. Clipping is relieving the headaches of patients with aneurysm rupture faster and more effective than endovascular coiling. This effect stays significant for at least 3 weeks and plays a crucial role in stress relieve during the acute and subacute ICU care of such patients.

  19. [Impact of headache among studied military population in Afghanistan deployed in the Kabul military field hospital].

    Science.gov (United States)

    Guilloton, L; Bruneau, O; Trousselard, M; Zagnoli, F; Blanc, P A; De Greslan, T; Drouet, A

    2015-11-01

    Headaches are a common reason for consultation with a prevalence of 30%. Few data exist for military personnel, including in situations of war operations. The main objective of this work was to measure the evolution of the impact of headache in such a context. Two hundred and one personnel deployed in the Kaïa military field hospital in Afghanistan were recruited. A questionnaire designed to recognize headaches, supported by two quality of life scales (MIDAS and HIT-6) and a stress questionnaire were filled out before departure and upon return from missions. Sixty-three patients with headache were initially identified, of whom 52 remained symptomatic during the mission. The average total score of MIDAS before departure was 4 days and fell to 1.4 days upon return, with a mean measured change of 3.3 days. For HIT-6, the mean total score was 51.2 points initially and 51.9 points at the end of the mission with a mean change of-0.3 points. Nine patients without headache initially became symptomatic: MIDAS and HIT-6 were not affected. Thus, the impact of headache in the particular context of presence in a theater of operations was low: improved MIDAS score and the lack of influence on the HIT-6 score are underlined. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  20. Mindfulness-Based Intervention for Adolescents with Recurrent Headaches: A Pilot Feasibility Study

    Directory of Open Access Journals (Sweden)

    Toni Hesse

    2015-01-01

    Full Text Available Recurrent headaches cause significant burden for adolescents and their families. Mindfulness-based interventions (MBIs have been shown to reduce stress and alter the experience of pain, reduce pain burden, and improve quality of life. Research indicates that MBIs can benefit adults with chronic pain conditions including headaches. A pilot nonrandomized clinical trial was conducted with 20 adolescent females with recurrent headaches. Median class attendance was 7 of 8 total sessions; average class attendance was 6.10±2.6. Adherence to home practice was good, with participants reporting an average of 4.69 (SD = 1.84 of 6 practices per week. Five participants dropped out for reasons not inherent to the group (e.g., extracurricular scheduling; no adverse events were reported. Parents reported improved quality of life and physical functioning for their child. Adolescent participants reported improved depression symptoms and improved ability to accept their pain rather than trying to control it. MBIs appear safe and feasible for adolescents with recurrent headaches. Although participants did not report decreased frequency or severity of headache following treatment, the treatment had a beneficial effect for depression, quality of life, and acceptance of pain and represents a promising adjunct treatment for adolescents with recurrent headaches.

  1. Headache characteristics during the development of tolerance to nitrates

    DEFF Research Database (Denmark)

    Christiansen, I; Iversen, Helle Klingenberg; Olesen, J

    2000-01-01

    Recent studies suggest that nitric oxide (NO) plays an important role in nitrate-induced headache and in spontaneous migraine attacks. Organic nitrates act as prodrugs for NO and headache is a predominant adverse effect of nitrates but often disappears during continuous treatment. Insight...... into tolerance to headache could lead to insight into vascular headache mechanisms in general. The specific aim of the present study was therefore to characterize the headache and accompanying symptoms during continuous nitrate administration until a state of tolerance to headache had developed. 5-isosorbide...

  2. Clinical Studies on HWANGRYUNHAEDOKTANG Herbal Acupuncture Therapy on Headache

    Directory of Open Access Journals (Sweden)

    Lee, Dae-Yong

    2003-02-01

    Full Text Available Objective: There are many treatments for headache. We suggested the clinical effect and utilization of HWANGRYUNHAEDOKTANG herbal acupuncture on headache. Methods: 1. We injected distillation of HWANGRYUNHAEDOKTANG(2.0cc on Both Pung-Ji(GB20 of patients. In 20 minutes later, We examined therapeutic value of headache. 2. We examined effects of HWANGRYUNHAEDOKTANG Herbal acupuncture by sex , age, area of headache, period of history, degree of headache. Results and Conclusions: 1. There was a significantly effect of HWANGRYUNHAEDOKTANG Herbal acupuncture on headache. 2. In therapeutic value, The effect of HWANGRYUNHAEDOKTANG Herbal acupuncture by each type is significant.

