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Sample records for preventing migraine headaches

  1. 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

  2. Sex differences in the prevalence, symptoms, and associated features of migraine, probable migraine and other severe headache: results of the American Migraine Prevalence and Prevention (AMPP) Study.

    Science.gov (United States)

    Buse, Dawn C; Loder, Elizabeth W; Gorman, Jennifer A; Stewart, Walter F; Reed, Michael L; Fanning, Kristina M; Serrano, Daniel; Lipton, Richard B

    2013-09-01

    The strikingly higher prevalence of migraine in females compared with males is one of the hallmarks of migraine. A large global body of evidence exists on the sex differences in the prevalence of migraine with female to male ratios ranging from 2:1 to 3:1 and peaking in midlife. Some data are available on sex differences in associated symptoms, headache-related disability and impairment, and healthcare resource utilization in migraine. Few data are available on corresponding sex differences in probable migraine (PM) and other severe headache (ie, nonmigraine-spectrum severe headache). Gaining a clear understanding of sex differences in a range of severe headache disorders may help differentiate the range of headache types. Herein, we compare sexes on prevalence and a range of clinical variables for migraine, PM, and other severe headache in a large sample from the US population. This study analyzed data from the 2004 American Migraine Prevalence and Prevention Study. Total and demographic-stratified sex-specific, prevalence estimates of headache subtypes (migraine, PM, and other severe headache) are reported. Log-binomial models are used to calculate sex-specific adjusted prevalence ratios and 95% confidence intervals for each across demographic strata. A smoothed sex prevalence ratio (female to male) figure is presented for migraine and PM. One hundred sixty-two thousand seven hundred fifty-six individuals aged 12 and older responded to the 2004 American Migraine Prevalence and Prevention Study survey (64.9% response rate). Twenty-eight thousand two hundred sixty-one (17.4%) reported "severe headache" in the preceding year (23.5% of females and 10.6% of males), 11.8% met International Classification of Headache Disorders-2 criteria for migraine (17.3% of females and 5.7% of males), 4.6% met criteria for PM (5.3% of females and 3.9% of males), and 1.0% were categorized with other severe headache (0.9% of females and 1.0% of males). Sex differences were observed in

  3. 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 ...

  4. CGRP, a target for preventive therapy in migraine and cluster headache

    DEFF Research Database (Denmark)

    Khan, Sabrina; Olesen, Astrid; Ashina, Messoud

    2018-01-01

    Introduction Migraine and cluster headache are challenging to manage, with no tailored preventive medications available. Targeting the calcitonin gene-related peptide (CGRP) pathway to treat these headaches may be the first focused therapeutic option to date, with the potential for promising...... efficacy. Methods We systematically searched PubMed and clinicaltrials.gov for randomized controlled trials investigating the preventive potential of monoclonal antibodies against the CGRP pathway in the treatment of migraine and cluster headache. Results The literature search returned a total of 136...... of cluster headache. Conclusion Efficacy of anti-CGRP monoclonal antibodies spells a promising future for the many patients suffering from migraine, and possibly also for the smaller but severely-affected population with cluster headache....

  5. 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/ ...

  6. Cyproheptadine versus propranolol in the prevention of migraine headaches in children

    International Nuclear Information System (INIS)

    Asadi, B.; Khorvash, F.

    2012-01-01

    Objective: There are conflicting results on the efficacy of propranolol and cyproheptadine in the prevention of migraine headaches in children. Therefore, in this study, we evaluated the efficacy of propranolol versus cyproheptadine in the prevention of migraine headaches. Methodology: This was a randomized, double-blind trial. Sixty children aged 8-15 yrs with migraine headaches were randomized to be treated with either propranolol (40-80 mg per day) or cyproheptadine (8-12 mg per day) for 4 weeks. The patients were requested to record the Severity and duration of their headaches during a 2-week period before starting the intervention. The patients were followed at 2-week intervals for a period of 1 month after starting treatment. The headache diary was analyzed for each patient and was compared with baseline using SPSS software and statistical tests including the student's t-test. Results: Out of 60 patients at baseline, nine patients in the cyproheptadine group and six patients in the propranolol group did not appear at the appropriate time for follow-up visits and therefore were excluded from the study. The mean age in the cyproheptadine group was 11.9+-2.23 years and in the propranolol group was 0.7 +- 2.33 years. Based on the diaries, the results Showed that propranolol and cyproheptadine decreased headaches by 54.61% and 70.53% (p < 0.05), respectively, at the end of four weeks of treatment. Conclusion: Overall, the results of our study suggest that cyproheptadine is a good choice for prevention of migraine headache in pediatric group although more prolonged study with higher number of the patient is recommended. (author)

  7. 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.

  8. Effects of Topiramate in the Prevention of Drug Resistant Migraine Headache

    Directory of Open Access Journals (Sweden)

    H Khani

    2009-04-01

    Full Text Available ABSTRACT Introduction & objective: Migraine is the most common cause of headache. The aim of the present study was to evaluate the effects of topiramate (TPM in the prevention of drug-resistant migraine headache. Materials & Methods: This is a double-blind clinical trial conducted on 70 patients between ages 15 to 45 years referred to the Bu Ali Sina Hospital in Sari with a history of migraine attacks based on International Headache Society criteria for a period of more than one years with a minimum incidence of 1 to 6 attacks per month. The drug rate performance was assessed by response rate to treatment, mean changes in the number and severity of migraine attacks compared with the placebo group for 3 months. Collected data were analyzed using analysis of variance (ANOVA, Newman-Keuls and Spearman’s Coefficient Rank Correlation as the post hoc tests. GRAPHPAD software was used for analysis of the data. Results: 66 of 70 patients completed the study. The mean age of the patients was 30.33±7.9 years. A significant reduction in the severity and frequency of migraine attacks was seen in all months (P < 0.0001 for topiramate treated group in compare to placebo group. Responder rate for patients treated with TPM was significantly higher than placebo group (63.6%, P<0.0001 in the 3rd month of the treatment Side effects of treatment were transient and well tolerated. Conclusion: Low dose of TPM showed significant efficacy in prevention of migraine attacks within the first, second, and third month of treatment. Low dose of TPM seems to be a good therapeutic option for the patients with refractory migraine.

  9. 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.

  10. Randomised controlled trial of food elimination diet based on IgG antibodies for the prevention of migraine like headaches

    Directory of Open Access Journals (Sweden)

    Adamson Joy

    2011-08-01

    Full Text Available Abstract Background Research suggests that food intolerance may be a precipitating factor for migraine like headaches. Aim To evaluate the effectiveness of the ELISA (Enzyme Linked Immuno-Sorbent Assay Test and subsequent dietary elimination advice for the prevention of migraine like headaches. Design Randomised controlled trial. Setting Community based volunteers in the UK. Participants Volunteers who met the inclusion criteria for migraine like headaches and had one or more food intolerance were included in the study. Participants received either a true diet (n = 84 or a sham diet (n = 83 sheet. Participants were advised to remove the intolerant foods from their diet for 12 weeks. Main outcome measures Number of headache days over a 12 week period (item A MIDAS questionnaire. Other measures includes the total MIDAS score and total HIT-6 score. Results The results indicated a small decrease in the number of migraine like headaches over 12 weeks, although this difference was not statistically significant (IRR 1.15 95% CI 0.94 to 1.41, p = 0.18. At the 4 week assessment, use of the ELISA test with subsequent diet elimination advice significantly reduced the number of migraine like headaches (IRR 1.23 95%CI 1.01 to 1.50, p = 0.04. The disability and impact on daily life of migraines were not significantly different between the true and sham diet groups. Conclusions Use of the ELISA test with subsequent diet elimination advice did not reduce the disability or impact on daily life of migraine like headaches or the number of migraine like headaches at 12 weeks but it did significantly reduce the number of migraine like headaches at 4 weeks. Trial registration number ISRCTN: ISRTCN89559672

  11. 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...

  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. Adding Additional Acute Medications to a Triptan Regimen for Migraine and Observed Changes in Headache-Related Disability: Results From the American Migraine Prevalence and Prevention (AMPP) Study.

    Science.gov (United States)

    Buse, Dawn C; Serrano, Daniel; Reed, Michael L; Kori, Shashi H; Cunanan, Cedric M; Adams, Aubrey Manack; Lipton, Richard B

    2015-06-01

    Though triptans are the most widely used acute treatments for migraine, response to treatment is sometimes suboptimal. Triptan therapy is often augmented by the addition of other acute treatments. The benefits of this practice have not been examined in large-scale, real-world observational studies. To assess changes in headache-related disability associated with adding additional acute treatments to a triptan regimen by category of added treatment including: a second triptan, nonsteroidal anti-inflammatory drugs (NSAID), opioids or barbiturates. Subjects were participants in the American Migraine Prevalence and Prevention study, a longitudinal, US population-based study of individuals with "severe" headache. Respondents who met International Classification of Headache Disorders 3 beta criteria for migraine were on triptan therapy per respondent self-report, used the same triptan, and provided headache-related disability data for at least 2 consecutive years. Subjects were divided based on headache days per month into 3 groups: low-frequency episodic migraine (LFEM, 0-4), moderate-frequency episodic migraine (MFEM, 5-9), and high-frequency episodic migraine/chronic migraine (HFEM/CM, ≥ 10 headache days per month). HFEM and CM were combined into a single group for analyses because of sample size limitations. Patterns of acute treatment for migraine were monitored from one year to the next over the following couplets of years (2005-2006, 2006-2007, 2007-2008, and 2008-2009). The first eligible couplet was analyzed for each respondent. Medication regimens studied included: (1) maintaining current triptan use (consistent group); (2) adding a different triptan; (3) adding an NSAID; or (4) adding a combination analgesic containing opioids or barbiturates. We assessed change in Migraine Disability Assessment (MIDAS) score from the first to the second year of a couplet, contrasting scores of participants with consistent use with those who added an acute treatment to

  14. 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.

  15. Migraine headache in patients with idiopathic intracranial hypertension.

    Science.gov (United States)

    Sina, Farzad; Razmeh, Saeed; Habibzadeh, Neda; Zavari, Arefeh; Nabovvati, Mona

    2017-08-29

    Migraine is a neurological disorder that afflicts many people in the world and can cause severe disability during the attacks. The pathophysiology of migraine is complex and not fully understood. It seems that migraine is common in idiopathic intracranial hypertension (IIH). However, the association between migraine headache and IIH is still unclear. The present study was conducted to assess the prevalence of migraine headache and associated factors in IIH patients. In this cross-sectional study, a total of 68 patients diagnosed with IIH underwent a medical history interview and a neurological examination. The diagnosis of migraine was based on the four diagnostic criteria of the International Classification of Headache Disorders 3rd edition. Forty-five patients (63.2%) met the diagnostic criteria of migraine headache. There was no significant difference between patients with and without migraine headache in respect of their age, gender, body mass. This study revealed high prevalence of migraine headache in IIH patients; appropriate treatment can reduce their headache and prevent unnecessary treatments for IIH.

  16. Preventive Migraine Treatment

    Science.gov (United States)

    Silberstein, Stephen D.

    2015-01-01

    Purpose of Review: This article reviews the evidence base for the preventive treatment of migraine. Recent Findings: Evidence-based guidelines for the preventive treatment of migraine have recently been published by the American Academy of Neurology (AAN) and the Canadian Headache Society (CHS), providing valuable guidance for clinicians. Strong evidence exists to support the use of metoprolol, timolol, propranolol, divalproex sodium, sodium valproate, and topiramate for migraine prevention, according to the AAN. Based on best available evidence, adverse event profile, and expert consensus, topiramate, propranolol, nadolol, metoprolol, amitriptyline, gabapentin, candesartan, Petasites (butterbur), riboflavin, coenzyme Q10, and magnesium citrate received a strong recommendation for use from the CHS. Summary: Migraine preventive drug treatments are underutilized in clinical practice. Principles of preventive treatment are important to improve compliance, minimize side effects, and improve patient outcomes. Choice of preventive treatment of migraine should be based on the presence of comorbid and coexistent illness, patient preference, reproductive potential and planning, and best available evidence. PMID:26252585

  17. Hair Transplantation in Migraine Headache Patients.

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    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

  18. Prevention for Pediatric and Adolescent Migraine.

    Science.gov (United States)

    Hickman, Carolyn; Lewis, Kara Stuart; Little, Robert; Rastogi, Reena Gogia; Yonker, Marcy

    2015-01-01

    Children and adolescents can experience significant disability from frequent migraine. A number of tools have been developed to help quantify the impact of migraine in this population. Many preventative medications used in adults are routinely used to prevent migraines in children, although there has been less rigorous study. This article reviews the indications and evidence for the use of migraine preventatives, such as antidepressants, antihypertensives, anticonvulsants, antihistamines, and botulinum toxin, in this population. © 2015 American Headache Society.

  19. 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.

  20. 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 ...

  1. Prophylaxis of migraine headaches with riboflavin: A systematic review.

    Science.gov (United States)

    Thompson, D F; Saluja, H S

    2017-08-01

    Migraine headache is a relatively common, debilitating condition that costs our healthcare system over 78 billion dollars per year. Riboflavin has been advocated as a safe, effective prophylactic therapy for the prevention of migraines. The purpose of this study was to provide a systematic review of the current role of riboflavin in the prophylaxis of migraine headache. A MEDLINE literature search inclusive of the dates 1966-2016 was performed using the search terms: riboflavin and migraine disorders. Excerpta Medica was searched from 1980 to 2016 using the search terms: riboflavin and migraine. Additionally, Web of Science was searched using the terms riboflavin and migraine inclusive of 1945-2016. Bibliographies of all relevant papers were reviewed for additional citations. We utilized the PRISMA guidelines to select English language, human, clinical trials of riboflavin as a single entity or in combination, review articles, and supporting pharmacokinetic and pharmacogenomic data assessing the efficacy and mechanism of riboflavin therapy in the prophylactic treatment of migraine headache. A total of 11 clinical trials reveal a mixed effect of riboflavin in the prophylaxis of migraine headache. Five clinical trials show a consistent positive therapeutic effect in adults; four clinical trials show a mixed effect in paediatric and adolescent patients, and two clinical trials of combination therapy have not shown benefit. Adverse reactions with riboflavin have generally been mild. Riboflavin is well tolerated, inexpensive and has demonstrated efficacy in the reduction of adult patient's migraine headache frequency. Additional data are needed, however, to resolve questions involving pharmacokinetic issues and pharmacogenomic implications of therapy. © 2017 John Wiley & Sons Ltd.

  2. 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.

  3. Migraine Headache Treatment & Research | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Migraine Headaches Treatment & Research Past Issues / Fall 2015 Table of Contents Nondrug Options to Manage Migraine Pain Dr. Josephine P. Briggs discusses complementary migraine ...

  4. Canadian Headache Society guideline for migraine prophylaxis.

    Science.gov (United States)

    Pringsheim, Tamara; Davenport, W Jeptha; Mackie, Gordon; Worthington, Irene; Aubé, Michel; Christie, Suzanne N; Gladstone, Jonathan; Becker, Werner J

    2012-03-01

    The primary objective of this guideline is to assist the practitioner in choosing an appropriate prophylactic medication for an individual with migraine, based on current evidence in the medical literature and expert consensus. This guideline is focused on patients with episodic migraine (headache on ≤ 14 days a month). Through a comprehensive search strategy, randomized, double blind, controlled trials of drug treatments for migraine prophylaxis and relevant Cochrane reviews were identified. Studies were graded according to criteria developed by the US Preventive Services Task Force. Recommendations were graded according to the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group. In addition, a general literature review and expert consensus were used for aspects of prophylactic therapy for which randomized controlled trials are not available. Prophylactic drug choice should be based on evidence for efficacy, side-effect profile, migraine clinical features, and co-existing disorders. Based on our review, 11 prophylactic drugs received a strong recommendation for use (topiramate, propranolol, nadolol, metoprolol, amitriptyline, gabapentin, candesartan, butterbur, riboflavin, coenzyme Q10, and magnesium citrate) and 6 received a weak recommendation (divalproex sodium, flunarizine, pizotifen, venlafaxine, verapamil, and lisinopril). Quality of evidence for different medications varied from high to low. Prophylactic treatment strategies were developed to assist the practitioner in selecting a prophylactic drug for specific clinical situations. These strategies included: first time strategies for patients who have not had prophylaxis before (a beta-blocker and a tricyclic strategy), low side effect strategies (including both drug and herbal/vitamin/mineral strategies), a strategy for patients with high body mass index, strategies for patients with co-existent hypertension or with co-existent depression and /or

  5. MIGRAIN AND TENSION TYPE HEADACHE IN CHILDREN: THE APPROACH TO EFFECTIVE TREATMENT. PART 1

    Directory of Open Access Journals (Sweden)

    A. V. Sergeev

    2012-01-01

    Full Text Available Headache is one of the most common complaints of children and adolescents. The most often causes of cephalgia in children are primary headaches (mainly migraine and tension-type headache. Recently there has been a significant increase in prevalence of primary headaches, which can be due to the changes of children’s way of life. The lack of the strict recommendations on symptomatic and preventive treatment of primary headaches in children in Russia often leads to erroneous indications. Inappropriate treatment can result in migraine and tension-type headache course aggravation with the formation of chronic daily headache, development of medicine-induced headache and other undesirable side-effects. The literature review covers the questions of therapy of the main forms of primary headaches in children: migraines and tension-type headaches. In the first part of the article the issues of diagnostics, algorithm of treatment and non-medicinal methods of treatment of headaches are discussed.

  6. 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 ...

  7. Arterial responses during migraine headache

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg; Nielsen, T H; Olesen, J

    1990-01-01

    The superficial temporal artery has been thought to be the main focus of pain during migraine attacks, but its diameter has never been measured directly. The use of a new, high-resolution ultrasound machine to measure arterial size in 25 migraine patients with unilateral head pain showed...... that the lumen was wider on the painful than on the non-painful side during a migraine attack. The diameters of both radial arteries and the temporal artery on the non-painful side were smaller during than between attacks. The generalised vasoconstriction was not shared by the temporal artery on the affected...... side, which suggests a local vasodilatory response. The findings suggest that cephalic arteries may play a role in migraine pathogenesis....

  8. Migraine headaches in a nutshell

    African Journals Online (AJOL)

    to severe pain intensity, aggravation by movement, and a pulsating feeling. ... This article aims to provide a concise, high-level overview of the classification, management and treatment of migraine. ... hypersensitivity to light, sound and odour.7.

  9. Effects of Medical Marijuana on Migraine Headache Frequency in an Adult Population.

    Science.gov (United States)

    Rhyne, Danielle N; Anderson, Sarah L; Gedde, Margaret; Borgelt, Laura M

    2016-05-01

    No clinical trials are currently available that demonstrate the effects of marijuana on patients with migraine headache; however, the potential effects of cannabinoids on serotonin in the central nervous system indicate that marijuana may be a therapeutic alternative. Thus, the objective of this study was to describe the effects of medical marijuana on the monthly frequency of migraine headache. Retrospective chart review. Two medical marijuana specialty clinics in Colorado. One hundred twenty-one adults with the primary diagnosis of migraine headache who were recommended migraine treatment or prophylaxis with medical marijuana by a physician, between January 2010 and September 2014, and had at least one follow-up visit. The primary outcome was number of migraine headaches per month with medical marijuana use. Secondary outcomes were the type and dose of medical marijuana used, previous and adjunctive migraine therapies, and patient-reported effects. Migraine headache frequency decreased from 10.4 to 4.6 headaches per month (pmedical marijuana. Most patients used more than one form of marijuana and used it daily for prevention of migraine headache. Positive effects were reported in 48 patients (39.7%), with the most common effects reported being prevention of migraine headache with decreased frequency of migraine headache (24 patients [19.8%]) and aborted migraine headache (14 patients [11.6%]). Inhaled forms of marijuana were commonly used for acute migraine treatment and were reported to abort migraine headache. Negative effects were reported in 14 patients (11.6%); the most common effects were somnolence (2 patients [1.7%]) and difficulty controlling the effects of marijuana related to timing and intensity of the dose (2 patients [1.7%]), which were experienced only in patients using edible marijuana. Edible marijuana was also reported to cause more negative effects compared with other forms. The frequency of migraine headache was decreased with medical

  10. 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.

  11. Defining refractory migraine: results of the RHSIS Survey of American Headache Society members.

    Science.gov (United States)

    Schulman, Elliott A; Peterlin, B Lee; Lake, Alvin E; Lipton, Richard B; Hanlon, Alexandra; Siegel, Sherry; Levin, Morris; Goadsby, Peter J; Markley, Herbert G

    2009-04-01

    To gauge consensus regarding a proposed definition for refractory migraine proposed by Refractory Headache Special Interest Section, and where its use would be most appropriate. Headache experts have long recognized that a subgroup of headache sufferers remains refractory to treatment. Although different groups have proposed criteria to define refractory migraine, the definition remains controversial. The Refractory Headache Special Interest Section of the American Headache Society developed a definition through a consensus process, assisted by a literature review and initial membership survey. A 12-item questionnaire was distributed at the American Headache Society meeting in 2007 during a platform session and at the Refractory Headache Special Interest Section symposium. The same questionnaire was subsequently sent to all American Headache Society members via e-mail. A total of 151 responses from AHS members form the basis of this report. The survey instrument was designed using Survey Monkey. Frequencies and percentages of the survey were used to describe survey responses. American Headache Society members agreed that a definition for refractory migraine is needed (91%) that it should be added to the International Classification of Headache Disorders-2 (86%), and that refractory forms of non-migraine headache disorders should be defined (87%). Responders believed a refractory migraine definition would be of greatest value in selecting patients for clinical drug trials. The current refractory migraine definition requires a diagnosis of migraine, interference with function or quality of life despite modification of lifestyle factors, and adequate trials of acute and preventive medicines with established efficacy. The proposed criteria for the refractory migraine definition require failing 2 preventive medications to meet the threshold for failure. Although 42% of respondents agreed with the working definition of refractory migraine, 43% favored increasing the

  12. The Effect of Migraine Headache on Educational Attainment

    Science.gov (United States)

    Rees, Daniel I.; Sabia, Joseph J.

    2011-01-01

    Despite the fact that migraine headaches are common and debilitating, little is known about their effect on educational attainment. Using data drawn from the National Longitudinal Study of Adolescent Health, we estimate the relationship between migraine headache and three outcomes: high school grade point average, the probability of graduating…

  13. Unique Migraine Subtypes, Rare Headache Disorders, and Other Disturbances.

    Science.gov (United States)

    Goadsby, Peter J

    2015-08-01

    The medical aphorism that common things happen commonly makes unique (and less common) migraine subtypes especially appropriate to review for the general neurologist. This article also identifies some rare headache disorders and other disturbances, and offers strategies to manage them. This article discusses migraine with brainstem aura, which is troublesome clinically and has had a change in terminology in the International Classification of Headache Disorders, Third Edition, beta version (ICHD-3 beta), and hemiplegic migraine, which is also troublesome in practice. The rare headache disorder hypnic headache and the exploding head syndrome are also discussed. When hypnic headache is recognized, it is eminently treatable, while exploding head syndrome is a benign condition with no reported consequences. Unique migraine subtypes, rare headache disorders, and other disturbances present to neurologists. When recognized, they can often be managed very well, which offers significant benefits to patients and practice satisfaction to neurologists.

  14. 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 ...

  15. Precipitating and relieving factors of migraine versus tension type headache

    OpenAIRE

    Haque, Badrul; Rahman, Kazi Mohibur; Hoque, Azharul; Hasan, ATM Hasibul; Chowdhury, Rajib Nayan; Khan, Sharif Uddin; Alam, Mondal Badrul; Habib, Mansur; Mohammad, Quazi Deen

    2012-01-01

    Abstract Background To determine the differences of precipitating and relieving factors between migraine and tension type headache. Methods This is a cross sectional study. We retrospectively reviewed the records of 250 migraine patients and 250 patients diagnosed as tension type headache from the specialized headache clinic in Dept. of Neurology, Dhaka Medical College Hospital. Data were collected through a predesigned questionnaire containing information on age, sex, social status and a pre...

  16. 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.

  17. Headache Characteristics and Clinical Features of Elderly Migraine Patients.

    Science.gov (United States)

    de Rijk, Pablo; Resseguier, Noémie; Donnet, Anne

    2018-04-01

    To investigate the headache characteristics and clinical features of elderly migraine patients at a tertiary headache center. We retrospectively reviewed 239 records of migraine patients, over the age of 64 at the first visit, who had migraine as defined by the International Classification of Headache Disorders 3rd edition (beta version) from 2006 to 2015 based on the Marseille registry at Timone Hospital. 13.8% (33/239) patients had migraine with aura only, 13.0% (31/239) had both diagnoses. Of the patients who presented with migraine with aura, 13.4% (32/239) presented with aura without headache. Unilateral pain location was reported by 58.6% (140/239) of patients and the throbbing type of pain was present in 50.2% (120/239) of our study group. Photo- and phonophobia were observed in 77.4% (185/239) and 79.5% (190/239) of patients. Seventy-nine out of 239 (30.1%) patients were found to have probable medication overuse. Within this group, 31.65% (25/79) overused triptan and 70.9% (56/79) overused combination analgesics. We found higher frequencies of migraine for patients whose age at onset of migraine was younger than 18 years, and low frequency migraine was reported more frequently in the later onset group (P = .0357). We assess the headache characteristics of elderly migraine patients who were seen at our tertiary headache center and report the high frequency of probable medication overuse headache in this study group. Finally, we suggest that age of onset is an important factor in the clinical profile of these patients. © 2017 American Headache Society.

  18. 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.

  19. 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.

  20. Migraine headaches in a nutshell | Schellack | South African Family ...

    African Journals Online (AJOL)

    This article aims to provide a concise, high-level overview of the classification, management and treatment of migraine. Migraine is a common, debilitating neurological disorder that is characterised by the presence of severe headaches, which may last anything from a few hours to a few days (4–72 hours). Thus, the ...

  1. Evidences of Reduced Antioxidant Activity in Patients With Chronic Migraine and Medication-Overuse Headache.

    Science.gov (United States)

    Lucchesi, Cinzia; Baldacci, Filippo; Cafalli, Martina; Chico, Lucia; Lo Gerfo, Annalisa; Bonuccelli, Ubaldo; Siciliano, Gabriele; Gori, Sara

    2015-01-01

    Migraine is a complex multifactorial, neurobiological disorder, whose pathogenesis is not fully understood, nor are the mechanisms associated with migraine transformation from episodic to chronic pattern. A possible role of impaired oxidative mitochondrial metabolism in migraine pathogenesis has been hypothesized, and increased levels of peripheral markers of oxidative stress have been reported in migraine patients, although the literature data are limited and heterogeneous. The aim of this cross-sectional study was to determine plasmatic levels of advanced oxidation protein products, ferric-reducing antioxidant power and total plasmatic thiol groups, all plasmatic markers related to oxidative stress, in a sample of chronic migraine patients and medication-overuse headache, compared to a control group of healthy subjects. Thirty-three patients with a diagnosis of both chronic migraine and medication-overuse headache (International Classification of Headache Disorders,3rd edition, beta version) and 33 healthy, headache-free subjects were enrolled. Patients with comorbid/coexisting conditions were excluded, as well as patients in treatment with migraine preventive drugs. Plasmatic levels of advanced oxidation protein products, ferric-reducing antioxidant power, and total thiol groups were determined in migraine patients and controls; moreover, oxidative stress biomarkers were compared in migraine patients with triptan compared to non-steroidal anti-inflammatory drug overuse. The statistical analysis showed significantly lower levels of ferric-reducing antioxidant power and total plasmatic thiol groups, both expression of antioxidant power, in patients with chronic migraine and medication-overuse headache compared to controls (respectively, ferric antioxidant power median [interquartile range] 0.53 [0.22] vs 0.82 [0.11] mmol/L, P stress biomarkers were detected between patients with triptan and nonsteroidal anti-inflammatory drug overuse. The data from the present

  2. Decreased Openness to Experience Is Associated with Migraine-Type Headaches in Subjects with Lifetime Depression.

    Science.gov (United States)

    Magyar, Mate; Gonda, Xenia; Pap, Dorottya; Edes, Andrea; Galambos, Attila; Baksa, Daniel; Kocsel, Natalia; Szabo, Edina; Bagdy, Gyorgy; Elliott, Rebecca; Kokonyei, Gyongyi; Juhasz, Gabriella

    2017-01-01

    Migraine and depression frequently occur as comorbid conditions, and it has been hypothesized that migraine with and without depression may have a different genetic background. A distinct personality trait constellation has been described in migraineurs. Less attention, however, was paid to personality differences in migraineurs with and without depression which may also shed light on differences in the neurobiological, background. The aim of our study was to investigate big five personality traits, headaches, and lifetime depression (DEP) in a large European general population sample. Relationship between DEP, Big Five Inventory personality traits, and headaches identified by the ID-Migraine Questionnaire were investigated in 3,026 individuals from Budapest and Manchester with multivariate and logistic regression analyses. Both DEP and migraine(ID) showed differences in personality traits. Neuroticism was an independent risk factor for both conditions while a significant interaction effect appeared between the two in the case of openness. Namely, subjects with migraine(ID) and without DEP scored higher on openness compared to those who had depression. While we confirmed previous results that high neuroticism is a risk factor for both depression and migraine, openness to experience was significantly lower in the co-occurrence of migraine and depression. Our results suggest that increased openness, possibly manifested in optimal or advantageous cognitive processing of pain experience in migraine may decrease the risk of co-occurrence of depression and migraine and thus may provide valuable insight for newer prevention and intervention approaches in the treatment of these conditions.

  3. 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.

  4. Risk of placental abruption in relation to migraines and headaches

    Directory of Open Access Journals (Sweden)

    Ananth Cande V

    2010-10-01

    Full Text Available Abstract Background Migraine, a common chronic-intermittent disorder of idiopathic origin characterized by severe debilitating headaches and autonomic nervous system dysfunction, and placental abruption, the premature separation of the placenta, share many common pathophysiological characteristics. Moreover, endothelial dysfunction, platelet activation, hypercoagulation, and inflammation are common to both disorders. We assessed risk of placental abruption in relation to maternal history of migraine before and during pregnancy in Peruvian women. Methods Cases were 375 women with pregnancies complicated by placental abruption, and controls were 368 women without an abruption. During in-person interviews conducted following delivery, women were asked if they had physician-diagnosed migraine, and they were asked questions that allowed headaches and migraine to be classified according to criteria established by the International Headache Society. Logistic regression procedures were used to calculate odds ratios (aOR and 95% confidence intervals (CI adjusted for confounders. Results Overall, a lifetime history of any headaches or migraine was associated with an increased odds of placental abruption (aOR = 1.60; 95% CI 1.16-2.20. A lifetime history of migraine was associated with a 2.14-fold increased odds of placental abruption (aOR = 2.14; 95% CI 1.22-3.75. The odds of placental abruption was 2.11 (95% CI 1.00-4.45 for migraineurs without aura; and 1.59 (95% 0.70-3.62 for migraineurs with aura. A lifetime history of tension-type headache was also increased with placental abruption (aOR = 1.61; 95% CI 1.01-2.57. Conclusions This study adds placental abruption to a growing list of pregnancy complications associated with maternal headache/migraine disorders. Nevertheless, prospective cohort studies are needed to more rigorously evaluate the extent to which migraines and/or its treatments are associated with the occurrence of placental abruption.

  5. Migraine

    Science.gov (United States)

    ... headache Migraine cause CT scan of the brain Central nervous system and peripheral nervous system References Becker WJ. Acute migraine treatment in adults. Headache . 2015;55(6):778-793. PMID: 25877672 ...

  6. 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.

  7. Precipitating and relieving factors of migraine versus tension type headache

    Directory of Open Access Journals (Sweden)

    Haque Badrul

    2012-08-01

    Full Text Available Abstract Background To determine the differences of precipitating and relieving factors between migraine and tension type headache. Methods This is a cross sectional study. We retrospectively reviewed the records of 250 migraine patients and 250 patients diagnosed as tension type headache from the specialized headache clinic in Dept. of Neurology, Dhaka Medical College Hospital. Data were collected through a predesigned questionnaire containing information on age, sex, social status and a predetermined list of precipitating and relieving factors. Results In this study, the female patients predominated (67%. Most of the patients were within 21–30 years age group (58.6%. About 58% of them belonged to middle class families. The common precipitating factors like stress, anxiety, activity, journey, reading, cold and warm were well distributed among both the migraine and tension type headache (TTH patients. But significant difference was demonstrated for fatigue (p  Conclusion The most frequent precipitating factors for headache appear to be identical for both migraine and TTH patients. Even though some factors like fatigue, sleep deprivation, sunlight and food significantly precipitate migraine and drug, massage are effective maneuver for relieving pain among migrianeurs.

  8. When to Go to the Emergency Room for a Headache or Migraine

    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 ...

  9. Galeata: chronic migraine independently considered in a medieval headache classification

    OpenAIRE

    Guerrero-Peral, Ángel Luís; de Frutos González, Virginia; Pedraza-Hueso, María Isabel

    2014-01-01

    Background Chronic migraine is a quite recent concept. However, there are descriptions suggestive of episodic migraine since the beginning of scientific medicine. We aim to review main headache classifications during Classical antiquity and compared them with that proposed in the 11th century by Constantine the African in his Liber Pantegni, one of the most influential texts in medieval medicine. Method We have carried out a descriptive review of Henricum Petrum's Latin edition, year 1539. Re...

  10. Epidemiologic and Clinical Characteristics of Migraine and Tension-Type Headaches among Hospitals Staffs of Shiraz (Iran

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    Ayatollahi Seyyed Mohammad Taghi

    2009-05-01

    Full Text Available Headache is a common symptom that constitutes a major health problem to all countries in the world. This study was conducted to estimate the prevalence of migraine and tension -type headaches(TTH, its associated occupational risk factors among Shiraz hospitals staffs, and to report on clinical characteristics of migraine and TTH with using the International Headache Society (IHS diagnosis criteria. A random sample of 1023 staffs constituting a 20% sample of the hospitals staff population was selected. Sampling method was categorical random sampling. Within each group sampling was carried out systematically. Data were collected by screening questionnaire followed by clinical interviews, general physical and neurological examination, and diagnostic criteria of IHS. Prevalence of migraine, TTH and coexisting migraine and TTH were estimated as 11.2% (115 cases, 19.5% (199 subjects and 3.2% (33 subjects respectively. In this study , clinical characteristics of headache including type, site, number , intensity ,concomitant symptom of headaches had been surveyed. TTH and migraine headaches were significantly associated with self reported abnormal sleep pattern and female gender (P < 0.001. Also TTH was negatively associated with total 24hr duration of sleep and history of involvement in second job significantly (P<0.026. The average of prevalence of migraine and TTH were lower than their counter parts in western countries but higher than previous studies conducted in other Asian countries. Clinical characteristics were almost parallel with IHS criteria, headache- related missed work rates were higher for subjects with migraine headache, and also TTH and migraine were separate disorders and were not as a part of a continuum of headache disorders. Headache disorders deserve more attention, especially concerning strategies leading to adequate primary prevention, diagnosis and treatment.

  11. [Migraine type childhood headache aggravated by sexual abuse: case report].

    Science.gov (United States)

    Kaleağasi, Hakan; Ozge, Aynur; Toros, Fevziye; Kar, Hakan

    2009-04-01

    Although the vast majority of chronic headache is idiopathic in origin, child abuse can be a very rare cause of paroxysmal headaches in children. The aim of this report was to present a case of migraine headache aggravated after sexual abuse, which did not respond to treatment. An 11-year-old girl admitted to the outpatient department of the Neurology Clinic with headache complaint for the past two years. Neurological examination, neuroimaging and laboratory tests were normal. According to the International Classification of Headache Disorders (ICHD)-II criteria, the headache was diagnosed as migraine without aura and treatment as prophylaxis was planned. Her headache did not respond to treatment, so she was consulted with the Department of Child and Adolescent Psychiatry and diagnosed as major depressive disorder. During one of the psychological interviews, she confessed that she had been sexually abused by her mother's boyfriend for two years. After this confession and punishment of the abuser, her headache improved dramatically. The prevalence of physical, sexual, and emotional abuse during childhood has been estimated between 13% and 27%, and these children may suffer chronic pain, headache or depression. Sexual abuse has been strongly associated with the migraine-depression phenotype when abuse first occurred before the age of 12 years. Despite the high prevalence of abuse, many physicians do not routinely ask about abuse history. In conclusion, child abuse must be kept in mind in intractable childhood headache. A multidisciplinary approach with the Departments of Forensic Sciences and Child and Adolescent Psychiatry and detailed psychiatric evaluation should be useful in these cases.

  12. Sphenopalatine Ganglion Block for the Treatment of Acute Migraine Headache

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    Mohamed Binfalah

    2018-01-01

    Full Text Available Transnasal sphenopalatine ganglion block is emerging as is an attractive and effective treatment modality for acute migraine headaches, cluster headache, trigeminal neuralgia, and several other conditions. We assessed the efficacy and safety of this treatment using the Sphenocath® device. 55 patients with acute migraine headaches underwent this procedure, receiving 2 ml of 2% lidocaine in each nostril. Pain numeric rating scale (baseline, 15 minutes, 2 hours, and 24 hours and patient global impression of change (2 hours and 24 hours after treatment were recorded. The majority of patients became headache-free at 15 minutes, 2 hours, and 24 hours after procedure (70.9%, 78.2%, and 70.4%, resp.. The rate of headache relief (50% or more reduction in headache intensity was 27.3% at 15 minutes, 20% at 2 hours, and 22.2% at 24 hours. The mean pain numeric rating scale decreased significantly at 15 minutes, 2 hours, and 24 hours, respectively. Most patients rated the results as very good or good. The procedure was well-tolerated with few adverse events. This treatment is emerging as an effective and safe option for management of acute migraine attacks.

  13. Migraine headaches among university students using id migraine test as a screening tool

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    Caylan Ayse

    2011-08-01

    Full Text Available Abstract Background Migraine is a significant health problem, especially for the young people, due to its frequency and accompanying morbidity, causing disability and loss of performance. In this study, our aim was to determine the prevalence of migraine headaches among university students in Edirne, a Turkish city. Methods In this cross-sectional and descriptive study, study population was composed of students registered to Trakya University in the academic year of 2008-2009. Out of these, 3694 of them accepted to participate. Participants who had two or more headaches in the last 3 months formed the headache group. Afterwards, two preliminary questions were applied to the headache group and participants with at least one affirmative response were asked to perform the validated ID-Migraine™ test. Results The mean age of 3694 students participated in the study was 19.23 ± 1.84 (17-39 years, with adolescents:adult ratio being 2.5:1. 1613 students (43.7% did have at least two headaches in the last three months. Migraine-type headache was detected in 266 subjects (7.2% based on the ID-Migraine™ test. Of the migraine group, 72 were male (27.1% and 194 were female (72.9%. There was no significant difference in migraine prevalence between adolescent and adult age groups. Conclusions With a prevalence similar to adults, primary care physicians should be aware of the probability of migraine headaches in university students in order to maintain a successful school performance.

  14. Psychosocial factors associated with migraine and tension-type headache in medical students.

    Science.gov (United States)

    Lebedeva, Elena R; Kobzeva, Natalia R; Gilev, Denis V; Kislyak, Nadezhda V; Olesen, Jes

    2017-11-01

    Background In our previous study of workers, blood donors and medical students, students stood out with a higher 1-year prevalence of migraine (28%) and tension-type headache (TTH) (74%). General factors associated with headache were common for all groups except low physical activity. The hypothesis of this study was therefore that a number of psychosocial factors relating to the personal sphere would better explain the high prevalence of migraine and TTH in students. Methods The study population consisted of 1042 students (719 females, 323 males, mean age 20.6, range 17-40). Headache diagnoses and associated factors were identified by direct professional semi-structured interview. We also interviewed about the following psychosocial factors: dissatisfaction with study, dissatisfaction with family life, dissatisfaction for personal reasons, bad financial situation, overwork, stress, not enough sleep, insomnia, depressed mood, anxiety, irritability, tendency towards conflicts and not being married. We report psychosocial factors associated with headache according to diagnosis and sex using univariate and multivariate logistic regression analyses. Results Several factors were significantly associated with migraine and TTH in the univariate analysis. In the multivariate analysis, two psychosocial factors were statistically significantly associated with migraine in all students: irritability (OR 2.2, 95% CI 1.4-3.6) and overwork (OR 2.2, 95% CI 1.4-3.5). Insomnia (2.7, 95% CI 1.1-6.9) and depressed mood (OR 2.1, 95% CI 1.1-4.2) were associated with migraine only in females. Two psychosocial factors were associated with TTH: dissatisfaction with study in males (OR 2.0, 95% CI 1.0-3.8) and depressed mood in females (OR 1.8, 95% CI 1.0-3.5). Conclusion Psychosocial factors from the personal sphere showed significant association with migraine and TTH in students. Such factors should therefore be major targets for preventive efforts to reduce the prevalence of primary

  15. Psychological Factors Associated with Chronic Migraine and Severe Migraine-Related Disability: an Observational Study in a Tertiary Headache Center

    Science.gov (United States)

    Seng, Elizabeth K.; Buse, Dawn C.; Klepper, Jaclyn E.; Mayson, Sarah Jo; Grinberg, Amy S.; Grosberg, Brian M.; Pavlovic, Jelena M.; Robbins, Matthew S.; Vollbracht, Sarah E.; Lipton, Richard B.

    2016-01-01

    Objective To evaluate relationships among modifiable psychological factors and chronic migraine and severe migraine-related disability in a clinic-based sample of persons with migraine. Background Evidence evaluating relationships between modifiable psychological factors and chronic migraine and severe migraine-related disability is lacking in people with migraine presenting for routine clinical care. Methods Adults with migraine completed surveys during routinely scheduled visits to a tertiary headache center. Participants completed surveys assessing chronic migraine (meeting criteria for migraine with ≥15 headache days in the past month), severe migraine disability (Migraine Disability Assessment Scale score ≥ 21), and modifiable psychological factors [depressive symptoms (Patient Health Questionnaire-9), anxious symptoms (Generalized Anxiety Disorder-7), Pain Catastrophizing Scale and Headache Specific Locus of Control]. Logistic regression evaluated relationships between modifiable psychological factors and chronic migraine and severe migraine disability. Results Among 90 eligible participants the mean age was 45.0 (SD = 12.4); 84.8% were women. One-third (36.0%) met study criteria for chronic migraine; half of participants (51.5%) reported severe migraine-related disability. Higher depressive symptoms (OR = 1.99, 95% CI = 1,11, 3.55) and chance HSLC (OR = 1.85, 95% CI = 1.13, 1.43) were associated with chronic migraine. Higher depressive symptoms (OR = 3.54, 95%CI = 1.49, 8.41), anxiety symptoms (OR = 3.65, 95% CI = 1.65, 8.06), and pain catastrophizing (OR = 1.95, 95% CI = 1.14, 3.35), were associated with severe migraine-related disability. Conclusions Psychiatric symptoms and pain catastrophizing were strongly associated with severe migraine-related disability. Depression and chance locus of control were associated with chronic migraine. This study supports the need for longitudinal observational studies to evaluate relationships among naturalistic

  16. 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.

  17. Decreased Openness to Experience Is Associated with Migraine-Type Headaches in Subjects with Lifetime Depression

    Directory of Open Access Journals (Sweden)

    Mate Magyar

    2017-06-01

    Full Text Available IntroductionMigraine and depression frequently occur as comorbid conditions, and it has been hypothesized that migraine with and without depression may have a different genetic background. A distinct personality trait constellation has been described in migraineurs. Less attention, however, was paid to personality differences in migraineurs with and without depression which may also shed light on differences in the neurobiological, background. The aim of our study was to investigate big five personality traits, headaches, and lifetime depression (DEP in a large European general population sample.MethodsRelationship between DEP, Big Five Inventory personality traits, and headaches identified by the ID-Migraine Questionnaire were investigated in 3,026 individuals from Budapest and Manchester with multivariate and logistic regression analyses.ResultsBoth DEP and migraine(ID showed differences in personality traits. Neuroticism was an independent risk factor for both conditions while a significant interaction effect appeared between the two in the case of openness. Namely, subjects with migraine(ID and without DEP scored higher on openness compared to those who had depression.ConclusionWhile we confirmed previous results that high neuroticism is a risk factor for both depression and migraine, openness to experience was significantly lower in the co-occurrence of migraine and depression. Our results suggest that increased openness, possibly manifested in optimal or advantageous cognitive processing of pain experience in migraine may decrease the risk of co-occurrence of depression and migraine and thus may provide valuable insight for newer prevention and intervention approaches in the treatment of these conditions.