  3. Complementary and Alternative Medicine Use Among US Adults With Headache or Migraine: Results from the 2012 National Health Interview Survey.

    Science.gov (United States)

    Zhang, Yan; Dennis, Jeff A; Leach, Matthew J; Bishop, Felicity L; Cramer, Holger; Chung, Vincent C H; Moore, Craig; Lauche, Romy; Cook, Ron; Sibbritt, David; Adams, Jon

    2017-09-01

    Given the safety concerns regarding pharmacological agents, and the considerable impact of headache and migraine on the sufferer's quality of life, many people seek other treatment options beyond conventional medication and care to address their symptoms; this includes complementary and alternative medicine (CAM). Some CAM interventions have shown promising results in clinical trials of headache and migraine management. Nonetheless, there has been little research exploring the reasons for using CAM, and the types of CAM used, among this population. The study aimed to answer the following questions: (1) Which CAM modalities are used most frequently among migraine/headache sufferers? and (2) What are the self-reported reasons for CAM use among migraine/headache sufferers? This secondary analysis of data from the 2012 U.S. NHIS (a national cross-sectional survey) examined the use of CAM among migraine/headache sufferers, including the main reasons related to CAM use. Data were weighted and analyzed using STATA 14.0. The sample of 34,525 adults included 6558 (18.7%) headache/migraine sufferers. Of the headache/migraine sufferers, a substantial proportion (37.6%, n = 2427) used CAM for various conditions; however, CAM use specifically for headache/migraine was much less prevalent (3.3%, n = 216). Of those who used CAM for headache/migraine, about half used CAM in conjunction with prescription (47.8%, n = 100) or over-the-counter medication (55.1%, n = 113). As severity of headache/migraine increased so did the likelihood of using CAM (severe migraine odds ratio [OR] = 2.32; 95% confidence interval [CI]: 1.41, 3.82; both recurring headache/severe migraine OR = 3.36; 95% CI: 2.08, 5.43; when compared to those with recurring headache only). The most frequently used CAM modality among all headache/migraine sufferers (N = 6558) was manipulative therapy (22.0%, n = 1317), herbal supplementation (21.7%, n = 1389) and mind-body therapy (17

  4. Risk factors and analysis of long-term headache in sporadic vestibular schwannoma: a multicenter cross-sectional study.

    Science.gov (United States)

    Carlson, Matthew L; Tveiten, Øystein Vesterli; Driscoll, Colin L; Boes, Christopher J; Sullan, Molly J; Goplen, Frederik K; Lund-Johansen, Morten; Link, Michael J

    2015-11-01

    The primary goals of this study were: 1) to examine the influence of disease and treatment on headache in patients with sporadic vestibular schwannoma (VS); and 2) to identify clinical predictors of long-term headache disability. This was a cross-sectional observational study with international multicenter enrollment. Patients included those with primary sporadic Headache Disability Inventory (HDI), the Hospital Anxiety and Depression Scale, and a VS symptom questionnaire. The main outcome measures were univariate and multivariable associations with HDI total score. The overall survey response rate was 79%. Data from 538 patients with VS were analyzed. The mean age at time of survey was 64 years, 56% of patients were female, and the average duration between treatment and survey was 7.7 years. Twenty-seven percent of patients received microsurgery, 46% stereotactic radiosurgery, and 28% observation. Patients with VS who were managed with observation were more than twice as likely to have severe headache disability compared with 103 control subjects without VS. When accounting for baseline differences, there was no statistically significant difference in HDI outcome between treatment modalities at time of survey. Similarly, among the microsurgery cohort, the long-term risk of severe headache disability was not different between surgical approaches. Multivariable regression demonstrated that younger age, greater anxiety and depression, and a preexisting diagnosis of headache were the primary predictors of severe long-term headache disability, while tumor size and treatment modality had little influence. At a mean of almost 8 years following treatment, approximately half of patients with VS experience headaches of varying frequency and severity. Patient-driven factors including age, sex, mental health, and preexisting headache syndrome are the strongest predictors of long-term severe headache disability. Tumor size and treatment modality have less impact. These data