  18. 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

  19. Migraine headaches and mood/anxiety disorders in the ELSA Brazil.

    Science.gov (United States)

    Goulart, Alessandra C; Santos, Itamar S; Brunoni, André R; Nunes, Maria Angélica; Passos, Valéria M; Griep, Rosane H; Lotufo, Paulo A; Benseñor, Isabela M

    2014-09-01

    To describe the relationship between mood/anxiety disorders and migraine headaches emphasizing the frequency of episodes based in a cross-sectional analysis in the Brazilian Longitudinal Study of Adult Health. It has been suggested that frequency of migraine headaches can be directly associated with the presence of psychiatric disorders. Migraine headaches (International Headache Society criteria) was classified as migraine and 10,531 without migraine headaches (reference). Our main result was an increase in the strength of association between migraine and MDD as frequency of migraine increased for all sample: odds ratio of 2.14 (95% confidence interval [CI] 1.33-3.43) for migraine/month to 6.94 (95% CI 4.20-11.49) for daily headaches for all sample. Significant associations with migraine were also found for GAD, OCD, MADD, and CMD for total sample: MDD, GAD, OCD, MADD, and CMD for women, and MADD and CMD for men. Among men with daily migraine complaint, we found a significant association between migraine and OCD after correction for multiple comparisons (odds ratio 29.86 [95% CI 4.66-191.43]). Analyzing probable and definite migraine cases together, we replicated the findings in a lower magnitude. The increase in migraine frequency was associated with progressively higher frequencies of having mood/anxiety disorders in all samples suggesting for some psychiatric disorders a likely dose-response effect especially for women. © 2014 American Headache Society.

  20. Prevalence and impact of headache and migraine among Pomeranians in Espirito Santo, Brazil.

    Science.gov (United States)

    Domingues, Renan B; Aquino, Camila C H; Santos, Jasper G; da Silva, André L Pirajá; Kuster, Gustavo W

    2006-12-01

    This is the first study to assess the prevalence of headache and migraine among Pomeranian descendents in Brazil. A high prevalence of headache in the last 6 months was found (53.2%). Most headache sufferers were diagnosed as having migraine (55%). More women reported to have headache than men (65% and 33.8%, respectively). Migraine was the most common headache found among women (62.2%). Among men migraine was responsible for only 37.8% of the cases of headache. A high impact of headache was found, especially among migraineurs. Most of the headache sufferers declared to seek medical assistance for headache (67%) and most of them used to take common analgesics for headache relief. None of them was under prophylactic therapy.

  1. Aggressiveness and characteristics of object-relations in students at risk of migrainous headaches

    Directory of Open Access Journals (Sweden)

    Darja Škrila

    2001-06-01

    Full Text Available The purpose of the research, carried out in a sample of Slovene students, was to determine how subjects with migraine differ from subjects with migrainous disorder, subjects with non-migrainous headaches and subjects without recurrent headaches. The existence of migraine was assessed by UCSD migraine questionnaire, aggressiveness by Buss-Durkee hostility inventory and characteristics of object-relations by Bell object relations and reality testing inventory - form O. Subjects with migraine express significantly more negativism, indirect aggressiveness, irritability, hostility, suspicion and feelings of guilt than subject without recurrent headaches, while there are no differences in physical and verbal aggressiveness. There are less significant differences among subjects with different types of headache (migraine, migrainous disorder, non-migrainous headaches. Subjects with migraine and subjects without recurrent headaches differ significantly in characteristics of object-relations, subjects with migraine having more disturbed object-relations. Subject with different types of headaches do not differ in characteristics of object-relations. It is concluded that subjects with migraine have a raised level of aggressiveness, especially of indirect forms, which can indicate non-neutralized aggressiveness, and their object-relations are more disturbed.

  2. Dietary patterns according to headache and migraine status: a cross-sectional study.

    Science.gov (United States)

    Rist, Pamela M; Buring, Julie E; Kurth, Tobias

    2015-08-01

    Several potential dietary trigger factors for migraine have been proposed. However, few studies have examined the intake pattern of these dietary items compared to adequate control populations and whether intake levels may vary by migraine aura status or attack frequency. We conducted a cross-sectional study among participants in the Women's Health Study. We used logistic regression to evaluate the association between migraine and headache status and low intake of foods commonly reported to affect migraine. A total of 25,755 women reported no history of migraine or headache, 5573 reported non-migraine headache and 7042 reported any migraine. Those with non-migraine headache or any migraine were more likely to have low intake of total alcohol (OR = 1.22, 95% CI:1.14-1.29 and OR = 1.17, 95% CI:1.11-1.24, respectively). Migraineurs with aura were more likely to have low intake of chocolate, ice cream, hot dogs, and processed meats. Those who experience migraine at least once per week were more likely to have low intake of skim/low-fat milk and white and red wine. Intake of most suggested migraine dietary triggers differs by migraine aura status and attack frequency, a pattern not found for non-migraine headache. © International Headache Society 2014.

  3. 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.

  4. Spinal Cord Injury and Migraine Headache: A Population-Based Study.

    Science.gov (United States)

    Warner, Freda M; Cragg, Jacquelyn J; Weisskopf, Marc G; Kramer, John K

    2015-01-01

    Migraine headaches are a common neurological condition, negatively impacting health and quality of life. The association between migraines and spinal cord injury (SCI) is intriguing to consider from the perspective that migraine headaches may be acquired in response to damage in the spinal cord [corrected].The primary objective of this study was to further examine the association between SCI and migraine headache, controlling for potential confounding variables. A secondary objective was to determine the impact of migraine headaches on self-perceived health. Data from a sample of 61,047 participants were obtained from the cross-sectional Canadian Community Health Survey. Multivariable logistic regression was used to explore the association between SCI and migraine headache using probability weights and adjusting for confounders. The multivariable age- and sex-adjusted model revealed a strong association between SCI and migraine headache, with an adjusted odds ratio for migraine of 4.82 (95% confidence interval [3.02, 7.67]) among those with SCI compared to those without SCI. Further, individuals who experienced both SCI and migraine tended to report poorer perceived general health compared with the other groups (i.e., SCI and no migraine). In conclusion, this study established a strong association between SCI and migraine headache. Further research is needed to explore the possible mechanisms underlying this relationship. Improvements in clinical practice to minimize this issue could result in significant improvements in quality of life.

  5. Spinal Cord Injury and Migraine Headache: A Population-Based Study.

    Directory of Open Access Journals (Sweden)

    Freda M Warner

    Full Text Available Migraine headaches are a common neurological condition, negatively impacting health and quality of life. The association between migraines and spinal cord injury (SCI is intriguing to consider from the perspective that migraine headaches may be acquired in response to damage in the spinal cord [corrected].The primary objective of this study was to further examine the association between SCI and migraine headache, controlling for potential confounding variables. A secondary objective was to determine the impact of migraine headaches on self-perceived health. Data from a sample of 61,047 participants were obtained from the cross-sectional Canadian Community Health Survey. Multivariable logistic regression was used to explore the association between SCI and migraine headache using probability weights and adjusting for confounders. The multivariable age- and sex-adjusted model revealed a strong association between SCI and migraine headache, with an adjusted odds ratio for migraine of 4.82 (95% confidence interval [3.02, 7.67] among those with SCI compared to those without SCI. Further, individuals who experienced both SCI and migraine tended to report poorer perceived general health compared with the other groups (i.e., SCI and no migraine. In conclusion, this study established a strong association between SCI and migraine headache. Further research is needed to explore the possible mechanisms underlying this relationship. Improvements in clinical practice to minimize this issue could result in significant improvements in quality of life.

  6. 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.

  7. Relationship between air mass type and emergency department visits for migraine headache across the Triangle region of North Carolina

    Science.gov (United States)

    Elcik, Christopher; Fuhrmann, Christopher M.; Mercer, Andrew E.; Davis, Robert E.

    2017-12-01

    An estimated 240 million people worldwide suffer from migraines. Because migraines are often debilitating, understanding the mechanisms that trigger them is crucial for effective prevention and treatment. Synoptic air mass types and emergency department (ED) visits for migraine headaches were examined over a 7-year period within a major metropolitan area of North Carolina to identify potential relationships between large-scale meteorological conditions and the incidence of migraine headaches. Barometric pressure changes associated with transitional air masses, or changing weather patterns, were also analyzed for potential relationships. Bootstrapping analysis revealed that tropical air masses (moist and dry) resulted in the greatest number of migraine ED visits over the study period, whereas polar air masses led to fewer. Moist polar air masses in particular were found to correspond with the fewest number of migraine ED visits. On transitional air mass days, the number of migraine ED visits fell between those of tropical air mass days and polar air mass days. Transitional days characterized by pressure increases exhibited a greater number of migraine ED visits than days characterized by pressure decreases. However, no relationship was found between migraine ED visits and the magnitude of barometric pressure changes associated with transitional air masses.

  8. The prevalence of vestibular symptoms in migraine or tension-type headache.

    Science.gov (United States)

    Akdal, Gülden; Ozge, Aynur; Ergör, Gül

    2013-01-01

    We assessed frequency of vestibular symptoms in Headache Clinic patients over 10 years. A descriptive study of 5111 consecutive patients with tension-type headache or migraine, analyzed for dizziness/ vertigo accompanying headache and for a lifetime history of motion-sickness, cyclic vomiting, recurrent abdominal pain or atopy. Migraine patients were re-grouped as those with vestibular symptoms (dizziness/vertigo or motion sickness) and those without and their data then re-analyzed. There were 1880 migraine patients and 3231 tension-type headache patients. Significantly more migraine patients than tension-type headache patients experienced vestibular symptoms (p< 0.0001). The migraine with vestibular symptoms group was significantly younger (p< 0.05) had more aura, more phonophobia with migraine attacks (p< 0.0001). Menstruation and reported sleep problems impacted on headaches. While past history of cyclical vomiting, recurrent abdominal pain or atopy was about twice as common in migraine with aura and it was also more common in migraine with vestibular symptoms than migraine without vestibular symptoms. Vestibular symptoms are common in migraine patients. Migraine with vestibular symptoms might constitute a special group, one more likely to have had cyclic vomiting, recurrent abdominal pain or atopy.

  9. 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.

  10. 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.

  11. Association of posttraumatic stress disorder symptoms with migraine and headache after a natural disaster.

    Science.gov (United States)

    Arcaya, Mariana C; Lowe, Sarah R; Asad, Asad L; Subramanian, S V; Waters, Mary C; Rhodes, Jean

    2017-05-01

    Previous research shows that migraine and general headache symptoms increase after traumatic events. Questions remain about whether posttraumatic stress disorder (PTSD) produces migraine/headache symptoms, or if individuals afflicted by migraine/headache are especially likely to develop PTSD. We test whether PTSD symptoms following a natural disaster are associated with higher odds of reporting frequent headaches/migraines postdisaster. We decompose PTSD into intrusion, avoidance, and hyperarousal symptom clusters to examine which, if any, are uniquely related to headache/migraine postdisaster. We use prospectively collected pre- and postdisaster data to explore whether overall PTSD symptoms and symptom clusters are associated with migraine/headache in a sample of Hurricane Katrina survivors. We account for severity of hurricane exposure and control for baseline migraine and headache problems to reduce the probability that heightened PTSD susceptibility among those who already suffered from the conditions could explain observed associations. PTSD symptoms were associated with higher odds of experiencing frequent headaches or migraines with a standard deviation change in PTSD score corresponding to over twice the odds (95% confidence interval [1.64, 2.68]) of having trouble with frequent headaches or migraines in the post-Katrina period. Each additional point on the intrusion subscale (sample M [SD] = 1.6 [1.1]) was associated with 55% higher odds of reporting frequent headache/migraine (95% confidence interval [1.03, 2.33]), but we found no association with avoidance or hyperarousal symptoms. Clinicians and disaster planners should be aware that disaster survivors might be at heightened risk of migraine/headache episodes, and those experiencing intrusive reminders may be most affected. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Cognitive Behavioral Therapy plus Amitriptyline for Children and Adolescents with Chronic Migraine Reduces Headache Days to ≤4 Per Month.

    Science.gov (United States)

    Kroner, John W; Hershey, Andrew D; Kashikar-Zuck, Susmita M; LeCates, Susan L; Allen, Janelle R; Slater, Shalonda K; Zafar, Marium; Kabbouche, Marielle A; O'Brien, Hope L; Shenk, Chad E; Rausch, Joseph R; Kroon Van Diest, Ashley M; Powers, Scott W

    2016-04-01

    The objective of this secondary analysis of results from a previously published trial (Clinical Trials Registration Number: NCT00389038) in chronic migraine in children and adolescents was to examine if participants who received cognitive behavioral therapy and amitriptyline reached a greater level of reduction in headache frequency that no longer indicated a recommendation for preventive treatment as compared to those who received headache education and amitriptyline. Chronic migraine negatively affects children's home, school, and social activities. Preventive medication therapy is suggested for 5 or more headaches per month. Reduction to one headache day per week or less may suggest that preventive treatment is no longer indicated and provide a clinically relevant outcome for treatment efficacy and patient care. Randomized study participants (N = 135) kept a daily record of their headache frequency during 20 weeks of treatment and during a 1 year follow-up period. Baseline headache frequency was determined at the end of a 28 day screening period. Post treatment frequency was determined at 20 weeks (N = 128 completed) and post treatment follow-up was measured 12 months later (N = 124 completed). A chi-square test of independence was conducted by treatment group and by time point to determine group differences in the proportion of headache days experienced. At 20 weeks (post treatment), 47% of the cognitive behavioral therapy plus amitriptyline group had ≤4 headache days per month compared to 20% of the headache education plus amitriptyline group, (P = .0011), and 32% of the cognitive behavioral therapy plus amitriptyline group had ≤3 headache days per month at 20 weeks compared to 16% of the headache education plus amitriptyline group, (P = .0304). At the month 12 follow-up, 72% of the cognitive behavioral therapy plus amitriptyline group had ≤4 headache days per month compared to 52% of the headache education plus amitriptyline group

  13. Aspirin is first-line treatment for migraine and episodic tension-type headache regardless of headache intensity.

    Science.gov (United States)

    Lampl, Christian; Voelker, Michael; Steiner, Timothy J

    2012-01-01

    (1) To establish whether pre-treatment headache intensity in migraine or episodic tension-type headache (ETTH) predicts success or failure of treatment with aspirin; and (2) to reflect, accordingly, on the place of aspirin in the management of these disorders. Stepped care in migraine management uses symptomatic treatments as first-line, reserving triptans for those in whom this proves ineffective. Stratified care chooses between symptomatic therapy and triptans as first-line on an individual basis according to perceived illness severity. We questioned the 2 assumptions underpinning stratified care in migraine that greater illness severity: (1) reflects greater need; and (2) is a risk factor for failure of symptomatic treatment but not of triptans. With regard to the first assumption, we developed a rhetorical argument that need for treatment is underpinned by expectation of benefit, not by illness severity. To address the second, we reviewed individual patient data from 6 clinical trials of aspirin 1000 mg in migraine (N = 2079; 1165 moderate headache, 914 severe) and one of aspirin 500 and 1000 mg in ETTH (N = 325; 180 moderate, 145 severe), relating outcome to pre-treatment headache intensity. In migraine, for headache relief at 2 hours, a small (4.7%) and non-significant risk difference (RD) in therapeutic gain favored moderate pain; for pain freedom at 2 hours, therapeutic gains were almost identical (RD: -0.2%). In ETTH, for headache relief at 2 hours, RDs for both aspirin 500 mg (-4.2%) and aspirin 1000 mg (-9.7%) favored severe pain, although neither significantly; for pain freedom at 2 hours, RDs (-14.2 and -3.6) again favored severe pain. In neither migraine nor ETTH does pre-treatment headache intensity predict success or failure of aspirin. This is not an arguable basis for stratified care in migraine. In both disorders, aspirin is first-line treatment regardless of headache intensity. © 2011 American Headache Society.

  14. Persistent post-traumatic headache vs. migraine: an MRI study demonstrating differences in brain structure.

    Science.gov (United States)

    Schwedt, Todd J; Chong, Catherine D; Peplinski, Jacob; Ross, Katherine; Berisha, Visar

    2017-08-22

    The majority of individuals with post-traumatic headache have symptoms that are indistinguishable from migraine. The overlap in symptoms amongst these individuals raises the question as to whether post-traumatic headache has a unique pathophysiology or if head trauma triggers migraine. The objective of this study was to compare brain structure in individuals with persistent post-traumatic headache (i.e. headache lasting at least 3 months following a traumatic brain injury) attributed to mild traumatic brain injury to that of individuals with migraine. Twenty-eight individuals with persistent post-traumatic headache attributed to mild traumatic brain injury and 28 individuals with migraine underwent brain magnetic resonance imaging on a 3 T scanner. Regional volumes, cortical thickness, surface area and curvature measurements were calculated from T1-weighted sequences and compared between subject groups using ANCOVA. MRI data from 28 healthy control subjects were used to interpret the differences in brain structure between migraine and persistent post-traumatic headache. Differences in regional volumes, cortical thickness, surface area and brain curvature were identified when comparing the group of individuals with persistent post-traumatic headache to the group with migraine. Structure was different between groups for regions within the right lateral orbitofrontal lobe, left caudal middle frontal lobe, left superior frontal lobe, left precuneus and right supramarginal gyrus (p right lateral orbitofrontal lobe, right supramarginal gyrus, and left superior frontal lobe and no differences when comparing the migraine cohort to healthy controls. In conclusion, persistent post-traumatic headache and migraine are associated with differences in brain structure, perhaps suggesting differences in their underlying pathophysiology. Additional studies are needed to further delineate similarities and differences in brain structure and function that are associated with post

  15. CGRP receptor antagonist olcegepant (BIBN4096BS) does not prevent glyceryl trinitrate-induced migraine

    DEFF Research Database (Denmark)

    Tvedskov, J F; Tfelt-Hansen, P; Petersen, K A

    2010-01-01

    and in nine of 13 with placebo (p=0.68). The headache scores were similar after the two treatments (p=0.58). Thus CGRP receptor blockade did not prevent GTN-induced migraine. CONCLUSIONS: The present study indicates that NO does not induce migraine by liberating CGRP. The most likely explanation for our...

  16. Neuroticism, depression and pain perception in migraine and tension-type headache

    DEFF Research Database (Denmark)

    Ashina, S; Bendtsen, L; Buse, D C

    2017-01-01

    OBJECTIVES: People with migraine and tension-type headache (TTH) have psychiatric comorbidities. We aimed to test differences in mental health constructs by type and frequency of primary headache and associated pain sensitivity. MATERIALS AND METHODS: Data on headache features, neuroticism (Eysen...

  17. Bariatric Surgery Promising in Migraine Control: a Controlled Trial on Weight Loss and Its Effect on Migraine Headache.

    Science.gov (United States)

    Razeghi Jahromi, Soodeh; Abolhasani, Maryam; Ghorbani, Zeinab; Sadre-Jahani, Solmaz; Alizadeh, Zahra; Talebpour, Mohammad; Meysamie, Alipasha; Togha, Mansoureh

    2018-01-01

    There is evidence that substantial weight loss through bariatric surgery (BS) may result in short-term improvement of migraine severity. However, it still remains to be seen whether smaller amounts of weight loss have a similar effect on migraine headache. This study has been designed to compare the effects of weight reduction through BS and non-surgical modifications. Migraine characteristics were assessed at 1 month before (T0), 1 month (T1), and 6 months (T2) after BS (vertical sleeve gastrectomy (VSG) (n = 25) or behavioral therapy (BT) (n = 26) in obese women (aged 18-60 years) with migraine headache. Migraine was diagnosed using the International Classification of Headache Disorders (ICHDIIβ) criteria. There was significant reduction in the visual analog scale (VAS) from the baseline to T1 and T2 in both groups. The number of migraine-free days showed a significant increase within each group (p migraine characteristics, age, changes in weight, BMI, body fat, and fat-free mass from T0 to T2, the BS group showed statistically significant lower VAS and duration of migraine attacks and a significantly higher number of migraine-free days than the BT group at T1 and T2 (p ≤ 0.028). Our results indicated that far before significant weight reduction after BS (VSG), there was marked alleviation in the severity and duration of migraine and a significant increase in the number of migraine-free days in obese female migraineurs. However, the effects in the BT group were not comparable with the effects in the BS group.

  18. 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

  19. Migraine

    Science.gov (United States)

    ... SEARCH Definition Treatment ... is often described as an intense pulsing or throbbing pain in one area of the head. However, it is much more; the International Headache Society diagnoses a migraine by its pain and number ...

  20. Nitric oxide is a key molecule in migraine and other vascular headaches

    DEFF Research Database (Denmark)

    Olesen, J; Thomsen, L L; Iversen, Helle Klingenberg

    1994-01-01

    Nitric oxide (NO) may play a key role in migraine and other vascular headaches since glyceryl trinitrate (a donor of NO) and histamine (which probably activates endothelial NO formation) both cause a pulsating dose-dependent headache with several migrainous characteristics. At relatively high doses...... Olesen, Lars Thomsen and Helle Iversen suggest that migraine may be caused by increased amounts and/or affinity of an enzyme in the NO-triggered cascade of reactions. NO may also be involved in the pathogenesis of other vascular headaches....

  1. 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

  2. Correlation of headache frequency and psychosocial impairment in migraine: a cross-sectional study.

    Science.gov (United States)

    Ruscheweyh, Ruth; Müller, Melanie; Blum, Bernhard; Straube, Andreas

    2014-05-01

    To investigate if a headache frequency of 15 days per month constitutes a turning point in the psychosocial impairment associated with migraine. Migraine is differentiated into episodic and chronic forms based on a headache frequency criterion (headache days per month). It is presently not clear if this criterion represents a clinically and pathophysiologically meaningful turning point of the disease. Six hundred and one migraine patients completed measures of pain-specific disability (Migraine Disability Assessment Scale, von Korff scale), health-related quality of life (Short Form-12 Health Survey), habitual well-being (Marburg questionnaire), and anxiety and depression (Hospital Anxiety and Depression Score). A significant increase of psychosocial impairment with the number of headache days per month was found at lower headache frequencies, but leveled off at higher headache frequencies. Visual inspection and spline interpolation suggested that the turning point was not exactly at 15 headache days per month but rather around 13.3 (confidence interval: 8.9-17.7) days. Accordingly, significant correlations between headache days and psychosocial impairment were found in the group with ≤13 headache days per month (Spearman's rho = 0.25, P 13 headache days (rho = -0.02, n.s.). These results suggest that a meaningful turning point in psychosocial impairment associated with migraine is located around 13.3 headache days per month, somewhat below the 15-headache days criterion that by definition separates chronic from episodic migraine. However, confidence intervals surrounding the turning point were large. Further studies will be needed to more exactly localize the turning point. © 2013 American Headache Society.

  3. Comparative efficacy trial of cupping and serkangabin versus conventional therapy of migraine headaches: A randomized, open-label, comparative efficacy trial.

    Science.gov (United States)

    Firoozabadi, Mohammad Dehghani; Navabzadeh, Maryam; Roudsari, Mohammad Khodashenas; Zahmatkash, Mohsen

    2014-12-01

    Migraine headaches are the most common acute and recurrent headaches. Current treatment of a migraine headache consists of multiple medications for control and prevention of recurrent attacks. Global emergence of alternative medicine led us to examine the efficacy of cupping therapy plus serkangabin syrup in the treatment of migraine headaches. This study was a randomized, controlled, open-label, comparative efficacy trial. We randomly assigned patients with migraine into cupping therapy plus serkangabin group (30 patients) and conventional treatment group (30 patients). An investigator assessed the severity of headache, frequency of attacks in a week and duration of attacks per hour in 5 visits (at the end of 2 weeks, 1, 3 and 6 months). Generalized estimating equations approach was used to analyze repeated measures data to compare outcomes in both groups. Average age for cupping therapy group and conventional treatment group were 31.7 (±7.6) and 32.6 (±12.7) years, respectively (P = 0.45). After treatment for 2 weeks; and 1, 3 and 6 months, severity of headache (P = 0.80), frequency of migraine attacks (P = 0.63) and duration of attacks per hours (P = 0.48) were similar in conventional and cupping groups but these symptoms were decreased in each group during the study (P cupping plus serkangabin therapy and conventional treatment in the treatment and prophylaxis of migraine. The alternative therapy may be used in cases of drug intolerance, no medication response, and in primary care.

  4. 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.

  5. The impact of serum 25-hydroxyvitamin D level on migraine headache

    Directory of Open Access Journals (Sweden)

    Gökhan Özer

    2018-03-01

    Full Text Available Objective: To investigate the impact of serum 25-hydroxyvitamin D levels on migraine headache in migraineurs Patients and Methods: A total of 72 patients were included in the study. Serum vitamin D concentration and its impact on the migraine headache were assessed in migraineurs and migraine subgroups. To assess serum levels of vitamin D, 25(OH D3 was measured by enzymelinked immunosorbent assay (ELISA. Patients were categorized as follows based on the results of serum vitamin D measurements. Severity of migraine, average duration and frequency of attacks per month were recorded. The headache diary result (HDR was determined as: Duration of headache × frequency of headache. Results: Average vitamin D level was 7.4 ng/ml among patients with migraine with aura group and 8.5 ng/ml in patients with migraine without aura. Severe vitamin D deficiency was detected in 14 (66.7% patients with migraine with aura and 9 (64.3% patients with migraine without aura, with no statistically significant difference between the two groups. No significant correlation was found between vitamin D levels and HDR among migraineurs (r=-0.042, p=0.812 as well as in patients with migraine with aura (r=0.044, p=0.842 and in patients with migraine without aura (r=0.059, p=0.842 versus control group with respect to HDR and vitamin D levels. The severity of migraine pain was not associated with vitamin D levels. Serum vitamin D concentration was lower in male patients versus control group. Conclusion: The impact of vitamin D on the severity and number of migraine attacks is not clear. Further studies are needed to demonstrate the association between vitamin D status and neurological diseases.

  6. Cortical and subcortical hyperfusion during migraine and cluster headache measured by Xe CT-CBF

    International Nuclear Information System (INIS)

    Kobari, M.; Meyer, J.S.; Ichijo, M.; Kawamura, J.; Baylor Univ., Houston, TX

    1990-01-01

    High-resolution, color-coded images of local cerebral blood flow (LCBF) were made utilizing stable xenon-enhanced computed tomography among patients with common migraine (n=18), classic migraine (n=12) and cluster headache (n=5). During spontaneously occurring headache in common and classic migraine patients, LCBF values for cerebral cortex and subcortical gray and white matter were diffusely increased by 20-40% with the exception of the occipital lobes. LCBF increases involved both hemispheres whether the head pain was unilateral or bilateral. No significant differences were noted in the degree or pattern of LCBF increases during headaches of common and classic migraineurs. Similar cerebral hyperperfusion of greater magnitude was observed during cluster headaches but was more prominent on the side of the head pain. Present observations do not support the hypothesis of spreading cortical depression as a cause of classic migraine. From a hemodynamic viewpoint, LCBF increases during headaches of common or classic migraine or cluster appear similar. Evidence is adduced that sympathetic hypofunction with denervation hypersensitivity of cerebral vessels plays a role in the cerebral hyperperfusion of migraine headaches. More pronounced unilateral autonomic derangements appear to account for the symptoms and cerebral hyperperfusion associated with cluster headaches. (orig.)

  7. The Use of the Cognitive Behavioral Therapy for the Treatment of Migraine and Tension Type Headaches

    OpenAIRE

    Yasemin Akkoca; Þehnaz Yýldýrým; Levent Ertuðrul Ýnan

    2015-01-01

    Headache, which affects a large part of the community and causes loss of workforce, is gaining importance in terms of the burden which it brings on the society, by its function of restricting individuals social activities as well as increasing the health expenditure likewise drug consumption. Migraine and tension headaches are primary headaches which any organic causes can not be determined for them. For the treatment of headaches of this type besides the use of medicine, exercises with bio-f...

  8. 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.

  9. Precipitating and Relieving Factors of Migraine Headache in 200 Iraqi Kurdish Patients

    Directory of Open Access Journals (Sweden)

    Ehsan K. Al-Shimmery

    2010-07-01

    Full Text Available Objectives: To study the precipitating and relieving factors of migraine headache in a group of Iraqi Kurdish patients including the effect of fasting in Ramadan, and to estimate the percentage of family history of migraine. Methods: A series of 200 migraine cases from different parts of the Kurdistan region in the North of Iraq attending the out-patient Neurology clinic at Rizgary Teaching Hospital and a private Neurology clinic at Erbil City was carried out between October 2007 and May 2008 were reviewed. The precipitating factors and relieving factors for migraine headache were registered and tabulated to be compared with others. Case definition of migraine was based on the International Headache Society (IHS criteria.Results: 33% of the patients were aged between 30-39 years, while 40.5% of patients experienced their first attack aged between 20-29 years. Stress or psychological upset was the commonest triggering factor (80%, followed by increasing physical activity (68%, change in weather (65.5%, and in relation to fasting (65%. Fasting in Ramadan was a triggering factor for headaches in 65% of patients. However, there was no significant association between the triggering factors with regards to sex difference. Relief of migraine in the studied sample was achieved using NSAIDs in 50% of patients, and sleep (45.5%. Hence, 61% of the study population had positive family history of migraine, 32.5% of them reported maternal history of migraine. Conclusion: Psychological upset, stress and excessive physical activity were the commonest triggering factors of migraine headache, while NSAID was the commonest relieving factor of migraine in this population. Family history was present in 61% of migraine patients based mainly from maternal root.

  10. Incidence of migraine and tension-type headache in three different populations at risk within the German DMKG headache study.

    Science.gov (United States)

    Khil, Laura; Pfaffenrath, Volker; Straube, Andreas; Evers, Stefan; Berger, Klaus

    2012-03-01

    Unlike the prevalence, the incidence of headache disorders has attracted only little attention in epidemiological research. Different definitions of the 'population at risk' among the few published migraine and tension-type headache incidence studies limit their comparability and warrant further research. Therefore, we analysed data from the German Migraine and Headache Society (DMKG). Incidences were assessed in the general population in Germany via standardized headache questions using the International Classification of Headache Disorders, 2nd Edition (ICHD-2). The population was drawn from a 5-year age-group- stratified and gender-stratified random sample from the population register. Of the 1312 baseline participants examined between 2003 and 2004, 1122 (85.5%) participated in the follow-up in 2006 and were the basis for three different populations at risk. We found that the three populations differed in size, age, gender and incidence estimate. The total sample incidence of migraine ranged between 0% and 3.3% and of tension-type headache between 5.3% and 9.2% depending on the definition of 'at risk'. We concluded that one significant problem in headache incidence estimation is the definition of 'at risk', limiting comparability. Thus, this study supports the need for a common definition for prospective headache incidence estimations.

  11. Stress and Migraine

    Science.gov (United States)

    ... Spotlight On News Content Capsule Contact Understanding Migraine Stress and Migraine Doctor Q&A Managing Migraine Migraine ... of Headache Disorders Cluster Headache Post-Traumatic Headache Stress and Migraine March 16, 2017 How to cope ...

  12. Acupuncture for the prevention of episodic migraine

    Science.gov (United States)

    Linde, Klaus; Allais, Gianni; Brinkhaus, Benno; Fei, Yutong; Mehring, Michael; Vertosick, Emily A.; Vickers, Andrew; White, Adrian R

    2016-01-01

    Background Acupuncture is often used for migraine prevention but its effectiveness is still controversial. We present an update of our Cochrane review from 2009. Objectives 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 prophylactic treatment with drugs in reducing headache frequency in adults with episodic migraine. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL: 2016, issue 1); MEDLINE (via Ovid, 2008 to January 2016); Ovid EMBASE (2008 to January 2016); and Ovid AMED (1985 to January 2016). We checked PubMed for recent publications to April 2016. We searched the World Health Organization (WHO) Clinical Trials Registry Platform to February 2016 for ongoing and unpublished trials. Selection criteria We included randomized trials at least eight weeks in duration that compared an acupuncture intervention with a no-acupuncture control (no prophylactic treatment or routine care only), a sham-acupuncture intervention, or prophylactic drug in participants with episodic migraine. Data collection and analysis Two reviewers checked eligibility; extracted information on participants, interventions, methods and results, and assessed risk of bias and quality of the acupuncture intervention. The primary outcome was migraine frequency (preferably migraine days, attacks or headache days if migraine days not measured/reported) after treatment and at follow-up. The secondary outcome was response (at least 50% frequency reduction). Safety outcomes were number of participants dropping out due to adverse effects and number of participants reporting at least one adverse effect. We calculated pooled effect size estimates using a fixed-effect model. We assessed the evidence using GRADE and created ’Summary of findings’ tables. Main results Twenty-two trials including 4985 participants in total (median 71, range

  13. Resolution of chronic migraine headaches with intrathecal ziconotide: a case report

    Directory of Open Access Journals (Sweden)

    Narain S

    2015-09-01

    Full Text Available Sachin Narain,1 Lama Al-Khoury,2 Eric Chang3–6 1Department of Anesthesiology and Perioperative Care, 2Department of Neurology, 3Department of Physical Medicine and Rehabilitation, 4Department of Neurosurgery, 5Department of Orthopedics, 6Reeve-Irvine Research Center for Spinal Cord Injury, University of California Irvine, Irvine, CA, USA Background: Migraine headaches are a common and functionally debilitating disorder affecting approximately 17% of women and 5.6% of men. Compared to episodic migraine patients, chronic migraineurs are more likely to be occupationally disabled, miss family activities, have comorbid anxiety and/or chronic pain disorders, and utilize significantly more health care dollars. Ziconotide is a calcium channel blocker used for the treatment of chronic severe pain without issues of tolerance or dependency found with opioid therapy. Case: A 59-year-old female had an intrathecal baclofen pump placed for spasticity secondary to multiple sclerosis. Her symptoms also included lower extremity neuropathic pain and severe migraine headaches with 22 migraine headache days per month. Prior treatments included nonsteroidal anti-inflammatory drugs, triptans, anticonvulsants, antihypertensives, and Botox injections which reduced her symptoms to four migraine days per month at best. While her spasticity had markedly improved with intrathecal baclofen, ziconotide was added to help her neuropathic pain complaints. Following initiation of low-dose ziconotide (1 µg/day, the patient noted both lower extremity pain improvement and complete resolution of migraine headaches resulting in zero migraine days per month. She has now been migraine free for 8 months. Conclusion: Upon review of the available literature, there are no published cases of migraine improvement with intrathecal ziconotide. This represents the first case describing resolution of migraine symptoms with low-dose ziconotide. Keywords: ziconotide, migraine, symptoms, chronic

  14. Hypoxia triggers high-altitude headache with migraine features: A prospective trial.

    Science.gov (United States)

    Broessner, Gregor; Rohregger, Johanna; Wille, Maria; Lackner, Peter; Ndayisaba, Jean-Pierre; Burtscher, Martin

    2016-07-01

    Given the high prevalence and clinical impact of high-altitude headache (HAH), a better understanding of risk factors and headache characteristics may give new insights into the understanding of hypoxia being a trigger for HAH or even migraine attacks. In this prospective trial, we simulated high altitude (4500 m) by controlled normobaric hypoxia (FiO2 = 12.6%) to investigate acute mountain sickness (AMS) and headache characteristics. Clinical symptoms of AMS according to the Lake Louise Scoring system (LLS) were recorded before and after six and 12 hours in hypoxia. O2 saturation was measured using pulse oximetry at the respective time points. History of primary headache, especially episodic or chronic migraine, was a strict exclusion criterion. In total 77 volunteers (43 (55.8%) males, 34 (44.2%) females) were enrolled in this study. Sixty-three (81.18%) and 40 (71.4%) participants developed headache at six or 12 hours, respectively, with height and SpO2 being significantly different between headache groups at six hours (p headache development (p headache according to the International Classification of Headache Disorders (ICHD-3 beta) in n = 5 (8%) or n = 6 (15%), at six and 12 hours, respectively. Normobaric hypoxia is a trigger for HAH and migraine-like headache attacks even in healthy volunteers without any history of migraine. Our study confirms the pivotal role of hypoxia in the development of AMS and beyond that suggests hypoxia may be involved in migraine pathophysiology. © International Headache Society 2015.

  15. 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.

  16. Psychosocial factors associated with migraine and tension-type headache in medical students

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Kobzeva, Natalia R; Gilev, Denis V

    2017-01-01

    BACKGROUND: In our previous study of workers, blood donors and medical students, students stood out with a higher 1-year prevalence of migraine (28%) and tension-type headache (TTH) (74%). General factors associated with headache were common for all groups except low physical activity. The hypoth...

  17. Are Migraine and Tension-Type Headache Genetically Related? An Investigation of Twin Family Data

    NARCIS (Netherlands)

    Ligthart, Lannie; Huijgen, Annemarie; Willemsen, Gonneke; De Geus, Eco J.C.; Boomsma, Dorret I.

    Migraine and tension-type headache (TTH) are often viewed as distinct entities and defined as such in the International Classification of Headache Disorders, 2nd edition (ICHD-II) criteria, although there is also empirical evidence to suggest they may be etiologically similar. This study aims to

  18. Temporomandibular disorder-type pain and migraine headache in women: a preliminary twin study.

    Science.gov (United States)

    Plesh, Octavia; Noonan, Carolyn; Buchwald, Dedra S; Goldberg, Jack; Afari, Niloo

    2012-01-01

    To determine whether shared genetic influences are responsible for the association between pain from temporomandibular disorders (TMD) and migraine headache. Data were obtained from 1,236 monozygotic and 570 dizygotic female twin pairs from the University of Washington Twin Registry. TMD pain was assessed with a question about persistent or recurrent pain in the jaw, temple, in front of the ear, or in the ear. The presence of migraine headache was determined by self-report of doctor-diagnosed migraine. Univariate and bivariate structural equation models estimated the components of variance attributable to genetic and environmental influences. The best fitting univariate models indicated that additive genetic effects contributed 27% of the variance in TMD pain (95% confidence interval = 15% to 38%) and 49% of the variance in migraine headache (95% confidence interval = 40% to 57%). The best-fitting bivariate model revealed that 12% of the genetic component of TMD pain is shared with migraine headache. These preliminary findings suggest that the association between TMD pain and migraine headache in women may be partially due to a modest shared genetic risk for both conditions. Future studies can focus on replicating these findings with symptom- and diagnosis-based instruments.

  19. The relation of PTSD symptoms to migraine and headache-related disability among substance dependent inpatients.

    Science.gov (United States)

    McDermott, Michael J; Fulwiler, Joshua C; Smitherman, Todd A; Gratz, Kim L; Connolly, Kevin M; Tull, Matthew T

    2016-04-01

    Despite emerging evidence for the comorbidity of posttraumatic stress disorder (PTSD) and migraine, few studies have examined the relation of PTSD and migraine, particularly among clinical populations at-risk for both conditions (e.g., substance-dependent patients). This study examined the role of PTSD symptoms in migraine and headache-related disability within a sample of 153 substance-dependent inpatients (37.25% female, Mean age 36.46). PTSD symptoms predicted both migraine and headache-related disability above and beyond gender, depression and anxiety symptoms, the experience of a Criterion A traumatic event, and current alcohol use disorder. Findings highlight the strong association between migraine and PTSD symptoms in a unique population at risk for both conditions.

  20. [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.

  1. Early Maladaptive Schemas in Patients with and without Migraine and Tension Headaches

    Directory of Open Access Journals (Sweden)

    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. 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.

  3. Relapsing Painful Ophthalmoplegic Neuropathy: No longer a "Migraine," but Still a Headache.

    Science.gov (United States)

    Smith, Stacy V; Schuster, Nathaniel M

    2018-06-14

    Recurrent painful ophthalmoplegic neuropathy (RPON), formerly known as ophthalmoplegic migraine, is an uncommon disorder with repeated episodes of ocular cranial nerve neuropathy associated with ipsilateral headache. This review discusses the clinical presentation, current understanding of the pathophysiology, key differential diagnoses, and evaluation and treatment of RPON. The literature is limited due to the rarity of the disorder. Recent case reports and series continue to suggest the age of first attack is most often during childhood or adolescence as well as a female predominance. Multiple recent case reports and series demonstrate focal enhancement of the affected cranial nerve, as the nerve root exits the brainstem. This finding contributed to the current classification of the disorder as a neuropathy, with the present understanding that it is due to a relapsing-remitting inflammatory or demyelinating process. The link to migraine remains a cause of disagreement in the literature. RPON is a complex disorder with features of inflammatory neuropathy and an unclear association with migraine. Regardless, the overall prognosis is good for individual episodes, but permanent nerve damage may accumulate with repeated attacks. A better understanding of the pathogenesis is needed to clarify whether it truly represents a single disorder and to guide its treatment. Until that time, a combined approach with acute and preventive therapies can mitigate acute symptoms as well as attempt to limit recurrence of this disabling syndrome.

  4. 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.

  5. 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.

  6. Headache and Dizziness: How to Differentiate Vestibular Migraine from Other Conditions.

    Science.gov (United States)

    Cohen, Joshua M; Escasena, Carlos A

    2015-07-01

    Headache and dizziness are two of the most common symptoms prompting medical evaluation and may be seen in many primary and secondary headache and dizziness syndromes. Many of these disease processes share common characteristics making determination of the diagnosis extremely challenging. As more is understood about the concurrence of these symptoms, new diagnostic considerations have emerged, and the beta version of the latest edition of the International Classification of Headache Disorders describes a new entity termed vestibular migraine that may affect many patients presenting with headache and dizziness. This article examines the epidemiology of headache and dizziness, describes the presenting features of patients with conditions which often express these two symptoms, discusses recommendations for evaluation and testing for these patients, and serves to aid in the differentiation between vestibular migraine and other potential diagnoses.

  7. Migraine and tension-type headache treated with stromal vascular fraction: a case series.

    Science.gov (United States)

    Bright, Ralph; Bright, Matthew; Bright, Pelin; Hayne, Shannon; Thomas, Wayne D

    2014-06-30

    Chronic migraines and tension-type headaches are debilitating diseases affecting 1.4 to 2.2% of the population with both quality of life and economic implications. To date, the pain associated with migraine and tension-type headaches has been controlled with a range of medications, with varying levels of success. In addition, the side-effect profile of these medications, as well as their potential for addiction, has been a cause for concern for both patients and physicians. Four women with long histories of migraine or frequent tension-type headache that meet the International Classification of Headache Disorders criteria for Chronic Migraine or Tension-type Headaches were given a systemic treatment(s) of autologous stromal vascular fraction or autologous 'StroMed' isolated from lipoaspirate. StroMed is stromal vascular fraction cells prepared by ultrasonic cavitation. Two of the four patients, both of whom are Arab women aged 40 and 36 years, ceased having migraines after 1 month, for a period of 12 to 18 months. The third patient, a Slavic woman aged 43 years, had a significant decrease in the frequency and severity of migraines with only seven migraines over 18 months. The fourth patient, an Asian woman aged 44 years, obtained a temporary decrease for a period of a month and was retreated 18 months later and has been free of migraines to date for 1 month. Pain medication was typically reduced from prescribed opioid analgesia to non-steroidal anti-inflammatory drugs and paracetamol. This case series is the first to provide evidence of the efficacy of autologous StroMed and stromal vascular fraction in the treatment of migraine and tension-type headache. The treatment of this disease by stromal vascular fraction adds a new dimension to its clinical applicability and suggests a relatively simple treatment that may help address the symptoms of the disease. Given what is known about the components of the stromal vascular fraction and how they act, the information

  8. Medication overuse headache and chronic migraine in a specialized headache centre: field-testing proposed new appendix criteria

    DEFF Research Database (Denmark)

    Zeeberg, P; Olesen, Jes; Jensen, R

    2009-01-01

    The classification subcommittee of the International Headache Society (IHS) has recently suggested revised criteria for medication overuse headache (MOH) and chronic migraine (CM). We field tested these revised criteria by applying them to the headache population at the Danish Headache Centre...... suggest that the IHS has succeeded in choosing new criteria for CM which are neither too strict, nor too loose. For MOH, a shift to the appendix criteria will increase the number of MOH patients, but take into account the possibility of permanent changes in pain perception due to medication overuse...... and the possibility of a renewed effect of prophylactic drugs due to medication withdrawal. We therefore recommend the implementation of the appendix criteria for both MOH and CM into the main body of the International Classification of Headache Disorders....

  9. Prevalence of neck pain in migraine and tension-type headache

    DEFF Research Database (Denmark)

    Ashina, Sait; Bendtsen, Lars; Lyngberg, Ann C

    2015-01-01

    BACKGROUND: We assessed the prevalence of neck pain in the population in relation to headache. METHODS: In a cross-sectional study, a total of 797 individuals completed a headache interview and provided self-reported data on neck pain. We identified migraine, TTH or both migraine and TTH (M......+TTH) groups. Pericranial tenderness was recorded in 496 individuals. A total tenderness score (TTS) was calculated as the sum of local scores with a maximum score of 48. RESULTS: The one-year prevalence of neck pain was 68.4% and higher in those with vs. without primary headache (85.7% vs. 56.7%; adjusted...... OR 3.0, 95% CI 2.0-4.4, pneck pain (56.7%) was significantly higher in those with M+TTH (89.3%), pure TTH (88.4%) and pure migraine (76.2%) (p

  10. Predictors of migraine headache recurrence: A pooled analysis from the eletriptan database

    DEFF Research Database (Denmark)

    Dodick, D.W.; Lipton, R.B.; Goadsby, P.J.

    2008-01-01

    Objective.-To identify clinical variables associated with risk of headache recurrence within 22 hours of initial successful treatment of a migraine attack (2-hour headache response), and to analyze the effect of eletriptan in reducing the incidence of recurrence. Methods.-Data were pooled from 10...... evaluable. A multivariable logistic regression analysis identified significant predictors of headache recurrence (return to moderate/severe pain intensity within 22 hours of initial headache response). Treatment response was assessed in two high-risk subgroups, defined by the presence of significant...

  11. Self- Reported Comorbid Pains in Severe Headaches or Migraines in a US National Sample

    Science.gov (United States)

    Plesh, Octavia; Adams, Sally H; Gansky, Stuart A

    2012-01-01

    Aims To compare prevalence of self-reported comorbid temporomandibular joint muscle disorder (TMJMD)-type, neck, back and joint pains in people with severe headache or migraine; analyze these self-reported pains in the 2000–2005 US National Health Interview Survey (NHIS) by gender and age for Non-Hispanic Whites, Hispanics and Non-Hispanic Blacks (African Americans). Methods NHIS data included information on gender, age, race, ethnicity, health status, and common pain types: severe headache or migraine, TMJMD-type, neck, and low back in the last 3 months, as well as prior month joint pains. Analyses included survey prevalence estimation and survey logistic regression to obtain odds ratios and 95% confidence intervals. Results 189,967 adults, 48% males, 52% females; 73% White, 12% Hispanic, and 11% Black were included. 29,712 (15%) of the entire sample reported severe headache or migraine, 19,228 (64%) had severe headache or migraine with at least one comorbid pain. 10,200 (33%) reported 2 or more comorbid pains, with no gender difference, and with Hispanics (n=1,847 or 32%) and Blacks (n=1,301 or 30%) less likely to report 2 or more comorbid pains than Whites (n=6,747 or 34%) (OR=0.91, p=0.032; OR=0.82, pheadache or migraine is often associated with other common pains, seldom existing alone. Two or more comorbid pains are common, similarly affecting gender and racial/ethnic groups. PMID:22553936

  12. Prevalence of neck pain in migraine and tension-type headache: a population study.

    Science.gov (United States)

    Ashina, Sait; Bendtsen, Lars; Lyngberg, Ann C; Lipton, Richard B; Hajiyeva, Nazrin; Jensen, Rigmor

    2015-03-01

    We assessed the prevalence of neck pain in the population in relation to headache. In a cross-sectional study, a total of 797 individuals completed a headache interview and provided self-reported data on neck pain. We identified migraine, TTH or both migraine and TTH (M+TTH) groups. Pericranial tenderness was recorded in 496 individuals. A total tenderness score (TTS) was calculated as the sum of local scores with a maximum score of 48. The one-year prevalence of neck pain was 68.4% and higher in those with vs. without primary headache (85.7% vs. 56.7%; adjusted OR 3.0, 95% CI 2.0-4.4, pneck pain (56.7%) was significantly higher in those with M+TTH (89.3%), pure TTH (88.4%) and pure migraine (76.2%) (pneck pain had higher TTS than individuals without neck pain (15.1±10.5 vs. 8.4±8.0, pNeck pain is highly prevalent in the general population and even more prevalent in individuals with primary headaches. Prevalence is highest in coexistent M+TTH, followed by pure TTH and migraine. Myofascial tenderness is significantly increased in individuals with neck pain. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  13. Understanding Menstrual Migraine.

    Science.gov (United States)

    Calhoun, Anne H

    2018-04-01

    Menstrual-related migraine is very prevalent, very disabling, yet very easy to manage given a good understanding of its cause. This article is intended to help with that understanding and to enable headache specialists to prescribe or create effective hormonal preventives of menstrual-related migraine. © 2018 American Headache Society.

  14. Dietary intake patterns and diet quality in a nationally representative sample of women with and without severe headache or migraine.

    Science.gov (United States)

    Evans, E Whitney; Lipton, Richard B; Peterlin, B Lee; Raynor, Hollie A; Thomas, J Graham; O'Leary, Kevin C; Pavlovic, Jelena; Wing, Rena R; Bond, Dale S

    2015-04-01

    The role of diet in migraine is not well understood. We sought to characterize usual dietary intake patterns and diet quality in a nationally representative sample of women with and without severe headache or migraine. We also examined whether the relationship between migraine and diet differs by weight status. In this analysis, women with migraine or severe headache status was determined by questionnaire for 3069 women, ages 20-50 years, who participated in the National Health and Nutrition Examination Study, 1999-2004. Women who experienced severe headaches or migraines were classified as migraine for the purposes of this analysis. Dietary intake patterns (micro- and macronutrient intake and eating frequency) and diet quality, measured by the Healthy Eating Index, 2005, were determined using one 24-hour dietary recall. Dietary intake patterns did not significantly differ between women with and without migraine. Normal weight women with migraine had significantly lower diet quality (Healthy Eating Index, 2005 total scores) than women without migraine (52.5 ± 0.9 vs. 45.9 ± 1.0; P quality differs by migraine status in normal weight women. Prospective analyses are needed to establish how diet relates to migraine onset, characteristics, and clinical features in individuals of varying weight status. © 2015 American Headache Society.

  15. Comparative efficacy trial of cupping and serkangabin versus conventional therapy of migraine headaches: A randomized, open-label, comparative efficacy trial

    Directory of Open Access Journals (Sweden)

    Mohammad Dehghani Firoozabadi

    2014-01-01

    Full Text Available Background: Migraine headaches are the most common acute and recurrent headaches. Current treatment of a migraine headache consists of multiple medications for control and prevention of recurrent attacks. Global emergence of alternative medicine led us to examine the efficacy of cupping therapy plus serkangabin syrup in the treatment of migraine headaches. Materials and Methods: This study was a randomized, controlled, open-label, comparative efficacy trial. We randomly assigned patients with migraine into cupping therapy plus serkangabin group (30 patients and conventional treatment group (30 patients. An investigator assessed the severity of headache, frequency of attacks in a week and duration of attacks per hour in 5 visits (at the end of 2 weeks, 1, 3 and 6 months. Generalized estimating equations approach was used to analyze repeated measures data to compare outcomes in both groups. Results: Average age for cupping therapy group and conventional treatment group were 31.7 (±7.6 and 32.6 (±12.7 years, respectively (P = 0.45. After treatment for 2 weeks; and 1, 3 and 6 months, severity of headache (P = 0.80, frequency of migraine attacks (P = 0.63 and duration of attacks per hours (P = 0.48 were similar in conventional and cupping groups but these symptoms were decreased in each group during the study (P < 0.001. Conclusion: There was no significant difference between cupping plus serkangabin therapy and conventional treatment in the treatment and prophylaxis of migraine. The alternative therapy may be used in cases of drug intolerance, no medication response, and in primary care.

  16. The acute and preventative treatment of episodic migraine

    Directory of Open Access Journals (Sweden)

    Sarah Miller

    2012-01-01

    Full Text Available Episodic migraine is a common debilitating condition with significant worldwide impact. An effective management plan must include acute treatment to relieve the pain and potential disability associated with the attacks and may also include preventative treatments with an aim of decreasing attack frequency and severity in the longer term. Acute treatments must be limited to a maximum of 2-3 days a week to prevent medication overuse headache and focus on simple analgesia, non-steroidal anti-inflammatory drugs and triptans. Preventative treatments are numerous and should be considered when migraine attacks are frequent and or disabling, acute medication is failing, in special circumstances such as hemiplegic migraines or if the patient requests them. All preventative medications must be given at therapeutic doses for at least 6-8 weeks before an adequate trial can be judged ineffective. The most important factor in choosing drugs is the patient and the clinical features of their attack and treatment should be tailored to these. Relative co-morbidities will influence drug choice, as will the side effect profile and the efficacy of the drug. First line preventative drugs include ß-blockers, amitriptyline and anti-epileptic drugs such as topiramate and valproate. Drugs with lower efficacy or poorer side effect profiles include selective serotonin reuptake inhibitors (SSRIs, calcium channel antagonists, gabapentin and herbal medicines.

  17. Throbbing headache is not always migraine; it can be serious

    Directory of Open Access Journals (Sweden)

    Marcelle G. Meseeha

    2016-10-01

    Full Text Available Cerebral venous thrombosis (CVT is a rare but serious venous thrombotic disorder in the general population. It has an estimated annual incidence of about 4–5 cases per 1 million persons. It is more common in females than males. We describe below a case of a 49-year-old female patient who presented to the emergency room with 1 day history of right-sided throbbing headache associated with vomiting. Computed tomography (CT scan of the head without contrast showed venous sinus thrombosis involving the posterior sagittal sinus, extending into the dominant right transverse sinus, which was confirmed by CT head with intravenous contrast. The patient was immediately started on anticoagulation with therapeutic low-molecular-weight heparin that was transitioned to warfarin. Follow-up CT head 3 months later showed resolution of the thrombus and recanalization of the affected veins. A high level of suspicion for a rare disorder like CVT should be considered as part of the differential diagnosis of headache, which is a commonly encountered problem, because immediate anticoagulation treatment can prevent fatal complications.

  18. 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.

  19. 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

  20. 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 ...

  1. Weight change associated with the use of migraine-preventive medications.

    Science.gov (United States)

    Taylor, Frederick R

    2008-06-01

    Medications administered long term, such as those used for migraine prophylaxis, are often associated with weight change as a side effect. Such effects may compromise general health status, exacerbate coexisting medical conditions, and affect medication adherence. Weight gain should be of particular concern in patients with migraine, as there is evidence that overweight and obese patients with migraine are at risk for an increased frequency and severity of migraine attacks. This article reviews weight-change data from recent clinical studies of migraine-preventive medications in children, adolescents, and adults with migraine. A PubMed search was conducted for English-language articles published between January 1970 and November 2007. Among the search terms were migraine prevention, migraine prophylaxis, migraine treatment, antidepressant drug, beta-adrenergic-receptor blockers, antiepileptic drug, anticonvulsant drug, weight gain, and weight loss. Studies that reported weight-change data (gain, loss, or neutral) were included. When available, double-blind, placebo-controlled studies were selected for review. Open-label, retrospective or prospective trials may also have been included. Most of the migraine-preventive medications classified by the United States Headache Consortium as group 1 based on the high level of evidence for their efficacy--for instance, amitriptyline, propranolol, and divalproex sodium-have been associated with varying degrees of weight gain. The exceptions are timolol, which is weight neutral, and topiramate, which is associated with weight loss. Among the drugs that have been associated with weight gain, a higher incidence of weight gain was observed with amitriptyline and divalproex sodium than with propranolol. Weight-change effects require careful consideration when selecting migraine-preventive medications, and weight should be monitored carefully over the course of any migraine treatment plan.

  2. Migraine and tension type headache in adolescents at grammar school in Germany - burden of disease and health care utilization.

    Science.gov (United States)

    Albers, Lucia; Straube, Andreas; Landgraf, Mirjam N; Filippopulos, Filipp; Heinen, Florian; von Kries, Rüdiger

    2015-01-01

    Tension-type headache and migraine are among the most prevalent chronic disorders in children/adolescents. Data on health care utilization for headache in this age group, however, are sparse. In 1399 grammar school students (aged 12-19 years) with headache in the last six months in Germany a) the burden of disease for headache (mean intensity, mean frequency in the last three months and PedMIDAS means), b) medical care utilization defined by proportion of students consulting a physician in the last 12 months and/or taking analgetic drugs in the last three months by headache types (migraine and tension-type headache) and by burden of disease were assessed. Primary headache substantially impaired daily living activities in adolescents which was mainly related to migraine. Medical care utilization and drug use, however, was low (consulting a physician: 12.0 %, 95 %-CI = [10.3-13.8]; taking analgetic drugs: 29.9 %, 95 %-CI = [27.5-32.4]) - even among students with severe headache (physician consultation: headache and 40 % of those with migraine had neither seen a physician nor used analgetic drugs because of their headache in the preceding 12 months. Adolescents with headache might too rarely seek professional help for treatment of headache. Health promotion in adolescents should increase awareness for evidence-based treatment options for headache.

  3. Anxiety and hopelessness levels in patients with migraine and tension headache

    Directory of Open Access Journals (Sweden)

    Yüksel Kıvrak

    2009-01-01

    Full Text Available Aim: Migraine and tension type headache (TTH are two most common headaches. In this study, we aimed to investigate whether the hopelessness, anxiety and social self-esteem scores are different in two headache groups.Materials and Methods: This study was conducted with 72 migraine patients, 28 TTH patients and 50 healthy controls. Participants filled the General Information Form, Hopeless-ness Scale (HS, Spielberger Trait Anxiety Inventory (STAI-II and Social Comparison Scale (SCS. Results: There were no differences between the groups with respect to gender, age, education years, marital status and economical status. Hopelessness scores of the TTH group was higher than the migraine and control group (p=0.001. There were no statistical differences between the migraine and TTH groups with respect to STAI-II scores but TTH group scores higher in study groups (p=0.003. Control group SCS scores were higher than both patient groups with no significant differences (p=0.072.Conclusion: These findings indicate that the patients with TTH have more hopelessness than the migraine group and more anxious than the healthy control group.

  4. Cognitive processing of visual images in migraine populations in between headache attacks.

    Science.gov (United States)

    Mickleborough, Marla J S; Chapman, Christine M; Toma, Andreea S; Handy, Todd C

    2014-09-25

    People with migraine headache have altered interictal visual sensory-level processing in between headache attacks. Here we examined the extent to which these migraine abnormalities may extend into higher visual processing such as implicit evaluative analysis of visual images in between migraine events. Specifically, we asked two groups of participants--migraineurs (N=29) and non-migraine controls (N=29)--to view a set of unfamiliar commercial logos in the context of a target identification task as the brain electrical responses to these objects were recorded via event-related potentials (ERPs). Following this task, participants individually identified those logos that they most liked or disliked. We applied a between-groups comparison of how ERP responses to logos varied as a function of hedonic evaluation. Our results suggest migraineurs have abnormal implicit evaluative processing of visual stimuli. Specifically, migraineurs lacked a bias for disliked logos found in control subjects, as measured via a late positive potential (LPP) ERP component. These results suggest post-sensory consequences of migraine in between headache events, specifically abnormal cognitive evaluative processing with a lack of normal categorical hedonic evaluation. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Herbal medicines in migraine prevention

    NARCIS (Netherlands)

    DeWeerdt, CJ; Bootsma, HPR; Hendriks, H

    The efficacy of feverfew capsules on migraine prophylaxis was investigated in a randomized double-blind, placebo-controlled crossover study in which 50 patients, who had not used feverfew before, participated. The capsules were filled with a dried alcoholic extract of feverfew on microcristalline

  6. Importance of Pain Acceptance in Relation to Headache Disability and Pain Interference in Women With Migraine and Overweight/Obesity.

    Science.gov (United States)

    Lillis, Jason; Graham Thomas, J; Seng, Elizabeth K; Lipton, Richard B; Pavlović, Jelena M; Rathier, Lucille; Roth, Julie; O'Leary, Kevin C; Bond, Dale S

    2017-05-01

    Pain acceptance involves willingness to experience pain and engaging in valued activities while pain is present. Though pain acceptance could limit both headache-related disability and pain interference in individuals with migraine, few studies have addressed this issue. This study evaluated whether higher levels of total pain acceptance and its two subcomponents, pain willingness and activity engagement, were associated with lower levels of headache-related impairment in women who had both migraine and overweight/obesity. In this cross-sectional study, participants seeking weight loss and headache relief in the Women's Health and Migraine trial completed baseline measures of pain acceptance (Chronic Pain Acceptance Questionnaire [CPAQ]), headache-related disability (Headache Impact Test-6), and pain interference (Brief Pain Inventory). Migraine headache frequency and pain intensity were assessed daily via smartphone diary. Using CPAQ total and subcomponent (pain willingness and activity engagement) scores, headache frequency, pain intensity, and body mass index (BMI) as predictors in linear regression, headache-related disability, and pain interference were modeled as outcomes. On average, participants (n = 126; age = 38.5 ± 8.2 years; BMI = 35.3 ± 6.6 kg/m 2 ) reported 8.4 ± 4.7 migraine days/month and pain intensity of 6.0 ± 1.5 on a 0-10 scale on headache days. After correcting for multiple comparisons (adjusted α = .008), pain willingness was independently associated with both lower headache-related disability (P treatment-seeking women with migraine and overweight/obesity. Future studies are needed to clarify direction of causality and test whether strategies designed to help women increase pain willingness, or relinquish ineffective efforts to control pain, can improve functional outcomes in women who have migraine and overweight/obesity. © 2017 American Headache Society.

  7. Cost and predictors of lost productive time in chronic migraine and episodic migraine: results from the American Migraine Prevalence and Prevention (AMPP) Study.

    Science.gov (United States)

    Serrano, Daniel; Manack, Aubrey N; Reed, Michael L; Buse, Dawn C; Varon, Sepideh F; Lipton, Richard B

    2013-01-01

    To quantify the cost differences and predictors of lost productive time (LPT) in persons with chronic migraine (CM) and episodic migraine (EM). The American Migraine Prevalence and Prevention (AMPP) study is a US national longitudinal survey of severe headache. Cost estimates were obtained via U.S. Census income data. To elucidate the unique predictors of LPT, the optimal distribution for modeling was determined. Zero inflation models for LPT were predicted from sociodemographics, headache features, characteristics and disability, medication use, and depression. The interaction between headache status and age was the primary effect of interest. The eligible sample included 6329 persons with EM and 374 persons with CM. Men with CM aged 45 to 54 years cost employers nearly $200 per week more than do their EM counterparts. Likewise, for women, costs were higher for CM, with the cost differential between EM and CM being $90 per week. After comprehensive adjustment, increases in LPT with age were significantly higher in CM than in EM (rate ratio 1.03; 95% confidence interval 1.01-1.05). When age was recoded to a decade, metric rates of LPT increased 25% more per decade for CM than for EM (rate ratio 1.25; 95% confidence interval 1.004-1.5). LPT is more costly and increases more rapidly for those with CM than for those with EM as age increases. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  8. Quality of life in adolescents with migraine and other headaches

    NARCIS (Netherlands)

    J.H. Langeveld

    1998-01-01

    textabstractIn 1975 Ihe research line "Stress and Migraine" was started at the "Free University", Amsterdam. Later this research program was continued at the Institute for Medical Psychology and Psychotherapy, Erasmus University Rotterdam. A first aim of this research line was to investigate the

  9. Patients' preference in migraine

    NARCIS (Netherlands)

    Dekker, François (Frans)

    2014-01-01

    This thesis is about migraine. Three elements are discussed. First element is preventive treatment, second element is attack treatment and the third part focuses on medication overuse headache. The preventive treatment of migraine is a valuable intervention in primary care. If preventive treatment

  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. Head pain referral during examination of the neck in migraine and tension-type headache.

    Science.gov (United States)

    Watson, Dean H; Drummond, Peter D

    2012-09-01

    To investigate if and to what extent typical head pain can be reproduced in tension-type headache (TTH), migraine without aura sufferers, and controls when sustained pressure was applied to the lateral posterior arch of C1 and the articular pillar of C2, stressing the atlantooccipital and C2-3 segments respectively. Occipital and neck symptoms often accompany primary headache, suggesting involvement of cervical afferents in central pain processing mechanisms in these disorders. Referral of head pain from upper cervical structures is made possible by convergence of cervical and trigeminal nociceptive afferent information in the trigemino-cervical nucleus. Upper cervical segmental and C2-3 zygapophysial joint dysfunction is recognized as a potential source of noxious afferent information and is present in primary headache sufferers. Furthermore, referral of head pain has been demonstrated from symptomatic upper cervical segments and the C2-3 zygapophysial joints, suggesting that head pain referral may be a characteristic of cervical afferent involvement in headache. Thirty-four headache sufferers and 14 controls were examined interictally. Headache patients were diagnosed according the criteria of the International Headache Society and comprised 20 migraine without aura (females n = 18; males n = 2; average age 35.3 years) and 14 TTH sufferers (females n = 11; males n = 3; average age 30.7 years). Two techniques were used specifically to stress the atlantooccipital segments (Technique 1 - C1) and C2-3 zygapophysial joints (Technique 2 - C2). Two techniques were also applied to the arm--the common extensor origin and the mid belly of the biceps brachii. Participants reported reproduction of head pain with "yes" or "no" and rated the intensity of head pain and local pressure of application on a scale of 0 -10, where 0 = no pain and 10 = intolerable pain. None of the subjects reported head pain during application of techniques on the arm. Head pain referral during the

  12. Canadian Headache Society systematic review and recommendations on the treatment of migraine pain in emergency settings.

    Science.gov (United States)

    Orr, Serena L; Aubé, Michel; Becker, Werner J; Davenport, W Jeptha; Dilli, Esma; Dodick, David; Giammarco, Rose; Gladstone, Jonathan; Leroux, Elizabeth; Pim, Heather; Dickinson, Garth; Christie, Suzanne N

    2015-03-01

    There is a considerable amount of practice variation in managing migraines in emergency settings, and evidence-based therapies are often not used first line. A peer-reviewed search of databases (MEDLINE, Embase, CENTRAL) was carried out to identify randomized and quasi-randomized controlled trials of interventions for acute pain relief in adults presenting with migraine to emergency settings. Where possible, data were pooled into meta-analyses. Two independent reviewers screened 831 titles and abstracts for eligibility. Three independent reviewers subsequently evaluated 120 full text articles for inclusion, of which 44 were included. Individual studies were then assigned a US Preventive Services Task Force quality rating. The GRADE scheme was used to assign a level of evidence and recommendation strength for each intervention. We strongly recommend the use of prochlorperazine based on a high level of evidence, lysine acetylsalicylic acid, metoclopramide and sumatriptan, based on a moderate level of evidence, and ketorolac, based on a low level of evidence. We weakly recommend the use of chlorpromazine based on a moderate level of evidence, and ergotamine, dihydroergotamine, lidocaine intranasal and meperidine, based on a low level of evidence. We found evidence to recommend strongly against the use of dexamethasone, based on a moderate level of evidence, and granisetron, haloperidol and trimethobenzamide based on a low level of evidence. Based on moderate-quality evidence, we recommend weakly against the use of acetaminophen and magnesium sulfate. Based on low-quality evidence, we recommend weakly against the use of diclofenac, droperidol, lidocaine intravenous, lysine clonixinate, morphine, propofol, sodium valproate and tramadol. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  13. Migraine--more than a headache: women's experiences of living with migraine.

    Science.gov (United States)

    Rutberg, Stina; Öhrling, Kerstin

    2012-01-01

    In this qualitative study the aim was to explore the meaning of living with migraine. In-depth interviews were conducted with ten women about their experience of living with migraine. Halfway through the interview, the women drew a picture of what living with migraine is like, and the interview continued with the conversation being guided by the picture. The interviews were analyzed using a hermeneutic phenomenological method inspired by van Manen. The analysis revealed an essence "Being obliged to endure a life accompanied by an unpredictable and invisible disorder" and three themes "Being besieged by an attack", "Struggling in a life characterized by uncertainty" and "Living with an invisible disorder." Migraine is a debilitating disorder which accompanies life in the sense that it or the threat of its return is always present, and yet invisible to others. The struggle of enduring life with migraine is worsened by the feeling of having an invisible disorder and of being doubted. There is a need to increase the knowledge among healthcare professionals about what it means to live with migraine, something this qualitative study offers.

  14. Migraine – more than a headache: Women's experiences of living with migraine

    Science.gov (United States)

    Rutberg, Stina; Öhrling, Kerstin

    2012-01-01

    Purpose In this qualitative study the aim was to explore the meaning of living with migraine. Methods In-depth interviews were conducted with ten women about their experience of living with migraine. Halfway through the interview, the women drew a picture of what living with migraine is like, and the interview continued with the conversation being guided by the picture. The interviews were analyzed using a hermeneutic phenomenological method inspired by van Manen. Results The analysis revealed an essence “Being obliged to endure a life accompanied by an unpredictable and invisible disorder" and three themes “Being besieged by an attack” “Struggling in a life characterized by uncertainty"and “Living with an invisible disorder." Conclusions Migraine is a debilitating disorder which accompanies life in the sense that it or the threat of its return is always present, and yet invisible to others. The struggle of enduring life with migraine is worsened by the feeling of having an invisible disorder and of being doubted. There is a need to increase the knowledge among healthcare professionals about what it means to live with migraine, something this qualitative study offers. PMID:21981545

  15. Comparison of validity and reliability of the Migraine disability assessment (MIDAS) versus headache impact test (HIT) in an Iranian population.

    Science.gov (United States)

    Ghorbani, Abbas; Chitsaz, Ahmad

    2011-01-01

    Migraine is one of the most common headaches that affect 11% or more adult population. Recently, researchers have designed two questionnaires, namely Headache Impact Test (HIT) and Migraine Disability Assessment (MIDAS), with the aim of improving migraine care. These two tests provide a standard measurement about migraine's effects on people's life style that divide patients into 4 groups (grades) based on headaches intensity. The aim of this study was to compare the validity and reliability of these two tests. This study was designed as a multicenter, descriptive study to compare validity and reliability of Persian version of MIDAS and HIT questionnaires in 240 males and females with a migraine diagnosis according to criteria for headache and facial pain of the International Headache Society (IHS). The patients were enrolled in the study from 3 neurology clinics in Isfahan, Iran, between July 2004 and January 2005 and were evaluated at baseline (visit 1) and 4 weeks later (visit 2). According to our study, there was a high correlation between two tests (r = 0.94). This decreased their MIDAS grade in comparison to their grade HIT questionnaire. These findings demonstrated that Persian version of HIT have the same validity and reliability as MIDAS. Replying to HIT questionnaire was easier than MIDAS for Iranian patients. Physicians can reliably use the Persian translation of both MIDAS and HIT questionnaires to define the severity of illness and its treatment strategy as a self-administered report by migraine patients. However, we recommend HIT for its simplicity in headache clinics.

  16. Migraine is the most prevalent primary headache in individuals with temporomandibular disorders.

    Science.gov (United States)

    Franco, Ana L; Gonçalves, Daniela A G; Castanharo, Sabrina M; Speciali, José G; Bigal, Marcelo E; Camparis, Cinara M

    2010-01-01

    To assess the prevalence of primary headaches (HA) in adults with temporomandibular disorders (TMD) who were assessed in a specialty orofacial pain clinic, as well as in controls without TMD. The sample consisted of 158 individuals with TMD seen at a university-based specialty clinic, as well as 68 controls. The Research Diagnostic Criteria for TMD were used to diagnose the TMD patients. HAs were assessed using a structured interview and classified according to the Second Edition of the International Classification for Headache Disorders. Data were analyzed by chi-square tests with a significance level of 5% and odds ratio (OR) tests with a 95% confidence interval (CI). HAs occurred in 45.6% of the control group (30.9% had migraine and 14.7% had tension-type headache [TTH]) and in 85.5% of individuals with TMD. Among individuals with TMD, migraine was the most prevalent primary HA (55.3%), followed by TTH (30.2%); 14.5% had no HA. In contrast to controls, the odds ratio (OR) for HA in those with TMD was 7.05 (95% confidence interval [CI] = 3.65-13.61; P = .000), for migraine, the OR was 2.76 (95% CI = 1.50-5.06; P = .001), and for TTH, the OR was 2.51 (95% CI = 1.18-5.35; P = .014). Myofascial pain/arthralgia was the most common TMD diagnosis (53.2%). The presence of HA or specific HAs was not associated with the time since the onset of TMD (P = .714). However, migraine frequency was positively associated with TMD pain severity (P = .000). TMD was associated with increased primary HA prevalence rates. Migraine was the most common primary HA diagnosis in individuals with TMD.

  17. Study of General health, resiliency, and defense mechanisms in patients with migraine headache

    Directory of Open Access Journals (Sweden)

    Alireza Aghayusefi

    2013-06-01

    Full Text Available Background: Migraine is a neurological disease that the etiology, several factors affect its onset or its exacerbation. One of the factors affecting disease is psychological factors such as defense mechanisms, resiliency, and general health. This study assessed the relationship between general health, resiliency, and general defense mechanisms, and also predicts the general health of people with migraine headaches that have a high resiliency and use mature defense mechanisms. Material and Methods: 50 women with migraine headache in the city of Bushehr using defense mechanisms, resiliency, and general health questionnaires were studied. For statistical analysis, Pearson correlation and multiple regression tests were used by SPSS 17 software. Results: The results showed that most of the defense mechanisms of migraine sufferers are Immature and Neuroticism. There is significant negative correlation between the deterioration of general health and resiliency as well as the mature defense mechanism (p=0/003, and also there is a significant positive correlation between this deterioration with neuroticism (p=0/040 and immature defense mechanisms (p=0/041. On the other hand there is significant negative correlation between resiliencies with immature (p=0/009 and neuroticism defense mechanisms (p=0/04, and also with mature defense mechanism has a significant positive correlation (p=0/003. Also, as more people use the mature defense mechanism, their deterioration of general health will be reduced, but this relationship will be stronger with the presence of resiliency. So migraine people use the mature defense mechanisms with high resiliency will have more favorable general health (less deterioration of general health. Conclusion: This study showed that migraine patients use the mature defense mechanisms with high resiliency will have more favorable general health (less deterioration of general health.

  18. Diamine oxidase (DAO) supplement reduces headache in episodic migraine patients with DAO deficiency: A randomized double-blind trial.

    Science.gov (United States)

    Izquierdo-Casas, Joan; Comas-Basté, Oriol; Latorre-Moratalla, M Luz; Lorente-Gascón, Marian; Duelo, Adriana; Soler-Singla, Luis; Vidal-Carou, M Carmen

    2018-02-15

    Histamine intolerance is a disorder in the homeostasis of histamine due to a reduced intestinal degradation of this amine, mainly caused by a deficiency in the enzyme diamine oxidase (DAO). Among histamine related symptoms, headache is one of the most recorded. Current clinical strategies for the treatment of the symptomatology related to this disorder are based on the exclusion of foods with histamine or other bioactive amines and/or exogenous DAO supplementation. The aim of this study was to assess the efficacy of a food supplement consisting of DAO enzyme as a preventive treatment of migraine in patients with DAO deficiency through a randomized double-blind trial. 100 patients with confirmed episodic migraine according to current International Headache Society (IHS) criteria and DAO deficiency (levels below 80 HDU/ml) were randomized in two groups. One group received DAO enzyme supplementation and the other received placebo for one month. Clinical outcomes assessed were duration and number of attacks, perception of pain intensity and adverse effects during treatment. The use of triptans was also recorded. Great variability was found in the duration of migraine attacks reported by placebo and DAO groups. A significant reduction (p = 0.0217) in hours of pain was achieved in patients treated with DAO supplement, with mean durations of 6.14 (±3.06) and 4.76 (±2.68) hours before and after treatment, respectively. A smaller reduction without statistical signification was also observed for this outcome in the placebo group, from 7.53 (±4.24) to 6.68 (±4.42) hours. Only in DAO group, a decrease in the percentage of patients taking triptans was observed. The number of attacks and the scores of pain intensity showed a similar reduction in both groups. No adverse effects were registered in patients treated with DAO enzyme. Migrainous patients supplemented with DAO enzyme during one month significantly reduced the duration of their migraine attacks by 1.4 h. No

  19. Investigation of Psychological Health and Migraine Headaches Among Personnel According to Effort-Reward Imbalance Model

    Directory of Open Access Journals (Sweden)

    Z. Darami

    2012-05-01

    Full Text Available Background and aims: The relationship between physical-mental health and Migraine headaches and stress, especially job stress, is known. Many factors can construct job stress in work settings. The factor that has gained much attention recently is inequality (imbalance of employees’ effort versus the reward they gain. The aim of the current attempt was to investigate the validity of effort-reward imbalance model and indicate the relation of this model with migraine headaches and psychological well-being among subjects in balance and imbalance groups. Methods: Participants were 180 personnel of Oil distribution company located in Isfahan city, and instruments used were General health questionnaire (Goldberg & Hilier, Social Re-adjustment Rating Scale (Holmes & Rahe, Ahvaz Migraine Questionnaire (Najariyan and Effort-reward imbalance scale (Van Vegchel & et al.   Results: The result of exploratory and confirmatory factor analysis for investigating the Construct validity of the effort-reward imbalance model showed that in both analyses, the two factor model was confirmed. Moreover, findings indicate that balance group was in better psychological (p<0/01 and physical (migraine (p<0/05 status comparing to the imbalance group. These findings indicate the significance of justice to present appropriate reward relative to personnel performance on their health.   Conclusion: Implication of these findings can improve Iranian industrial personnel health from both physical and psychological aspects.  

  20. Greater Occipital Nerve Block for Acute Treatment of Migraine Headache: A Large Retrospective Cohort Study.

    Science.gov (United States)

    Allen, Sorcha M; Mookadam, Farouk; Cha, Stephen S; Freeman, John A; Starling, Amaal J; Mookadam, Martina

    2018-01-01

    Greater occipital nerve (GON) blocks are frequently used to treat migraine headaches, although a paucity of supporting clinical evidence exists. The objective of this study was to assess the efficacy of GON block in acute treatment of migraine headache, with a focus on pain relief. This retrospective cohort study was undertaken between January 2009 and August 2014 and included patients who underwent at least 1 GON block and attended at least 1 follow-up appointment. Change in the 11-point numeric pain rating scale (NPRS) was used to assess the response to GON block. Response was defined as "minimal" (50% NPRS point reduction). A total of 562 patients met inclusion criteria; 423 were women (75%). Mean age was 58.6 ± 16.7 years. Of these 562, 459 patients (82%) rated their response to GON block as moderate or significant. No statistically significant relationship existed between previous treatment regimens and response to GON block. GON block was equally effective across the different age and sex groups. Greater occipital block seems to be an effective option for acute management of migraine headache, with promising reductions in pain scores. © Copyright 2018 by the American Board of Family Medicine.

  1. Associations between stress and migraine and tension-type headache: results from a school-based study in adolescents from grammar schools in Germany.

    Science.gov (United States)

    Milde-Busch, Astrid; Blaschek, Astrid; Heinen, Florian; Borggräfe, Ingo; Koerte, Inga; Straube, Andreas; Schankin, Christoph; von Kries, Rüdiger

    2011-05-01

    Stress is considered the major contributor to migraine and tension-type headache in adolescents. Previous studies have focused on general stressors, whereas the aim of the present study was to investigate associations between individuals' stressful experiences and different types of headache. Adolescents from 10th and 11th grades of grammar schools filled in questionnaires. Stressful experiences were measured with the Trier Inventory of Chronic Stress. Type of headache was classified according to the International Classification of Headache Disorders. Linear regressions, adjusted for sex and grade, were calculated to estimate differences in stress scores that can be attributed to migraine, tension-type headache or miscellaneous headache. A total of 1260 questionnaires were analysed. Tension-type headache, migraine and co-existing migraine plus tension-type headache were found in 48.7%, 10.2% and 19.8% of the participants. In subjects with migraine or co-existing migraine plus tension-type headache, high increases in stress scores were found in all investigated dimensions, whereas much weaker and inconsistent associations were found in subjects with tension-type headache only. The characteristic of migraine is more associated with stressful experiences than this is the case for tension-type headache. This suggests that adolescent migraine patients might especially benefit from behavioural interventions regarding stress.

  2. The Use of the Cognitive Behavioral Therapy for the Treatment of Migraine and Tension Type Headaches

    Directory of Open Access Journals (Sweden)

    Yasemin Akkoca

    2015-04-01

    Full Text Available Headache, which affects a large part of the community and causes loss of workforce, is gaining importance in terms of the burden which it brings on the society, by its function of restricting individuals social activities as well as increasing the health expenditure likewise drug consumption. Migraine and tension headaches are primary headaches which any organic causes can not be determined for them. For the treatment of headaches of this type besides the use of medicine, exercises with bio-feedbacks and acupuncture; in recent years cognitive behavioral treatments (CBT appears to be effective. It’s shown that the negative mode of thinking onindividuals which have recurrent headaches, stimulates the headache, increase its severity and complicates the management of it. CBT provides for the person a self-help opportunity even the therapy is terminated, besides behavioral methods such as relaxation exercises, by developing strategies of self-monitoring, education, abilities of pain management and coping with the maladaptive beliefs and houghts. The purpose of this text is, providing information about the use of the cognitive behavioral therapies on primary headaches and basic principles of treatment. [JCBPR 2015; 4(1.000: 10-17

  3. Critical analysis of the use of onabotulinumtoxinA (botulinum toxin type A) in migraine

    OpenAIRE

    Robertson, Carrie E; Garza, Ivan

    2012-01-01

    Carrie E Robertson, Ivan GarzaDepartment of Neurology, Mayo Clinic, Rochester, MN, USAAbstract: OnabotulinumtoxinA, a neurotoxin, has been studied in numerous trials as a novel preventive therapy for migraine headache. The data would support that it may be effective at reducing headache days in patients suffering from chronic migraine (≥15 headache days/month, with eight or more of those migraine headache days). The mechanism by which onabotulinumtoxinA exerts its effects on migraine i...

  4. Atypical dengue meningitis in Makkah, Saudi Arabia with slow resolving, prominent migraine like headache, phobia, and arrhythmia

    Directory of Open Access Journals (Sweden)

    Kalakatawi H Mamdouh

    2013-01-01

    Full Text Available Although dengue meningitis is a rare presentation of dengue infection, our aim is to focus on atypical presentation of dengue meningitis that may appear in dengue endemic area like the Makkah region. We report two cases of clinical meningitis with positive dengue virus (DENV IgM in cerebrospinal fluid, followed for minimal 3 months for their prominent attacks of migraine like headache, phobia, and arrhythmia. With special consideration to attack time, type, severity, and respond to classical therapy, using regular ECG monitoring, visual analog pain score and neuropsychological assessments were done. Both cases showed resistant migraine like headaches to classic anti-migraine therapy except for strong NSAID and narcotics with tendency to have severe to extreme severe daily migraine like headache on early to late afternoon time, associated with non-fatal arrhythmias and extreme death phobia, that resolve slowly in a minimal 3 month period. In conclusion, dengue meningitis in the endemic area may present atypically.

  5. The Relationship between Sleep Quality and Academic Achievement with Migraine Headaches among Alborz Medical Sciences University Students

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    Leila Sadati

    2017-03-01

    Full Text Available Background : Considering the issue of sleep quality in medical students as a stratum of society who are concerned with human health and its relationship with other psychological variables (in particular academic achievement and headaches seems essential. So, the present study was done to evaluate the relationship between Sleep Quality and academic achievement with migraine headaches. Materials and Methods: The present study was descriptive _ correlation. The population in this study includes all the students in Alborz Medical Sciences University in the academic year of 2014. 256 students (156 females and 100 males who were selected according to research entrance criteria by stratified sampling method; and they answered to the Sleep of Quality Test and Examine Migraine Headaches Symptom Questionnaires. Also, the mean of first term scores were considered as an index of the academic achievement. The data were analyzed by SPSS 19 software. Results: The results showed that there were statistically significant correlation between migraine headaches with academic achievement, Sleep of Quality and substandard mental sleep quality, delay into going to sleep, sleep disorders, taking hypnotic pills, and daily function disorder; and sleep disorders, daily function disorder, academic achievement and taking hypnotic pills could predict and explain 25/6 changes associated to migraine headaches. Conclusion: Those students with inappropriate Sleep of Quality; they experienced more migraine headaches and failure in academic achievements.

  6. Migraine Trainers as Models: the effectiveness of Lay trainerswith migraine for behavioural attack prevention

    NARCIS (Netherlands)

    S.Y.M. Mérelle (Saskia)

    2008-01-01

    textabstractMigraine is a chronic brain disorder, characterized by attacks of severe headache accompanied by nausea, vomiting and sensitivity to light, sound and smell. Attacks can be preceded by premonitory symptoms such as fatigue, muscular stiff ness or negative aff ect. It has been shown that

  7. Migraine-preventive prescription patterns by physician specialty in ambulatory care settings in the United States.

    Science.gov (United States)

    Takaki, Hiroko; Onozuka, Daisuke; Hagihara, Akihito

    2018-03-01

    Many adults with migraine who require preventive therapy are often not prescribed the proper medications. The most likely reason is that primary care physicians are unacquainted with preventive medications for migraine. The present study assessed the migraine-preventive prescription patterns in office visits using data from the National Ambulatory Medical Care Survey from 2006 to 2009 in the United States. Patients who were 18 years or older and diagnosed with migraine were included in the analysis. In accordance with the recommendations of the headache guidelines, we included beta-blockers, antidepressants, triptans for short-term prevention of menstrual migraine, and other triptans for acute treatment. Weighted visits of adults with migraine prescribed with preventive medication ranged from 32.8% in 2006 to 38.6% in 2009. Visits to primary care physicians accounted for 72.6% of the analyzed adult migraine visits. Anticonvulsants (odds ratio [OR] 0.29, 95% confidence interval [CI] 0.14-0.57, p  < 0.001) and triptans for menstrual migraine (OR 0.50, 95% CI 0.28-0.91, p  = 0.025) were less frequently prescribed by primary care physicians compared with specialty care physicians, such as neurologists and psychiatrists. There were no significant differences in the prescription patterns of antidepressants and beta-blockers between primary and specialty care physicians. Beta-blockers were prescribed to patients with comorbidity of hypertension, and antidepressants were used by patients with comorbidity of depression. There are differences in the prescription patterns of certain type of preventive medications between primary care physicians and specialty care physicians.

  8. Migraine-preventive prescription patterns by physician specialty in ambulatory care settings in the United States

    Directory of Open Access Journals (Sweden)

    Hiroko Takaki

    2018-03-01

    Full Text Available Many adults with migraine who require preventive therapy are often not prescribed the proper medications. The most likely reason is that primary care physicians are unacquainted with preventive medications for migraine. The present study assessed the migraine-preventive prescription patterns in office visits using data from the National Ambulatory Medical Care Survey from 2006 to 2009 in the United States. Patients who were 18 years or older and diagnosed with migraine were included in the analysis. In accordance with the recommendations of the headache guidelines, we included beta-blockers, antidepressants, triptans for short-term prevention of menstrual migraine, and other triptans for acute treatment. Weighted visits of adults with migraine prescribed with preventive medication ranged from 32.8% in 2006 to 38.6% in 2009. Visits to primary care physicians accounted for 72.6% of the analyzed adult migraine visits. Anticonvulsants (odds ratio [OR] 0.29, 95% confidence interval [CI] 0.14–0.57, p < 0.001 and triptans for menstrual migraine (OR 0.50, 95% CI 0.28–0.91, p = 0.025 were less frequently prescribed by primary care physicians compared with specialty care physicians, such as neurologists and psychiatrists. There were no significant differences in the prescription patterns of antidepressants and beta-blockers between primary and specialty care physicians. Beta-blockers were prescribed to patients with comorbidity of hypertension, and antidepressants were used by patients with comorbidity of depression. There are differences in the prescription patterns of certain type of preventive medications between primary care physicians and specialty care physicians.