  5. Acupuncture for the Prevention of Tension-Type Headache (2016).

    Science.gov (United States)

    Nielsen, Arya

    Linde K, Allais G, Brinkhaus B, et al. Acupuncture for the prevention of tension-type headache.Cochrane Database Syst Rev2016, Issue 48. Art No.: CD007587. DOI: 10.1002/14651858.CD007587.pub2. Acupuncture is often used for prevention of tension-type headache but its effectiveness is still controversial. This is an update of our Cochrane review originally published in Issue 1, 2009 of The Cochrane Library. To investigate whether acupuncture is (a) more effective than no prophylactic treatment/routine care only; (b) more effective than "sham" (placebo) acupuncture; and (c) as effective as other interventions in reducing headache frequency in adults with episodic or chronic tension-type headache. We searched CENTRAL, MEDLINE, EMBASE, and AMED to 19 January 2016. We searched the World Health Organization (WHO) International Clinical Trials Registry Platform to 10 February 2016 for ongoing and unpublished trials. We included randomized trials with a post-randomization observation period of at least eight weeks, which compared the clinical effects of an acupuncture intervention with a control (treatment of acute headaches only or routine care), a sham acupuncture intervention or another prophylactic intervention in adults with episodic or chronic tension-type headache. Two review authors checked eligibility; extracted information on participants, interventions, methods and results; and assessed study risk of bias and the quality of the acupuncture intervention. The main efficacy outcome measure was response (at least 50% reduction of headache frequency) after completion of treatment (three to four months after randomization). To assess safety/acceptability we extracted the number of participants dropping out due to adverse effects and the number of participants reporting adverse effects. We assessed the quality of the evidence using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Twelve trials (11 included in the previous version and one newly

  6. How Safe Is Ginger Rhizome for Decreasing Nausea and Vomiting in Women during Early Pregnancy?

    Science.gov (United States)

    Stanisiere, Julien; Mousset, Pierre-Yves; Lafay, Sophie

    2018-01-01

    Ginger, Zingiber officinale Roscoe, is increasingly consumed as a food or in food supplements. It is also recognized as a popular nonpharmacological treatment for nausea and vomiting of pregnancy (NVP). However, its consumption is not recommended by all countries for pregnant women. Study results are heterogeneous and conclusions are not persuasive enough to permit heath care professionals to recommend ginger safely. Some drugs are also contraindicated, leaving pregnant women with NVP with few solutions. We conducted a review to assess effectiveness and safety of ginger consumption during early pregnancy. Systematic literature searches were conducted on Medline (via Pubmed) until the end of December 2017. For the evaluation of efficacy, only double-blind, randomized, controlled trials were included. For the evaluation of the safety, controlled, uncontrolled, and pre-clinical studies were included in the review. Concerning toxicity, none can be extrapolated to humans from in vitro results. In vivo studies do not identify any major toxicities. Concerning efficacy and safety, a total of 15 studies and 3 prospective clinical studies have been studied. For 1 g of fresh ginger root per day for four days, results show a significant decrease in nausea and vomiting and no risk for the mother or her future baby. The available evidence suggests that ginger is a safe and effective treatment for NVP. However, beyond the ginger quantity needed to be effective, ginger quality is important from the perspective of safety. PMID:29614764

  7. New approaches to chemotherapy-induced nausea and vomiting: from neuropharmacology to clinical investigations.

    Science.gov (United States)