  9. Efficacy and feasibility of antidepressants for the prevention of migraine in adults: a meta-analysis.

    Science.gov (United States)

    Xu, X-M; Yang, C; Liu, Y; Dong, M-X; Zou, D-Z; Wei, Y-D

    2017-08-01

    Migraine has greatly impacted the quality of life for migraineurs and was ranked as the seventh highest specific cause of disability worldwide in 2012. Because of the role of serotonin in migraine mechanisms, antidepressants have been used in the prevention of migraine. However, the role of antidepressants for migraine prophylaxis in adults has not been completely established. Our aim was systematically to assess the efficacy and feasibility of antidepressants for the prevention of migraine in adults based on currently available literature. A comprehensive search of databases was conducted including the Cochrane, PubMed, Web of Science and Embase databases from inception to July 2016. Randomized controlled trials that assigned adults with a clinical diagnosis of migraine to antidepressant or placebo treatment were included. The primary outcome was the reduction of migraine frequency or index. Overall, 16 randomized controlled trials including 1082 participants were identified. Antidepressants had a significant advantage over placebo in reducing the migraine frequency or index of adults with a standardized mean difference of -0.79 [95% confidence interval (CI) -1.13 to -0.45, P < 0.00001]. Patients receiving antidepressant therapy were more likely to experience an at least 50% reduction of headache burden than those receiving placebo (28.9% vs. 20.2%; risk ratio 1.40; 95% CI 0.97-2.02; P = 0.07). However, antidepressants were less well tolerated than placebo because of some adverse events (risk ratio 1.74, 95% CI 1.05-2.89, P = 0.03). Antidepressants are effective in the prophylaxis of migraine in adults, but the level of evidence for antidepressants except for amitriptyline seems to be quite shaky. © 2017 EAN.

  10. Real-time sharing and expression of migraine headache suffering on Twitter: a cross-sectional infodemiology study.

    Science.gov (United States)

    Nascimento, Thiago D; DosSantos, Marcos F; Danciu, Theodora; DeBoer, Misty; van Holsbeeck, Hendrik; Lucas, Sarah R; Aiello, Christine; Khatib, Leen; Bender, MaryCatherine A; Zubieta, Jon-Kar; DaSilva, Alexandre F

    2014-04-03

    Although population studies have greatly improved our understanding of migraine, they have relied on retrospective self-reports that are subject to memory error and experimenter-induced bias. Furthermore, these studies also lack specifics from the actual time that attacks were occurring, and how patients express and share their ongoing suffering. As technology and language constantly evolve, so does the way we share our suffering. We sought to evaluate the infodemiology of self-reported migraine headache suffering on Twitter. Trained observers in an academic setting categorized the meaning of every single "migraine" tweet posted during seven consecutive days. The main outcome measures were prevalence, life-style impact, linguistic, and timeline of actual self-reported migraine headache suffering on Twitter. From a total of 21,741 migraine tweets collected, only 64.52% (14,028/21,741 collected tweets) were from users reporting their migraine headache attacks in real-time. The remainder of the posts were commercial, re-tweets, general discussion or third person's migraine, and metaphor. The gender distribution available for the actual migraine posts was 73.47% female (10,306/14,028), 17.40% males (2441/14,028), and 0.01% transgendered (2/14,028). The personal impact of migraine headache was immediate on mood (43.91%, 6159/14,028), productivity at work (3.46%, 486/14,028), social life (3.45%, 484/14,028), and school (2.78%, 390/14,028). The most common migraine descriptor was "Worst" (14.59%, 201/1378) and profanity, the "F-word" (5.3%, 73/1378). The majority of postings occurred in the United States (58.28%, 3413/5856), peaking on weekdays at 10:00h and then gradually again at 22:00h; the weekend had a later morning peak. Twitter proved to be a powerful source of knowledge for migraine research. The data in this study overlap large-scale epidemiological studies, avoiding memory bias and experimenter-induced error. Furthermore, linguistics of ongoing migraine reports

  11. Importance of Pain Acceptance in Relation to Headache Disability and Pain Interference in Women with Migraine and Overweight/Obesity

    Science.gov (United States)

    Lillis, Jason; Thomas, J. Graham; Seng, Elizabeth K.; Lipton, Richard B.; Pavlovic, Jelena; Rathier, Lucille; Roth, Julie; O’Leary, Kevin C.; Bond, Dale S.

    2018-01-01

    BACKGROUND Pain acceptance involves willingness to experience pain and engaging in valued activities while pain is present. Though pain acceptance could limit both headache-related disability and pain interference in individuals with migraine, few studies have addressed this issue. The current study evaluated whether higher levels of total pain acceptance and it’s 2 subcomponents, pain willingness and activity engagement, were associated with lower levels of headache-related impairment in women who had both migraine and overweight/obesity. METHODS In this cross-sectional study, participants seeking weight loss and headache relief in the Women’s Health and Migraine (WHAM) trial completed baseline measures of pain acceptance (Chronic Pain Acceptance Questionnaire [CPAQ]), headache-related disability (Headache Impact Test-6 [HIT-6]), and pain interference (Brief Pain Inventory [BPI]). Migraine headache frequency and pain intensity were assessed daily via smartphone diary. Using CPAQ total and subcomponent (pain willingness and activity engagement) scores, headache frequency, pain intensity, and BMI as predictors in linear regression, headache-related disability and pain interference were modeled as outcomes. RESULTS On average, participants (n=126; age=38.5±8.2 years; BMI=35.3±6.6 kg/m2) reported 8.4±4.7 migraine days/month and pain intensity of 6.0±1.5 on a 0–10 scale on headache days. After correcting for multiple comparisons (adjusted α=.008), pain willingness was independently associated with both lower headache related disability (pheadache related disability (p=.128; β= −.138) and pain interference (p=.042; β= −.154). CPAQ Total Score was not associated with headache related disability (p=.439; β=.066) and pain interference (p=.305; β=.074). Pain intensity was significantly associated with outcomes in all analyses (p’s headache-related disability and general pain interference in treatment-seeking women with migraine and overweight

  12. Attacks of common migraine or hortons headache may not be accompanied by changes in regional cerebral blood flow

    International Nuclear Information System (INIS)

    Henriksen, L.; Aebelholt Krabbe, A.; Tfelt-Hansen, P.; Olesen, J.

    1982-01-01

    Vasospasm and cerebral ischemia, followed by cerebral and extracerebral vasodilation and hyperemia, are generally believed to form the common pathophysiology of the various subtypes of migraine. Mild forms of reactions are thought to result in common migraine (no neurological prodromes or accompaniments), and more severe reactions are thought to induce classical migraine. 8 induced common migraine attacks in 6 patients do not support this unitarian view, as no regional cerebral blood flow changes was found, but suggests a different pathophysiology in common migraine compaired to classical migraine. There are few features in Hortons headache to incriminate the cerebral vessels, and generally patients do not have symptoms attributable to cerebral involvement. In 6 out of 14 patients with known Hortons headache we succesfully induced an attack after alcohol alone or in combination with sublingual nitroglycerine. A slight hyperventilation occurred during the attack, correcting cerebral blood flow for these changes left mean CBF totally unchanged. No regional abnormalities occurred in any of the about 700 regions measured from during each investigation in neither the group with common migraine, nor in the patients with Hortons headache. (Author)

  13. Cardiovascular responses to cognitive stress in patients with migraine and tension-type headache

    Directory of Open Access Journals (Sweden)

    Nilsen Kristian B

    2007-08-01

    Full Text Available Abstract Background The purpose of this study was to investigate the temporal relationship between autonomic changes and pain activation in migraine and tension-type headache induced by stress in a model relevant for everyday office-work. Methods We measured pain, blood pressure (BP, heart rate (HR and skin blood flow (BF during and after controlled low-grade cognitive stress in 22 migraineurs during headache-free periods, 18 patients with tension-type headache (TTH and 44 healthy controls. The stress lasted for one hour and was followed by 30 minutes of relaxation. Results Cardiovascular responses to cognitive stress in migraine did not differ from those in control subjects. In TTH patients HR was maintained during stress, whereas it decreased for migraineurs and controls. A trend towards a delayed systolic BP response during stress was also observed in TTH. Finger BF recovery was delayed after stress and stress-induced pain was associated with less vasoconstriction in TTH during recovery. Conclusion It is hypothesized that TTH patients have different stress adaptive mechanisms than controls and migraineurs, involving delayed cardiovascular adaptation and reduced pain control system inhibition.

  14. Ecological momentary assessment of the relationship between headache pain intensity and pain interference in women with migraine and obesity.

    Science.gov (United States)

    Thomas, J Graham; Pavlovic, Jelena; Lipton, Richard B; Roth, Julie; Rathier, Lucille; O'Leary, Kevin C; Buse, Dawn C; Evans, E Whitney; Bond, Dale S

    2016-11-01

    Background While pain intensity during migraine headache attacks is known to be a determinant of interference with daily activities, no study has evaluated: (a) the pain intensity-interference association in real-time on a per-headache basis, (b) multiple interference domains, and (c) factors that modify the association. Methods Participants were 116 women with overweight/obesity and migraine seeking behavioral treatment to lose weight and decrease headaches in the Women's Health and Migraine trial. Ecological momentary assessment, via smartphone-based 28-day headache diary, and linear mixed-effects models were used to study associations between pain intensity and total- and domain-specific interference scores using the Brief Pain Inventory. Multiple factors (e.g. pain catastrophizing (PC) and headache management self-efficacy (HMSE)) were evaluated either as independent predictors or moderators of the pain intensity-interference relationship. Results Pain intensity predicted degree of pain interference across all domains either as a main effect (coeff = 0.61-0.78, p < 0.001) or interaction with PC, allodynia, and HMSE ( p < 0.05). Older age and greater allodynia consistently predicted higher interference, regardless of pain intensity (coeff = 0.04-0.19, p < 0.05). Conclusions Pain intensity is a consistent predictor of pain interference on migraine headache days. Allodynia, PC, and HMSE moderated the pain intensity-interference relationship, and may be promising targets for interventions to reduce pain interference.

  15. A multicenter, prospective, single arm, open label, observational study of sTMS for migraine prevention (ESPOUSE Study).

    Science.gov (United States)

    Starling, Amaal J; Tepper, Stewart J; Marmura, Michael J; Shamim, Ejaz A; Robbins, Matthew S; Hindiyeh, Nada; Charles, Andrew C; Goadsby, Peter J; Lipton, Richard B; Silberstein, Stephen D; Gelfand, Amy A; Chiacchierini, Richard P; Dodick, David W

    2018-05-01

    Objective To evaluate the efficacy and tolerability of single pulse transcranial magnetic stimulation (sTMS) for the preventive treatment of migraine. Background sTMS was originally developed for the acute treatment of migraine with aura. Open label experience has suggested a preventive benefit. The objective of this trial was to evaluate the efficacy and tolerability of sTMS for migraine prevention. Methods The eNeura SpringTMS Post-Market Observational U.S. Study of Migraine (ESPOUSE) Study was a multicenter, prospective, open label, observational study. From December 2014 to March 2016, patients with migraine (n = 263) were consented to complete a 1-month baseline headache diary followed by 3 months of treatment. The treatment protocol consisted of preventive (four pulses twice daily) and acute (three pulses repeated up to three times for each attack) treatment. Patients reported daily headache status, medication use, and device use with a monthly headache diary. The primary endpoint, mean reduction of headache days compared to baseline, was measured over the 28-day period during weeks 9 to 12. The primary endpoint was compared to a statistically-derived placebo estimate (performance goal). Secondary endpoints included: 50% responder rate, acute headache medication consumption, HIT-6, and mean reduction in total headache days from baseline of any intensity. Results Of a total of 263 consented subjects, 229 completed a baseline diary, and 220 were found to be eligible based on the number of headache days. The device was assigned to 217 subjects (Safety Data Set) and 132 were included in the intention to treat Full Analysis Set. For the primary endpoint, there was a -2.75 ± 0.40 mean reduction of headache days from baseline (9.06 days) compared to the performance goal (-0.63 days) ( p < 0.0001). The 50% responder rate of 46% (95% CI 37%, 56%) was also significantly higher ( p < 0.0001) than the performance goal (20%). There was a reduction of -2

  16. The effects of aerobic exercise for persons with migraine and co-existing tension-type headache and neck pain. A randomized, controlled, clinical trial

    DEFF Research Database (Denmark)

    Krøll, Lotte Skytte; Hammarlund, Catharina Sjödahl; Linde, Mattias

    2018-01-01

    Aim To evaluate aerobic exercise in migraine and co-existing tension-type headache and neck pain. Methods Consecutively recruited persons with migraine and co-existing tension-type headache and neck pain were randomized into an exercise group or control group. Aerobic exercise consisted of bike...

  17. The Headache Action Plan Project for Youth (HAPPY): School Nurses as Facilitators of System Change in Pediatric Migraine Care.

    Science.gov (United States)

    Connelly, Mark; Bickel, Jennifer; Wingert, Tammie; Galemore, Cynthia

    2018-01-01

    Migraine is a common health problem in youth that is ranked highest for disability among neurological conditions and is one of the leading reasons for school absences. Children with migraines frequently are seen by the school nurse for care, sometimes before ever being seen by another healthcare provider for evaluation and treatment. As such, school nurses have the unique opportunity to provide education and resources to children with migraines and their family. This article provides information on the Headache Action Plan Program for Youth (HAPPY), a project involving the provision of live and online migraine education and management resources to school nurses, children, families, and primary care providers in an effort to improve migraine recognition and care in the community.

  18. Prevalence of right-to-left shunts on transcranial Doppler in chronic migraine and medication-overuse headache

    DEFF Research Database (Denmark)

    Guo, Song; Shalchian, Sarvnaz; Gérard, Pascale

    2014-01-01

    BACKGROUND: It was suggested that right-to-left shunt (RLS) may be highly prevalent in chronic migraine (CM) patients, indicating that patent foramen ovale (PFO) might be an aggravating and chronifying factor of migraine. Since a high proportion of chronic migraineurs also have medication...... prevalence in CM is within the upper range of those reported in episodic migraine without aura or in the general population, and not higher in MOH. PFO is thus unlikely to have a significant causal role in these chronic headaches....

  19. Level of physical activity, well-being, stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain.

    Science.gov (United States)

    Krøll, Lotte Skytte; Hammarlund, Catharina Sjödahl; Westergaard, Maria Lurenda; Nielsen, Trine; Sloth, Louise Bönsdorff; Jensen, Rigmor Højland; Gard, Gunvor

    2017-12-01

    The prevalence of migraine with co-existing tension-type headache and neck pain is high in the general population. However, there is very little literature on the characteristics of these combined conditions. The aim of this study was to investigate a) the prevalence of migraine with co-existing tension-type headache and neck pain in a clinic-based sample, b) the level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain compared to healthy controls, c) the perceived ability of persons with migraine and co-existing tension-type headache and neck pain to perform physical activity, and d) which among the three conditions (migraine, tension-type headache or neck pain) is rated as the most burdensome condition. The study was conducted at a tertiary referral specialised headache centre where questionnaires on physical activity, psychological well-being, perceived stress and self-rated health were completed by 148 persons with migraine and 100 healthy controls matched by sex and average age. Semi-structured interviews were conducted to assess characteristics of migraine, tension-type headache and neck pain. Out of 148 persons with migraine, 100 (67%) suffered from co-existing tension-type headache and neck pain. Only 11% suffered from migraine only. Persons with migraine and co-existing tension-type headache and neck pain had lower level of physical activity and psychological well-being, higher level of perceived stress and poorer self-rated health compared to healthy controls. They reported reduced ability to perform physical activity owing to migraine (high degree), tension-type headache (moderate degree) and neck pain (low degree). The most burdensome condition was migraine, followed by tension-type headache and neck pain. Migraine with co-existing tension-type headache and neck pain was highly prevalent in a clinic-based sample. Persons with migraine and co

  20. Clinical characteristics of migraine and episodic tension-type headache in relation to old and new diagnostic criteria

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg; Langemark, M; Andersson, P G

    1990-01-01

    Eighty-one patients were diagnosed as having migraine, tension headache or both according to previously used criteria. Then we performed a standardized interview to determine the frequency and severity of headache characteristics used in the new operational diagnostic criteria of the International...... Headache Society (IHS). In every patient the original diagnosis fulfilled also the IHS criteria, but in 9 patients the criteria were only fulfilled in half or less of the attacks, and applying the IHS criteria they also achieved an additional diagnosis. In one patient these attacks did not fulfill the pain...... criteria and in 8 (4 migraine, 4 tension headache) they did not fulfill the criteria for accompanying symptoms. Overall the IHS criteria are sensitive and specific, but they may possibly be improved with regard to accompanying symptoms. The present study suggests that recording of frequency and graded...

  1. Migraine and Common Morbidities

    Science.gov (United States)

    ... routine eating and drinking habits. Prolonged periods of fasting, dehydration, or hyperglycemia (too much sugar) may all ... More › Related Articles Retinal Migraine Tinnitus and Headache Obesity and Migraine Abdominal Migraine Opioid Narcotics and Headache ...

  2. The Relationship between Sleep Quality and Academic Achievement with Migraine Headaches among Alborz Medical Sciences University Students

    OpenAIRE

    Leila Sadati; Katayon Bakhteyar; Meysam Saadatmand; Saeid Saadatmand; Saeid Asadnia

    2017-01-01

    Background : Considering the issue of sleep quality in medical students as a stratum of society who are concerned with human health and its relationship with other psychological variables (in particular academic achievement and headaches) seems essential. So, the present study was done to evaluate the relationship between Sleep Quality and academic achievement with migraine headaches. Materials and Methods: The present study was descriptive _ correlation. The population in this study incl...

  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. A Rare Cause of Chronic Headache that May Be Misdiagnosed as Migraine: Chronic Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Mehmet Kenan KANBUROGLU

    2014-09-01

    Full Text Available SUMMARY: Differential diagnosis of primary headache disorders can be challenging for physicians. Although the association of headache with acute carbon monoxide intoxication is very well-defined, in refractory nonspecific headaches associated with chronic low dose exposure to carbon monoxide, CO intoxication is usually overlooked, mostly due to vague symptoms. Herein we present a 15-year-old female patient with chronic carbon monoxide poisoning who was undergoing two years of follow-up care for migraines. Chronic carbon monoxide intoxication may mimic the episodic nature and familial predisposition of migraine attacks. Normal carboxyhemoglobin levels do not exclude the diagnosis, and smoking is a confounding factor. In emergency rooms, patients presenting with headaches had higher levels of carboxyhemoglobin, but, as far as we know, there have been no studies investigating carboxyhemoglobin levels in migraine patients. Chronic carbon monoxide poisoning should be suspected in migraine patients, especially if the attacks occur during winter months. ÖZET: Primer baş ağrısında ayırıcı tanının yapılması bazen doktorlar açısından zor olabilmektedir. Literatürde karbon monoksit ile baş ağrısı arasındaki ilişki çok iyi ortaya konulmuş olmasına karşın, dirençli ve nonspesifik başağrısı nedenlerinden biri olan kronik düşük doz karbon monoksit maruziyeti kendine özgü bulgusu olmadığından sıklıkla atlanmaktadır. Bu yazıda, iki yıl migren tanısı ile takip ve tedavi edilen kronik karbon monoksit zehirlenmesi olan bir olgu sunuldu. Kronik karbon monoksit zehirlenmesi epizodik paterni ve aile fertlerinde benzer şikayetlerin olması nedeniyle migren ataklarını andırabilmektedir. Karboksihemoglobin konsantrasyonlarının normal saptanması tanıyı ekarte ettirmemekte, ayrıca sigara kullanımı da karıştırıcı bir faktör olabilmektedir. Acil servislerine baş ağrısı ile başvuran hastalar

  5. 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.

  6. Effect of Prayer on Intensity of Migraine Headache: A Randomized Clinical Trial.

    Science.gov (United States)

    Tajadini, Haleh; Zangiabadi, Nasser; Divsalar, Kouros; Safizadeh, Hossein; Esmaili, Zahra; Rafiei, Hossein

    2017-01-01

    Migraine is a common form of headache that affects patients quality of life negatively. In addition to pharmacologic treatment, there are a variety of nonpharmacologic treatments for migraine headache. In present study, we examined the effect of prayer on intensity of migraine pain. In a prospective, randomized, controlled trial from October 2013 to June 2014, this study has been conducted in Kerman, Iran. We randomly assigned 92 patients in 2 groups to receive either 40 mg of propranolol twice a day for 2 month (group "A") or 40 mg of propranolol twice a day for 2 months with prayer (group "B"). At the beginning of study and 3 months after intervention, patients' pain was measured using the visual analogue scale. At the beginning of study and before intervention, the mean score of pain in patients in groups A and B were 5.7 ± 1.6 and 6.5 ± 1.9, respectively. According to results of independent t test, mean score of pain intensity at the beginning of study were similar between patients in 2 groups (P > .05). Three month after intervention, mean score of pain intensity decreased in patients in both groups. At this time, the mean scores of pain intensity were 5.4 ± 1.1 and 4.2 ± 2.3 in patients in groups A and B, respectively. This difference between groups was statistically significant (P prayer can be used as a nonpharmacologic pain coping strategy in addition to pharmacologic intervention for this group of patients. © The Author(s) 2016.

  7. Migraine Headache and Ischemic Stroke Risk: An Updated Meta-analysis

    Science.gov (United States)

    Spector, June T.; Kahn, Susan R.; Jones, Miranda R.; Jayakumar, Monisha; Dalal, Deepan; Nazarian, Saman

    2010-01-01

    Background Observational studies, including recent large cohort studies which were unavailable for prior meta-analysis, have suggested an association between migraine headache and ischemic stroke. We performed an updated meta-analysis to quantitatively summarize the strength of association between migraine and ischemic stroke risk. Methods We systematically searched electronic databases, including MEDLINE and EMBASE, through February 2009 for studies of human subjects in the English language. Study selection using a priori selection criteria, data extraction, and assessment of study quality were conducted independently by reviewer pairs using standardized forms. Results Twenty-one (60%) of 35 studies met the selection criteria, for a total of 622,381 participants (13 case-control, 8 cohort studies) included in the meta-analysis. The pooled adjusted odds ratio of ischemic stroke comparing migraineurs to non-migraineurs using a random effects model was 2.30 (95% confidence interval [CI], 1.91-2.76). The pooled adjusted effect estimates for studies that reported relative risks and hazard ratios, respectively, were 2.41 (95% CI, 1.81-3.20) and 1.52 (95% CI, 0.99-2.35). The overall pooled effect estimate was 2.04 (95% CI, 1.72-2.43). Results were robust to sensitivity analyses excluding lower quality studies. Conclusions Migraine is associated with increased ischemic stroke risk. These findings underscore the importance of identifying high-risk migraineurs with other modifiable stroke risk factors. Future studies of the effect of migraine treatment and modifiable risk factor reduction on stroke risk in migraineurs are warranted. PMID:20493462

  8. Personality traits in patients with cluster headache: a comparison with migraine patients.

    Science.gov (United States)

    Muñoz, I; Hernández, M S; Santos, S; Jurado, C; Ruiz, L; Toribio, E; Sotelo, E M; Guerrero, A L; Molina, V; Uribe, F; Cuadrado, M L

    2016-01-01

    Cluster headache (CH) has been associated with certain personality traits and lifestyle features, but there are few studies assessing personality profiles in CH. We aimed to analyze personality traits in patients with CH, and to compare them with those found in migraine. We included all consecutive patients with CH attending 5 outpatient offices between January and December 2013. Personality traits were evaluated using the Salamanca screening test, a validated inventory assessing 11 personality traits grouped in 3 clusters. We analyzed the test results in this population, and compared them with those of a migraine population previously assessed with the same test. Eighty patients with CH (75 men, 5 women; mean age, 43.2 ± 9.9 years) were recruited. The reference population consisted of 164 migraine patients (30 men, 134 women; mean age 36.4 ± 12.7 years). In CH patients, the most frequent personality traits were anancastic (52.5 %), anxious (47.5 %), histrionic (45 %), schizoid (42.5 %), impulsive (32.5 %) and paranoid (30 %). When compared to migraine patients, paranoid (p traits (p = 0.007; χ2 test) were significantly more prevalent in CH patients. In logistic regression analysis the paranoid trait was significantly associated with CH (p = 0.001; OR: 3.27, 95 % CI [1.66-6.43]). According to the Salamanca screening test, personality traits included in cluster A (odd or eccentric disorders) are more prevalent in CH patients than in a population of migraineurs. Larger studies are needed to determine whether certain personality traits are related to CH.

  9. Primary intracranial angiomatoid fibrous histiocytoma presenting with anaemia and migraine-like headaches and aura as early clinical features

    DEFF Research Database (Denmark)

    Hansen, Jakob Møller; Larsen, Vibeke Andrée; Scheie, David

    2015-01-01

    A 17-year-old female with migraine with aura complained of fatigue and was diagnosed with anemia. Three years later, changes in her headache pattern prompted hospital referral. Brain MRI showed a bi-lobed extra-axial intracerebral tumor encroaching both parieto-occipital regions. The resection...

  10. 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

  11. 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

  12. International Classification of Headache Disorders 3rd edition beta-based field testing of vestibular migraine in China: Demographic, clinical characteristics, audiometric findings and diagnosis statues.

    Science.gov (United States)

    Zhang, Yixin; Kong, Qingtao; Chen, Jinjin; Li, Lunxi; Wang, Dayan; Zhou, Jiying

    2016-03-01

    This study explored the clinical characteristics of vestibular migraine in Chinese subjects and performed a field test of the criteria of the International Classification of Headache Disorders 3rd edition beta version. Consecutive patients with vestibular migraine were surveyed and registered in a headache clinic during the study period. The diagnosis of vestibular migraine was made according to International Classification of Headache Disorders 3rd edition beta version. Assessments included standardized neuro-otology bedside examination, pure-tone audiogram, bithermal caloric testing, neurological imaging, cervical X-ray or magnetic resonance imaging, Doppler ultrasound of cerebral arteries and laboratory tests. A total of 67 patients (62 female/five male, 47.8 ± 10.3 years old) were enrolled in this study. The mean ages of migraine and vertigo onset were 32.2 ± 11.5 and 37.9 ± 10.1 years, respectively. The most common migraine subtype was migraine without aura (79%), followed by migraine with aura (12%) and chronic migraine (9%). The duration of vertigo attacks varied from seconds to days and 25% of patients had attacks that lasted less than 5 minutes. Among the patients with short-lasting attacks, 75% of these patients had ≥5 attacks per day within 72 hours. Auditory symptoms were reported in 36% of the patients. Migraine prophylactic treatments were effective in 77% of the patients. Our study showed that the clinical features of vestibular migraine in China were similar to those of Western studies. The definition of vertigo episodes and migraine subtypes of vestibular migraine in International Classification of Headache Disorders 3rd edition beta version might be modified further. More than five vertigo attacks per day within 72 hours might be helpful as far as identifying vestibular migraine patients with short-lasting attacks. © International Headache Society 2015.

  13. Histamine metabolism in cluster headache and migraine. Catabolism of /sup 14/C histamine

    Energy Technology Data Exchange (ETDEWEB)

    Sjaastad, O; Sjaastad, O V

    1977-09-12

    Various parameters of histamine metabolism were studied in patients with migraine, cluster headache and chronic paroxysmal hemicrania. These included urinary excretion of radioactivity and of /sup 14/C histamine and its metabolites, exhaled /sup 14/CO/sub 2/ and fecal radioactivity after oral as well as subcutaneous administration of radioactive histamine. No marked deviation from the normal was found except in one patient with the cluster headache variant, chronic paroxysmal hemicrania, in whom an aberration in /sup 14/C histamine degradation seemed to be present. Only minute quantities of the /sup 14/C histamine metabolite C14 imidazoleacetic acid riboside seemed to be formed during a period with severe paraxysms. During a symptom-free period no deviation from normal was observed. The most likely explanation for this finding seems to be a defect in the conversion of imidazoleacetic acid to its riboside. This defect may possibly explain the increased urinary excretion of histamine in this particular patient. The relationship of this metabolic aberration to the production of headache still remains dubious for various reasons.

  14. MIGRAINE: BASIC PRINCIPLES OF TREATMENT AND PREVENTION

    Directory of Open Access Journals (Sweden)

    O. R. Esin

    2011-01-01

    Full Text Available Modern recommendations for the migraine attack treatment and it's prophylaxis are analyzed in this review. Established, that acetylsalicylic acid, diclofenac potassium, ibuprofen, naproxen, paracetamol, metamizol and their combination with caffeine are drugs of the first choice for migraine attack treatment. Metoclopramide and domperidone are used to reduce nausea and vomiting. Also triptans are high effective drugs for migraine attack treatment. Metoprolol, propranolol, flunarizine, valproic acid can be used for migraine prophylaxis. Drugs of the second choice are: amitriptyline, venlafaxine, naproxen and bisoprolol.

  15. [Chronic migraine and work: occupational risks and prevention].

    Science.gov (United States)

    Vicente-Herrero, M T; Ramírez Iñiguez de la Torre, M V; Capdevila García, L M; López-González, Á A; Terradillos García, M J

    2013-09-01

    Chronic migraine is a clinically difficult to manage primary headache which affects the quality of life of the patients. This impact is important in the occupational world, where along with the clinical aspects of the disease, the therapies used for the control of the symptoms or preventive aspects, must be assessed. The side effects of the drugs and the limitations associated with their symptoms are aspects to highlight in occupational health, especially in individual workplaces, where there is a high risk of work-related injuries. The medical officer must assess the occupational risks of particular importance in the progression of this disease, as well as preventive actions, within the ambit of the current Spanish legislation, that may be favorable for both the company and the worker. The coordinated medical intervention and knowledge of these occupational aspects can provide clinically relevant tools, andoccupational and social optimization in the use of available resources. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  16. Effect of sumatriptan on cerebral blood flow during migraine headache. Measurement by sequential SPECT used 99mTc-ECD background subtraction method

    International Nuclear Information System (INIS)

    Ueda, Takashi; Torihara, Yoshito; Tsuneyoshi, Noritaka; Ikeda, Yoshitomo

    2001-01-01

    The present study was designed to examine the effect of sumatriptan on regional cerebral blood flow (CBF) during migraine headache. Nine cases were examined by 99m Tc-ECD background subtraction method for the absolute value measurement of regional CBF before and after sumatriptan injection. rCBF except for occipital and perioccipital lobes, were increased 10-20% during migraine headache and significant decreases were observed by sumatriptan injection. Two cases of nine had transiently increased systemic blood pressure and cardiac pulse rate, however, all cases improved migraine headache after injection of sumatriptan. (author)

  17. Effect of sumatriptan on cerebral blood flow during migraine headache. Measurement by sequential SPECT used {sup 99m}Tc-ECD background subtraction method

    Energy Technology Data Exchange (ETDEWEB)

    Ueda, Takashi; Torihara, Yoshito; Tsuneyoshi, Noritaka; Ikeda, Yoshitomo [Miyazaki Social Insurance Hospital (Japan)

    2001-07-01

    The present study was designed to examine the effect of sumatriptan on regional cerebral blood flow (CBF) during migraine headache. Nine cases were examined by {sup 99m}Tc-ECD background subtraction method for the absolute value measurement of regional CBF before and after sumatriptan injection. rCBF except for occipital and perioccipital lobes, were increased 10-20% during migraine headache and significant decreases were observed by sumatriptan injection. Two cases of nine had transiently increased systemic blood pressure and cardiac pulse rate, however, all cases improved migraine headache after injection of sumatriptan. (author)

  18. Interictal Spect with Tc-99m ECD studies in migraine patients. Role of Spect in the diagnosis of migraine with ura in headache-free periods

    International Nuclear Information System (INIS)

    Gonzalez, F.M.; Martinez, J.J.; Bermudez, M.C.; Fernandez, B.; Delgado, J.; Martin, A.; Padilla, O.; Nieto, R.

    2002-01-01

    Aim: The migraine is one of the neurological alterations more frequent provoking a discharge morbility and big inconveniences the one that endures it. The presence of brain perfusion abnormalities during the pain-free intervals of migraine even is fueling of controversies being so numerous the supporters of its existence as whom they deny it. This study was aimed at assessing the presence of cerebral perfusion abnormalities also during the interictal phase and the role of SPECT with Tc99 ECD on diagnosis of this migrainous patients. Materials And Methods: We studied 20 patients (16 woman and 4 man) with diagnose of migraine with aura during a periods without headache and 20 apareaded controls for age and sex of this patients.Was realized brain spect with 925 MBq Tc99m-ECD on a two heads rotating gamma camera (Piker Axis) equipped with a fan-beam collimator. The images were reconstructed using a filter Mezt and presented in courts in the three axes and reconstruction in three dimensions and later they were analyzed by two observers. Results: We found 14 of the patients (70%) with images of focal hypoperfusion with clear interhemispheric asymmetry while on control groups only two have this find (10%) being this difference statistically significant. The part of the brain more affected was the occipital one, though also they predominated over the more widespread hipocaptations. Conclusion: The brain Spect is a useful technology to identify the patients with migraine, being able to be used in the periods without pain. The boss of perfusion in the patients is the located hypoperfusion and is significantly different from that of the controls, It can be explained by an impaired regional cerebral vascular autoregulation may exist even during headache-free intervals in patients suffering from migraine. Future studies must be realized to determine if it exists relation between the zone of hypoperfusion and the type of present symptomatology in the aura

  19. 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.

  20. Preventive Agents for Migraine: Focus on the Antiepileptic Drugs

    Directory of Open Access Journals (Sweden)

    R. Shahien

    2012-04-01

    Full Text Available Migraine is among the 10 most disabling disorders worldwide. It is characterized by episodes of moderate or severe headaches with various degree of disability, resulting in a considerable health burden upon the sufferers and their family. The objective of this article is to review the use of prophylaxis with antiepileptic drugs. Particular focus is given to their mechanism of action, metabolism, pharmacokinetics, safety profile, efficacy and to provide a summary of the most relevant clinical studies and patient preference.

  1. Headache, migraine, and structural brain lesions and function: population based Epidemiology of Vascular Ageing-MRI study

    International Nuclear Information System (INIS)

    Kurth, T.; Mohamed, S.; Zhu, Y.C.; Dufouil, C.; Tzourio, Ch.; Kurth, T.; Zhu, Y.C.; Dufouil, C.; Tzourio, Ch.; Kurth, T.; Maillard, P.; Mazoyer, B.; Zhu, Y.C.; Chabriat, H.; Bousser, M.G.; Tzourio, Ch.; Zhu, Y.C.; Chabriat, H.; Bousser, M.G.; Mazoyer, B.

    2011-01-01

    Objective: To evaluate the association of overall and specific headaches with volume of white matter hyper-intensities, brain infarcts, and cognition. Design: Population based, cross sectional study. Setting: Epidemiology of Vascular Ageing study, Nantes, France. Participants: 780 participants (mean age 69, 58.5% women) with detailed headache assessment. Main outcome measures: Brain scans were evaluated for volume of white matter hyper-intensities (by fully automated imaging processing) and for classification of infarcts (by visual reading with a standardised assessment grid). Cognitive function was assessed by a battery of tests including the mini-mental state examination. Results: 163 (20.9%) participants reported a history of severe headache and 116 had migraine, of whom 17 (14.7%) reported aura symptoms. An association was found between any history of severe headache and increasing volume of white matter hyper-intensities. The adjusted odds ratio of being in the highest third for total volume of white matter hyper-intensities was 2.0 (95% confidence interval 1.3 to 3.1, P for trend 0.002) for participants with any history of severe headache when compared with participants without severe headache being in the lowest third. The association pattern was similar for all headache types. Migraine with aura was the only headache type strongly associated with volume of deep white matter hyper-intensities (highest third odds ratio 12.4, 1.6 to 99.4, P for trend 0.005) and with brain infarcts (3.4, 1.2 to 9.3). The location of infarcts was predominantly outside the cerebellum and brain stem. Evidence was lacking for cognitive impairment for any headache type with or without brain lesions. Conclusions: In this population based study, any history of severe headache was associated with an increased volume of white matter hyper-intensities. Migraine with aura was the only headache type associated with brain infarcts. Evidence that headache of any type by itself or in

  2. Transcranial direct current stimulation (tDCS) and its influence on analgesics effectiveness in patients suffering from migraine headache.

    Science.gov (United States)

    Przeklasa-Muszyńska, Anna; Kocot-Kępska, Magdalena; Dobrogowski, Jan; Wiatr, Maciej; Mika, Joanna

    2017-08-01

    Headache is one of the most common conditions troubling nearly 45% of the world's population. Migraine headache itself, being more common among women, affects 7-18% of people. As much as 20-30% of the population report accompanying aura and neurological symptoms. In many cases, migraine headache can be effectively treated with suitably selected pharmacotherapies which include drugs used in symptomatic treatment. Frequent occurrence of the condition is treated with prophylaxis, which often fails. Neuromodulating methods are part of the multidirectional treatment and they may be valuable complement to pharmacotherapy. Our study evaluates the impact of the transcranial direct current stimulation (tDCS) on the consumption of drugs and on pain conditions (frequency, duration, intensity). We recruited 50 patients with migraine headache (30 with aura, 20 without aura) refractory to pharmacological therapy. In 30 patients (18 with aura, 12 without aura) previous unsatisfactory treatment was supplemented with tDCS performed tenfold. 20 patients (12 with aura, 8 without aura) from a control group were treated with pharmacological methods The observation continued for 30 days after the stimulation. After tDCS, a reduction in the consumption of analgesics and triptans was reported. Additionally, we monitored pain intensity decrease during pain episodes, duration of episodes and the number of pain days. The subjective assessment of pain reduction in migraine patients encompassed 36-40% after tDCS much more effective in comparison to group with only pharmacotherapy (10-12.5%). The study suggests that tDCS may be safe and useful clinical tool in migraine prophylaxis and treatment. Copyright © 2017 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  3. The quality of diagnosis and management of migraine and tension-type headache in three social groups in Russia.

    Science.gov (United States)

    Lebedeva, Elena R; Kobzeva, Natalia R; Gilev, Denis V; Olesen, Jes

    2017-03-01

    Background Three successive editions of the International Classification of Headache Disorders and multiple guideline papers on headache care have described evidence based diagnosis and treatment of headache disorders. It remains unknown, however, to which extent this has improved the diagnosis and management of headache. That was the aim of our study in which we also analysed differences between three social groups in Russia. Methods We studied 1042 students (719 females, 323 males, mean age 20.6, age range 17-40), 1075 workers (146 females, 929 males, mean age 40.4, age range 21-67) and 1007 blood donors (484 females, 523 males, mean age 34.1, age range 18-64). We conducted a semi-structured, validated, face-to-face professional interview. Data on prevalence and associated factors have previously been published. A section of the interview focused on previous diagnosis and treatment, the topic of this paper. Results Only 496 of 2110 participants (23%) with headache in Russia had consulted because of headache. Students consulted more frequently (35%), workers and blood donors less often (13% and 14%). Only 12% of the patients with ICHD-3beta diagnosis of migraine and 11.7% with ICHD-3beta diagnosis of tension-type headache (TTH) had previously been correctly diagnosed. Triptans were used by only 6% of migraine patients. Only 0.4% of migraine patients and no TTH patients had received prophylactic treatment. Conclusion Despite existing guidelines about diagnosis and treatment, both remain poor in Russia. According to the literature this is only slightly better in Europe and America. Dissemination of existing knowledge should have higher priority in the future.

  4. Symptoms of central sensitization and comorbidity for juvenile fibromyalgia in childhood migraine: an observational study in a tertiary headache center.

    Science.gov (United States)

    de Tommaso, Marina; Sciruicchio, Vittorio; Delussi, Marianna; Vecchio, Eleonora; Goffredo, Marvita; Simeone, Michele; Barbaro, Maria Grazia Foschino

    2017-12-01

    Central sensitization is an important epiphenomenon of the adult migraine, clinically expressed by allodynia, pericranial tenderness and comorbidity for fibromyalgia in a relevant number of patients. This study aimed to evaluate the frequency and the clinical characteristics of allodynia, pericranial tenderness, and comorbidity for Juvenile Fibromialgia (JFM) in a cohort of migraine children selected in a tertiary headache center. This was an observational cross-sectional study on 8-15 years old migraine patients. Allodynia was assessed by a questionnaire. Pericranial tenderness and comorbidity for JFM as well as their possible association with poor quality of life and migraine related disability, and with other clinical symptoms as anxiety, depression, sleep disorders and pain catastrophizing, were also evaluated. One hundred and fifty one patients were selected, including chronic migraine (n°47), migraine without aura (n° 92) and migraine with aura (n° 12) sufferers. Allodynia was reported in the 96,6% and pericranial tenderness was observed in the 68.8% of patients. Pericranial tenderness was more severe in patients with more frequent migraine and shorter sleep duration. Allodynia seemed associated with anxiety, pain catastrophizing and high disability scores. Comorbidity for JFM was present in the 0.03% ofpatients. These children presented with a severe depression and a significant reduction of quality of life as compared to the other patients. This study outlined a relevant presence of symptoms of central sensitization among children with migraine. Severe allodynia and comorbidity for JFM seemed to cause a general decline of quality of life, which would suggest the opportunity of a routine assessment of these clinical features.

  5. A Comparative Effectiveness Meta-Analysis of Drugs for the Prophylaxis of Migraine Headache.

    Directory of Open Access Journals (Sweden)

    Jeffrey L Jackson

    Full Text Available To compare the effectiveness and side effects of migraine prophylactic medications.We performed a network meta-analysis. Data were extracted independently in duplicate and quality was assessed using both the JADAD and Cochrane Risk of Bias instruments. Data were pooled and network meta-analysis performed using random effects models.PUBMED, EMBASE, Cochrane Trial Registry, bibliography of retrieved articles through 18 May 2014.We included randomized controlled trials of adults with migraine headaches of at least 4 weeks in duration.Placebo controlled trials included alpha blockers (n = 9, angiotensin converting enzyme inhibitors (n = 3, angiotensin receptor blockers (n = 3, anticonvulsants (n = 32, beta-blockers (n = 39, calcium channel blockers (n = 12, flunarizine (n = 7, serotonin reuptake inhibitors (n = 6, serotonin norepinephrine reuptake inhibitors (n = 1 serotonin agonists (n = 9 and tricyclic antidepressants (n = 11. In addition there were 53 trials comparing different drugs. Drugs with at least 3 trials that were more effective than placebo for episodic migraines included amitriptyline (SMD: -1.2, 95% CI: -1.7 to -0.82, -flunarizine (-1.1 headaches/month (ha/month, 95% CI: -1.6 to -0.67, fluoxetine (SMD: -0.57, 95% CI: -0.97 to -0.17, metoprolol (-0.94 ha/month, 95% CI: -1.4 to -0.46, pizotifen (-0.43 ha/month, 95% CI: -0.6 to -0.21, propranolol (-1.3 ha/month, 95% CI: -2.0 to -0.62, topiramate (-1.1 ha/month, 95% CI: -1.9 to -0.73 and valproate (-1.5 ha/month, 95% CI: -2.1 to -0.8. Several effective drugs with less than 3 trials included: 3 ace inhibitors (enalapril, lisinopril, captopril, two angiotensin receptor blockers (candesartan, telmisartan, two anticonvulsants (lamotrigine, levetiracetam, and several beta-blockers (atenolol, bisoprolol, timolol. Network meta-analysis found amitriptyline to be better than several other medications including candesartan, fluoxetine, propranolol, topiramate and valproate and no different than

  6. A Comparative Effectiveness Meta-Analysis of Drugs for the Prophylaxis of Migraine Headache

    Science.gov (United States)

    2015-01-01

    Objective To compare the effectiveness and side effects of migraine prophylactic medications. Design We performed a network meta-analysis. Data were extracted independently in duplicate and quality was assessed using both the JADAD and Cochrane Risk of Bias instruments. Data were pooled and network meta-analysis performed using random effects models. Data Sources PUBMED, EMBASE, Cochrane Trial Registry, bibliography of retrieved articles through 18 May 2014. Eligibility Criteria for Selecting Studies We included randomized controlled trials of adults with migraine headaches of at least 4 weeks in duration. Results Placebo controlled trials included alpha blockers (n = 9), angiotensin converting enzyme inhibitors (n = 3), angiotensin receptor blockers (n = 3), anticonvulsants (n = 32), beta-blockers (n = 39), calcium channel blockers (n = 12), flunarizine (n = 7), serotonin reuptake inhibitors (n = 6), serotonin norepinephrine reuptake inhibitors (n = 1) serotonin agonists (n = 9) and tricyclic antidepressants (n = 11). In addition there were 53 trials comparing different drugs. Drugs with at least 3 trials that were more effective than placebo for episodic migraines included amitriptyline (SMD: -1.2, 95% CI: -1.7 to -0.82), -flunarizine (-1.1 headaches/month (ha/month), 95% CI: -1.6 to -0.67), fluoxetine (SMD: -0.57, 95% CI: -0.97 to -0.17), metoprolol (-0.94 ha/month, 95% CI: -1.4 to -0.46), pizotifen (-0.43 ha/month, 95% CI: -0.6 to -0.21), propranolol (-1.3 ha/month, 95% CI: -2.0 to -0.62), topiramate (-1.1 ha/month, 95% CI: -1.9 to -0.73) and valproate (-1.5 ha/month, 95% CI: -2.1 to -0.8). Several effective drugs with less than 3 trials included: 3 ace inhibitors (enalapril, lisinopril, captopril), two angiotensin receptor blockers (candesartan, telmisartan), two anticonvulsants (lamotrigine, levetiracetam), and several beta-blockers (atenolol, bisoprolol, timolol). Network meta-analysis found amitriptyline to be better than several other medications including

  7. A feasible repetitive transcranial magnetic stimulation clinical protocol in migraine prevention.

    Science.gov (United States)

    Zardouz, Shawn; Shi, Lei; Leung, Albert

    2016-01-01

    This case series was conducted to determine the clinical feasibility of a repetitive transcranial magnetic stimulation protocol for the prevention of migraine (with and without aura). Five patients with migraines underwent five repetitive transcranial magnetic stimulation sessions separated in 1- to 2-week intervals for a period of 2 months at a single tertiary medical center. Repetitive transcranial magnetic stimulation was applied to the left motor cortex with 2000 pulses (20 trains with 1s inter-train interval) delivered per session, at a frequency of 10 Hz and 80% resting motor threshold. Pre- and post-treatment numerical rating pain scales were collected, and percent reductions in intensity, frequency, and duration were generated. An average decrease in 37.8%, 32.1%, and 31.2% were noted in the intensity, frequency, and duration of migraines post-repetitive transcranial magnetic stimulation, respectively. A mean decrease in 1.9±1.0 (numerical rating pain scale ± standard deviation; range: 0.4-2.8) in headache intensity scores was noted after the repetitive transcranial magnetic stimulation sessions. The tested repetitive transcranial magnetic stimulation protocol is a well-tolerated, safe, and effective method for migraine prevention.

  8. 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 ...

  9. 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

  10. The effects of aerobic exercise for persons with migraine and co-existing tension-type headache and neck pain. A randomized, controlled, clinical trial.

    Science.gov (United States)

    Krøll, Lotte Skytte; Hammarlund, Catharina Sjödahl; Linde, Mattias; Gard, Gunvor; Jensen, Rigmor Højland

    2018-01-01

    Aim To evaluate aerobic exercise in migraine and co-existing tension-type headache and neck pain. Methods Consecutively recruited persons with migraine and co-existing tension-type headache and neck pain were randomized into an exercise group or control group. Aerobic exercise consisted of bike/cross-trainer/brisk walking for 45 minutes, three times/week. Controls continued usual daily activities. Pain frequency, intensity, and duration; physical fitness, level of physical activity, well-being and ability to engage in daily activities were assessed at baseline, after treatment and at follow-up. Results Fifty-two persons completed the study. Significant between-group improvements for the exercise group were found for physical fitness, level of physical activity, migraine burden and the ability to engage in physical activity because of reduced impact of tension-type headache and neck pain. Within the exercise group, significant reduction was found for migraine frequency, pain intensity and duration, neck pain intensity, and burden of migraine; an increase in physical fitness and well-being. Conclusions Exercise significantly reduced the burden of migraine and the ability to engage in physical activity because of reduced impact of tension-type headache and neck pain. Exercise also reduced migraine frequency, pain intensity and duration, although this was not significant compared to controls. These results emphasize the importance of regular aerobic exercise for reduction of migraine burden.

  11. Migrainous infarction

    DEFF Research Database (Denmark)

    Laurell, K; Artto, V; Bendtsen, L

    2011-01-01

    Migrainous infarction (MI), i.e. an ischemic stroke developing during an attack of migraine with aura is rare and the knowledge of its clinical characteristics is limited. Previous case series using the International Classification of Headache Disorders (ICHD) included......Migrainous infarction (MI), i.e. an ischemic stroke developing during an attack of migraine with aura is rare and the knowledge of its clinical characteristics is limited. Previous case series using the International Classification of Headache Disorders (ICHD) included...

  12. 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.

  13. Hearing voices: does it give your patient a headache? A case of auditory hallucinations as acoustic aura in migraine

    Directory of Open Access Journals (Sweden)

    Van der Feltz-Cornelis CM

    2012-03-01

    Full Text Available Christina M van der Feltz-Cornelis1–3, Henk Biemans1, Jan Timmer11Clinical Centre for Body, Mind and Health, GGz Breburg, Tilburg, The Netherlands; 2Faculty of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands; 3Trimbos Instituut, Utrecht, The NetherlandsObjective: Auditory hallucinations are generally considered to be a psychotic symptom. However, they do occur without other psychotic symptoms in a substantive number of cases in the general population and can cause a lot of individual distress because of the supposed association with schizophrenia. We describe a case of nonpsychotic auditory hallucinations occurring in the context of migraine.Method: Case report and literature review.Results: A 40-year-old man presented with imperative auditory hallucinations that caused depressive and anxiety symptoms. He reported migraine with visual aura as well which started at the same time as the auditory hallucinations. The auditory hallucinations occurred in the context of nocturnal migraine attacks, preceding them as aura. No psychotic disorder was present. After treatment of the migraine with propranolol 40 mg twice daily, explanation of the etiology of the hallucinations, and mirtazapine 45 mg daily, the migraine subsided and no further hallucinations occurred. The patient recovered.Discussion: Visual auras have been described in migraine and occur quite often. Auditory hallucinations as aura in migraine have been described in children without psychosis, but this is the first case describing auditory hallucinations without psychosis as aura in migraine in an adult. For description of this kind of hallucination, DSM-IV lacks an appropriate category.Conclusion: Psychiatrists should consider migraine with acoustic aura as a possible etiological factor in patients without further psychotic symptoms presenting with auditory hallucinations, and they should ask for headache symptoms when they take the history. Prognosis may be

  14. Migraine

    Science.gov (United States)

    ... processed foods may trigger migraines. Skipping meals or fasting also can trigger attacks. Food additives. The sweetener ... weight or maintain a healthy body weight, and obesity is thought to be a factor in migraines. ...

  15. Depression and Anxiety in Migraine Patients

    Science.gov (United States)

    ... Spotlight On News Content Capsule Contact Understanding Migraine Depression and Anxiety in Migraine Patients Doctor Q&A ... of Headache Disorders Cluster Headache Post-Traumatic Headache Depression and Anxiety in Migraine Patients August 13, 2015 ...

  16. Effect of biofeedback-assisted autogenic training on headache activity and mood states in Korean female migraine patients.

    Science.gov (United States)

    Kang, Eun-Ho; Park, Joo-Eon; Chung, Chin-Sang; Yu, Bum-Hee

    2009-10-01

    Biofeedback with or without combined autogenic training is known to be effective for the treatment of migraine. This study aimed to examine the effect of biofeedback treatment on headache activity, anxiety, and depression in Korean female patients with migraine headache. Patients were randomized into the treatment group (n=17) and monitoring group (n=15). Mood states including anxiety and depression, and psychophysiological variables such as mean skin temperature of the patients were compared with those of the normal controls (n=21). We found greater treatment response rate (defined as > or =50% reduction in headache index) in patients with biofeedback-assisted autogenic training than in monitoring group. The scores on the anxiety and depression scales in the patients receiving biofeedback-assisted autogenic training decreased after the biofeedback treatment. Moreover, the decrease in their anxiety levels was significantly related to the treatment outcome. This result suggests that the biofeedback-assisted autogenic training is effective for the treatment of migraine and its therapeutic effect is closely related to the improvement of the anxiety level.

  17. Randomized controlled trial of the CGRP receptor antagonist telcagepant for migraine prevention

    DEFF Research Database (Denmark)

    Ho, Tony W; Connor, Kathryn M; Zhang, Ying

    2014-01-01

    elevations do not support the use of telcagepant for daily administration. CLASSIFICATION OF EVIDENCE: This study provides Class II evidence that in patients with migraine, telcagepant taken daily reduces headache days by 1.4 days per month compared to placebo and causes 2.5% of patients to have elevations......-14 migraine days during a 4-week baseline were randomized to telcagepant 140 mg, telcagepant 280 mg, or placebo twice daily for 12 weeks. Efficacy was assessed by mean monthly headache days and migraine/probable migraine days (headache plus ≥ 1 associated symptom). RESULTS: The trial was terminated following...... initiation and resolved after treatment discontinuation. The originally planned efficacy analysis over 12 weeks was not performed due to limited data at later time points, but there was evidence that telcagepant resulted in a larger reduction from baseline than placebo for mean monthly headache days (month 1...

  18. Level of physical activity, well-being, stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain

    DEFF Research Database (Denmark)

    Krøll, Lotte Skytte; Hammarlund, Catharina Sjödahl; Westergaard, Maria Lurenda

    2017-01-01

    where questionnaires on physical activity, psychological well-being, perceived stress and self-rated health were completed by 148 persons with migraine and 100 healthy controls matched by sex and average age. Semi-structured interviews were conducted to assess characteristics of migraine, tension......-existing tension-type headache and neck pain in a clinic-based sample, b) the level of physical activity, psychological well-being, perceived stress and self-rated health in persons with migraine and co-existing tension-type headache and neck pain compared to healthy controls, c) the perceived ability of persons...... well-being, higher level of perceived stress and poorer self-rated health compared to healthy controls. They reported reduced ability to perform physical activity owing to migraine (high degree), tension-type headache (moderate degree) and neck pain (low degree). The most burdensome condition...

  19. Treatment of Menstrual-Related Migraine

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2008-05-01

    Full Text Available A review and meta-analysis of therapy trials for menstrual-related migraine headache (MRM and evidence-based recommendations for acute and short-term preventive treatment are reported from Toronto Western Hospital, ON, Canada.

  20. Has aerobic exercise effect on pain perception in persons with migraine and coexisting tension-type headache and neck pain? A randomized, controlled, clinical trial.

    Science.gov (United States)

    Krøll, L S; Sjödahl Hammarlund, C; Gard, G; Jensen, R H; Bendtsen, L

    2018-04-10

    A large subset of persons with migraine suffers from coexisting tension-type headache and neck pain which may adversely affect the prognosis of migraine. Aerobic exercise has been shown to decrease migraine burden in these persons. Therefore, the aim of this study was to investigate whether the effect of aerobic exercise in persons with migraine and coexisting tension-type headache and neck pain can be explained by changes in pain perception. Seventy consecutively recruited persons with migraine and coexisting tension-type headache and neck pain were randomized into exercise group or control group. Aerobic exercise consisted of bike/cross-trainer/brisk walking for 45 min, three times/week for 3 months. Controls continued their usual daily activities. Pericranial tenderness, pain thresholds, supra-thresholds and temporal summation were assessed at baseline, after treatment and at follow-up (6 months from baseline). Fifty-two persons with migraine and coexisting tension-type headache and neck pain completed the study. Aerobic exercise did not induce consistent changes in nociceptive pathways measured by pericranial tenderness, pressure pain thresholds and sensitivity to electrical stimulation. The effect of aerobic exercise cannot be explained by measurable effects on the pain modulation system. Thus, the positive effect on migraine burden may rather be explained by positive alteration of avoidance behaviour. Aerobic exercise can be recommended as a safe and inexpensive migraine treatment strategy. This study adds further knowledge about the positive effect of aerobic exercise for persons with migraine and coexisting tension-type headache and neck pain. This effect cannot be measured by changes in pain modulation, but may rather be explained by positive alteration of avoidance behaviour. © 2018 European Pain Federation - EFIC®.

  1. Genetics Home Reference: sporadic hemiplegic migraine

    Science.gov (United States)

    ... Home Health Conditions Sporadic hemiplegic migraine Sporadic hemiplegic migraine Printable PDF Open All Close All Enable Javascript ... view the expand/collapse boxes. Description Sporadic hemiplegic migraine is a rare form of migraine headache. Migraines ...

  2. Effect of A Bioenergy Economy Program on Pain Control, Depression, and Anxiety In Patients with Migraine Headache

    Directory of Open Access Journals (Sweden)

    Afsoon Derakhshan

    2016-08-01

    Full Text Available Background: Psychological problems such as depression and anxiety are very common in patients withchronic headaches and give rise to the repetition and continuity of the headaches. This study aimed to assessthe effect of a bioenergy economy program and particularly the biofield attunement on the improvement of thepain control, depression, and anxiety in patients suffering from migraine, a common psychosomatic disorder.Methods: To collect data, a quasi-experimental method was adopted including pretest, posttest, andfollow-up phase. Thirty patients with migraine were selected based on convenience sampling method andput into two experimental and control groups. Data collection tools included Beck Depression Inventory-II(BDI-II, Beck Anxiety Inventory, and Headache Impact Test (HIT-6TM. The data were analyzed usingrepeated-measures analysis of variance (ANOVA and covariance (ANCOVA tests. Both experimentaland control groups participated in the entire program to assess the effect of bioenergy economy programon mentioned variables. To assess the effect of biofield attunement, a non-expert person performed theattunement of participants in the control group while an expert bioenergy healer and channel performedattunement procedures for the participants in the experimental group.Results: The mean scores of pain, anxiety, and depression of 30 participants in pretest differedsignificantly with those in posttest and follow-up phases; but such a difference was not observed betweenthe scores of posttest and follow-up in control group. Moreover, the participants’ mean scores in posttestand follow-up phases differed significantly between the two groups.Conclusion: Bioenergy economy program caused a significant decrease in anxiety, depression, andintensity and frequency of pain in patients with migraine. The decrease on mentioned variables wereconsistent in a two-month interval. These therapeutic effects were even more in experimental group whohad received

  3. Vestibular migraine

    DEFF Research Database (Denmark)

    Lempert, Thomas; Olesen, Jes; Furman, Joseph

    2012-01-01

    This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). The classification includes vestibular...... migraine and probable vestibular migraine. Vestibular migraine will appear in an appendix of the third edition of the International Classification of Headache Disorders (ICHD) as a first step for new entities, in accordance with the usual IHS procedures. Probable vestibular migraine may be included...... in a later version of the ICHD, when further evidence has been accumulated. The diagnosis of vestibular migraine is based on recurrent vestibular symptoms, a history of migraine, a temporal association between vestibular symptoms and migraine symptoms and exclusion of other causes of vestibular symptoms...

  4. Migraine Variants in Children

    Science.gov (United States)

    ... Headaches in Children FAQ Migraine Variants In Children Children Get Migraines Too! Learn More Migraine Information Find Help Doctors & Resources Get Connected Join the Conversation Follow Us on Social Media Company About News Resources Privacy Policy Contact Phone: ...

  5. The migraine postdrome

    DEFF Research Database (Denmark)

    Giffin, Nicola J; Lipton, Richard B; Silberstein, Stephen D

    2016-01-01

    OBJECTIVE: To report migraine postdrome symptoms in patients who report nonheadache symptoms as part of their attacks. METHODS: A prospective daily electronic diary study was conducted over 3 months in 120 patients with migraine. Nonheadache symptoms before, during, and after headache were...... pain resolved. There was no relationship between medication taken for the headache and the duration of the postdrome. The severity of the migraine was not associated with the duration of the postdrome. Overall state of health scores remained low during the postdrome. CONCLUSION: Nonheadache symptoms...... in the postdrome were common and may contribute to the distress and disability in the patients studied. Postdrome symptoms merit larger observational studies and careful recording in clinical trials of acute and preventive migraine treatments....

  6. The migraine postdrome

    DEFF Research Database (Denmark)

    Giffin, Nicola J.; Lipton, Richard B; Silberstein, Stephen D

    2016-01-01

    Objective: To report migraine postdrome symptoms in patients who report nonheadache symptoms as part of their attacks.  Methods: A prospective daily electronic diary study was conducted over 3 months in 120 patients with migraine. Nonheadache symptoms before, during, and after headache were...... pain resolved. There was no relationship between medication taken for the headache and the duration of the postdrome. The severity of the migraine was not associated with the duration of the postdrome. Overall state of health scores remained low during the postdrome.  Conclusion: Nonheadache symptoms...... in the postdrome were common and may contribute to the distress and disability in the patients studied. Postdrome symptoms merit larger observational studies and careful recording in clinical trials of acute and preventive migraine treatments....

  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. The effect of foetal growth restriction on the development of migraine and tension-type headache in adulthood. The HUNT Study.

    Directory of Open Access Journals (Sweden)

    Sigrid Børte

    Full Text Available There is little knowledge about how factors early in life affect the development of migraine and tension-type headache. We aimed to examine whether growth restriction in utero is associated with development of migraine and frequent tension-type headache in adults.The population-based Nord-Trøndelag Health Study (HUNT 3 contained a validated headache questionnaire, which differentiated between migraine and tension-type headache. These data were linked to information on weight and gestational age at birth from the Norwegian Medical Birth Registry. In total 4557 females and 2789 males, aged 19-41 years, were included in this registry-based study. Participants were categorized as appropriate for gestational age (AGA, 10th-90th percentile, small for gestational age (SGA, 3rd-10th percentile or very small for gestational age (VSGA, < 3rd percentile. Logistic regression was used to calculate odds ratios (OR with 95% confidence intervals (CI for migraine and tension-type headache, with exposure being growth restriction at birth.The effect of growth restriction on migraine was modified by sex, with a significant association in males (p<0.001, but not in females (p = 0.20. In particular, males born VSGA were at increased risk of developing migraine (OR 2.73, 95% CI 1.63-4.58, p<0.001, with an intermediate risk among those born SGA (OR 1.50, 95% CI 0.96-2.35, p = 0.08 compared to those born AGA. There was no significant association between growth restriction and frequent TTH (p = 0.051.Growth restriction was associated with increased risk of migraine in adulthood among males, but not among females. This suggests that migraine might, in part, be influenced by early life events, and that males seem to be particularly vulnerable.

  10. 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 ...

  11. 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: ...

  12. Amitriptyline and intraoral devices for migraine prevention: a randomized comparative trial

    Directory of Open Access Journals (Sweden)

    Marco A. D. Bruno

    Full Text Available ABSTRACT Objectives: Nonpharmacological treatments, such as the Nociceptive Trigeminal Inhibition Tension Suppression System (NTI-tss, are approved for migraine prophylaxis. We aimed at evaluating the effectiveness of the NTI-tss and to compare its efficacy with amitriptyline and with a sham intraoral device in the preventive treatment of migraine. Methods: Consecutive patients with migraine were randomized to receive 25 mg of amitriptyline/day (n = 34, NTI-tss (n = 33 and a non-occlusal splint (n = 30. The headache frequency was evaluated at six and 12 weeks. Results: The amitriptyline group showed, respectively, 60% and 64% reduction in attack frequency at six and 12 weeks (P = 0.000. In the NTI-tss and non-occlusal splint groups, reduction was 39% and 30%, respectively, at six weeks and 48% for both groups at 12 weeks. Conclusions: Amitriptyline proved superior to the NTI-tss and the non-occlusal splint. Despite its approval by the United States Food and Drug Administration, the NTI-tss was not superior to a sham device.

  13. The auriculotemporal nerve in etiology of migraine headaches: compression points and anatomical variations.

    Science.gov (United States)

    Chim, Harvey; Okada, Haruko C; Brown, Matthew S; Alleyne, Brendan; Liu, Mengyuan T; Zwiebel, Samantha; Guyuron, Bahman

    2012-08-01

    The auriculotemporal nerve has been identified as one of the peripheral trigger sites for migraine headaches. However, its distal course is poorly mapped following emergence from the parotid gland. In addition, a reliable anatomical landmark for locating the potential compression points along the course of the nerve during surgery has not been sufficiently described. Twenty hemifaces on 10 fresh cadavers were dissected to trace the course of the auriculotemporal nerve from the inferior border of the zygomatic arch to its termination in the temporal scalp. The compression points were mapped and the distances were measured from the most anterosuperior point of the external auditory meatus, which was used as a fixed anatomical landmark. Three potential compression points along the course of the auriculotemporal nerve were identified. Compression points 1 and 2 corresponded to preauricular fascial bands. Compression point 1 was centered 13.1±5.9 mm anterior and 5.0±7.0 mm superior to the most anterosuperior point of the external auditory meatus, whereas compression point 2 was centered at 11.9±6.0 mm anterior and 17.2±10.4 mm superior to the most anterosuperior point of the external auditory meatus. A significant relationship was found between the auriculotemporal nerve and superficial temporal artery (compression point 3) in 80 percent of hemifaces, with three patterns of interaction: a single site of artery crossing over the nerve (62.5 percent), a helical intertwining relationship (18.8 percent), and nerve crossing over the artery (18.8 percent). Findings from this cadaver study provide information relevant to the operative localization of potential compression points along the auriculotemporal nerve.

  14. Children with migraine: Provocation of headache via pressure to myofascial trigger points in the trapezius muscle? - A prospective controlled observational study.

    Science.gov (United States)

    Landgraf, M N; Biebl, J T; Langhagen, T; Hannibal, I; Eggert, T; Vill, K; Gerstl, L; Albers, L; von Kries, R; Straube, A; Heinen, F

    2018-02-01

    The objective was to evaluate a supposed clinical interdependency of myofascial trigger points and migraine in children. Such interdependency would support an interaction of spinal and trigeminal afferences in the trigemino-cervical complex as a contributing factor in migraine. Children ≤18 years with the confirmed diagnosis of migraine were prospectively investigated. Comprehensive data on medical history, clinical neurological and psychological status were gathered. Trigger points in the trapezius muscle were identified by palpation and the threshold of pressure pain at these points was measured. Manual pressure was applied to the trigger points, and the occurrence and duration of induced headache were recorded. At a second consultation (4 weeks after the first), manual pressure with the detected pressure threshold was applied to non-trigger points within the same trapezius muscle (control). Headache and related parameters were again recorded and compared to the results of the first consultation. A total of 13 girls and 13 boys with migraine and a median age of 14.5 (Range 6.3-17.8) years took part in the study. Manual pressure to trigger points in the trapezius muscle led to lasting headache after termination of the manual pressure in 13 patients while no patient experienced headache when manual pressure was applied to non-trigger points at the control visit (p complex, especially in adolescents. In children with migraine headache can often be induced by pressure to myofascial trigger points, but not by pressure to non-trigger points in the trapezius muscle. This supports the hypothesis of a trigemino-cervical-complex in the pathophysiology of migraine, which might have implications for innovative therapies in children with migraine. © 2017 European Pain Federation - EFIC®.

  15. 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 ...

  16. Temporo-mandibular disorders are an important comorbidity of migraine and may be clinically difficult to distinguish them from tension-type headache.

    Science.gov (United States)

    Silva, Ariovaldo Alberto da; Brandão, Karina Viana; Faleiros, Bruno Engler; Tavares, Rafael Mattos; Lara, Rodrigo Pinto; Januzzi, Eduardo; Carvalho, Anísio Bueno de; Carvalho, Eliane Maria Duarte de; Gomes, João Bosco Lima; Leite, Frederico Mota Gonçalves; Alves, Betania Mara Franco; Gómez, Rodrigo Santiago; Teixeira, Antônio Lúcio

    2014-02-01

    Clinical differentiation between the primary headaches and temporomandibular disorders (TMD) can be challenging. To investigate the relationship between TMD and primary headaches by conducting face to face assessments in patients from an orofacial pain clinic and a headache tertiary center. Sample consists of 289 individuals consecutively identified at a headache center and 78 individuals seen in an orofacial pain clinic because of symptoms suggestive of TMD. Migraine was diagnosed in 79.8% of headache sufferers, in headache tertiary center, and 25.6% of those in orofacial pain clinic (pheadache was present in 20.4% and 46.1%, while the TMD painful occurred in 48.1% and 70.5% respectively (pheadache, and this headache was more frequent in the dental center than at the medical center.

  17. 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 ...

  18. Treatment in chronic migraine: choice of reabilitation strategies

    Directory of Open Access Journals (Sweden)

    Ioana STANESCU

    2015-12-01

    Full Text Available Migraine is a disabling neurologic condition with a spontaneous clinical evolution into a chronic form. Migraine progression from an episodic into a chronic form is realized through a period of time involving several months or years, during which an increase attack frequency occurs. .According to the International Classification of Headache Disorders (ICHD-3 chronic migraine is a type of primary headache occurring on 15 or more days per month for more than 3 months, in which more than 8 days per month headache meet criteria for migraine with or without aura or respond to specific migraine treatment. The prevalence of chronic migraine is estimated between 1- 3% of general population. Persons with chronic migraine are more likely to suffer from severe disability; chronic migraine has an important socio-economic impact. Diagnostic approach in chronic migraine includes exclusion of a secondary headache disorder and confirmation of a primary episodic headache. When a patient is found to overuse pain medication, diagnosis of both chronic migraine and MOH should be considered. Treating episodic migraine early and managing attack frequency using preventive medication and behavioural interventions will be benefic in reducing the risk of chronicisation. Lifestyle changes are important for avoiding triggers for migraine attacks; treatment of comorbidities is equally important because these conditions exacerbate patient’s tendency to have headaches. The initial relief step for drug abusers always relies in drug withdrawal. For migraine attacks treatment begins with non-pharmacologic interventions (staying in a quiet, dark room, pressure on painful areas, applying cold compresses , simple OTC analgetics (NSAIDs, paracetamol, aspirin, acetaminophen. If these are not effective, triptans are the drugs of choice. Preventive treatment is always recommended in patients with chronic migraine because the high frequency of headache attacks. Treatment should be

  19. Migraines

    Science.gov (United States)

    ... may trigger migraines: Aged, canned, cured or processed meat, including bologna, game, ham, herring, hot dogs, pepperoni and sausage Aged cheese Alcoholic beverages, especially red wine Aspartame Avocados Beans, ... Lentils Meat tenderizer Monosodium glutamate (MSG) Nuts and peanut butter ...

  20. Migraine

    Science.gov (United States)

    ... Certain foods and food additives such as Alcohol Chocolate Aged cheeses Monosodium glutamate (MSG) Some fruits and ... consistent sleep schedule and eating regular meals. Hormone therapy may help some women whose migraines seem to ...

  1. Temporo-mandibular disorders are an important comorbidity of migraine and may be clinically difficult to distinguish them from tension-type headache

    Directory of Open Access Journals (Sweden)

    Ariovaldo Alberto da Silva Júnior

    2014-02-01

    Full Text Available Clinical differentiation between the primary headaches and temporomandibular disorders (TMD can be challenging. Objectives : To investigate the relationship between TMD and primary headaches by conducting face to face assessments in patients from an orofacial pain clinic and a headache tertiary center. Method : Sample consists of 289 individuals consecutively identified at a headache center and 78 individuals seen in an orofacial pain clinic because of symptoms suggestive of TMD. Results : Migraine was diagnosed in 79.8% of headache sufferers, in headache tertiary center, and 25.6% of those in orofacial pain clinic (p<0.001. Tension-type headache was present in 20.4% and 46.1%, while the TMD painful occurred in 48.1% and 70.5% respectively (p<0.001. Conclusion : TMD is an important comorbidity of migraine and difficult to distinguish clinically from tension-type headache, and this headache was more frequent in the dental center than at the medical center.

  2. Timing and topography of cerebral blood flow, aura, and headache during migraine attacks

    DEFF Research Database (Denmark)

    Olesen, J; Friberg, L; Olsen, T S

    1990-01-01

    Ten years of study has resulted in considerable but fragmented knowledge about regional cerebral blood flow in migraine with aura (classic migraine). In the present study, the number of repeatedly studied patients (n = 63) was large enough to determine statistically significant sequences of event...

  3. Allodynia Is Associated With Initial and Sustained Response to Acute Migraine Treatment: Results from the American Migraine Prevalence and Prevention Study.

    Science.gov (United States)

    Lipton, Richard B; Munjal, Sagar; Buse, Dawn C; Bennett, Alix; Fanning, Kristina M; Burstein, Rami; Reed, Michael L

    2017-07-01

    In a population sample of persons with migraine treating with a single category of acute migraine medication, to identify rates and factors associated with acute treatment outcomes, including 2-hour pain freedom (2hPF), 24-hour pain response (24hPR), and 24-hour sustained pain response (24hSPR). Key predictors include acute treatment type (triptans and other medication categories), the influence of allodynia on response to medication, and the interaction between medication category and presence of allodynia in response to treatment among people with migraine. Cutaneous allodynia was previously associated with inadequate 2hPF, 24hPR, and 24hSPR (sustained response at 24 hours among those with adequate 2hPF) among people with migraine in the American Migraine Prevalence and Prevention (AMPP) Study. The AMPP Study obtained data from a representative US sample of persons with migraine by mailed questionnaire. The 2006 survey included 8233 people with migraine aged 18 or over who completed the Migraine Treatment Optimization Questionnaire (mTOQ). mTOQ was used to assess acute treatment outcomes including 2hPF, 24hPR, and 24hSPR. Eligible individuals used only a single category of acute prescription migraine treatments (n  =  5236, 63.6%). This sample was stratified into 5 categories of type of acute prescription headache medication used (triptans, nonsteroidal anti-inflammatory drugs, barbiturate-combinations, opioids, and opioid combinations and ergot alkaloids). Separate binary logistic regression models evaluated: (1) triptans vs other medication types; (2) presence of allodynia vs no allodynia; and (3) the interaction of medication category with allodynia. Sociodemographic variables, health insurance status, over-the-counter and preventive medication use were included as covariates. Odds ratios (OR) and 95% confidence intervals (CI) were generated for each acute treatment outcome. Among eligible participants, the mean age was 46 years, and 82.5% were women

  4. Associations between stress and migraine and tension-type headache: Results from a school-based study in adolescents from grammar schools in Germany

    OpenAIRE

    Milde-Busch, Astrid; Blaschek, Astrid; Heinen, Florian; Borggräfe, Ingo; Koerte, Inga; Straube, Andreas; Schankin, Christoph; Kries, Rüdiger

    2011-01-01

    Introduction: Stress is considered the major contributor to migraine and tension-type headache in adolescents. Previous studies have focused on general stressors, whereas the aim of the present study was to investigate associations between individuals’ stressful experiences and different types of headache. Methods: Adolescents from 10th and 11th grades of grammar schools filled in questionnaires. Stressful experiences were measured with the Trier Inventory of Chronic Stress. Type of heada...

  5. [The importance of chronic migraine in a general neurology service].

    Science.gov (United States)

    Gracia-Naya, M; Alarcia-Alejos, R; Modrego-Pardo, P J

    Chronic migraine is a primary headache that is difficult to treat and has an important impact on the patient's quality of life. The international headache classification recently modified the criteria for chronic migraine and therefore few studies have been conducted that analyse groups according to these new criteria. AIM. To analyse a group of patients with chronic migraine who were referred to a general neurology service. The first 100 patients with migraine were selected. Researchers established and analysed a number of subgroups of patients with episodic, chronic or chronic migraine with probable headache due to medication abuse, in accordance with the International Headache Society (IHS) headache classification and its revised version from 2006. Of the total sample of 738 new patients, 100 (13.5%) suffered from migraines and of these 100 new patients with migraine 42 (5.6% of the total series) satisfied criteria for chronic migraine and 15 patients with chronic migraine met the criteria for probable headache due to medication abuse. Before visiting the neurology service, only 41% had been diagnosed as suffering from migraine, 38% had received no information about this condition, only 17% took triptans for symptomatic relief and 23% had followed some kind of preventive treatment. One notable finding was the importance of episodic and chronic migraine in a general neurology service, on applying the recent IHS criteria. A high percentage of patients with chronic migraine who were referred to the neurology service have not been diagnosed or given any information or proper treatment; an elevated degree of self-medication and medication abuse also exists. Preventive treatment and triptans in cases of intense migraines are still not commonly used in primary care.

  6. Dural afferents express acid-sensing ion channels: a role for decreased meningeal pH in migraine headache.

    Science.gov (United States)

    Yan, Jin; Edelmayer, Rebecca M; Wei, Xiaomei; De Felice, Milena; Porreca, Frank; Dussor, Gregory

    2011-01-01

    Migraine headache is one of the most common neurological disorders. The pathological conditions that directly initiate afferent pain signaling are poorly understood. In trigeminal neurons retrogradely labeled from the cranial meninges, we have recorded pH-evoked currents using whole-cell patch-clamp electrophysiology. Approximately 80% of dural-afferent neurons responded to a pH 6.0 application with a rapidly activating and rapidly desensitizing ASIC-like current that often exceeded 20nA in amplitude. Inward currents were observed in response to a wide range of pH values and 30% of the neurons exhibited inward currents at pH 7.1. These currents led to action potentials in 53%, 30% and 7% of the dural afferents at pH 6.8, 6.9 and 7.0, respectively. Small decreases in extracellular pH were also able to generate sustained window currents and sustained membrane depolarizations. Amiloride, a non-specific blocker of ASIC channels, inhibited the peak currents evoked upon application of decreased pH while no inhibition was observed upon application of TRPV1 antagonists. The desensitization time constant of pH 6.0-evoked currents in the majority of dural afferents was less than 500ms which is consistent with that reported for ASIC3 homomeric or heteromeric channels. Finally, application of pH 5.0 synthetic-interstitial fluid to the dura produced significant decreases in facial and hind-paw withdrawal threshold, an effect blocked by amiloride but not TRPV1 antagonists, suggesting that ASIC activation produces migraine-related behavior in vivo. These data provide a cellular mechanism by which decreased pH in the meninges following ischemic or inflammatory events directly excites afferent pain-sensing neurons potentially contributing to migraine headache. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  7. 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.

  8. [Prevalence and indirect costs of headache in a Brazilian Company].

    Science.gov (United States)

    Vincent, M; Rodrigues, A de J; De Oliveira, G V; De Souza, K F; Doi, L M; Rocha, M B; Saporta, M A; Orleans, R B; Kotecki, R; Estrela, V V; De Medeiros, V A; Borges, W I

    1998-12-01

    Employees from a Brazilian oil company research centre (n = 993) were interviewed on the occurrence of headache during a 30 days period. Headache prevalence was 49.8%, with a mean frequency of 4.3 +/- 7.0 attacks per month, lasting 12.2 +/- 21.4 hours each. According to the International Headache Society diagnostic criteria, migraine (5.5%), episodic tension-type headache (26.4%), chronic tension-type headache (1.7%) and headaches not fulfilling the criteria for such disorders (16.2%) were observed. Women suffered comparatively more headache and specifically migraine than men. The pain interfered with work productivity in 10% of the subjects, corresponding to 538.75 hours off. According to an indirect costs estimation for each headache, the company may loose up to US$125.98 per employee annually. Since among headaches migraine has the highest indirect cost, migraine prevention and treatment is particularly important at the working environment. Migraine frequency may be prevented to a large extent, resulting on positive effects in both the quality of life and productivity. The cost-benefit ratio clearly favours therapeutic and preventive programs against chronic headaches.

  9. What is Migraine? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... of this page please turn JavaScript on. Feature: Migraine Headaches What is Migraine? Past Issues / Fall 2015 Table of Contents If ... exhausted or weak following a migraine. Who Gets Migraines? Migraines occur in both children and adults, but ...

  10. CONSORT recommendations in abstracts of randomised, controlled trials on migraine and headache

    DEFF Research Database (Denmark)

    Tfelt-Hansen, Peer Carsten

    2011-01-01

    A CONSORT statement on the content of abstracts of randomised, controlled trials (RCTs) was published in 2008. I therefore reviewed the abstracts from 2009 to 2010 published on RCTs in Cephalalgia, Headache and other (non-headache) journals. The following items were reviewed: number of patients, ....... The influence of the CONSORT statement on reporting in abstracts has so far only had a limited influence on the headache literature....

  11. 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

  12. Commonly Used Acute Migraine Treatments

    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 ...

  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. Cortical Spreading Depression Closes Paravascular Space and Impairs Glymphatic Flow: Implications for Migraine Headache.

    Science.gov (United States)

    Schain, Aaron J; Melo-Carrillo, Agustin; Strassman, Andrew M; Burstein, Rami

    2017-03-15

    Functioning of the glymphatic system, a network of paravascular tunnels through which cortical interstitial solutes are cleared from the brain, has recently been linked to sleep and traumatic brain injury, both of which can affect the progression of migraine. This led us to investigate the connection between migraine and the glymphatic system. Taking advantage of a novel in vivo method we developed using two-photon microscopy to visualize the paravascular space (PVS) in naive uninjected mice, we show that a single wave of cortical spreading depression (CSD), an animal model of migraine aura, induces a rapid and nearly complete closure of the PVS around surface as well as penetrating cortical arteries and veins lasting several minutes, and gradually recovering over 30 min. A temporal mismatch between the constriction or dilation of the blood vessel lumen and the closure of the PVS suggests that this closure is not likely to result from changes in vessel diameter. We also show that CSD impairs glymphatic flow, as indicated by the reduced rate at which intraparenchymally injected dye was cleared from the cortex to the PVS. This is the first observation of a PVS closure in connection with an abnormal cortical event that underlies a neurological disorder. More specifically, the findings demonstrate a link between the glymphatic system and migraine, and suggest a novel mechanism for regulation of glymphatic flow. SIGNIFICANCE STATEMENT Impairment of brain solute clearance through the recently described glymphatic system has been linked with traumatic brain injury, prolonged wakefulness, and aging. This paper shows that cortical spreading depression, the neural correlate of migraine aura, closes the paravascular space and impairs glymphatic flow. This closure holds the potential to define a novel mechanism for regulation of glymphatic flow. It also implicates the glymphatic system in the altered cortical and endothelial functioning of the migraine brain. Copyright © 2017

  15. 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 ...

  16. Menstrual migraine

    OpenAIRE

    Moschiano, Franca; Grazzi, Licia; D?Amico, Domenico; Schieroni, Ferdinando; Bussone, Gennaro

    2001-01-01

    An association between migraine and menstruation can be ascertained by use of a diary for a minimum of three cycles. The pathophysiological and clinical peculiarities of menstrual migraine indicate that its management should differ from that of non?menstrual migraine. NSAIDS or migraine-specific medications (e.g. triptans) are often effective for the acute management of menstrual migraine. Preventive treatment is indicated when the attacks are long?lasting, severe and disabling and do not res...

  17. Efficacy of single versus three sessions of high rate repetitive transcranial magnetic stimulation in chronic migraine and tension-type headache.

    Science.gov (United States)

    Kalita, Jayantee; Laskar, Sanghamitra; Bhoi, Sanjeev Kumar; Misra, Usha Kant

    2016-11-01

    We report the efficacy of three versus single session of 10 Hz repetitive transcranial magnetic stimulation (rTMS) in chronic migraine (CM) and chronic tension-type headache (CTTH). Ninety-eight patients with CM or CTTH were included and their headache frequency, severity, functional disability and number of abortive medications were noted. Fifty-two patients were randomly assigned to group I (three true sessions) and 46 to group II (one true and two sham rTMS sessions) treatment. 10 Hz rTMS comprising 600 pulses was delivered in 412.4 s on the left frontal cortex. Outcomes were noted at 1, 2 and 3 months. The primary outcome was 50 % reduction in headache frequency, and secondary outcomes were improvement in severity, functional disability, abortive drugs and side effects. The baseline headache characteristics were similar between the two groups. Follow up at different time points revealed significant improvement in headache frequency, severity, functional disability and number of abortive drugs compared to baseline in both group I and group II patients, although these parameters were not different between the two groups. In group I, 31 (79.4 %) had reduction of headache frequency and 29 (74.4 %) converted to episodic headache. In group II, these were 24 (64.8 %) and 22 (59.2 %), respectively. In chronic migraine, the severity of headache at 2 months reduced in group I compared to group II (62.5 vs 35.3 %; P = 0.01). Both single and three sessions of 10 Hz rTMS were found to be equally effective in CM and CTTH, and resulted in conversion of chronic to episodic headache in 67.1 % patients.

  18. [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

  19. 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 ...

  20. Amitriptyline and intraoral devices for migraine prevention: a randomized comparative trial

    OpenAIRE

    Bruno, Marco A. D.; Krymchantowski, Abouch V.

    2018-01-01

    ABSTRACT Objectives: Nonpharmacological treatments, such as the Nociceptive Trigeminal Inhibition Tension Suppression System (NTI-tss), are approved for migraine prophylaxis. We aimed at evaluating the effectiveness of the NTI-tss and to compare its efficacy with amitriptyline and with a sham intraoral device in the preventive treatment of migraine. Methods: Consecutive patients with migraine were randomized to receive 25 mg of amitriptyline/day (n = 34), NTI-tss (n = 33) and a non-occlusal...

  1. Cognitive behavior therapy for comorbid migraine and/or tension-type headache and major depressive disorder: An exploratory randomized controlled trial.

    Science.gov (United States)

    Martin, Paul R; Aiello, Rachele; Gilson, Kathryn; Meadows, Graham; Milgrom, Jeannette; Reece, John

    2015-10-01

    Numerous studies have demonstrated comorbidity between migraine and tension-type headache on the one hand, and depression on the other. Presence of depression is a negative prognostic indicator for behavioral treatment of headaches. Despite the recognised comorbidity, there is a limited research literature evaluating interventions designed for comorbid headaches and depression. Sixty six participants (49 female, 17 male) suffering from migraine and/or tension-type headache and major depressive disorder were randomly allocated to a Routine Primary Care control group or a Cognitive Behavior Therapy group that also received routine primary care. The treatment program involved 12 weekly 50-min sessions administered by clinical psychologists. Participants in the treatment group improved significantly more than participants in the control group from pre-to post-treatment on measures of headaches, depression, anxiety, and quality of life. Improvements achieved with treatment were maintained at four month follow-up. Comorbid anxiety disorders were not a predictor of response to treatment, and the only significant predictor was gender (men improved more than women). The new integrated treatment program appears promising and worthy of further investigation. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Critical analysis of the use of onabotulinumtoxinA (botulinum toxin type A) in migraine.

    Science.gov (United States)

    Robertson, Carrie E; Garza, Ivan

    2012-01-01

    OnabotulinumtoxinA, a neurotoxin, has been studied in numerous trials as a novel preventive therapy for migraine headache. The data would support that it may be effective at reducing headache days in patients suffering from chronic migraine (≥15 headache days/month, with eight or more of those migraine headache days). The mechanism by which onabotulinumtoxinA exerts its effects on migraine is not yet understood. It is known to inhibit acetylcholine release at the neuromuscular junction, but this probably does not explain the observed antinociceptive properties noted in preclinical and clinical trials. This review will discuss the known mechanisms of action of botulinum toxin type A, and will review the available randomized, placebo-controlled trials that have looked at its efficacy as a migraine preventative. We also describe the onabotulinumtoxinA injection sites used at our institution.

  3. Outpatient Combined Group and Individual Cognitive-Behavioral Treatment for Patients With Migraine and Tension-Type Headache in a Routine Clinical Setting.

    Science.gov (United States)

    Christiansen, Sandra; Jürgens, Tim P; Klinger, Regine

    2015-09-01

    To test the long-term clinical effectiveness (follow-up at 3, 6 and 12 months) of an outpatient combined group and individual cognitive-behavioral treatment (CBT) for headache patients following standard medical care. A decrease in headache intensity, frequency, headache-specific impairment, depression, and change of pain-related cognitions was expected. The efficacy of CBT for primary headaches has been confirmed in research, yet the translation into clinical practice has remained untested thus far. In this single-group outcome study, 87 headache patients diagnosed with migraine and/or tension-type headache received (1) headache-specific medication for 10 weeks and (2) a subsequent CBT treatment made up of 13 individual and 12 group sessions consisting of psychoeducation, progressive muscle relaxation, coping strategies for pain and stress, and goal setting skills. Booster group sessions after 3 and 6 months were implemented to stimulate individual goal attainment, and follow-up measures were recorded up to 12 months. A significant decrease was found for all primary and secondary outcome criteria, ie, average headache intensity (prae M: 6.0, standard deviation [SD]: 1.5 vs follow-up [FU] 1 year M: 5.1, SD: 1.9), headache frequency (prae M: 16.0, SD: 9.5 vs FU 1 year M: 13.4, SD: 9.9), and catastrophizing (prae M: 3.4, SD: 1.0 vs FU 1 year M: 2.6, SD: 1.1). Coping strategies were increased (prae M: 3.4, SD: .9 vs FU 1 year M: 4.0, SD: 1.0). CBT treatment is a useful component within a routine clinical setting and can improve standard medical care thereby helping patients in managing their headache pain. © 2015 American Headache Society.