    Rubenstein, Edward B; Slusher, Barbara S; Rojas, Camilo; Navari, Rudolph M

    2006-01-01

    Nausea and vomiting are considered to be among the most distressing consequences of cytotoxic chemotherapies. Currently, there are several novel 5-HT(3) receptor antagonists for the treatment of chemotherapy-induced nausea and vomiting (CINV), including ondansetron, granisetron, and dolasetron. These agents provide significant improvement in the management of acute emesis but are ineffective at preventing delayed emesis. In 2003, a new 5-HT(3) receptor antagonist, palonosetron HCL (Aloxi), was introduced to the U.S. market. Palonosetron was found to be effective in preventing delayed CINV. Indeed, palonosetron was the first and only 5-HT(3) receptor antagonist approved by the FDA for the prevention of both acute and delayed CINV. More recently, studies on the role of substance P in the emetic process led to the development of aprepitant (Emend) for the prevention of delayed emesis in combination with 5-HT(3) receptor antagonists. Despite these major advances, CINV remains uncontrolled in some patients. Current efforts are focused on treating refractory emesis and include both the clinical evaluation of compounds marketed for other indications and the preclinical evaluation of novel molecules targeting other transmitters in the emetic pathway. Ongoing work in pharmacogenomics has postulated several candidate genes that could be involved in emetic sensitivity and responsiveness to antiemetic therapy. Investigations into the pharmacogenomics of CINV may someday be able to aid in the identification of high risk patients and patients unlikely to respond to conventional therapies.

  8. How Safe Is Ginger Rhizome for Decreasing Nausea and Vomiting in Women during Early Pregnancy?

    Directory of Open Access Journals (Sweden)

    Julien Stanisiere

    2018-04-01

    Full Text Available Ginger, Zingiber officinale Roscoe, is increasingly consumed as a food or in food supplements. It is also recognized as a popular nonpharmacological treatment for nausea and vomiting of pregnancy (NVP. However, its consumption is not recommended by all countries for pregnant women. Study results are heterogeneous and conclusions are not persuasive enough to permit heath care professionals to recommend ginger safely. Some drugs are also contraindicated, leaving pregnant women with NVP with few solutions. We conducted a review to assess effectiveness and safety of ginger consumption during early pregnancy. Systematic literature searches were conducted on Medline (via Pubmed until the end of December 2017. For the evaluation of efficacy, only double-blind, randomized, controlled trials were included. For the evaluation of the safety, controlled, uncontrolled, and pre-clinical studies were included in the review. Concerning toxicity, none can be extrapolated to humans from in vitro results. In vivo studies do not identify any major toxicities. Concerning efficacy and safety, a total of 15 studies and 3 prospective clinical studies have been studied. For 1 g of fresh ginger root per day for four days, results show a significant decrease in nausea and vomiting and no risk for the mother or her future baby. The available evidence suggests that ginger is a safe and effective treatment for NVP. However, beyond the ginger quantity needed to be effective, ginger quality is important from the perspective of safety.

  9. Nausea in Children With Functional Abdominal Pain Predicts Poor Health Outcomes in Young Adulthood.

    Science.gov (United States)

    Russell, Alexandra C; Stone, Amanda L; Walker, Lynn S

    2017-05-01

    Nausea is common among children with functional abdominal pain (FAP). We evaluated the relation of nausea to short- and long-term morbidity in pediatric patients with FAP. We performed a prospective study of 871 children with FAP (age, 8-17 y) seen in a pediatric gastroenterology practice; follow-up data were collected from 392 of the patients at 8.7 ± 3.3 years later. Participants were defined as having significant nausea if they reported nausea "a lot" or "a whole lot" within the past 2 weeks. Validated questionnaires assessed abdominal pain, gastrointestinal and somatic symptoms, and depression. Baseline measures, anxiety, and the Rome III criteria were assessed in the follow-up evaluation. At baseline, 44.8% of the patients reported significant nausea. Those with nausea reported worse abdominal pain, gastrointestinal symptoms, somatic symptoms, and depression than those without nausea (P abdominal pain severity. Pediatric patients with FAP and nausea have more severe short- and long-term gastrointestinal and somatic symptoms than patients with FAP without nausea, as well as reductions in mental health and daily function. Pediatric patients with FAP and nausea therefore need intensive treatment and follow-up evaluation. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  10. Tension‑Type Headache - Psychiatric Perspective

    Directory of Open Access Journals (Sweden)

    João Campos Mendes

    2013-11-01

    Full Text Available Introduction: The tension‑type headaches (Ctt are the most frequent headaches in the general population and those with higher socio‑economic impact, given the high degree of disability they cause. Objective: The authors propose to conduct a review of the available literature on the subject, from a psychiatric perspective. Discussion: Several studies have identified a higher prevalence of psychiatric disorders, personality traits and ineffective coping mechanisms in patients with Ctt, so it is essential to understand this relationship and the impact of these psychopathological factors on this kind of headaches. Conclusion: Their clinical and therapeutic approach is hampered by these and other factors and multiple strategies of pharmacological and psycho‑behavioral treatment have been used on them, however, scientific evidence is still scarce.

  11. The International Classification of Headache Disorders

    DEFF Research Database (Denmark)

    Olesen, J.

    2008-01-01

    A set of related medical disorders that lack a proper classification system and diagnostic criteria is like a society without laws. The result is incoherence at best, chaos at worst. For this reason, the International Classification of Headache Disorders (ICHD) is arguably the single most important....... In summary, the ICHD has attained widespread acceptance at the international level and has substantially facilitated both clinical research and clinical care in the field of headache medicine Udgivelsesdato: 2008/5...... universally accepted, and criticism of the classification has been minor relative to that directed at other disease classification systems. Over the 20 years following publication of the first edition of the ICHD, headache research has rapidly accelerated despite sparse allocation of resources to that effort...

  12. Endovascular thrombectomy and post-procedural headache

    DEFF Research Database (Denmark)

    Khan, Sabrina; Amin, Faisal Mohammad; Holtmannspötter, Markus

    2017-01-01

    BACKGROUND: We investigated the prevalence of post-procedural headache in patients who have undergone thrombectomy for ischemic stroke, and correlated history of migraine with risk of peri-procedural complications. A total of 314 patients underwent thrombectomy at the Danish National Hospital from...... January 2012 to December 2014. Eligible subjects were phone-interviewed using a purpose-developed semi-structured questionnaire according to the International Classification of Headache Disorders 3, beta version criteria. FINDINGS: Among 96 eligible subjects, there was a significant decrease in migraine...... (p = 0.022) within the first 3 months after EVT compared to 1 year before treatment, which was further evident at interview time (on average 1.6 years after EVT, p = 0.013). A minority of patients experienced headaches for the first time within 3 months of their EVT (migraine 2, TTH 9), which...

  13. Headache Exacerbates Pain Characteristics in Temporomandibular Disorders.

    Science.gov (United States)

    Costa, Yuri Martins; Alves da Costa, Dayse Regina; de Lima Ferreira, Ana Paula; Porporatti, André Luís; Svensson, Peter; Rodrigues Conti, Paulo César; Bonjardim, Leonardo Rigoldi

    2017-01-01

    To evaluate the impact of headache in adults with masticatory myofascial pain (MMP) on the outcome variables clinical pain (ie, self-reported pain intensity and pressure pain sensitivity), sleep quality, and pain catastrophizing. A total of 97 patients with MMP were diagnosed with co-existing headache (MMPH group, n = 50) or without headache (MMP group, n = 47) according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The outcome parameters were the Pittsburgh Sleep Quality Index (PSQI); the Catastrophizing Thoughts subscale of the Pain-Related Self-Statement Scale (PRSS-C); pressure pain thresholds (PPTs) of the masseter and anterior temporalis muscles; and self-reported facial pain intensity measured on a 0- to 10-cm visual analog scale (VAS). Student t test for independent samples (α = 1.2%) and factorial analysis of variance (ANOVA) (α = 5%) were used to analyze the data. The MMPH group showed significantly impaired sleep quality (mean ± standard deviation [SD] PSQI score 9.1 ± 3.5) compared with the MMP group (7.2 ± 3.4; P = .008). Subscale scores on the PRSS-C were significantly higher in the MMPH (2.1 ± 1.2) than in the MMP group (1.6 ± 1.4, uncorrected P = .048). Also, the PPTs (kgf/cm²) of the masseter and anterior temporalis muscles were significantly lower in the MMPH group (1.52 ± 0.53; 1.29 ± 0.43, respectively) than in the MMP group (2.09 ± 0.73; 1.70 ± 0.68, respectively; P headache patients had lower PPTs in the anterior temporalis muscle (P = .041) in comparison with non-headache patients. Co-existence of headache further exacerbates clinical characteristics in patients with painful TMD, which implies involvement of common mechanisms and pathways of vulnerability in these patients.