  4. [A case of migraine presenting with thunderclap headache associated with posterior reversible encephalopathy syndrome].

    Science.gov (United States)

    Katoh, Hirotaka; Saito, Yu; Ohwan, Yoshiyuki; Kasai, Hideyo; Fujita, Kazuhisa; Kawamura, Mitsuru

    2014-10-01

    We report a 47-year-old woman who developed a thunderclap headache. Head axial, fluid-attenuated inversion recovery magnetic resonance imaging (FLAIR MRI) revealed high signal lesions in the left occipital and right parietal lobes. Apparent diffusion coefficient mapping showed a vasogenic edema pattern. Upon admission, the patient's blood pressure was normal and the neurological examination was unremarkable. As thunderclap headaches are associated with a repeated rise in blood pressure, we considered cerebral vasoconstriction and administered a calcium channel blocker. Thereafter, her headache with high blood pressure eased significantly and the high signal lesions on FLAIR MRI disappeared. We diagnosed the condition as posterior reversible encephalopathy syndrome (PRES). In addition, head magnetic resonance angiogram showed vasoconstriction of the right anterior cerebral artery, left middle cerebral artery, and bilateral posterior cerebral artery. Calcium channel blocker use was continued and vasoconstriction improved by day 70. In this case, the presenting symptom was thunderclap headache, which is a characteristic feature of reversible cerebral vasoconstriction syndrome (RCVS). Therefore, PRES may be caused by RCVS.

  5. Basilar migraine.

    Science.gov (United States)

    Kuhn, W F; Kuhn, S C; Daylida, L

    1997-03-01

    Basilar migraine is a complicated headache which the International Headache Society describes as 'migraine with aura symptoms clearly originating from the brainstem or from both occipital lobes'. For years this headache was thought to originate from a transient disturbance in the vertebrobasilar circulation, but more recent studies suggest that a central neuronal disorder may be the source of migraine. Basilar migraines may have certain symptoms which are similar to other neurologic, vascular, psychiatric and metabolic diseases, yet there are specific criteria which can help differentiate it from other diagnoses. It is characterized by a throbbing occipital headache which may be preceded by an aura. The unusual symptoms of basilar migraine, which may precede and continue throughout the duration of the headache and even after it, include bilateral visual symptoms, altered mental status, vertigo, gait ataxia, bilateral paresthesia, bilateral paralysis and dysarthria. We describe a 29-year-old black female whose husband brought her to the emergency department complaining of confusion, headache, and left-sided weakness for 2 h prior to arrival.

  6. 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 ...

  7. Grey zones in the diagnosis of adult migraine without aura based on the International Classification of Headache Disorders-III beta: exploring the covariates of possible migraine without aura.

    Science.gov (United States)

    Ozge, Aynur; Aydinlar, Elif; Tasdelen, Bahar

    2015-01-01

    Exploring clinical characteristics and migraine covariates may be useful in the diagnosis of migraine without aura. To evaluate the diagnostic value of the International Classification of Headache Disorders (ICHD)-III beta-based diagnosis of migraine without aura; to explore the covariates of possible migraine without aura using an analysis of grey zones in this area; and, finally, to make suggestions for the final version of the ICHD-III. A total of 1365 patients (mean [± SD] age 38.5±10.4 years, 82.8% female) diagnosed with migraine without aura according to the criteria of the ICHD-III beta were included in the present tertiary care-based retrospective study. Patients meeting all of the criteria of the ICHD-III beta were classified as having full migraine without aura, while those who did not meet one, two or ≥3 of the diagnostic criteria were classified as zones I, II and III, respectively. The diagnostic value of the clinical characteristics and covariates of migraine were determined. Full migraine without aura was evident in 25.7% of the migraineurs. A higher likelihood of zone I classification was shown for an attack lasting 4 h to 72 h (OR 1.560; P=0.002), with pulsating quality (OR 4.096; P<0.001), concomitant nausea⁄vomiting (OR 2.300; P<0.001) and photophobia⁄phonophobia (OR 4.865; P<0.001). The first-rank determinants for full migraine without aura were sleep irregularities (OR 1.596; P=0.005) and periodic vomiting (OR 1.464; P=0.026). However, even if not mentioned in ICHD-III beta, the authors determined that motion sickness, abdominal pain or infantile colic attacks in childhood, associated dizziness and osmophobia have important diagnostic value. In cases that do not fulfill all of the diagnostic criteria although they are largely consistent with the characteristics of migraine in clinical terms, the authors believe that a history of infantile colic; periodic vomiting (but not periodic vomiting syndrome); recurrent abdominal pain; the

  8. Clinical Characterization and Imaging of Triggered Attacks in Chronic Migraine and Posttraumatic Headache

    Science.gov (United States)

    2016-02-01

    UCSF (Dr. Goadsby’s move leading to a change to a part-time appointment there), and because of an unexpected inability to obtain pharmaceutical grade...These studies were not performed, in part because pharmaceutical grade PGE2 became unavailable after the study was approved. Task 4. Functional...persistent posttraumatic headache. (Months 6-36) b. Perform a baseline anatomical and resting-state functional MRI in the same subjects at the same time as

  9. 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.

  10. 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.

  11. 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.

  12. Migraine vestibulaire 

    DEFF Research Database (Denmark)

    Lempert, T; Olesen, J; Furman, J

    2014-01-01

    This paper presents diagnostic criteria for vestibular migraine, jointly formulated by the Committee for Classification of Vestibular Disorders of the Bárány Society and the Migraine Classification Subcommittee of the International Headache Society (IHS). The classification includes vestibular...... migraine and probable vestibular migraine. Vestibular migraine will appear in an appendix of the third edition of the International Classification of Headache Disorders (ICHD) as a first step for new entities, in accordance with the usual IHS procedures. Probable vestibular migraine may be included...... in a later version of the ICHD, when further evidence has been accumulated. The diagnosis of vestibular migraine is based on recurrent vestibular symptoms, a history of migraine, a temporal association between vestibular symptoms and migraine symptoms and exclusion of other causes of vestibular symptoms...

  13. Migraine's House of Headaches…and Visiting the Neighbors

    Science.gov (United States)

    ... Headache) Migraine in Women Secondary Headaches Headaches in Children FAQ Learn More Migraine Information Find Help Doctors & Resources Get Connected Join the Conversation Follow Us on Social Media Company About News Resources Privacy Policy Contact Phone: ...

  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. Managing migraine by patient profile: role of frovatriptan.

    Science.gov (United States)

    Cady, Roger K; Farmer, Kathleen

    2016-01-01

    For the last quarter of a century, triptans have been available for acute treatment of migraine but with little guidance on which of the different triptan products to use for which patient or which attack of migraine. In this article, we propose a structured approach to analysis of individual migraine attacks and patient characteristics as a means of defining and optimizing acute intervention. Assessment of patient and attack profiles includes the "5-Ps": pattern, phenotype, patient, pharmacology, and precipitants. Attending to these five components of information can assist in developing an individualized behavioral, pharmacological, and nonpharmacological comprehensive treatment plan for most migraine patients. This clinical approach is then focused on frovatriptan because of its unique molecular signature and potential novel clinical applications. Frovatriptan like all triptans is indicated for acute treatment of migraine but its role has been explored in management of several unique migraine phenotypes. Frovatriptan has the longest half-life of any triptan and consequently is often promoted for acute treatment of migraine of longer duration. It has also been studied as a short-term preventive treatment in women with menstrual-related migraine. Given that 60% of female migraineurs suffer from menstrual-related migraine, this population is the obvious group for continued study. Small studies have also explored frovatriptan's use in treating migraine predicted by premonitory symptoms as a preventive for the headache phase of migraine. By identifying patient and attack profiles, clinicians may effectively determine the viability of frovatriptan as an effective pharmacological intervention for migraine.

  16. Visual Disturbances: Related to Migraine or Not?

    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. The quality of diagnosis and management of migraine and tension-type headache in three social groups in Russia

    DEFF Research Database (Denmark)

    Lebedeva, Elena R; Kobzeva, Natalia R; Gilev, Denis V

    2017-01-01

    BACKGROUND: Three successive editions of the International Classification of Headache Disorders and multiple guideline papers on headache care have described evidence based diagnosis and treatment of headache disorders. It remains unknown, however, to which extent this has improved the diagnosis ...

  18. 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.

  19. Pharmacological migraine provocation: a human model of migraine

    DEFF Research Database (Denmark)

    Ashina, Messoud; Hansen, Jakob Møller

    2010-01-01

    for migraine mechanisms. So far, however, animal models cannot predict the efficacy of new therapies for migraine. Because migraine attacks are fully reversible and can be aborted by therapy, the headache- or migraine-provoking property of naturally occurring signaling molecules can be tested in a human model....... If a naturally occurring substance can provoke migraine in human patients, then it is likely, although not certain, that blocking its effect will be effective in the treatment of acute migraine attacks. To this end, a human in vivo model of experimental headache and migraine in humans has been developed...

  20. [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%).

  1. 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.

  2. Neurovascular pharmacology of migraine

    NARCIS (Netherlands)

    MaassenVanDenBrink, Antoinette; Chan, Kayi Y.

    2008-01-01

    Migraine is a paroxysmal neurovascular disorder, which affects a significant proportion of the population. Since dilation of cranial blood vessels is likely to be responsible for the headache experienced in migraine, many experimental models for the study of migraine have focussed on this feature.

  3. 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

  4. Ophthalmoplegic migraine.

    Science.gov (United States)

    Bek, Semai; Genc, Gencer; Demirkaya, Seref; Eroglu, Erdal; Odabasi, Zeki

    2009-05-01

    According to the International Headache Society, ophthalmoplegic migraine is recurrent attacks of headache with migrainous characteristics associated with paresis of one or more ocular cranial nerves (commonly the third nerve) in the absence of any demonstrable intracranial lesion. We report a patient with typical clinical features of ophthalmoplegic migraine. A 21-year-old man had right frontal throbbing headaches recurring twice a year. His headache lasted for 1 to 5 days and was followed by slight drooping of his eyelid and double vision that lasted for approximately 3 months. On examination he had ptosis and adduction paralysis of the right eye. Brain MRI revealed a thickened, enhancing right oculomotor nerve. He was treated with methylprednisolone 1000 mg/d IV for 5 days. Only 2 weeks later, clinical improvement was observed and 3 months later the oculomotor nerve enhancement resolved. Ophthalmoplegic migraine has been considered to have a microvascular, ischemic etiology, but more recently it has been reclassified as a demyelinating condition affecting the oculomotor. To our knowledge, this is the first ophthalmoplegic migraine case presented pretreatment and post-treatment with clinical photographic documentation and an MRI showing enduring thickening of the oculomotor nerve although symptoms and contrast enhancement resolved.

  5. Cilostazol induces C-fos expression in the trigeminal nucleus caudalis and behavioural changes suggestive of headache with the migraine-like feature photophobia in female rats

    DEFF Research Database (Denmark)

    Christensen, S L; Petersen, Steffen; Sørensen, Dorte B

    2018-01-01

    -like behaviours and c-fos expression in rats. In order to evaluate the predictive validity of the model, we examined the response to the migraine specific drug sumatriptan. Methods The effect of cilostazol (125 mg/kg p.o.) in female Sprague Dawley rats was evaluated on a range of spontaneous behavioural...... parameters, light sensitivity and mechanical sensitivity thresholds. We also measured c-fos expression in the trigeminal nucleus caudalis. Results Cilostazol increased light sensitivity and grooming behaviour. These manifestations were not inhibited by sumatriptan. Cilostazol also induced c-fos expression...... in the trigeminal nucleus caudalis. Furthermore, trigeminal - but not hind paw hyperalgesia was observed. Conclusion The altered behaviours are suggestive of cilostazol induced headache with migraine-like features, but not specific. The presence of head specific hyperalgesia and the c-fos response in the trigeminal...

  6. 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

  7. 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 ...

  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. Brain stimulation in migraine.

    Science.gov (United States)

    Brighina, Filippo; Cosentino, Giuseppe; Fierro, Brigida

    2013-01-01

    Migraine is a very prevalent disease with great individual disability and socioeconomic burden. Despite intensive research effort in recent years, the etiopathogenesis of the disease remains to be elucidated. Recently, much importance has been given to mechanisms underlying the cortical excitability that has been suggested to be dysfunctional in migraine. In recent years, noninvasive brain stimulation techniques based on magnetic fields (transcranial magnetic stimulation, TMS) and on direct electrical currents (transcranial direct current stimulation, tDCS) have been shown to be safe and effective tools to explore the issue of cortical excitability, activation, and plasticity in migraine. Moreover, TMS, repetitive TMS (rTMS), and tDCS, thanks to their ability to interfere with and/or modulate cortical activity inducing plastic, persistent effects, have been also explored as potential therapeutic approaches, opening an interesting perspective for noninvasive neurostimulation for both symptomatic and preventive treatment of migraine and other types of headache. In this chapter we critically review evidence regarding the role of noninvasive brain stimulation in the pathophysiology and treatment of migraine, delineating the advantages and limits of these techniques together with potential development and future application. © 2013 Elsevier B.V. All rights reserved.

  10. Sphenopalatine ganglion neuromodulation in migraine

    DEFF Research Database (Denmark)

    Khan, Sabrina; Schoenen, Jean; Ashina, Messoud

    2014-01-01

    OBJECTIVE: The objective of this article is to review the prospect of treating migraine with sphenopalatine ganglion (SPG) neurostimulation. BACKGROUND: Fuelled by preliminary studies showing a beneficial effect in cluster headache patients, the potential of treating migraine with neurostimulation...

  11. Acupuncture for the prevention of tension-type headache

    Science.gov (United States)

    Linde, Klaus; Allais, Gianni; Brinkhaus, Benno; Fei, Yutong; Mehring, Michael; Shin, Byung-Cheul; Vickers, Andrew; White, Adrian R

    2016-01-01

    Background 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. Objectives 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. Search methods 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. Selection criteria We included randomised trials with a post-randomisation 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. Data collection and analysis 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 randomisation). 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 GRADE (Grading of Recommendations Assessment, Development and Evaluation). Main results Twelve trials (11 included in the previous version and one newly identified) with 2349 participants (median 56, range 10 to 1265) met the inclusion criteria

  12. Acupuncture for the prevention of tension-type headache.

    Science.gov (United States)

    Linde, Klaus; Allais, Gianni; Brinkhaus, Benno; Fei, Yutong; Mehring, Michael; Shin, Byung-Cheul; Vickers, Andrew; White, Adrian R

    2016-04-19

    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 randomised trials with a post-randomisation 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 randomisation). 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 GRADE (Grading of Recommendations Assessment, Development and Evaluation). Twelve trials (11 included in the previous version and one newly identified) with 2349 participants (median 56, range 10 to 1265) met the inclusion criteria.Acupuncture was compared with routine care or treatment of acute headaches only in two large trials (1265

  13. CILOSTAZOL INDUCES C-FOS EXPRESSION IN THE TRIGEMINAL NUCLEUS CAUDALIS AND BEHAVIOURAL CHANGES SUGGESTIVE OF HEADACHE WITH MIGRAINE-LIKE MANIFESTATIONS IN RATS

    DEFF Research Database (Denmark)

    Christensen, S. L. T.; Petersen, S.; Sorensen, D. B.

    2016-01-01

    in rats. Also, we tested the response to sumatriptan in order to evaluate the predictive properties of the model. Methods: The effect of cilostazol (125 mg/kg p.o.) was evaluated on a range of spontaneous behavioural parameters, light sensitivity and mechanical sensitivity thresholds. To assess headache...... specificity we evaluated the c-fos expression in the trigeminal nucleus caudalis. All experiments were done in female Sprague Dawley rats and the oestrous cycle was included in the analyses. Results: We found that cilostazol increased the light sensitivity and grooming behaviour of the rats and decreased......: The altered behaviours are suggestive of headache with migraine features, but not specific. The c-fos response in the trigeminal nucleus caudalis implies that the rats had pain originating from the head. The lack of response to sumatriptan disqualifies the model as predictive, but confirms the translation...

  14. Behavioural management of migraine

    OpenAIRE

    Brown, Helen; Newman, Craig; Noad, Rupert; Weatherby, Stuart

    2012-01-01

    It is important to recognise that migraine is a ′biological′ and not a ′psychological′ entity. However, psychological factors can be involved in migraine in 4 different ways:- 1) Migraines can be triggered by psychological stressors; 2) Severe migraine can itself be a cause of significant psychological stress which can, in turn, exacerbate the problem; 3) Even if psychological stress is not significantly involved in the genesis of the headache, pain management techniques can help people cope ...

  15. Refractory chronic migraine

    DEFF Research Database (Denmark)

    Martelletti, Paolo; Katsarava, Zaza; Lampl, Christian

    2014-01-01

    The debate on the clinical definition of refractory Chronic Migraine (rCM) is still far to be concluded. The importance to create a clinical framing of these rCM patients resides in the complete disability they show, in the high risk of serious adverse events from acute and preventative drugs...... and in the uncontrolled application of therapeutic techniques not yet validated.The European Headache Federation Expert Group on rCM presents hereby the updated definition criteria for this harmful subset of headache disorders. This attempt wants to be the first impulse towards the correct identification...... of these patients, the correct application of innovative therapeutic techniques and lastly aim to be acknowledged as clinical entity in the next definitive version of the International Classification of Headache Disorders 3 (ICHD-3 beta)....

  16. 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.

  17. The impact of migraine prevention on daily activities: a longitudinal and responder analysis from three topiramate placebo-controlled clinical trials

    Directory of Open Access Journals (Sweden)

    Papadopoulos George

    2007-10-01

    Full Text Available Abstract Background Topiramate is approved for the prophylaxis (prevention of migraine headache in adults. The most common adverse events in the three pivotal, randomized, double-blind, placebo-controlled trials were paresthesia, fatigue, cognitive impairment, anorexia, nausea, and taste alteration. In these trials, topiramate 100 mg/d significantly improved Migraine-Specific Questionnaire (MSQ scores versus placebo (p Methods Mean MSQ and Medical Outcome Study Short Form 36 (SF-36 change scores (baseline to each double-blind assessment point were calculated for pooled intent-to-treat (ITT patients. Additionally, pooled ITT patients receiving topiramate 100 mg/d or placebo were combined and divided into two responder groups according to percent reduction in monthly migraine frequency: Results Of 756 patients (mean age 39.8 years, 86% female, 384 received topiramate 100 mg/d and 372 placebo. Topiramate significantly improved all three MSQ domains throughout the double-blind phase versus placebo (p = 0.024 [week 8], p Conclusion Topiramate 100 mg/d significantly improved daily activities and patient functioning at all time points throughout the double-blind phase. Daily function and health status significantly improved for those achieving a ≥ 50% migraine frequency reduction.

  18. 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.

  19. Targeting the CRMP2-Ca2+ Channel Complex for Abortive Treatment of Migraine and Posttraumatic Headache

    Science.gov (United States)

    2017-09-01

    LCM prevents nitric oxide (NO) donor -induced CA and blood CGRP elevation in rats with triptan-induced latent sensitization. • Aim 3 (PORRECA Lab...the development of cephalic and extracephalic allodynia induced by nitric oxide (NO) donor given at 30 min prior to the NO donor injections in...cranial cup, inflammatory mediators, nitric oxide donor , sodium channels, calcium channels, excitability, constellation pharmacology constellation

  20. Toward a rational understanding of migraine trigger factors.

    Science.gov (United States)

    Martin, V T; Behbehani, M M

    2001-07-01

    The typical migraine patient is exposed to a myriad of migraine triggers on a daily basis. These triggers potentially can act at various sites within the cerebral vasculature and the central nervous system to promote the development of migraine headache. The challenge to the physician is in the identification and avoidance of migraine trigger factors within patients suffering from migraine headache. Only through a rational approach to migraine trigger factors can physicians develop an appropriate treatment strategy for migraine patients.

  1. Managing migraine by patient profile: role of frovatriptan

    Directory of Open Access Journals (Sweden)

    Cady RK

    2016-04-01

    Full Text Available Roger K Cady, Kathleen Farmer Headache Care Center, Springfield, MO, USA Abstract: For the last quarter of a century, triptans have been available for acute treatment of migraine but with little guidance on which of the different triptan products to use for which patient or which attack of migraine. In this article, we propose a structured approach to analysis of individual migraine attacks and patient characteristics as a means of defining and optimizing acute intervention. Assessment of patient and attack profiles includes the “5-Ps”: pattern, phenotype, patient, pharmacology, and precipitants. Attending to these five components of information can assist in developing an individualized behavioral, pharmacological, and nonpharmacological comprehensive treatment plan for most migraine patients. This clinical approach is then focused on frovatriptan because of its unique molecular signature and potential novel clinical applications. Frovatriptan like all triptans is indicated for acute treatment of migraine but its role has been explored in management of several unique migraine phenotypes. Frovatriptan has the longest half-life of any triptan and consequently is often promoted for acute treatment of migraine of longer duration. It has also been studied as a short-term preventive treatment in women with menstrual-related migraine. Given that 60% of female migraineurs suffer from menstrual-related migraine, this population is the obvious group for continued study. Small studies have also explored frovatriptan’s use in treating migraine predicted by premonitory symptoms as a preventive for the headache phase of migraine. By identifying patient and attack profiles, clinicians may effectively determine the viability of frovatriptan as an effective pharmacological intervention for migraine. Keywords: frovatriptan, acute treatment, preventive therapy, early intervention

  2. 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...

  3. Attitudes of a group of Brazilian orthodontists towards the diagnosis and management of primary headache (migraine: an electronic-based survey

    Directory of Open Access Journals (Sweden)

    Reynaldo Leite Martins Junior

    2011-12-01

    Full Text Available OBJECTIVES: The aim of this study was to investigate the knowledge and attitudes of orthodontists in the diagnosis and management of migraine without aura. MATERIAL AND METHODS: Participants were dentists, recruited among members of the Brazilian Association of Orthodontics and Facial Orthopedics (ABOR. An e-mail was sent to all ABOR members, with a link to a website, especially prepared for this research. Dentists were presented to a report of a fictional patient fulfilling diagnostic criteria for a primary headache disorder, known as migraine without aura. Participants were asked to describe how they would relieve the patient's pain. Professional procedures were classified as "adequate" or "inadequate" according to the answers given. RESULTS: 161 valid answers were received (18.8% response rate. Of them, 36% of the actions were considered to be "adequate" procedures, while 64% were "inadequate". The results yielded 12 main procedures, based on common characteristics. Eighty-two orthodontists suggested orthodontic treatment with or without orthognathic surgery, and some suggested using stabilization appliances prior to the orthodontic treatment. CONCLUSIONS: The majority of participants proposed inadequate therapies, and 51% suggested orthodontic correction of occlusion, including orthognathic surgery. Educational activities on migraine should also target orthodontists.

  4. Human migraine models

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg

    2001-01-01

    , which is a human experience. A set-up for investigations of experimental headache and migraine in humans, has been evaluated and headache mechanisms explored by using nitroglycerin and other headache-inducing agents. Nitric oxide (NO) or other parts of the NO activated cascade seems to be responsible...

  5. HeadacheCoach: Towards headache prevention by sensing and making sense of personal lifestyle data

    OpenAIRE

    Terzimehić, Nađa; Leipold, Nadja; Fritzen, Alexandra; Böhm, Markus; Krcmar, Helmut

    2018-01-01

    Estimates are that almost half of the world’s population has an active primary headache disorder, i.e. with no illness as an underlying cause. These can start manifesting in early adulthood and can last until the rest of the sufferer’s life. Most specialists concur that sudden changes in daily lifestyle, such are sleep rhythm, nutrition behavior or stress experience, can be valid triggers for headache sufferers. Health care professionals recommend leading a diary to self-mon...

  6. Long-term Treatment Benefits and Prolonged Efficacy of OnabotulinumtoxinA in Patients Affected by Chronic Migraine and Medication Overuse Headache over 3 Years of Therapy

    Directory of Open Access Journals (Sweden)

    Simona Guerzoni

    2017-11-01

    Full Text Available BackgroundChronic migraine (CM affects about the 2% of the general population and it has been recognized as one of the most-disabling conditions worldwide by the World Health Organization. CM is often associated with the overuse of abortive medication, which determines the worsening of headache itself and the development of a secondary headache called medication overuse headache. The management of these associated conditions is difficult, but a growing amount of evidence is pointing out the effectiveness and the good safety profile of OnabotulinumtoxinA (OnabotA. Despite this, data on OnabotA effects and safety in long-term use lack. The purpose of the present article is to retrospectively assess the efficacy and safety of OnabotA in a cohort of chronic migraineurs with drug overuse from the 18th month of treatment until the third year.Materials and methods90 chronic migraineurs with medication overuse were enrolled between January 2013 and February 2017. All patients were treated with OnabotA according to PREEMPT dictates. Before every injection session the headache index, the analgesic consumption, the visual analog scale for pain score, the 36-items short form health survey questionnaire score, the 6-items headache impact test (HIT-6 score and the Zung self-rating anxiety and depression scale scores were collected. Adverse events were carefully registered. A simple linear regression was performed to explore the mean changes in the abovementioned parameters for a single injection session and mean comparison tests were performed using the one-way analysis of variance followed by Tukey–Kramer post-hoc test.ResultsA significantly improvement for a single injection was registered for all the above-mentioned parameters. Headache index, analgesic consumption, visual analog pain scale, and 6-items HIT-6 scores were significantly lower than baseline from the 18th month of treatment onwards. The 36-items short form health survey questionnaire scores

  7. Safety and efficacy of AMG 334 for prevention of episodic migraine

    DEFF Research Database (Denmark)

    Sun, Hong Yan; Dodick, David W; Silberstein, Stephen D

    2016-01-01

    BACKGROUND: The calcitonin gene-related peptide (CGRP) pathway is a promising target for preventive therapies in patients with migraine. We assessed the safety and efficacy of AMG 334, a fully human monoclonal antibody against the CGRP receptor, for migraine prevention. METHODS: In this multicentre...... in monthly migraine days from baseline to the last 4 weeks of the 12-week double-blind treatment phase. The primary endpoint was calculated using the least squares mean at each timepoint from a generalised linear mixed-effect model for repeated measures. Safety endpoints were adverse events, clinical...... laboratory values, vital signs, and anti-AMG 334 antibodies. The study is registered with ClinicalTrials.gov, number NCT01952574. An open-label extension phase of up to 256 weeks is ongoing and will assess the long-term safety of AMG 334. FINDINGS: From Aug 6, 2013, to June 30, 2014, 483 patients were...

  8. Patients' preferences for headache acute and preventive treatment.

    Science.gov (United States)

    Mitsikostas, Dimos D; Belesioti, Ioanna; Arvaniti, Chryssa; Mitropoulou, Euthymia; Deligianni, Christina; Kasioti, Elina; Constantinidis, Theodoros; Dermitzakis, Manolis; Vikelis, Michail

    2017-10-06

    We aimed to explore patients' preferences for headache treatments with a self-administered questionnaire including the Q-No questionnaire for nocebo. Questionnaires from 514 outpatients naïve to neurostimulation and monoclonal antibodies were collected. Patients assessed that the efficacy of a treatment is more important than safety or route of administration. They preferred to use an external neurostimulation device for both acute (67.1%) and preventive treatment (62.8%). Most patients preferred to take a pill (86%) than any other drug given parenterally for symptomatic pharmaceutical treatment. For preventive pharmaceutical treatment, most patients preferred to take a pill once per day (52%) compared to an injection either subcutaneously or intravenously each month (9% and 4%), or three months (15% and 11%). 56.6% of all participants scored more than 15 in Q-No questionnaire indicating potential nocebo behaviors that contributed significantly in their choices. These patient preferences along with efficacy and safety data may help physicians better choose the right treatment for the right person.

  9. Safety and efficacy of AMG 334 for prevention of episodic migraine: a randomised, double-blind, placebo-controlled, phase 2 trial.

    Science.gov (United States)

    Sun, Hong; Dodick, David W; Silberstein, Stephen; Goadsby, Peter J; Reuter, Uwe; Ashina, Messoud; Saper, Joel; Cady, Roger; Chon, Yun; Dietrich, Julie; Lenz, Robert

    2016-04-01

    The calcitonin gene-related peptide (CGRP) pathway is a promising target for preventive therapies in patients with migraine. We assessed the safety and efficacy of AMG 334, a fully human monoclonal antibody against the CGRP receptor, for migraine prevention. In this multicentre, randomised, double-blind, placebo-controlled, phase 2 trial, patients aged 18-60 years with 4 to 14 migraine days per month were enrolled at 59 headache and clinical research centres in North America and Europe, and randomly assigned in a 3:2:2:2 ratio to monthly subcutaneous placebo, AMG 334 7 mg, AMG 334 21 mg, or AMG 334 70 mg using a sponsor-generated randomisation sequence centrally executed by an interactive voice response or interactive web response system. Study site personnel, patients, and the sponsor study personnel were masked to the treatment assignment. The primary endpoint was the change in monthly migraine days from baseline to the last 4 weeks of the 12-week double-blind treatment phase. The primary endpoint was calculated using the least squares mean at each timepoint from a generalised linear mixed-effect model for repeated measures. Safety endpoints were adverse events, clinical laboratory values, vital signs, and anti-AMG 334 antibodies. The study is registered with ClinicalTrials.gov, number NCT01952574. An open-label extension phase of up to 256 weeks is ongoing and will assess the long-term safety of AMG 334. From Aug 6, 2013, to June 30, 2014, 483 patients were randomly assigned to placebo (n=160), AMG 334 7 mg (n=108), AMG 334 21 mg (n=108), or AMG 334 70 mg (n=107). The mean change in monthly migraine days at week 12 was -3·4 (SE 0·4) days with AMG 334 70 mg versus -2·3 (0·3) days with placebo (difference -1·1 days [95% CI -2·1 to -0·2], p=0·021). The mean reductions in monthly migraine days with the 7 mg (-2·2 [SE 0·4]) and the 21 mg (-2·4 [0·4]) doses were not significantly different from that with placebo. Adverse events were recorded in 82 (54

  10. The diet factor in pediatric and adolescent migraine.

    Science.gov (United States)

    Millichap, J Gordon; Yee, Michelle M

    2003-01-01

    Diet can play an important role in the precipitation of headaches in children and adolescents with migraine. The diet factor in pediatric migraine is frequently neglected in favor of preventive drug therapy. The list of foods, beverages, and additives that trigger migraine includes cheese, chocolate, citrus fruits, hot dogs, monosodium glutamate, aspartame, fatty foods, ice cream, caffeine withdrawal, and alcoholic drinks, especially red wine and beer. Underage drinking is a significant potential cause of recurrent headache in today's adolescent patients. Tyramine, phenylethylamine, histamine, nitrites, and sulfites are involved in the mechanism of food intolerance headache. Immunoglobulin E-mediated food allergy is an infrequent cause. Dietary triggers affect phases of the migraine process by influencing release of serotonin and norepinephrine, causing vasoconstriction or vasodilatation, or by direct stimulation of trigeminal ganglia, brainstem, and cortical neuronal pathways. Treatment begins with a headache and diet diary and the selective avoidance of foods presumed to trigger attacks. A universal migraine diet with simultaneous elimination of all potential food triggers is generally not advised in practice. A well-balanced diet is encouraged, with avoidance of fasting or skipped meals. Long-term prophylactic drug therapy is appropriate only after exclusion of headache-precipitating trigger factors, including dietary factors.

  11. Why does sleep stop migraine?

    Science.gov (United States)

    Bigal, Marcelo E; Hargreaves, Richard J

    2013-10-01

    The relationship between sleep and migraine headaches is complex. Changes in sleep patterns can trigger migraine attacks, and sleep disorders may be associated with increased migraine frequency. Furthermore, migraine patients and their doctors very consistently report that sleep relieves already established migraine attacks. Herein we will try to answer the question, "Why does sleep stop migraine?" Since evidence for this relationship is largely based on empirical clinical observation, we will not provide a clinical review of the association. Instead, we will focus on the pathophysiology of migraine attacks and its intersections with sleep biology.

  12. 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.

  13. Effects of acetaminophen and ibuprofen in children with migraine receiving preventive treatment with magnesium.

    Science.gov (United States)

    Gallelli, Luca; Avenoso, Tiziana; Falcone, Daniela; Palleria, Caterina; Peltrone, Francesco; Esposito, Maria; De Sarro, Giovambattista; Carotenuto, Marco; Guidetti, Vincenzo

    2014-02-01

    The purpose of this study was to evaluate both the effects of ibuprofen and/or acetaminophen for the acute treatment of primary migraine in children in or out prophylactic treatment with magnesium. Children ranging from the ages of 5 to 16 years with at least 4 attack/month of primary migraine were eligible for participation the study. A visual analog scale was used to evaluate pain intensity at the moment of admission to the study (start of the study) and every month up to 18 months later (end of the study). One hundred sixty children of both sexes aged 5-16 years were enrolled and assigned in 4 groups to receive a treatment with acetaminophen or ibuprofen without or with magnesium. Migraine pain endurance and monthly frequency were similar in the 4 groups. Both acetaminophen and ibuprofen induced a significant decrease in pain intensity (P < .01), without a time-dependent correlation, but did not modify its frequency. Magnesium pretreatment induced a significant decrease in pain intensity (P < .01) without a time-dependent correlation in both acetaminophen- and ibuprofen-treated children and also significantly reduced (P < .01) the pain relief timing during acetaminophen but not during ibuprofen treatment (P < .01). In both acetaminophen and ibuprofen groups, magnesium pretreatment significantly reduced the pain frequency (P < .01). Magnesium increased the efficacy of ibuprofen and acetaminophen with not age-related effects. © 2013 American Headache Society.

  14. Tips for Starting Yoga in Adults with Migraines

    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 ...

  15. 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...

  16. Cerebral hemodynamics in migraine

    DEFF Research Database (Denmark)

    Hachinski, V C; Olesen, Jes; Norris, J W

    1977-01-01

    Clinical and angiographic findings in migraine are briefly reviewed in relation to cerebral hemodynamic changes shown by regional cerebral blood flow (rCBF) studies. Three cases of migraine studied by the intracarotid xenon 133 method during attacks are reported. In classic migraine, with typical...... prodromal symptoms, a decrease in cerebral blood flow has been demonstrated during the aura. Occasionally, this flow decrease persists during the headache phase. In common migraine, where such prodromata are not seen, a flow decrease has not been demonstrated. During the headache phase of both types...... of migraine, rCBF has usually been found to be normal or in the high range of normal values. The high values may represent postischemic hyperemia, but are probably more frequently secondary to arousal caused by pain. Thus, during the headache phase rCBF may be subnormal, normal or high. These findings do...

  17. The role of exercise in migraine treatment.

    Science.gov (United States)

    Koseoglu, E; Yetkin, M F; Ugur, F; Bilgen, M

    2015-09-01

    This review aims to provide a comprehensive overview of the literature on the use of exercise for migraine treatment with regard to its efficacy, mechanism of action and role in practice. Many randomized studies have reported the efficacy of prophylactic treatment of migrane with medications such as beta blockers or antiepileptic drugs. Studies on alternative approaches, like aerobic exercise and biofeedback, are however limited but also considered to be effective. Scientific databases were searched with keywords "exercise" and "migraine". The resulting publications were gathered, examined and discussed throughly. Past studies had limitations and were few in number, but more recent randomized controlled studies have concretely provided level of evidence about the effectiveness of exercise in prophylactic treatment of migraine. Core properties of exercise like intensity, duration, frequency, type and warming up period are required to be monitored while treating migraine to increase the beneficial effects and, also to prevent injuries and side effects which may include exertional headache. Isometric neck exercise is helpful when the migraine is accompanied by neck pain. Patient population with low beta endorphin level in blood, high physical fitness and high motivation receives significant benefits from the exercise treatment. The action of exercise on migraine is in general related to neurochemical factors, psychological states and increase in cardivascular and cerebrovascular fitness. Considering its effectiveness and minimal side effects, migraine patients should often be encouraged to practice physical exercise with intensity, frequency and duration that should be carefully instituted to achieve the most beneficial outcome while preventing potential injuries and side effects.

  18. Administration of palmitoylethanolamide in combination with topiramate in the preventive treatment of nummular headache

    Directory of Open Access Journals (Sweden)

    Chirchiglia D

    2016-07-01

    Full Text Available Domenico Chirchiglia,1 Attilio Della Torre,2 Francesco Signorelli,2 Giorgio Volpentesta,2 Giusy Guzzi,2 Carmelino Angelo Stroscio,2 Federica Deodato,2 Donatella Gabriele,2 Angelo Lavano,2 1Department of Neurosurgery, Neurophysiopathology Unit, 2Department of Neurosurgery, University of Catanzaro “Magna Graecia”, Catanzaro, Italy Abstract: Nummular headache has been recently described as a primary disorder characterized by head pain exclusively felt in a small rounded area typically 2–6 cm in diameter, not attributed to another disorder. Both size and shape of the painful area remain constant since the onset of symptoms. A 57-year-old woman presented with a history of focal episodic pain in a circumscribed area on the right parietal region. The administration of standard oral doses of palmitoylethanolamide and topiramate in combination showed an improvement in pain symptoms and on pain measuring scales. Keywords: algometry, migraine, nummular headache, palmitoylethanolamide, topiramate

  19. Dipyridamole may induce migraine in patients with migraine without aura

    DEFF Research Database (Denmark)

    Kruuse, C; Lassen, L H; Iversen, Helle Klingenberg

    2006-01-01

    Dipyridamole inhibits phosphodiesterase 5 (PDE5) and adenosine re-uptake. The most prominent side-effect is headache. We examined the migraine-generating effects of dipyridamole as well as the cerebral blood velocity response in a single-blind study, including 10 patients with migraine without aura...... repeatedly. Headache was induced in all migraine patients and in eight of 10 healthy subjects (P = 0.47) with no significant difference in headache intensity (P = 0.53). However, five patients but only one healthy subject experienced the symptoms of migraine without aura, according to ICHD-2 criteria, within....... Thus, dipyridamole induces symptoms of migraine and an initial decrease in V(mca) in migraine patients, but not significantly more than in healthy subjects. This relatively low frequency of migraine induction, compared with nitric oxide donors and sildenafil, is probably due to the less specific action...

  20. [Is childhood migraine an immature form of adult migraine?].

    Science.gov (United States)

    Ozge, Aynur

    2007-01-01

    Childhood migraine is a common problem among the primary complaints of the pediatric population. But for the general practitioners there are little known about clinical characteristics and management strategies. Headache practitioners commonly notice the age related differences of headache characteristics and management schedules. This paper primarily aimed to answer the question if pediatric migraine is an unmaturated form of adult migraine, by discussing the pathophysiological basis, clinical forms and management strategies.

  1. The use of combined techniques: Scottish showers, hot bath and manual techniques in the treatment of migraine headache

    Directory of Open Access Journals (Sweden)

    Andrei-Cătălin Ionițe

    2017-12-01

    Full Text Available Migraines are caused by internal factors (out of which the most important are genetically and physiologically determined and the external ones, namely, the environment. The most common factor which triggers the migraines is the physiological one. According to some specialized studies, in most cases, it is assumed that migraines are caused by a neuro-vascular disorder. This statement works as a compromise solution for the two theories supported by specialists, which explain the occurrence of migraines: neural mechanisms theory and the theory of vascular origin. Starting from these two theories, we’ve used Scottish showers, hot baths (37oC followed by manual drainage of the venous sinuses. The Scottish showers determine the toning of the muscle capillaries. Immersion in warm water for 15 minutes determines vasodilation, along with muscle and mental relaxation. Drainage techniques of venous sinuses operate on the reciprocal tension membranes (RTM, restoring their mobility and improving neuro-vascular disorders. In this research, there were involved 3 subjects, who have taken part in the treatment sessions; they have been monitored and the resulting data has been recorded.

  2. Do I need an imaging study for my 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 ...

  3. 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.

  4. One hundred years of migraine research

    DEFF Research Database (Denmark)

    Tfelt-Hansen, Peer C; Koehler, Peter J

    2011-01-01

    ); oligemia in the wake of CSD in rats (1982); neurogenic inflammation theory of migraine (1987); a new headache classification (1988); the discovery of sumatriptan (1988); migraine and calcitonin gene-related peptide (1990); the brainstem "migraine generator" and PET studies (1995); migraine...

  5. The pathophysiology of the migraine attack

    NARCIS (Netherlands)

    E.L.H. Spierings

    1980-01-01

    textabstractMigraine, a word of French origin, is a mediaeval corruption of the Greek hemicrania". Its etymological meaning, half-headache, indicates two important features of the disorder, the headache and its onesidedness. In classical migraine, the headache is preceded by an 'aura' of

  6. Diagnosis and Development of Screening Items for Migraine in Neurological Practice in Taiwan

    Directory of Open Access Journals (Sweden)

    Shuu-Jiun Wang

    2008-06-01

    Conclusion: Migraine was the most common headache diagnosis in the neurologists’ clinics. Probable migraine was not completely adopted as a migraine spectrum among neurologists. In contrast to ID™, moderate or severe headache intensity replaced headache-related disability as one screening item for migraine in Taiwan.

  7. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for the prevention of tension-type headache in adults.

    Science.gov (United States)

    Banzi, Rita; Cusi, Cristina; Randazzo, Concetta; Sterzi, Roberto; Tedesco, Dario; Moja, Lorenzo

    2015-05-01

    This is an updated version of the Cochrane review published in 2005 on selective serotonin re-uptake inhibitors (SSRIs) for preventing migraine and tension-type headache. The original review has been split in two parts and this review now only regards tension-type headache prevention. Another updated review covers migraine. Tension-type headache is the second most common disorder worldwide and has high social and economic relevance. As serotonin and other neurotransmitters may have a role in pain mechanisms, SSRIs and serotonin-norepinephrine reuptake inhibitors (SNRIs) have been evaluated for the prevention of tension-type headache. To determine the efficacy and tolerability of SSRIs and SNRIs compared to placebo and other active interventions in the prevention of episodic and chronic tension-type headache in adults. For the original review, we searched the Cochrane Central Register of Controlled Trials (CENTRAL 2003, Issue 4), MEDLINE (1966 to January 2004), EMBASE (1994 to May 2003), and Headache Quarterly (1990 to 2003). For this update, we revised the original search strategy to reflect the broader type of intervention (SSRIs and SNRIs). We searched CENTRAL (2014, Issue 10) on the Cochrane Library, MEDLINE (1946 to November 2014), EMBASE (1980 to November 2014), and PsycINFO (1987 to November 2014). We also checked the reference lists of retrieved articles and searched trial registries for ongoing trials. We included randomised controlled trials comparing SSRIs or SNRIs with any type of control intervention in participants 18 years and older, of either sex, with tension-type headache. Two authors independently extracted data (headache frequency, index, intensity, and duration; use of symptomatic/analgesic medication; quality of life; and withdrawals) and assessed the risk of bias of trials. The primary outcome is tension-type headache frequency, measured by the number of headache attacks or the number of days with headache per evaluation period. The original

  8. Premonitory symptoms in migraine

    DEFF Research Database (Denmark)

    Laurell, Katarina; Artto, Ville; Bendtsen, Lars

    2016-01-01

    AIM: To describe the frequency and number of premonitory symptoms (PS) in migraine, the co-occurrence of different PS, and their association with migraine-related factors. METHODS: In this cross-sectional study, a validated questionnaire was sent to Finnish migraine families between 2002 and 2013...... to obtain data on 14 predefined PS, migraine diagnoses, demographic factors, and migraine characteristics. The estimated response rate was 80%. RESULTS: Out of 2714 persons, 2223 were diagnosed with migraine. Among these, 77% reported PS, with a mean number of 3.0 symptoms compared to 30% (p ....5 symptoms (p migraine headaches. Yawning was the most commonly reported symptom (34%) among migraineurs. Females reported PS more frequently than males (81 versus 64%, p 

  9. Critical analysis of the use of onabotulinumtoxinA (botulinum toxin type A in migraine

    Directory of Open Access Journals (Sweden)

    Robertson CE

    2012-01-01

    Full Text Available Carrie E Robertson, Ivan GarzaDepartment of Neurology, Mayo Clinic, Rochester, MN, USAAbstract: OnabotulinumtoxinA, a neurotoxin, has been studied in numerous trials as a novel preventive therapy for migraine headache. The data would support that it may be effective at reducing headache days in patients suffering from chronic migraine (≥15 headache days/month, with eight or more of those migraine headache days. The mechanism by which onabotulinumtoxinA exerts its effects on migraine is not yet understood. It is known to inhibit acetylcholine release at the neuromuscular junction, but this probably does not explain the observed antinociceptive properties noted in preclinical and clinical trials. This review will discuss the known mechanisms of action of botulinum toxin type A, and will review the available randomized, placebo-controlled trials that have looked at its efficacy as a migraine preventative. We also describe the onabotulinumtoxinA injection sites used at our institution.Keywords: botulinum toxin, prophylaxis, onabotulinumtoxinA, mechanism, migraine, prevention

  10. Headache at high school: clinical characteristics and impact.

    Science.gov (United States)

    Tonini, M C; Frediani, F

    2012-05-01

    Although migraine (MH) and tension type headache (TTH) are the most common and important causes of recurrent headache in adolescents, they are poorly understood and not recognized by parents and teachers, delaying the first physician evaluation for correct diagnosis and management. The purpose of this study is to assess the knowledge about headache impact among the students of a Communication Private High School in Rimini city, and to evaluate the main different types of headaches interfering with school and social day activities. A self-administered questionnaire interview was given to students of the last 2 years of high school; ten items assessed the headache experience during the prior 12 months, especially during school time: the features and diagnosis of headaches types (based on the 2004 IHS criteria), precipitating factors, disability measured using the migraine disability assessment (MIDAS); therapeutic intervention. Out of the 60 students, 84 % experienced recurrent headache during the last 12 months. 79 % were females, aged 17-20 years; a family history was present in 74 % of headache students, in the maternal line; 45 % of subjects were identified as having MH and 27 % TTH; 25 % had morning headache and 20 % in the afternoon; fatigue, emotional stress and lack of sleep were the main trigger factors for headache, respectively in 86, 50 and 50 % of students; 92 % of headache students could not follow the lessons, could not participate in exercises and physical activity because of the headache; none had consulted a medical doctor and the 90 % of all students had never read, listened or watched television about headache. This study remarks on the need to promote headache educational programs, starting from high school, to increase communication between teachers-family-physician and patient-adolescents, with the goal to have an early appropriate therapeutic intervention, improvement of the quality of life and to prevent long-term headache disease in the

  11. A large pharmacy claims-based descriptive analysis of patients with migraine and associated pharmacologic treatment patterns

    Directory of Open Access Journals (Sweden)

    Muzina DJ

    2011-11-01

    rates that raise concern of overuse; high use is often seen without any preventive medications. Furthermore, use of US Food and Drug Administration–approved preventive medications is low. Finally, patients with migraine are significantly more likely to receive other psychotropic medications. These findings suggest efforts to optimize the management of migraines could address appropriate use of triptans, increased and more effective use of migraine preventive medications, and better understanding of the use of other psychotropics.Keywords: headaches, triptans, migraine preventive therapy, comorbidity, psychotropics

  12. The Role of Melatonin in the Treatment of Primary Headache Disorders

    Science.gov (United States)

    Gelfand, Amy A.; Goadsby, Peter J.

    2016-01-01

    Objective To provide a summary of knowledge about the use of melatonin in the treatment of primary headache disorders. Background Melatonin is secreted by the pineal gland; its production is regulated by the hypothalamus and increases during periods of darkness. Methods We undertook a narrative review of the literature on the role of melatonin in the treatment of primary headache disorders. Results There are randomized placebo-controlled trials examining melatonin for preventive treatment of migraine and cluster headache. For cluster headache, melatonin 10 mg was superior to placebo. For migraine, a randomized placebo-controlled trial of melatonin 3 mg (immediate release) was positive, though an underpowered trial of melatonin 2 mg (sustained release) was negative. Uncontrolled studies, case series, and case reports cover melatonin’s role in treating tension-type headache, hypnic headache, hemicrania continua, SUNCT/SUNA and primary stabbing headache. Conclusions Melatonin may be effective in treating several primary headache disorders, particularly cluster headache and migraine. Future research should focus on elucidating the underlying mechanisms of benefit of melatonin in different headache disorders, as well as clarifying optimal dosing and formulation. PMID:27316772

  13. Botulinum toxin type a for chronic migraine.

    Science.gov (United States)

    Ashkenazi, Avi

    2010-03-01

    Chronic migraine (CM) is the leading cause of chronic daily headache, a common and debilitating headache syndrome. The management of CM patients is challenging, with only limited benefit from available oral preventive medications. Botulinum neurotoxin (BoNT) has been used extensively to treat disorders associated with increased muscle tone. More recent scientific data support an analgesic effect of the toxin. The pharmacokinetic and pharmacodynamic profiles of BoNT make it an appealing candidate for migraine prevention. Results from older clinical trials on the efficacy of the toxin in CM were inconclusive. However, recent trials using more stringent inclusion criteria have shown positive results, supporting the use of the toxin in some patients with this disorder. This review summarizes the scientific data on the analgesic properties of BoNT, as well as the clinical data on the efficacy of the toxin in treating CM.

  14. Management of Pediatric Migraine: Current Therapies.

    Science.gov (United States)

    Khrizman, Marina; Pakalnis, Ann

    2018-02-01

    Migraine is one of the most common neurologic conditions in pediatrics. It can be a significant stressor, causing absences from school and interruption of parents' work and family schedules. The mainstay of treatment remains educating patients about healthy lifestyle practices and the influences of sleep, stressors, and hydration on triggering migraine attacks. Psychological therapies such as biofeedback or cognitive-behavioral therapy may be beneficial in some patients, especially those with prominent psychological comorbidities. New advances in the pathophysiology of migraine and additional pediatric approval of abortive therapy with triptans have led to significant advances in the management of migraine in children. Some challenges to preventive therapy were recently noted with the negative results obtained in the Childhood and Adolescent Migraine Prevention Study, which compared prescription drugs to placebo. Inherent differences between adult and pediatric headaches, with shorter duration of pediatric migraine and prominent placebo effect, present recurring challenges for clinicians. [Pediatr Ann. 2018;47(2):e55-e60.]. Copyright 2018, SLACK Incorporated.

  15. [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.

  16. Migraine, Osmophobia, and Anxiety.

    Science.gov (United States)

    Rocha-Filho, Pedro Augusto Sampaio; Marques, Karine Sobral; Torres, Rinailda Cascia Santos; Leal, Kamila Nazare Ribas

    2016-04-01

    To evaluate the association between osmophobia and the characteristics of patients and their headaches, among migraine patients. This was a cross-sectional study. Patients who consecutively sought medical attendance in a primary care unit were asked about their headaches over the last 12 months. Those who had migraine were included. A semi-structured interview, the Headache Impact Test and the Hospital Anxiety and Depression Scale were used. 147 patients had migraine; 78 had osmophobia; 60 had significant anxiety symptoms; and 78 had significant depression symptoms. The mean age of these patients was 43.2 years (± 13.7); 91.2% were women. The mean length of time with complaints of headache was 13.8 years (± 12). Among the migraine patients, those with anxiety, more years of headache history, and phonophobia presented significantly more osmophobia (multivariate logistic regression). Osmophobia in migraine patients is associated with significant anxiety symptoms, length of headache history, and phonophobia. © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Low levels of serum serotonin and amino acids identified in migraine patients.

    Science.gov (United States)

    Ren, Caixia; Liu, Jia; Zhou, Juntuo; Liang, Hui; Wang, Yayun; Sun, Yinping; Ma, Bin; Yin, Yuxin

    2018-02-05

    Migraine is a highly disabling primary headache associated with a high socioeconomic burden and a generally high prevalence. The clinical management of migraine remains a challenge. This study was undertaken to identify potential serum biomarkers of migraine. Using Liquid Chromatography coupled to Mass Spectrometry (LC-MS), the metabolomic profile of migraine was compared with healthy individuals. Principal component analysis (PCA) and Orthogonal partial least squares-discriminant analysis (orthoPLS-DA) showed the metabolomic profile of migraine is distinguishable from controls. Volcano plot analysis identified 10 serum metabolites significantly decreased during migraine. One of these was serotonin, and the other 9 were amino acids. Pathway analysis and enrichment analysis showed tryptophan metabolism (serotonin metabolism), arginine and proline metabolism, and aminoacyl-tRNA biosynthesis are the three most prominently altered pathways in migraine. ROC curve analysis indicated Glycyl-l-proline, N-Methyl-dl-Alanine and l-Methionine are potential sensitive and specific biomarkers for migraine. Our results show Glycyl-l-proline, N-Methyl-dl-Alanine and l-Methionine may be as specific or more specific for migraine than serotonin which is the traditional biomarker of migraine. We propose that therapeutic manipulation of these metabolites or metabolic pathways may be helpful in the prevention and treatment of migraine. Copyright © 2018 Elsevier Inc. All rights reserved.

  18. 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.

  19. Migraine among medical students in Kuwait University.

    Science.gov (United States)

    Al-Hashel, Jasem Y; Ahmed, Samar Farouk; Alroughani, Raed; Goadsby, Peter J

    2014-05-10

    Medical students routinely have triggers, notably stress and irregular sleep, which are typically associated with migraine. We hypothesized that they may be at higher risk to manifest migraine. We aimed to determine the prevalence of migraine among medical students in Kuwait University. This is cross-sectional, questionnaire-based study. Participants who had two or more headaches in the last 3 months were subjected to two preliminary questions and participants with at least one positive response were asked to perform the validated Identification of Migraine (ID Migraine™) test. Frequency of headache per month and its severity were also reported. Migraine headache was suggested in 27.9% subjects based on ID-Migraine™. Migraine prevalence (35.5% and 44%, versus 31.1%, 25%, 21.1%, 14.8%, 26.5%, p Kuwait University compared to other published studies. The migraine prevalence, frequency and headache severity, all increased in the final two years of education.

  20. 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.

  1. The influence of ictal cutaneous allodynia on the response to occipital transcutaneous electrical stimulation in chronic migraine and chronic tension-type headache: a randomized, sham-controlled study.

    Science.gov (United States)

    Bono, F; Salvino, D; Mazza, M R; Curcio, M; Trimboli, M; Vescio, B; Quattrone, A

    2015-04-01

    The objective of this article is to determine whether cutaneous allodynia (CA) influences the response to treatment with occipital transcutaneous electrical stimulation (OTES) in chronic migraine (CM) and chronic tension-type headache (CTTH). One hundred and sixty consecutive patients with CM or CTTH were randomized to be treated with real or sham OTES stimulation three times a day for two consecutive weeks. All patients completed the validated 12-item allodynia symptom checklist for assessing the presence and the severity of CA during headache attack. Primary end-point was change (≥50%) in number of monthly headache-free days. There was a significant difference in the percentage of responders in the real OTES compared with sham OTES group (p headache-free days in the allodynic patients with CM and CTTH treated both with real and sham OTES, while the number of headache-free days per month was significantly reduced in the real (86%) but not in the sham group (7%) of non-allodynic patients with CTTH and CM. Severe CA is associated with decreased response to treatment with OTES in patients with CM and CTTH. © International Headache Society 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  2. Direct and Indirect Healthcare Resource Utilization and Costs Among Migraine Patients in the United States.

    Science.gov (United States)

    Bonafede, Machaon; Sapra, Sandhya; Shah, Neel; Tepper, Stewart; Cappell, Katherine; Desai, Pooja

    2018-05-01

    clinical characteristics. A second analysis, conducted among the migraine patients only, compared the odds of having a short-term disability claim between (1) patients treated with acute or preventive migraine medications only during the baseline period and patients with no migraine treatment during baseline and (2) patients treated with both acute and preventive migraine medications during the baseline period and patients with no migraine treatment during baseline, after controlling for patient demographic and clinical characteristics. Migraine patients had total annual direct plus indirect costs that were $8924 (in 2014 United States dollars) higher than those of demographically similar individuals without evidence of migraine. Migraine patients' mean annual direct all-cause healthcare costs were $6575 higher than those of matched patients without migraine ($11,010 [standard deviation = $19,663] vs $4436 [standard deviation=$13,081]; P costs were $2350 higher in the migraine cohort than in the matched no migraine patients ($11,294 vs $8945. Migraine patients were 2.0 times more likely as their nonmigraine counterparts to use opioids (45.5% vs 21.9%; P cost burden in the United States. Compared to matched nonmigraine patients, migraine patients were more likely to have work loss and longer periods of work loss, leading to significantly higher indirect costs. Migraine patients also had higher levels of healthcare utilization, despite the relatively stable prevalence of migraine and the available acute and preventive treatment options for migraine management. © 2018 American Headache Society.

  3. An Association between Carpal Tunnel Syndrome and Migraine Headaches—National Health Interview Survey, 2010

    Directory of Open Access Journals (Sweden)

    Huay-Zong Law, MD

    2015-03-01

    Conclusions: This study is the first to demonstrate an association between CTS and migraine headache. Longitudinal and genetic studies with physician verification of migraine headaches and CTS are needed to further define this association.

  4. Chiropractic management using a brain-based model of care for a 15-year-old adolescent boy with migraine headaches and behavioral and learning difficulties: a case report

    Science.gov (United States)

    Kuhn, Kurt W.; Cambron, Jerrilyn

    2013-01-01

    Objective The purpose of this report is to describe chiropractic management, using a brain-based model of care, of a teen who had migraine headaches and several social and learning difficulties. Clinical features A 15-year-old adolescent boy with a chronic history of migraines and more than 10 years of learning and behavioral difficulties, including attention-deficit/hyperactivity disorder, obsessive compulsive disorder, and Tourette syndrome, presented for chiropractic care. Intervention and outcome The patient received spinal manipulation and was given home physical coordination activities that were contralateral to the side of the involved basal ganglia and ipsilateral to the involved cerebellum, along with interactive metronome training. Quantitative changes were noted in neurological soft signs, tests of variables of attention Conners’ Parent Rating Scale, the California Achievement Test, grade point, and reduction of medications. The patient reported qualitative improvements in tics, attention, reading, vision, health, relationships with his peers and his family, and self-esteem. Conclusion The patient with migraine headaches and learning difficulties responded well to the course of chiropractic care. This study suggests that there may be value in a brain-based model of care in the chiropractic management of conditions that are beyond musculoskeletal in nature. PMID:24396330

  5. [Possibilities of preventive therapy in frequent episodic tension-type headache].

    Science.gov (United States)

    Tabeeva, G R; Fokina, N M

    2016-01-01

    To study the efficacy and safety of tenoten in the preventive treatment of frequent episodic tension-type headache (FETHA) compared to patients treated with pain relievers. A study included 60 patients with FETHA. Patients of the main group (n=30) received tenoten in addition to standard treatment. The study comprised 3 visits: beginning of treatment, after one month and after three months. All patients underwent physical and clinical/neurological examinations. In each visit, treatment efficacy was assessed according the following parameters: VAS scores (0-10) for assessment of pain and tension in pericranial muscles in 6 standard points, mean frequency and duration of the headache episode, quality of life indices, Beck depression scores, Spilberger trait and state anxiety, autonomic symptom severity, parameters of sleep disorders, frequency of adverse effects, CGI scores (0-7). Tenoten as a preventive medication reduced the frequency of headache episodes that allowed to diagnose patients with rare episodic tension-type headache in the end of treatment. At the same time, there was a significant reduction in headache intensity during the episode and decrease in amount of analgesics used by the patients.

  6. Prevalence and impact of headache in undergraduate students in Southern Brazil

    OpenAIRE

    Falavigna,Asdrubal; Teles,Alisson Roberto; Velho,Maíra Cristina; Vedana,Viviane Maria; Silva,Roberta Castilhos da; Mazzocchin,Thaís; Basso,Maira; Braga,Gustavo Lisbôa de

    2010-01-01

    OBJECTIVE: To determine the prevalence, characteristics and impact of headache among university students. METHOD: The criteria established by the International Headache Society were used to define the primary headache subtypes and the Migraine Disability Assessment Questionnaire (MIDAS), to assess the disability. The students were then grouped into six categories: [1] migraine; [2] probable migraine; [3] tension-type headache; [4] probable tension-type headache; [5] non-classifiable headache;...

  7. Association Between Severity of Temporomandibular Disorders and the Frequency of Headache Attacks in Women With Migraine: A Cross-Sectional Study.

    Science.gov (United States)

    Florencio, Lidiane Lima; de Oliveira, Anamaria Siriani; Carvalho, Gabriela Ferreira; Dach, Fabiola; Bigal, Marcelo Eduardo; Fernández-de-Las-Peñas, César; Bevilaqua-Grossi, Débora

    2017-05-01

    The aim of this study was to investigate the magnitude of association of the severity of temporomandibular disorders (TMDs) in women with episodic and chronic migraine. Thirty-one women with episodic migraine (mean age: 33 years), 21 with chronic migraine (mean age: 35 years) and 32 healthy controls (mean age: 31 years) were included. The Fonseca Anamnestic Index was applied to assess severity of TMDs. TMD severity was considered as follows: no TMD (0-19 points), mild TMD (20-49 points), moderate TMD (50-69 points), and severe TMD (70-100 points). To compare the proportion of TMD severity among groups, a χ 2 test was performed. Prevalence ratio (PR) was calculated to determine the association of TMD severity and both migraine groups using the control group as the reference. Women with chronic and episodic migraine were more likely to exhibit TMD signs and symptoms of any severity than healthy controls (χ 2 = 30.26; P < .001). TMD prevalence was 54% for healthy controls, 78% for episodic migraine, and 100% for chronic migraine. Women with chronic migraine exhibited greater risk of more severe manifestations of TMD than healthy controls (PR: 3.31; P = .008). This association was not identified for episodic migraine (PR: 2.18; P = .101). The presence of TMD signs and symptoms was associated with migraine independently of the frequency; however, the magnitude of the association of more severe TMD was significantly greater in chronic, but not episodic, migraine. Copyright © 2017. Published by Elsevier Inc.

  8. 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).

  9. Management of migraine in adolescents

    Directory of Open Access Journals (Sweden)

    Marielle A Kabbouche

    2008-06-01

    Full Text Available Marielle A Kabbouche1,2, Deborah K Gilman31Department of Pediatrics, Department of 2Neurology, Cincinnati Children’s Hospital Medical Center; 3Department of Psychology, Columbus Children’s Hospital, OH, USAAbstract: Headaches in children and adolescents are still under-diagnosed. 75% of children are affected by primary headache by the age of 15 with 28% fitting the ICHD2 criteria of migraine. Migraine is considered a chronic disorder that can severely impact a child’s daily activities, including schooling and socializing. Early recognition and aggressive therapy, with acute and prophylactic treatments, as well as intensive biobehavioral interventions, are essential to control the migraine attacks and reverse the progression into intractable disabling headache.Keywords: migraine, children, adolescents, headache, biofeedback

  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. Intractable Headache - The Pain in Your Head that Just Won't Quit

    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 ...

  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. The power features of Masseter muscle activity in tension-type and migraine without aura headache during open-close clench cycles

    Directory of Open Access Journals (Sweden)

    Behrouz Alizadeh Savareh

    2017-07-01

    Full Text Available Introduction Different types of headaches and TMJ click influence the masseter muscle activity. The aim of this study was to assess the trend of energy level of the electromyography (EMG activity of the masseter muscle during open-close clench cycles in migraine without aura (MOA and tension-type headache (TTH with or without TMJ click. Methods Twenty-five women with MOA and twenty four women with TTH participated in the study. They matched with 25 healthy subjects, in terms of class of occlusion and prevalence of temporomandibular joint (TMJ with click. The EMG of both masseter muscles were recorded during open-close clench cycles at a rate of 80 cycles per minute for 15 seconds. The mouth opening was restricted to two centimeters by mandibular motion frame. Signal processing steps have been done on the EMG as: noise removing, smoothing, feature extraction, and statistical analyzing. The six statistical parameters of energy computed were mean, Variance, Skewness, Kurtosis, and first and second half energy over all signal energy. Results A three-way ANOVA indicated that during all the cycles, the mean of energy was more and there was a delay in showing the peak of energy in the masseter of the left side with clicked TMJ in MOA group compared to the two other groups, while this pattern occurred inversely in the side with no-clicked TMJ (P < 0.009. The variation of energy was significantly less in MOA group compared to the two other groups in the no-clicked TMJ (P < 0.003. However, the proportion of the first or second part of signal energy to all energy showed that TTH group had less energy in the first part and more energy in the second part in comparison to the two other groups (P < 0.05. Conclusion The study showed different changes in the energy distribution of masseter muscle activity during cycles in MOA and TTH. MOA, in contrast to TTH, had lateralization effect on EMG and interacted with TMJ click.

  14. 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.

  15. [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

  16. Migraine induced by hypoxia

    DEFF Research Database (Denmark)

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

    2016-01-01

    in the visual cortex were measured by proton magnetic resonance spectroscopy. The circumference of cranial arteries was measured by 3 T high-resolution magnetic resonance angiography. Hypoxia induced migraine-like attacks in eight patients compared to one patient after sham (P = 0.039), aura in three...... and possible aura in 4 of 15 patients. Hypoxia did not change glutamate concentration in the visual cortex compared to sham, but increased lactate concentration (P = 0.028) and circumference of the cranial arteries (P ... suggests that hypoxia may provoke migraine headache and aura symptoms in some patients. The mechanisms behind the migraine-inducing effect of hypoxia should be further investigated....

  17. 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.

  18. The Relationship between Attention Deficit Hyperactivity Disorder and Personality Characteristics in Migrainous Patients

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    Abdol Reza Sabahi

    2014-08-01

    Full Text Available Background: World Health Organization reports described migraine as one of the 4 most disabling chronic medical disorders. A day with migraine is as disabling as a day with quadriplegia, schizophrenia, or dementia in who is view 87% of people with migraine has some degree of disability. Migraine headaches are associated with psychological factors and personality characteristics. This study compares the personality characteristics of migraine patients with Attention Deficit Hyperactivity Disorder (ADHD and without ADHD. Materials and Methods: Eighty patients with migraine were evaluated in this cross sectional study with simple sampling method. All participants were assessed with semi structured clinical interview, adult ADHD self-report scale (ASRS and Millone clinical multiaxial inventory questionnaire. The migraine patients were divided into two groups, with and without ADHD. The correlation of variables was tested by χ2 test and t-test with 0.05 significance with the use of software SPSS-20. Results: Our participants were 80% female, 56% married and 36.2% with at least graduation from high school. Patients with migraine and ADHD were younger and their first headache experience had occurred in lower age compared with non-ADHD patients (p<0.05. In current study, we showed that there is a significant correlation between ADHD and depressive and independent personality traits and dysthymic clinical syndrome in migraine patients (p<0.05. Conclusion: Our results demonstrate that personality characteristics in migraine patients may be affected by some other mental disorders such as ADHD. These findings might be helpful in early treatment and prevention of dysfunctioning in patients with migraine.

  19. 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....

  20. Prophylactic treatment of migraine; the patient's view, a qualitative study

    Directory of Open Access Journals (Sweden)

    Dekker Frans

    2012-03-01

    Full Text Available Abstract Background Prophylactic treatment is an important but under-utilised option for the management of migraine. Patients and physicians appear to have reservations about initiating this treatment option. This paper explores the opinions, motives and expectations of patients regarding prophylactic migraine therapy. Methods A qualitative focus group study in general practice in the Netherlands with twenty patients recruited from urban and rural general practices. Three focus group meetings were held with 6-7 migraine patients per group (2 female and 1 male group. All participants were migraine patients according to the IHS (International Headache Society; 9 had experience with prophylactic medication. The focus group meetings were analysed using a general thematic analysis. Results For patients several distinguished factors count when making a decision on prophylactic treatment. The decision of a patient on prophylactic medication is depending on experience and perspectives, grouped into five categories, namely the context of being active or passive in taking the initiative to start prophylaxis; assessing the advantages and disadvantages of prophylaxis; satisfaction with current migraine treatment; the relationship with the physician and the feeling to be heard; and previous steps taken to prevent migraine. Conclusion In addition to the functional impact of migraine, the decision to start prophylaxis is based on a complex of considerations from the patient's perspective (e.g. perceived burden of migraine, expected benefits or disadvantages, interaction with relatives, colleagues and physician. Therefore, when advising migraine patients about prophylaxis, their opinions should be taken into account. Patients need to be open to advice and information and intervention have to be offered at an appropriate moment in the course of migraine.

  1. Effects of autogenic training on nitroglycerin-induced headaches.

    Science.gov (United States)

    Juhasz, Gabriella; Zsombok, Terezia; Gonda, Xenia; Nagyne, Nora; Modosne, Edit; Bagdy, Gyorgy

    2007-03-01

    To investigate the prophylactic and acute effects of autogenic training (AT) during a nitroglycerin-induced migraine attack. Thirty female migraineurs (without aura) and 11 controls participated in the study. Of these, 11 migraineurs and 5 controls practiced AT regularly for at least 6 months prior to and during the sublingual nitroglycerin test. Headache intensity and characteristics were recorded with a standardized method. During the nitroglycerin challenge, blood was collected for plasma cortisol determination and blood pressure and pulse rate were recorded. As a long-term preventive treatment, AT significantly decreased the mean headache frequency and intensity (P = .001) compared to the pretreatment period in the migraineurs who regularly practiced AT (n = 11). During the nitroglycerin challenge, AT successfully attenuated the nitroglycerin-induced acute decrease in blood pressure and pulse rate (P = .013; n = 16 AT subjects vs n = 25 non-AT subjects). However, it was not effective in preventing immediate headache (P = .71), did not decrease the frequency of acute migraine attacks (P = .79), and could not alleviate acute migraine pain (P = .78; n = 16 AT subjects vs n = 25 non-AT subjects). Plasma cortisol concentration significantly increased (P = .003) during the acute migraine attack (n = 22), and migraine intensity correlated with plasma cortisol elevations (P < .001; n = 41) and showed a tendency of negative correlation with morning plasma cortisol concentration (P = .08; n = 41). However, AT did not alter plasma cortisol responses (P = .99; n = 16 AT subjects vs n = 25 non-AT subjects). (1) The long-term AT therapy proved to be a significantly effective preventive intervention in migraine sufferers. We hypothesized that this long-term effect of AT is based on modulation of the pain anticipation system, which is strongly correlated with function of the anterior cingulate cortex. (2) We demonstrated that AT could not alter the nitroglycerin-induced acute

  2. Aerobic Exercise for Reducing Migraine Burden: Mechanisms, Markers, and Models of Change Processes.

    Science.gov (United States)

    Irby, Megan B; Bond, Dale S; Lipton, Richard B; Nicklas, Barbara; Houle, Timothy T; Penzien, Donald B

    2016-02-01

    Engagement in regular exercise routinely is recommended as an intervention for managing and preventing migraine, and yet empirical support is far from definitive. We possess at best a weak understanding of how aerobic exercise and resulting change in aerobic capacity influence migraine, let alone the optimal parameters for exercise regimens as migraine therapy (eg, who will benefit, when to prescribe, optimal types, and doses/intensities of exercise, level of anticipated benefit). These fundamental knowledge gaps critically limit our capacity to deploy exercise as an intervention for migraine. Clear articulation of the markers and mechanisms through which aerobic exercise confers benefits for migraine would prove invaluable and could yield insights on migraine pathophysiology. Neurovascular and neuroinflammatory pathways, including an effect on obesity or adiposity, are obvious candidates for study given their role both in migraine as well as the changes known to accrue with regular exercise. In addition to these biological pathways, improvements in aerobic fitness and migraine alike also are mediated by changes in psychological and sociocognitive factors. Indeed a number of specific mechanisms and pathways likely are operational in the relationship between exercise and migraine improvement, and it remains to be established whether these pathways operate in parallel or synergistically. As heuristics that might conceptually benefit our research programs here forward, we: (1) provide an extensive listing of potential mechanisms and markers that could account for the effects of aerobic exercise on migraine and are worthy of empirical exploration and (2) present two exemplar conceptual models depicting pathways through which exercise may serve to reduce the burden of migraine. Should the promise of aerobic exercise as a feasible and effective migraine therapy be realized, this line of endeavor stands to benefit migraineurs (including the many who presently remain

  3. CGRP as the target of new migraine therapies - successful translation from bench to clinic.

    Science.gov (United States)

    Edvinsson, Lars; Haanes, Kristian Agmund; Warfvinge, Karin; Krause, Diana N

    2018-06-01

    Treatment of migraine is on the cusp of a new era with the development of drugs that target the trigeminal sensory neuropeptide calcitonin gene-related peptide (CGRP) or its receptor. Several of these drugs are expected to receive approval for use in migraine headache in 2018 and 2019. CGRP-related therapies offer considerable improvements over existing drugs as they are the first to be designed specifically to act on the trigeminal pain system, they are more specific and they seem to have few or no adverse effects. CGRP receptor antagonists such as ubrogepant are effective for acute relief of migraine headache, whereas monoclonal antibodies against CGRP (eptinezumab, fremanezumab and galcanezumab) or the CGRP receptor (erenumab) effectively prevent migraine attacks. As these drugs come into clinical use, we provide an overview of knowledge that has led to successful development of these drugs. We describe the biology of CGRP signalling, summarize key clinical evidence for the role of CGRP in migraine headache, including the efficacy of CGRP-targeted treatment, and synthesize what is known about the role of CGRP in the trigeminovascular system. Finally, we consider how the latest findings provide new insight into the central role of the trigeminal ganglion in the pathophysiology of migraine.

  4. Comparison of Levetiracetam and sodium Valproate in migraine prophylaxis: A randomized placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Homa Sadeghian

    2015-01-01

    Full Text Available Background: Migraine is a chronic and disabling disorder. Treatment of migraine often comprises of symptomatic (abortive and preventive (prophylactic treatment. The current drugs used in migraine prophylaxis include antidepressant drugs (Serotonin Reuptake Inhibitors, Tricyclic antidepressants, and anti-epileptic drugs (valproate, gabapentin, etc. Objective: The objective of our study was to assess the efficacy and tolerability of levetiracetam in adult migraine prophylaxis, compared to valproate and placebo. Materials and Methods: We conducted a prospective, randomized, placebo-controlled study. A total of 85 patients were randomized to receive levetiracetam 500 mg/d (n = 27, valproate 500 mg/d (n = 32 or placebo (n = 26. The patients were evaluated for treatment efficacy after 6 months. Efficacy was assessed as a more than 50% decrease in headache frequency. Results: In levetiracetam group, 17 (63.0% patients experienced a more than 50% decrease in headache frequency, while this efficacy number was 21 (65.6% for valproate group and 4 (15.4% for placebo group. The difference was not statistically significant between levetiracetam and valproate, while it was significant when comparing either levetiracetam or valproate to placebo. Conclusion: Compared to placebo, levetiracetam offers improvement in headache frequency in patients with migraine. The efficacy of levetiracetam in migraine prophylaxis is comparable to currently used drugs such as valproate.

  5. Vestibular migraine: who is the patient?

    Science.gov (United States)

    Colombo, Bruno; Teggi, Roberto

    2017-05-01

    Vestibular migraine has been classified as a specific entity in which vestibular symptomatology is defined as part of the migrainous disorder. New and appropriate diagnostic criteria have been proposed by the Barany and International Headache Societies. The diagnosis of vestibular migraine mainly depends on the patient history. The NIVE project is a prospectic multicentric study on vestibular migraine. The aim of this project is to evaluate demographics, epidemiology, clinical manifestations of migraine and vertigo in a large cohort of Caucasian patients affected by vestibular migraine.

  6. 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.

  7. Safety and efficacy of ALD403, an antibody to calcitonin gene-related peptide, for the prevention of frequent episodic migraine

    DEFF Research Database (Denmark)

    Dodick, David W; Goadsby, Peter J; Silberstein, Stephen D

    2014-01-01

    BACKGROUND: Calcitonin gene-related peptide (CGRP) is crucial in the pathophysiology of migraine. We assessed the safety, tolerability, and efficacy of ALD403, a genetically engineered humanised anti-CGRP antibody, for migraine prevention. METHODS: In this randomised, double-blind, placebo-contro...

  8. 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.

  9. Food and migraine in adolescents

    Directory of Open Access Journals (Sweden)

    Magda Bouhairet

    2011-08-01

    Full Text Available Background Migraine headaches are a common problem worldwide, especially in adolescents. They are usually chronic, with frequent relapses. Therefore, any dietary risk factor for headaches has important implications on migraineurs. However, the association between migraine and diet needs to be examined further. Objective To investigate the association between diet and migraine in adolescents. Methods We conducted a cross-sectional study in August to September 2009 on 13 - 18 year old adolescents in a senior high school in Medan, North Sumatera. We included subjects diagnosed with migraine, according to the International Headache Society (IHS criteria. Ninety participants completed the questionnaire. Foods we observed for a link to migraine included milk, chocolate, ice cream, cheese, bread, instant noodles, meatballs, chili sauce, sweetener, yoghurt, pizza, and other foods and beverages. Results Of the 90 participants with migraines, there were more females (61.1% than males. There were statistically significant associations between migraine and triggering foods (P = 0.045, 95% CI 0.59 to 0.79 as well as between migraine and family history of migraine (P = 0.043, 95% CI 0.46 to 0.66. Stress (P = 0.164, menstruation (P = 0.369, and sound or light (P= 0.577 had no significant association with migraine. A wide variety of foods and beverages were implicated as migraine precipitants. The most common were chili sauce (75.8%, ice cream (71.0%, milk (67.7%, instant noodles (67.7%, chocolate (61.3%, peanuts (59.7%, cheese (54.8% and meatballs (54.8%. Conclusion Food and family history have a significant association with the occurrence of migraine in adolescents.

  10. 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.

  11. 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.

  12. 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

  13. Prostaglandins and prostaglandin receptor antagonism in migraine

    DEFF Research Database (Denmark)

    Antonova, Maria

    2013-01-01

    Human models of headache may contribute to understanding of prostaglandins' role in migraine pathogenesis. The current thesis investigated the migraine triggering effect of prostaglandin E2 (PGE2) in migraine patients without aura, the efficacy of a novel EP4 receptor antagonist, BGC20....... The infusion of PGE2 caused the immediate migraine-like attacks and vasodilatation of the middle cerebral artery in migraine patients without aura. The highly specific and potent EP4 receptor antagonist, BGC20-1531, was not able to attenuate PGE2-induced headache and vasodilatation of both intra- and extra......-cerebral arteries. The intravenous infusion of PGF2α did not induce headache or statistically significant vasoconstriction of cerebral arteries in healthy volunteers. Novel data on PGE2-provoked immediate migraine-like attacks suggest that PGE2 may be one of the important final products in the pathogenesis...

  14. The KATP channel in migraine pathophysiology

    DEFF Research Database (Denmark)

    Al-Karagholi, Mohammad Al-Mahdi; Hansen, Jakob Møller; Severinsen, Johanne

    2017-01-01

    BACKGROUND: To review the distribution and function of KATP channels, describe the use of KATP channels openers in clinical trials and make the case that these channels may play a role in headache and migraine. DISCUSSION: KATP channels are widely present in the trigeminovascular system and play...... an important role in the regulation of tone in cerebral and meningeal arteries. Clinical trials using synthetic KATP channel openers report headache as a prevalent-side effect in non-migraine sufferers, indicating that KATP channel opening may cause headache, possibly due to vascular mechanisms. Whether KATP...... channel openers can provoke migraine in migraine sufferers is not known. CONCLUSION: We suggest that KATP channels may play an important role in migraine pathogenesis and could be a potential novel therapeutic anti-migraine target....

  15. Infant Colic and Migraine: Is There a Connection?

    Science.gov (United States)

    ... FOR MORE INFORMATION AAN Patients and Caregivers site http://patients.aan.com/go/home Migraine Research Foundation http://www.migraineresearchfoundation.org American Headache Society Committee for ...

  16. Prednisolone reduces nitric oxide-induced migraine

    DEFF Research Database (Denmark)

    Tfelt-Hansen, P; Daugaard, D; Lassen, L H

    2009-01-01

    BACKGROUND AND PURPOSE: Glyceryl trinitrate (GTN) induces delayed migraine attacks in migraine patients. The purpose of this study was to investigate whether pre-treatment with prednisolon could decrease this effect of GTN. METHODS: In this double-blind, randomized and placebo-controlled, crossover...... study 15 migraineurs with migraine without aura were pre-treated with 150 mg of prednisolone or placebo followed by a 20-min infusion of GTN (0.5 ug/kg/min). One hour after the GTN-infusion, the participants were sent home, but continued to rate headache and possible associated symptoms by filling out...... a headache diary every hour for 12 h. There were two equal primary efficacy end-points: frequency of delayed migraine and intensity of delayed headache. RESULTS: Nine patients experienced a GTN headache fulfilling the diagnostic criteria for migraine without aura on the placebo day compared with four...

  17. Headache associated with hemodialysis

    Directory of Open Access Journals (Sweden)

    Nikić Petar M.

    2008-01-01

    , serum concentration of hemoglobin, blood urea nitrogen, creatinine, glucose, MCHC, total protein, sodium and potassium. Fourteen patients (34% of those with headaches experienced headache during the HD session and were sub classified as HDH using diagnostic criteria of the International Headache Society. Tension type headache (41% of those with headaches and migraine without aura (10% were most common in the primary headache group and headache due to arterial hypertension (7% was the most prevalent among the secondary headaches. Although there were some common clinical characteristics, we could not find a unifying clinical pattern in the patients with HDH. CONCLUSION Hemodialysis headache is the most common headache in patients undergoing hemodialysis, and despite some common symptoms, it does not appear to be uniform in its clinical characteristics.

  18. [Health care activity in a headache-specific clinic].

    Science.gov (United States)

    Garcia-Escrivà, A; Asensio-Asensio, M; López-Hernández, N; González-Aznar, O J; Oliver-Navarrete, C; Alvarez-Saúco, M; Pampliega-Pérez, A

    It is reckoned that headaches affect, at least once a year, around 90% of the population. The socioeconomic repercussion occasioned by this malady justifies the appearance in recent years of headache units. To conduct a descriptive epidemiological and health care study of the activity carried out in a headache-specific clinic. All the relevant points from the histories of patients who visited our surgery over a period of two years were collected prospectively and consecutively. The different types of headaches were classified according to the 1988 IHS criteria. Both the symptomatic and the preventive treatment were analysed. In all, a total of 866 patients were found; 691 (79.8%) were females and the mean age was 39.8 +/- 15.9 years (range: 6-90 years); 208 (24%) had a history of migraine in the family; 399 (49.9%) were diagnosed as suffering from migraine: 256 (64.2%) had migraine without aura, 152 (19%) were diagnosed as having tension-type headache, and 218 (27.3%) presented chronic daily headache (CDH). The most frequently used symptomatic treatments were NSAI drugs (36.7%) and triptanes (28.4%). Amitriptyline (47.7%), beta-blockers (14.5%) and calcium antagonists (11.3%) were the main drugs used as preventive treatment. After several years' operation of our Headache Unit, we thought there was a need to analyse the population seen in the visits. The fact that the majority of our patients were middle-aged females matched our expectations. Although most of the patients were diagnosed as suffering from M, we also want to highlight the high proportion of cases of CDH, above all associated with the abuse of analgesics.

  19. The Relationship between Migraine and Nutrition

    Directory of Open Access Journals (Sweden)

    Ayçıl Özturan

    2016-06-01

    Full Text Available Migraine is a kind of headache accompanied by neurologic, gastrointestinal, and autonomous variations. The roles of factors that trigger migraine, especially nutrition triggers, have become much more questionable with the increase in the rate of migraine occurrence. Some patients with migraine have stated that their headache attacks start without any reason. However, inner triggers such as hormonal changes or external triggers such as air exchange, some smells or the association of both triggers can start the headache. Each patient may not have same sensitivity to these triggers. A single factor might become prominent in some patients, but more than one factor may need to be required in other patients. Although the connection between migraine and the factors such as stress, environmental factors, chronic diseases, and nutritional and sleep status has been known, their mechanisms are still not clear. Nutritional status and the effects of nutrition play an important role being pain triggers in everybody, especially children and young people who suffer from migraine headache. Considering the migraine triggers generally, it has been suggested in studies that there is at least one nutrition-related trigger and hunger is the most frequently reported trigger in terms of diet. Moreover it is known that chocolate, tea, coffee, cheese, and alcohol may trigger migraine because of some specific elements within them. In recently conducted studies, using some functional foods have raised on the treatment of migraine. For this reason, the relationship between migraine and triggering factors as food and nutrition are examined in this study.

  20. Menstrual migraine

    OpenAIRE

    Simić Svetlana; Slankamenac Petar; Cvijanović Milan; Banić-Horvat Sofija; Jovin Zita; Ilin Miroslav

    2007-01-01

    Introduction. The prevalence of migraine in childhood and adolescence has not changed to a great extent, but it increases in adolescence, especially in female adolescents. Menstrual migraine – definition. There are two types of menstrual migraine: true menstrual migraine and menstrual related migraine. True menstrual migraine occurs predominantly around menstruation, whereas menstrual related migraine occurs during menstruation, but also at other times during the month. Causes. Exaggerated or...

  1. 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.

  2. [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.

  3. 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...

  4. Behavioural management of migraine

    Science.gov (United States)

    Brown, Helen; Newman, Craig; Noad, Rupert; Weatherby, Stuart

    2012-01-01

    It is important to recognise that migraine is a ‘biological’ and not a ‘psychological’ entity. However, psychological factors can be involved in migraine in 4 different ways:- 1) Migraines can be triggered by psychological stressors; 2) Severe migraine can itself be a cause of significant psychological stress which can, in turn, exacerbate the problem; 3) Even if psychological stress is not significantly involved in the genesis of the headache, pain management techniques can help people cope with their pain more effectively; 4) Longitudinal data demonstrate a complex bidirectional association between mood disorders and migraine. Treatment of a co-existing mood disorder, for example with cognitive behavioural techniques, may therefore reduce the impact of migraine. It would thus appear logical to view medical and psychological approaches as potentially synergistic rather than mutually exclusive. Functional imaging indicates that cognition, emotions, and pain experiences change the way the brain processes pain inputs. This may provide a physiological rationale for psychological interventions in pain management. As most studies of psychological management of migraine have been relatively small and the approach often varies between clinicians, the magnitude of benefit, optimum method of delivery, and the length of intervention are uncertain. PMID:23024569

  5. Behavioural management of migraine

    Directory of Open Access Journals (Sweden)

    Helen Brown

    2012-01-01

    Full Text Available It is important to recognise that migraine is a ′biological′ and not a ′psychological′ entity. However, psychological factors can be involved in migraine in 4 different ways:- 1 Migraines can be triggered by psychological stressors; 2 Severe migraine can itself be a cause of significant psychological stress which can, in turn, exacerbate the problem; 3 Even if psychological stress is not significantly involved in the genesis of the headache, pain management techniques can help people cope with their pain more effectively; 4 Longitudinal data demonstrate a complex bidirectional association between mood disorders and migraine. Treatment of a co-existing mood disorder, for example with cognitive behavioural techniques, may therefore reduce the impact of migraine. It would thus appear logical to view medical and psychological approaches as potentially synergistic rather than mutually exclusive. Functional imaging indicates that cognition, emotions, and pain experiences change the way the brain processes pain inputs. This may provide a physiological rationale for psychological interventions in pain management. As most studies of psychological management of migraine have been relatively small and the approach often varies between clinicians, the magnitude of benefit, optimum method of delivery, and the length of intervention are uncertain.

  6. 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.