  14. Central mechanisms of stress-induced headache.

    Science.gov (United States)

    Cathcart, S; Petkov, J; Winefield, A H; Lushington, K; Rolan, P

    2010-03-01

    Stress is the most commonly reported trigger of an episode of chronic tension-type headache (CTTH); however, the causal significance has not been experimentally demonstrated to date. Stress may trigger CTTH through hyperalgesic effects on already sensitized pain pathways in CTTH sufferers. This hypothesis could be partially tested by examining pain sensitivity in an experimental model of stress-induced headache in CTTH sufferers. Such examinations have not been reported to date. We measured pericranial muscle tenderness and pain thresholds at the finger, head and shoulder in 23 CTTH sufferers (CTH-S) and 25 healthy control subjects (CNT) exposed to an hour-long stressful mental task, and in 23 CTTH sufferers exposed to an hour-long neutral condition (CTH-N). Headache developed in 91% of CTH-S, 4% of CNT, and 17% of CTH-N subjects. Headache sufferers had increased muscle tenderness and reduced pain thresholds compared with healthy controls. During the task, muscle tenderness increased and pain thresholds decreased in the CTH-S group compared with CTH-N and CNT groups. Pre-task muscle tenderness and reduction in pain threshold during task were predictive of the development and intensity of headache following task. The main findings are that stress induced a headache in CTTH sufferers, and this was associated with pre-task muscle tenderness and stress-induced reduction in pain thresholds. The results support the hypothesis that stress triggers CTTH through hyperalgesic effects on already increased pain sensitivity in CTTH sufferers, reducing the threshold to noxious input from pericranial structures.

  15. Habituation and sensitization in primary headaches

    Science.gov (United States)

    2013-01-01

    The phenomena of habituation and sensitization are considered most useful for studying the neuronal substrates of information processing in the CNS. Both were studied in primary headaches, that are functional disorders of the brain characterized by an abnormal responsivity to any kind of incoming innocuous or painful stimuli and it’s cycling pattern over time (interictal, pre-ictal, ictal). The present review summarizes available data on stimulus responsivity in primary headaches obtained with clinical neurophysiology. In migraine, the majority of electrophysiological studies between attacks have shown that, for a number of different sensory modalities, the brain is characterised by a lack of habituation of evoked responses to repeated stimuli. This abnormal processing of the incoming information reaches its maximum a few days before the beginning of an attack, and normalizes during the attack, at a time when sensitization may also manifest itself. An abnormal rhythmic activity between thalamus and cortex, namely thalamocortical dysrhythmia, may be the pathophysiological mechanism subtending abnormal information processing in migraine. In tension-type headache (TTH), only few signs of deficient habituation were observed only in subgroups of patients. By contrast, using grand-average responses indirect evidence for sensitization has been found in chronic TTH with increased nociceptive specific reflexes and evoked potentials. Generalized increased sensitivity to pain (lower thresholds and increased pain rating) and a dysfunction in supraspinal descending pain control systems may contribute to the development and/or maintenance of central sensitization in chronic TTH. Cluster headache patients are chrarcterized during the bout and on the headache side by a pronounced lack of habituation of the brainstem blink reflex and a general sensitization of pain processing. A better insight into the nature of these ictal/interictal electrophysiological dysfunctions in primary

  16. Forecasting Individual Headache Attacks Using Perceived Stress: Development of a Multivariable Prediction Model for Persons With Episodic Migraine.

    Science.gov (United States)

    Houle, Timothy T; Turner, Dana P; Golding, Adrienne N; Porter, John A H; Martin, Vincent T; Penzien, Donald B; Tegeler, Charles H

    2017-07-01

    To develop and validate a prediction model that forecasts future migraine attacks for an individual headache sufferer. Many headache patients and physicians believe that precipitants of headache can be identified and avoided or managed to reduce the frequency of headache attacks. Of the numerous candidate triggers, perceived stress has received considerable attention for its association with the onset of headache in episodic and chronic headache sufferers. However, no evidence is available to support forecasting headache attacks within individuals using any of the candidate headache triggers. This longitudinal cohort with forecasting model development study enrolled 100 participants with episodic migraine with or without aura, and N = 95 contributed 4626 days of electronic diary data and were included in the analysis. Individual headache forecasts were derived from current headache state and current levels of stress using several aspects of the Daily Stress Inventory, a measure of daily hassles that is completed at the end of each day. The primary outcome measure was the presence/absence of any headache attack (head pain > 0 on a numerical rating scale of 0-10) over the next 24 h period. After removing missing data (n = 431 days), participants in the study experienced a headache attack on 1613/4195 (38.5%) days. A generalized linear mixed-effects forecast model using either the frequency of stressful events or the perceived intensity of these events fit the data well. This simple forecasting model possessed promising predictive utility with an AUC of 0.73 (95% CI 0.71-0.75) in the training sample and an AUC of 0.65 (95% CI 0.6-0.67) in a leave-one-out validation sample. This forecasting model had a Brier score of 0.202 and possessed good calibration between forecasted probabilities and observed frequencies but had only low levels of resolution (ie, sharpness). This study demonstrates that future headache attacks can be forecasted for a diverse group of

  17. Commercially available mobile phone headache diary apps: a systematic review.

    Science.gov (United States)

    Hundert, Amos S; Huguet, Anna; McGrath, Patrick J; Stinson, Jennifer N; Wheaton, Mike

    2014-08-19

    Headache diaries are often used by headache sufferers to self-monitor headaches. With advances in mobile technology, mobile electronic diary apps are becoming increasingly common. This review aims to identify and evaluate all commercially available mobile headache diary apps for the two most popular mobile phone platforms, iOS and Android. The authors developed a priori a set of 7 criteria that define an ideal headache diary app intended to help headache sufferers better understand and manage their headaches, while providing relevant data to health professionals. The app criteria were intended as minimum requirements for an acceptable headache diary app that could be prescribed by health care professionals. Each app was evaluated and scored against each criterion. Of the 38 apps identified, none of the apps met all 7 app criteria. The 3 highest scoring apps, meeting 5 of the app criteria, were iHeadache (developed by Better QOL), ecoHeadache (developed by ecoTouchMedia), and Headache Diary Pro (developed by Froggyware). Only 18% of the apps were created with scientific or clinical headache expertise and none of the apps reported on psychometric properties. Despite the growing market and demand, there is a concerning lack of scientific expertise and evidence base associated with headache diary apps.

  18. Surveying the effect of a self-care education program on severity of nausea and emesis in colorectal cancer patients under chemotherapy

    Directory of Open Access Journals (Sweden)

    Karimi S

    2017-08-01

    Full Text Available Saba Karimi,1 Behnam Reza Makhsosi,2 Seyed Jalil Seyedi-Andi,3 Maryam Behzadi,4 Yasaman Moghofeh,5 Kourosh Mohammadinasrabadi,1 Alireza Abdi,1 Pegah Ahmadi1 1School of Nursing and Midwifery, 2Surgical Department, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, 3Social Determinants of Health Research Center, Babol University of Medical Sciences, Babol, 4Taleghani Hospital, 5Imam Khomeini Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran Background and objective: Colorectal cancer is one of the main causes of mortality in both developed and developing countries, including Iran. One of the treatments available for colorectal cancer is chemotherapy, of which nausea and emesis are the side effects. Owing to problems in controlling the side effects, a combination of medicine and non-medicine interventions is usually used. Self-care is one of the non-medicine interventions in this regard. The present study was aimed at surveying the effect of a self-care education program on severity of nausea and emesis in colorectal cancer patients under chemotherapy.Methods: A semi-experimental study was carried out in Imam Reza Hospital of Kermanshah, Iran. The sample group comprised 52 patients with colorectal cancer under chemotherapy. Data gathering tools included a demographics questionnaire and Morrow Assessment of Nausea and Emesis. To control intensity of nausea and emesis, a package of self-care measures including muscular progressive relaxation, music, and education on nutrition was used. Afterward, the collected data were analyzed using statistical tests such as Shapiro–Wilk test (to check normal distribution of the data, Mann–Whitney U test, Wilcoxon test, and chi-square test with the help of SPSS 20.Results: The results showed a considerable decrease in intensity and frequency of nausea and emesis after the intervention. The p-value of Mann–Whitney U test results with regard to intensity of nausea in