  7. Vomiting and migraine-related clinical parameters in pediatric migraine.

    Science.gov (United States)

    Eidlitz-Markus, Tal; Haimi-Cohen, Yishai; Zeharia, Avraham

    2017-06-01

    To investigate the characteristics of vomiting in pediatric migraineurs and the relationship of vomiting with other migraine-related parameters. The cohort included children and adolescents with migraine attending a headache clinic of a tertiary pediatric medical center from 2010 to 2016. Patients were identified by a retrospective database search. Data were collected from medical files. The presence of vomiting was associated with background and headache-related parameters. The study group included 453 patients, 210 boys (46.4%) and 243 girls (53.6%), of mean age 11.3 ± 3.7 years. Vomiting was reported by 161 patients (35.5%). On comparison of patients with and without vomiting, vomiting was found to be significantly associated with male gender (54% vs 42.1%, P migraine onset (8.0 ± 3. years vs 9.6 ± 3.7 years, P migraine (67% vs 58.7%, P migraine (24.1% vs 10.1%, P migraine in both parents (9.3% vs 3.1%, P = .007), and migraine in either parent (57.5% vs 45.5%, P = .02). The higher rate of vomiting in the younger patients and the patients with awakening pain may be explained by a common underlying pathogenetic mechanism of vomiting and migraine involving autonomic nerve dysfunction/immaturity. The association of vomiting with parental migraine points to a genetic component of vomiting and migraine. It should be noted that some of the findings may simply reflect referral patterns in the tertiary clinic. © 2017 American Headache Society.

  8. The KATP channel in migraine pathophysiology: a novel therapeutic target for migraine.

    Science.gov (United States)

    Al-Karagholi, Mohammad Al-Mahdi; Hansen, Jakob Møller; Severinsen, Johanne; Jansen-Olesen, Inger; Ashina, Messoud

    2017-08-23

    To review the distribution and function of K ATP channels, describe the use of K ATP channels openers in clinical trials and make the case that these channels may play a role in headache and migraine. K ATP channels are widely present in the trigeminovascular system and play an important role in the regulation of tone in cerebral and meningeal arteries. Clinical trials using synthetic K ATP channel openers report headache as a prevalent-side effect in non-migraine sufferers, indicating that K ATP channel opening may cause headache, possibly due to vascular mechanisms. Whether K ATP channel openers can provoke migraine in migraine sufferers is not known. We suggest that K ATP channels may play an important role in migraine pathogenesis and could be a potential novel therapeutic anti-migraine target.

  9. Energy Metabolism Impairment in Migraine.

    Science.gov (United States)

    Cevoli, Sabina; Favoni, Valentina; Cortelli, Pietro

    2018-06-22

    Migraine is a common disabling neurological disorder which is characterised by recurring headache associated with a variety of sensory and autonomic symptoms. The pathophysiology of migraine remains not entirely understood, although many mechanisms involving the central and peripheral nervous system are now becoming clear. In particular, it is widely accepted that migraine is associated with energy metabolic impairment of the brain. The purpose of this review is to present an update overview of the energy metabolism involvement in the migraine pathophysiology. Several biochemical, morphological and magnetic resonance spectroscopy studies have confirmed the presence of energy production deficiency together with an increment of energy consumption in migraine patients. An increment of energy demand over a certain threshold create metabolic and biochemical preconditions for the onset of the migraine attack. The defect of oxidative energy metabolism in migraine is generalized. It remains to be determined if the mitochondrial deficit in migraine is primary or secondary. Riboflavin and Co-Enzyme Q10, both physiologically implicated in mitochondrial respiratory chain functioning, are effective in migraine prophylaxis, supporting the hypothesis that improving brain energy metabolism may reduce the susceptibility to migraine. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  10. Efficacy of ibuprofen on prevention of high altitude headache: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Juan Xiong

    Full Text Available Ibuprofen is used to prevent high altitude headache (HAH but its efficacy remains controversial. We conducted a systematic review and meta-analysis of randomized, placebo-controlled trials (RCTs of ibuprofen for the prevention of HAH.Studies reporting efficacy of ibuprofen for prevention of HAH were identified by searching electronic databases (until December 2016. The primary outcome was the difference in incidence of HAH between ibuprofen and placebo groups. Risk ratios (RR were aggregated using a Mantel-Haenszel random effect model. Heterogeneity of included trials was assessed using the I2 statistics.In three randomized-controlled clinical trials involving 407 subjects, HAH occurred in 101 of 239 subjects (42% who received ibuprofen and 96 of 168 (57% who received placebo (RR = 0.79, 95% CI 0.66 to 0.96, Z = 2.43, P = 0.02, I2 = 0%. The absolute risk reduction (ARR was 15%. Number needed to treat (NNT to prevent HAH was 7. Similarly, The incidence of severe HAH was significant in the two groups (RR = 0.40, 95% CI 0.17 to 0.93, Z = 2.14, P = 0.03, I2 = 0%. Severe HAH occurred in 3% treated with ibuprofen and 10% with placebo. The ARR was 8%. NNT to prevent severe HAH was 13. Headache severity using a visual analogue scale was not different between ibuprofen and placebo. Similarly, the difference between the two groups in the change in SpO2 from baseline to altitude was not different. One included RCT reported one participant with black stools and three participants with stomach pain in the ibuprofen group, while seven participants reported stomach pain in the placebo group.Based on a limited number of studies ibuprofen seems efficacious for the prevention of HAH and may therefore represent an alternative for preventing HAH with acetazolamide or dexamethasone.

  11. Neurotrophins and Migraine.

    Science.gov (United States)

    Martins, L B; Teixeira, A L; Domingues, R B

    2017-01-01

    Neurotrophins (NTs) have been implicated in generation and modulation of nociceptive pathways. Change in NTs levels is associated with painful conditions and neurological diseases such as migraine. Currently, it is generally recognized that migraine headaches result from the activation and sensitization of trigeminal sensory afferent fibers leading to neuropeptides release such as calcitonin gene-related peptide (CGRP) and substance P (SP). This triggers an inflammatory cascade causing a neurogenic inflammation. The agents responsible for trigeminal activation and release of neuropeptides are still unclear. It is known that the transient receptor potential vanilloid receptor-1 (TRPV1) is an important mediator of CGRP and SP release. TRPV1 is closely associated with tyrosine receptors kinases (Trk), which are NTs receptors. NTs can act on TRPV1 increasing its sensitivity to painful stimuli, therefore predisposing to hyperalgesia. Upregulation of ion channels and pain receptors in dorsal root ganglion neurons may be alternative mechanisms by which NTs contribute to pain development. Only a few studies have been performed to investigate the role of NTs in migraine. These studies have reported changes in NTs levels in migraine patients either during the migraine attack or in free-headache periods. © 2017 Elsevier Inc. All rights reserved.

  12. Sustained long-term benefit of patent foramen ovale closure on migraine.

    Science.gov (United States)

    Trabattoni, Daniela; Fabbiocchi, Franco; Montorsi, Piero; Galli, Stefano; Teruzzi, Giovanni; Grancini, Luca; Gatto, Pamela; Bartorelli, Antonio L

    2011-03-01

    This single-center, observational, prospective study evaluated the impact of patent foramen ovale (PFO) closure on migraine attacks over time. PFO closure may reduce the frequency and severity of migraine headaches in patients with significant right-to-left shunts. Between May 2000 and September 2009, 305 consecutive patients (mean age, 43 ± 12 years; 54.5% women) with a prior embolic cerebrovascular event underwent PFO closure with the Amplatzer PFO occluder for recurrence prevention. All patients had right-to-left shunts; the shunts were associated with migraine symptoms in 77 (25%), either alone (n = 64, 83%) or with aura (n = 13, 17%). Septal aneurysm was present in 15 (19.5%) migraine patients, and 43 (56%) had a previous transient brain ischemic attack. All migraine patients had a computed tomography scan or magnetic resonance imaging, indicating a previous brain ischemic lesion. All 305 patients underwent transthoracic echocardiography with clinical follow-up at 24 hr, at 3, 6, and 12 months, and then yearly. An acute migraine attack occurred 24-48 hr after PFO closure in 28 (36.4%) of 77 patients. There was a significant reduction (>50%) in the number and intensity of attacks in 46 (60.5%) of 77 patients at the 3-month follow-up. At the 12-month follow-up, migraine had ceased in 23 (46%) patients, and 20 (40%) had a reduction in the migraine recurrence rate and disabling symptoms. These results were maintained at follow-up (mean, 28 ± 27 months). There was overall improvement in migraine in 89% of the treated patients. Percutaneous PFO closure in migraineurs may provide beneficial mid-term and long-term results, with significant reduction in the intensity and frequency of headache symptoms. Copyright © 2010 Wiley-Liss, Inc.

  13. Cognitive functioning in adolescents with migraine

    Directory of Open Access Journals (Sweden)

    Melissa Andréia Costa-Silva

    Full Text Available Although migraine is highly prevalent in children and teenagers, it often goes undetected in these patients, resulting in underdiagnosis and inadequate treatment. Several studies have investigated cognitive changes in adults with migraine. However, there are few studies focusing on children and adolescents. Objective : To investigate cognitive performance of adolescents with migraine. Methods : Twenty-eight adolescents diagnosed with migraine and twenty-six individuals without a history of headache were recruited for the study. All participants were evaluated using standardized neuropsychological tests. Results : Adolescents with migraine had worse performance on tests evaluating short- and long-term verbal memory, attention, executive function, and speed of processing information than controls. Conclusion : Cognitive dysfunction is common in adolescents with migraine. Since the cognitive deficits found in adolescents with migraine are similar to those reported in adults with migraine, cognitive impairment seems to persist throughout life.

  14. New Developments in the Prophylactic Drug Treatment of Pediatric Migraine: What Is New in 2017 and Where Does It Leave Us?

    Science.gov (United States)

    Kacperski, Joanne; Bazarsky, Allyson

    2017-08-01

    Headaches in children are quite common; however, the study and characterization of headache disorders in the pediatric age group has historically been limited. Because of the lack of controlled studies on prophylactic treatment of headache disorders in this age group, the diagnosis of migraine rests on criteria similar those in adults. Likewise, data from adult studies is often inferred and applied to children. Although it appears that many preventives are safe in children, currently none are FDA or EMA approved for this age group. Consequently, many children who present to their primary care physicians with migraines do not receive any preventive therapy despite experiencing significant disability. Controlled clinical trials investigating the use of preventive medications in children have suffered from high placebo response rates. The shorter duration of headaches and other characteristic features seen in children are such that designing randomized controlled trials in this age group is more problematic and limiting. Treatment practices vary widely, even among specialists, due to the absence of evidence-based guidelines from clinical trials. The Childhood and Adolescent Migraine Prevention Study (CHAMP) was developed to examine the effectiveness of two of the most widely prescribed preventive medications for pediatric migraine and help narrow this gap. To date, it has been the largest enrolling study of its kind within the pediatric migraine world; its results and implications will be discussed and considered here. The CHAMP trial was discontinued early on account of futility and exhibited that neither of two preventive medications for pediatric migraine was more effective than placebo in reducing the number of headache days over a period of 24 weeks. Subjects in the amitriptyline and topiramate groups had higher rates of adverse events than those who had received placebo.

  15. Percutaneous Closure of Patent Foramen Ovale in Patients With Migraine: The PREMIUM Trial.

    Science.gov (United States)

    Tobis, Jonathan M; Charles, Andrew; Silberstein, Stephen D; Sorensen, Sherman; Maini, Brijeshwar; Horwitz, Phillip A; Gurley, John C

    2017-12-05

    Migraine is a prevalent and disabling disorder. Patent foramen ovale (PFO) has been associated with migraine, but its role in the disorder remains poorly understood. This study examined the efficacy of percutaneous PFO closure as a therapy for migraine with or without aura. The PREMIUM (Prospective, Randomized Investigation to Evaluate Incidence of Headache Reduction in Subjects With Migraine and PFO Using the AMPLATZER PFO Occluder to Medical Management) was a double-blind study investigating migraine characteristics over 1 year in subjects randomized to medical therapy with a sham procedure (right heart catheterization) versus medical therapy and PFO closure with the Amplatzer PFO Occluder device (St. Jude Medical, St. Paul, Minnesota). Subjects had 6 to 14 days of migraine per month, had failed at least 3 migraine preventive medications, and had significant right-to-left shunt defined by transcranial Doppler. Primary endpoints were responder rate defined as 50% reduction in migraine attacks and adverse events. Secondary endpoints included reduction in migraine days and efficacy in patients with versus without aura. Of 1,653 subjects consented, 230 were enrolled. There was no difference in responder rate in the PFO closure (45 of 117) versus control (33 of 103) groups. One serious adverse event (transient atrial fibrillation) occurred in 205 subjects who underwent PFO closure. Subjects in the PFO closure group had a significantly greater reduction in headache days (-3.4 vs. -2.0 days/month, p = 0.025). Complete migraine remission for 1 year occurred in 10 patients (8.5%) in the treatment group versus 1 (1%) in the control group (p = 0.01). PFO closure did not meet the primary endpoint of reduction in responder rate in patients with frequent migraine. (Prospective, Randomized Investigation to Evaluate Incidence of Headache Reduction in Subjects With Migraine and PFO Using the AMPLATZER PFO Occluder to Medical Management [PREMIUM]; NCT00355056). Copyright

  16. [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.

  17. 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

  18. Improved description of the migraine aura by a diagnostic aura diary

    DEFF Research Database (Denmark)

    Russell, M B; Iversen, Helle Klingenberg; Olesen, J

    1994-01-01

    We present a diagnostic aura diary for prospective recordings of migraine with aura. Three questionnaires are supplemented with sheets for drawings and plottings of visual and sensory auras. Twenty patients recorded 54 attacks of migraine with aura and 2 attacks of migraine aura without headache...... head pain, headache and aura symptoms were contralateral in 90% and ipsilateral in 10%....

  19. Nitric oxide-related drug targets in headache

    DEFF Research Database (Denmark)

    Olesen, Jes

    2010-01-01

    -called delayed headache that fulfils criteria for migraine without aura in migraine sufferers. Blockade of nitric oxide synthases (NOS) by L-nitromonomethylarginine effectively treats attacks of migraine without aura. Similar results have been obtained for chronic the tension-type headache and cluster headache....... Inhibition of the breakdown of cyclic guanylate phosphate (cGMP) also provokes migraine in sufferers, indicating that cGMP is the effector of NO-induced migraine. Similar evidence suggests an important role of NO in the tension-type headache and cluster headache. These very strong data from human...... experimentation make it highly likely that antagonizing NO effects will be effective in the treatment of primary headaches. Nonselective NOS inhibitors are likely to have side effects whereas selective compounds are now in early clinical trials. Antagonizing the rate limiting cofactor tetrahydrobiopterin seems...

  20. 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...

  1. Clinic and Emergency Room Evaluation and Testing of Headache.

    Science.gov (United States)

    Nye, Barbara L; Ward, Thomas N

    2015-10-01

    Evaluation of the headache patient in the outpatient clinic and emergency department (ED) has different focuses and goals. The focus of this paper is to review the evaluation of patients in both settings with mention of evaluation in the pediatric and pregnant patient population.  The patient's history should drive the practitioner's decision and evaluation choices. We review recommendations made by the American Board of Internal Medicine and American Headache Society through the Choosing Wisely Campaign, which has an emphasis on choosing the right imaging modality for the clinical situation and elimination/prevention of medication overuse headache, as well as the US Headache Consortium guidelines for migraine headache. We will also review focusing on ED evaluation of the pediatric patient and pregnant patient presenting with headache. At the end of the review we hope to have provided you with a framework to think about the headache patient and what is the appropriate test in the given clinical setting in order to ensure that the patient gets the right diagnosis and is set on a path to the appropriate management plan. © 2015 American Headache Society.

  2. Prevalence and impact of headache in undergraduate students in Southern Brazil

    Directory of Open Access Journals (Sweden)

    Asdrubal Falavigna

    2010-12-01

    Full Text Available OBJECTIVE: To determine the prevalence, characteristics and impact of headache among university students. METHOD: The criteria established by the International Headache Society were used to define the primary headache subtypes and the Migraine Disability Assessment Questionnaire (MIDAS, to assess the disability. The students were then grouped into six categories: [1] migraine; [2] probable migraine; [3] tension-type headache; [4] probable tension-type headache; [5] non-classifiable headache; [6] no headache. RESULTS: Of all undergraduate students interviewed, 74.5% had at least one headache episode in the last three months. Regarding disability, there was a significant difference between the headache types (p<0.0001. In the post-hoc analysis, migraine was the headache type with most reported disability. CONCLUSION: Headache is a highly prevalent condition among the students at the University of Caxias do Sul. This disease may have a major impact on the students' lives and in some cases, ultimately lead to educational failure.

  3. Dietary Treatment for Migraine Under Six Years

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-11-01

    Full Text Available Clinical factors and response to treatment were compared in children < 6 years and older children treated for migraine by nonpharmacologic measures in a pediatric headache clinic at Schneider Children’s Medical Center, Petah Tiqwa, Israel.

  4. Workplace disability in migraine: an Italian experience.

    Science.gov (United States)

    D'Amico, D; Genco, S; Perini, F

    2004-10-01

    Workplace disability due to migraine has not been extensively researched in non-English speaking countries. We assessed the repercussions of headache, and particularly of migraine, on work in a sample of employees from an Italian company (Bulgari). Information was obtained through a self-answering questionnaire in "all headaches" sufferers, and through direct interview in migraine sufferers (diagnosis according to IHS criteria). Headache frequency, pain intensity and headache-related disability were higher in migraineurs than in "all headaches" sufferers. About a quarter of migraineurs missed at least one day in the three months prior to the interview due to headache, and around 10% lost two or more days over the same period. Moore than 50% of migraineurs reported 1-7 days per month at work with headache, with reduction in productivity level by 50% or more in 15% of respondents. Our data confirmed that headaches, and particularly migraine, cause a considerable reduction in workplace productivity. Workplace interventions to effectively manage migraine are needed.

  5. Epigone migraine vertigo (EMV): a late migraine equivalent.

    Science.gov (United States)

    Pagnini, P; Vannucchi, P; Giannoni, B; Pecci, R

    2014-02-01

    Migrainous headache is determined by pathogenetic mechanisms that are also able to affect the peripheral and/or central vestibular system, so that vestibular symptoms may substitute and/or present with headache. We are convinced that there can be many different manifestations of vestibular disorders in migrainous patients, representing true different clinical entities due to their different characteristics and temporal relashionship with headache. Based on such considerations, we proposed a classification of vertigo and other vestibular disorders related to migraine, and believe that a particular variant of migraine-related vertigo should be introduced, namely "epigone migraine vertigo" (EMV): this could be a kind of late migraine equivalent, i.e. a kind of vertigo, migrainous in origin, starting late in the lifetime that substitutes, as an equivalent, pre-existing migraine headache. To clarify this particular clinical picture, we report three illustrative clinical cases among 28 patients collected during an observation period of 13 years (November 1991 - November 2004). For all patients, we collected complete personal clinical history. All patients underwent standard neurotological examination, looking for spontaneous-positional, gaze-evoked and caloric induced nystagmus, using an infrared video camera. We also performed a head shaking test (HST) and an head thrust test (HTT). Ocular motility was tested looking at saccades and smooth pursuit. To exclude other significant neurological pathologies, a brain magnetic resonance imaging (MRI) with gadolinium was performed. During the three months after the first visit, patients were invited to keep a diary noting frequency, intensity and duration of vertigo attacks. After that period, we suggested that they use prophylactic treatment with flunarizine (5 mg per day) and/or acetylsalicylic acid (100 mg per day), or propranolol (40 mg twice a day). All patients were again recommended to note in their diary the frequency

  6. Understanding migraine and psychiatric comorbidity.

    Science.gov (United States)

    Seng, Elizabeth K; Seng, Cynthia D

    2016-06-01

    This article describes recent trends in our understanding of the role of psychiatric disorders in the experience and treatment of migraine, and the role of migraine in the experience and treatment of psychiatric disorders. Although the majority of studies evaluating psychiatric comorbidity in migraine have focused on depression, anxiety, and bipolar disorders are highly associated with migraine and relevant for prognosis and treatment planning. Comorbid psychiatric disorders may be associated with poorer treatment response for some acute pharmacotherapies; however, people with comorbid migraine and mood or anxiety disorders can achieve large responses to preventive pharmacologic and behavioral therapies. Emerging research is developing and evaluating behavioral treatments designed to manage cooccurring migraine and mood or anxiety disorders. Stigma related to psychiatric disorders has been well characterized, and could exacerbate extant migraine-related stigma. Anxiety and mood disorders are prevalent in people with migraine, although not ubiquitous. Psychiatric comorbidity is associated with greater migraine symptoms and disability; however, people with comorbid depression or anxiety are amenable to preventive migraine treatment. Research regarding migraine treatment strategies optimized for people with comorbid psychiatric disorders is critical to advancing care and reducing stigma for this important subpopulation of people with migraine.

  7. Migraine and pregnancy: an internet survey.

    Science.gov (United States)

    Allais, Gianni; Rolando, Sara; De Lorenzo, Cristina; Manzoni, Gian Camillo; Messina, Paolo; Benedetto, Chiara; d'Onofrio, Florindo; Bonavita, Vincenzo; Bussone, Gennaro

    2013-05-01

    Data in the literature show that migraine tends to improve during pregnancy in most migrainous women. The aim of this Internet survey was to obtain the most likely cross section of the situation in the general population with respect to the presence and course of migraine in pregnancy. All women who participated were asked to answer questions pertaining to their history of pregnancy and headache. One thousand and eighteen women participated in the survey; only 775 met the eligibility criteria for inclusion. One hundred and ninety-five women (25.2 %) reported having had a headache only before pregnancy, 425 (54.8 %) before and during pregnancy, and 155 (20.0 %) only during pregnancy. Women suffering from headache before and/or during pregnancy were much more likely to have headaches with more migrainous features at the ID Migraine Screener test when compared to women whose headache began during pregnancy. "Definite migraines" were 277/620 (44.7 %) and 26/155 (16.8 %), respectively, in the two groups (p < 0.0001). Among the 620 females that suffered from headache before pregnancy, 375 (60.5 %) improved, 195 (31.5 %) showed complete resolution of the disorder, and 180 (29.0 %) had a reduction in headache frequency. Moreover, the multinomial logistic model (with headache pattern as dependent variable) proved fetal presentation as significant (p = 0.0042). Women with "new headache" (No/Yes pattern) had an OR (95 % CI) of 1.9 (1.2-3.0) of breech presentation at delivery versus those with a stable pattern of headache (Yes/Yes). Finally, women with not recent pregnancy stated they suffered from headache less than the women with recent pregnancy.

  8. The role of personality, disability and physical activity in the development of medication-overuse headache

    DEFF Research Database (Denmark)

    Mose, Louise S; Pedersen, Susanne S; Debrabant, Birgit

    2018-01-01

    BACKGROUND: Factors associated with development of medication-overuse headache (MOH) in migraine patients are not fully understood, but with respect to prevention, the ability to predict the onset of MOH is clinically important. The aims were to examine if personality characteristics, disability...... and physical activity level are associated with the onset of MOH in a group of migraine patients and explore to which extend these factors combined can predict the onset of MOH. METHODS: The study was a single-center prospective observational study of migraine patients. At inclusion, all patients completed...... questionnaires evaluating 1) personality (NEO Five-Factor Inventory), 2) disability (Migraine Disability Assessment), and 3) physical activity level (Physical Activity Scale 2.1). Diagnostic codes from patients' electronic health records confirmed if they had developed MOH during the study period of 20 months...

  9. Avaliação da utilização do placebo nas crises agudas de migrânea sem aura, migrânea com aura e cefaléia do tipo tensional episódica Evaluation of placebo use in migraine without aura, migraine with aura and episodic tension-type headache acute attacks

    Directory of Open Access Journals (Sweden)

    Marcelo Eduardo Bigal

    2001-09-01

    Full Text Available O presente estudo apresenta a avaliação do efeito placebo no tratamento agudo da migrânea sem aura, migrânea com aura e cefaléia do tipo tensional episódica. Foram estudados pacientes que deram entrada entre 1 de março de 1997 a 31 de novembro de 1999 em dois pronto-socorros. Definiram-se três grupos, cada um com 30 pacientes: 1 - migrânea sem aura (MSA; 2 -- migrânea com aura (MCO; 3 -- cefaléia do tipo tensional episódica (CTTE. Os pacientes participavam de estudo randomizado para avaliar a eficácia de 4 drogas; aqueles randomizados para o placebo foram incluídos também. Os parâmetros avaliados foram: 1 -- dor; 2 - sintomas associados. Avaliados uma hora após a administração do placebo, 50% dos pacientes do grupo MSA, 23,3% dos pacientes do grupo MCA e 26,7% dos pacientes do grupo CTTE apresentavam melhora da dor. A melhora, avaliada pela escala numérica da dor foi, em média, de 41,6%, 23,1% e 36%, respectivamente. Houve também redução significativa de todos os sintomas associados. A utilização do placebo é, portanto, essencial na avaliação de drogas utilizadas no tratamento de cefaléias agudas.This study presents an evaluation of placebo response in the acute treatment of migraine with or without aura and episodic tension type headache. We studied patients admitted between March 1st,1997 and November 31st,1999 in two Emergency Room Units. Three groups had been defined, each one with 30 participants: migraine without aura (MWOA, migraine with aura (MWA and episodic tension-type headache (ETTH. Patients were participating of a randomized study to evaluate efficacy of 4 different drugs; those randomized to receive placebo were included. We evaluated pain and associated symptoms. After one hour of placebo administration, 50% of MWOA patients, 23.3% of MWA and 26.7% of ETTH had presented pain relief. The mean of this relief, evaluated by the numerical pain scale, was 41.6%, 23.1% and 36%, respectively. Use of placebo

  10. Influence of caffeine and caffeine withdrawal on headache and cerebral blood flow velocities

    NARCIS (Netherlands)

    Couturier, EGM; Laman, DM; vanDuijn, MAJ; vanDuijn, H

    Caffeine consumption may cause headache, particularly migraine. Its withdrawal also produces headaches and may be related to weekend migraine attacks. Transcranial Doppler sonography (TCD) has shown changes in cerebral blood flow velocities (BFV) during and between attacks of migraine. In order to

  11. Classification of perimenstrual headache: clinical relevance.

    Science.gov (United States)

    MacGregor, E Anne

    2012-10-01

    Although more than 50% of women with migraine report an association between migraine and menstruation, menstruation has generally considered to be no more than one of a variety of different migraine triggers. In 2004, the second edition of the International Classification of Headache Disorders introduced specific diagnostic criteria for menstrual migraine. Results from research undertaken subsequently lend support to the clinical impression that menstrual migraine should be seen as a distinct clinical entity. This paper reviews the recent research and provides specific recommendations for consideration in future editions of the classification.

  12. Remission of migraine after clipping of saccular intracranial aneurysms

    DEFF Research Database (Denmark)

    Lebedeva, E R; Busygina, A V; Kolotvinov, V S

    2015-01-01

    interview. The remission rates of migraine and tension-type headache (TTH) in these patients were compared to 92 patients from a headache center. Diagnoses were made according to the ICHD-2. RESULTS: During 1 year preceding rupture 51 patients with SIA had migraine. During the year after clipping......BACKGROUND: Unruptured saccular intracranial aneurysm (SIA) is associated with an increased prevalence of migraine, but it is unclear whether this is altered by clipping of the aneurysm. The aim of our study was to determine whether remission rate of migraine and other recurrent headaches...... was greater in patients with SIA after clipping than in controls. METHODS: We prospectively studied 87 SIA patients with migraine or other recurrent headaches. They were interviewed about headaches in the preceding year before and 1 year after clipping using a validated semi-structured neurologist conducted...

  13. 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.

  14. Positron emission tomography and migraine

    International Nuclear Information System (INIS)

    Chabriat, H.

    1992-01-01

    Positron emission tomography (PET) is a brain imaging technique that allows in vivo studies of numerous physiological parameters. There have been few PET studies in migraine patients. Cerebral blood flow changes with no variations in brain oxygen consumption have been reported in patients with prolonged neurologic manifestations during migraine attacks. Parenteral administration of reserpine during migraine headache has been followed by a fall in the overall cerebral uptake of glucose. The small sample sizes and a number of methodologic problems complicate the interpretation of these results. Recent technical advances and the development of new PET tracers can be expected to provide further insight into the pathophysiology of migraine. Today cerebral cortex 5 HT 2 serotonin receptors can be studied in migraine patients with PET

  15. [The migraine of Immanual Kant].

    Science.gov (United States)

    Podoll, K; Hoff, P; Sass, H

    2000-07-01

    The German philosopher Immanuel Kant (1724-1804) suffered, since his forties, from a migraine with aura which showed a significant exacerbation in his seventies, coinciding with the onset of symptoms of a senile dementia of Alzheimer's type. Recorded symptoms of Kant's migraine include recurrent scintillating scotomas, one episode of diplopia, two episodes of complete amaurosis and frequent headaches described as oppressions of the head. The said symptoms of Kant's migraine can be traced not only in his letters and in accounts of his contemporary biographers, but also in the philosopher's published work.

  16. 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.

  17. How specific are risk factors for headache in adolescents? Results from a cross-sectional study in Germany.

    Science.gov (United States)

    Lehmann, Steffi; Milde-Busch, Astrid; Straube, Andreas; von Kries, Ruediger; Heinen, Florian

    2013-02-01

    The identified preventable risk factors for primary headache in adolescents are smoking; consumption of coffee or alcoholic mixed drinks; physical inactivity; muscle pain in the head, neck, or shoulder region; and chronic stress. To investigate the interrelation of headache with other health complaints and the specificity of the above-mentioned risk factors for headache in adolescents. A total of 1,260 students (grades 10 and 11) filled in questionnaires on headache, dietary, and lifestyle factors. The type of headache and health complaints such as dizziness, abdominal pain, musculoskeletal pains, symptoms of possible fatigue syndrome, and psychic complaints were assessed. Isolated headache was found in 18% of the headache sufferers; most frequently isolated tension-type headache (78.2%). Only among adolescents with a combination of headache (mainly migraine) and other health complaints, significant associations for almost all analyzed risk factors were found. The strength of the associations with the considered risk factors was very similar in all three analyzed strata except for considerably lower odds ratios for isolated headache. All analyzed risk factors are nonspecific for headache in adolescents because they also increase the risk for other health complaints. Interventions, therefore, should consider a holistic approach focusing not only on headache but also on a broader spectrum of health complaints. Georg Thieme Verlag KG Stuttgart · New York.

  18. Towards a pragmatic human migraine model for drug testing

    DEFF Research Database (Denmark)

    Hansen, Emma Katrine; Olesen, Jes

    2017-01-01

    Background A model for the testing of novel anti-migraine drugs should preferably use healthy volunteers for ease of recruiting. Isosorbide-5-mononitrate (5-ISMN) provokes headache in healthy volunteers with some migraine features such as pulsating pain quality and aggravation by physical activity.......003). Difference in area under the headache score curve (AUC) 0-4 hours between sumatriptan and placebo was not significant ( p = 0.30). Conclusion 5-ISMN is a very powerful inducer of migraine-like headache in healthy individuals but the headache does not respond to sumatriptan. The model is not useful for future...

  19. 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

  20. 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 ...

  1. Computed tomography scan of the head in patients with migraine or tension-type headache Tomografia computadorizada do crânio em pacientes com migrânea ou cefaléia tensional

    Directory of Open Access Journals (Sweden)

    Marcelo Moraes Valença

    2002-09-01

    Full Text Available A retrospective study was performed in order to evaluate the frequency of abnormalities found by computed tomography (CT scan of the head in 78 patients with migraine or tension-type headache. In the present study CT scan was normal in 61.5% of the patients with migraine or tension-type headache. A number of abnormalities were encountered in more than one third of the patients studied, including inflammatory sinus disease (19.2%, cysticercosis (3.9%, unruptuted cerebral aneurysm (2.6%, basilar impression (2.6%, intracranial lipoma (2.6%, arachnoid cyst (2.6%, empty sella (2.6%, intracranial neoplasm (2.6%, and others (2.6%. None of these lesions were symptomatic or responsible by the headache picture, therefore, considered incidental findings. In conclusion, the fortuitous encounter of some abnormalities on CT scan of the head is often higher than what we could predict in patients suffering migraine or tension-type headache. We briefly discuss clinical, epidemiologic, and practical management of some of the abnormalities detected by CT scan as well as the indication to request a neuroimaging investigation.Um estudo retrospectivo foi realizado visando avaliar a frequência de anormalidades encontradas durante a realização de estudo por tomografia computadorizada (TC em 78 pacientes com migrânea ou cefaléia do tipo tensional. A TC foi normal em 61,5% dos pacientes examinados. Em um terço dos pacientes estudados foram detectadas anormalidades, como doença inflamatória dos seios paranasais (19,2%, cisticercose (3,9%, aneurisma cerebral não-roto (2,6%, impressão basilar (2,6%, lipoma intracraniano (2,6%, cisto aracnoideo (2,6%, sela vazia (2,6%, neoplasia intracraniana (2,6% e outras afecções (2,6%. Nenhuma destas lesões era sintomática (achado incidental. Concluindo, o encontro fortuito de algumas anormalidades na TC é frequentemente mais elevado do que se prediz em pacientes com cefaléia primária. Nós discutimos brevemente alguns

  2. Psychiatric comorbidity and suicide risk in patients with chronic migraine

    Directory of Open Access Journals (Sweden)

    Maurizio Pompili

    2010-04-01

    Full Text Available Maurizio Pompili1,2, Gianluca Serafini1, Daniela Di Cosimo1, Giovanni Dominici1, Marco Innamorati1, David Lester3, Alberto Forte1, Nicoletta Girardi1, Sergio De Filippis4, Roberto Tatarelli1, Paolo Martelletti41Department of Neurosciences, Mental Health and Sensory Functions, Suicide Prevention Center, Sant’Andrea Hospital, Sapienza University of Rome, Rome, Italy; 2McLean Hospital, Harvard Medical School, Boston,  Massachusetts, USA; 3The Richard Stockton College of New Jersey, USA; 4Department of Medical Sciences, Second School of Medicine, Sant’Andrea Hospital, Sapienza University of Rome, Rome, ItalyAbstract: The aim of this study was to explore the impact of mental illness among patients with migraine. We performed MedLine and PsycINFO searches from 1980 to 2008. Research has systematically documented a strong bidirectional association between migraine and psychiatric disorders. The relationship between migraine and psychopathology has often been clinically discussed rather than systematically studied. Future research should include sound methodologically-based studies focusing on the interplay of factors behind the relationship between migraine, suicide risk, and mental illness.Keywords: headache, migraine, suicide*, psychiatric disorders

  3. Comparison of the effects of dietary factors in the management and prophylaxis of migraine

    Directory of Open Access Journals (Sweden)

    Beyazit Zencirci

    2010-07-01

    Full Text Available Beyazit Zencirci11Department of Anesthesiology and Reanimation, Medical Faculty of Sutcu Imam University, Kahramanmaras, TurkeyAbstract: Migraine is defined as a disorder characterized by intermittent headache episodes, accompanied with nausea, photophobia and/or phonophobia. Pharmacological therapy is in accordance with the severity of pain and may include acute, prophylactic and most commonly both approaches. The aim of the acute therapy is stopping or alleviating the attack or progression of the pain and in case of a migraine attack that has started, lessening the pain it. Preventive therapy aims to reduce attack frequency and severity. This study was designed to evaluate the effect of dietary factors in the management and prophylaxis of migraine in cases diagnosed as having migraine disorder according to the 2003-IHS criteria. Fifty consecutive Turkish patients (13 men, 37 women with diagnosis of migraine were randomly divided into two groups for treatment protocols with the written approval of the ethics committee. The cases in the first group (K were treated with metoprolol, vitamin B2 (riboflavin, and naproxen sodium just at the aura or at the beginning of the attacks. The cases in the second group (D were also supplied with a comprehensive dietary list arranged by our algology clinics in addition to the same medication protocol. There were no demographic differences between the cases (P > 0.05. VAS scores were lower in group D than group K (P < 0.01, and also the migraine attack frequencies and monthly amounts of analgesic consumed amounts were also statistically significantly less. It was concluded that beta-blocker and riboflavin therapy supplemented with convenient diet with appropriate alternatives in patients with migraine disorder was associated with statistically significant decreases in headache frequency, intensity, duration and medication intake.Keywords: migraine, food intake, trigger

  4. Osler on migraine.

    Science.gov (United States)

    Boes, Christopher J

    2015-03-01

    William Osler's 1892 textbook The Principles and Practice of Medicine became the dominant medical text in the English-speaking world. Osler was labeled a therapeutic nihilist by some. The topic of migraine, including treatment, was succinctly covered in his text. The objectives of this study were to review Osler's thoughts on migraine, and outline his therapeutic recommendations. Preventively Osler mentioned bromides, iron, arsenic, nitroglycerin, and cannabis. Acutely he recommended coffee, chloroform, cannabis, antipyrin, antifebrin, phenacetin, caffeine citrate, nux vomica, or ergot. He thought cannabis was the most satisfactory remedy. Osler was not a therapeutic nihilist when it came to migraine, and his treatment recommendations were similar to other writers of his time. Osler did not draw upon his personal experience to contribute new knowledge about migraine. Regardless, given the popularity and clarity of his text, Osler's well-summarized migraine chapter had a great influence on practicing physicians.

  5. Safety and efficacy of erenumab for preventive treatment of chronic migraine

    DEFF Research Database (Denmark)

    Tepper, Stewart; Ashina, Messoud; Reuter, Uwe

    2017-01-01

    BACKGROUND: The calcitonin gene-related peptide (CGRP) pathway is important in migraine pathophysiology. We assessed the efficacy and safety of erenumab, a fully human monoclonal antibody against the CGRP receptor, in patients with chronic migraine. METHODS: This was a phase 2, randomised, double...... assignment. The primary endpoint was the change in monthly migraine days from baseline to the last 4 weeks of double-blind treatment (weeks 9-12). Safety endpoints were adverse events, clinical laboratory values, vital signs, and anti-erenumab antibodies. The efficacy analysis set included patients who...... received at least one dose of investigational product and completed at least one post-baseline monthly measurement. The safety analysis set included patients who received at least one dose of investigational product. The study is registered with ClinicalTrials.gov, number NCT02066415. FINDINGS: From April...

  6. Classification of headache on the basis of the IHS diagnostic criteria

    NARCIS (Netherlands)

    de Bruijn-Kofman, AT; van de Wiel, H; Sorbi, MJ

    1999-01-01

    Objective: To test the effects of a mass-media behavioral treatment program on migraine and tension-type headache, patients with pure migraine, and with pure tension-type headache were to be selected. Patient Selection: A random sample of 233 headache sufferers of 15,000 subscribers to the program.

  7. 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.

  8. Migraine aura

    DEFF Research Database (Denmark)

    Charles, Andrew; Hansen, Jakob Møller

    2015-01-01

    classification of migraine aura is becoming both broader and more detailed. Traditionally viewed as a primary event that triggers a migraine attack, studies regarding the timing of aura relative to other symptoms of migraine indicate that it may not in fact play a primary role in initiating an attack. Careful....... SUMMARY: There has been significant evolution of concepts regarding the causes of migraine aura, how it is best defined, and how it fits into the picture of the migraine disorder as a whole. Regardless of its exact role in the genesis of migraine, an increased understanding of aura has the potential...

  9. Trigger factors and mechanisms in migraine

    NARCIS (Netherlands)

    Schoonman, Geurt Gerhard

    2008-01-01

    Migraine is a severe headache syndrome, affecting approximately 33% of females and 13% of males. Patients suffer from recurring headache episodes in combination with nausea, vomiting, phono and photophobia. It is a paroxysmal disorder for which several several trigger factors have been identified by

  10. 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.

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

    DEFF Research Database (Denmark)

    Carlsen, Louise Ninett; Westergaard, Maria Lurenda; Bisgaard, Mette

    2018-01-01

    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...... 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...

  12. Non-invasive methods for measuring vascular changes in neurovascular headaches

    DEFF Research Database (Denmark)

    Schytz, Henrik W; Amin, Faisal M; Selb, Juliette

    2018-01-01

    Vascular changes during spontaneous headache attacks have been studied over the last 30 years. The interest in cerebral vessels in headache research was initially due to the hypothesis of cerebral vessels as the pain source. Here, we review the knowledge gained by measuring the cerebral vasculature...... studies of migraine and other headache disorders do not provide solid evidence for cerebral blood flow velocity changes during spontaneous attacks of migraine headache. SPECT studies have clearly shown cortical vascular changes following migraine aura and the differences between migraine with aura...... compared to migraine without aura. PET studies have shown focal activation in brain structures related to headache, but whether the changes are specific to different primary headaches have yet to be demonstrated. MR angiography has shown precise changes in large cerebral vessels during spontaneous migraine...

  13. Migraine attacks the Basal Ganglia

    Directory of Open Access Journals (Sweden)

    Bigal Marcelo

    2011-09-01

    Full Text Available Abstract Background With time, episodes of migraine headache afflict patients with increased frequency, longer duration and more intense pain. While episodic migraine may be defined as 1-14 attacks per month, there are no clear-cut phases defined, and those patients with low frequency may progress to high frequency episodic migraine and the latter may progress into chronic daily headache (> 15 attacks per month. The pathophysiology of this progression is completely unknown. Attempting to unravel this phenomenon, we used high field (human brain imaging to compare functional responses, functional connectivity and brain morphology in patients whose migraine episodes did not progress (LF to a matched (gender, age, age of onset and type of medication group of patients whose migraine episodes progressed (HF. Results In comparison to LF patients, responses to pain in HF patients were significantly lower in the caudate, putamen and pallidum. Paradoxically, associated with these lower responses in HF patients, gray matter volume of the right and left caudate nuclei were significantly larger than in the LF patients. Functional connectivity analysis revealed additional differences between the two groups in regard to response to pain. Conclusions Supported by current understanding of basal ganglia role in pain processing, the findings suggest a significant role of the basal ganglia in the pathophysiology of the episodic migraine.

  14. Menstrual Migraine

    OpenAIRE

    J Gordon Millichap

    2004-01-01

    The association between migraine and menstruation was determined using diary data from 155 women of median age 44 years (range, 15 to 58 years) who were not using hormonal contraception and attended the City of London Migraine Clinic, UK.

  15. Prevention of stress- or nitric oxide donor-induced medication overuse headache by a calcitonin gene-related peptide antibody in rodents.

    Science.gov (United States)

    Kopruszinski, Caroline Machado; Xie, Jennifer Yanhua; Eyde, Nathan Mackenzie; Remeniuk, Bethany; Walter, Sarah; Stratton, Jennifer; Bigal, Marcelo; Chichorro, Juliana Geremias; Dodick, David; Porreca, Frank

    2017-05-01

    Objective The objective of this study was the determination of the role of calcitonin gene-related peptide (CGRP) in the induction of medication overuse headache (MOH)-related migraine in an injury-free preclinical model. Methods Rats were primed by a 7-day period of exposure to acute migraine therapies including sumatriptan and morphine. After an additional 14-day drug-free period, rats were exposed to putative migraine triggers including bright light stress (BLS) or nitric oxide (NO) donor in the presence or absence of TEV48125, a fully humanized CGRP antibody. Cutaneous allodynia (CA) was used as an outcome measure and CGRP blood and cerebrospinal fluid (CSF) levels were measured. Results BLS and NO donor challenge evoked delayed, long-lasting CA selectively in rats that were previously treated with sumatriptan or morphine. BLS produced a significant increase in CGRP in the plasma, but not CSF, in animals that were previously exposed to sumatriptan compared to saline controls. TEV48125 did not modify baseline tactile thresholds or produce behavioral side effects, but significantly inhibited both BLS- and NO donor-induced CA in animals that were previously primed with sumatriptan or morphine; an isotype control protein that does not bind CGRP had no effect. Interpretation These data suggest that acute migraine medications may promote MOH in susceptible individuals through CGRP-dependent mechanisms and that anti-CGRP antibodies may be a useful clinical strategy for the treatment of MOH.

  16. 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.

  17. 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.

  18. Central and peripheral mechanisms in chronic tension-type headache

    OpenAIRE

    Lipchik, Gay L.; Holroyd, Kenneth A.; France, Christopher R.; Kvaal, Steven A.; Segal, David; Cordingley, Gary E.; Rokicki, Lori A.; McCool, Heidi R.

    1996-01-01

    The second exteroceptive suppression of masseter muscle activity (ES2) and tenderness in pericranial muscles were evaluated in 112 young adults who met IHS criteria in the following diagnostic classifications: 31 chronic tension headache, 31 episodic tension headache, 33 migraine without aura and 17 migraine with aura. An additional 31 subjects served as controls. Pericranial muscle tenderness better distinguished diagnostic subgroups and better distinguished recurrent headache sufferers from...

  19. Food related antibodies in headache patients.

    OpenAIRE

    Merrett, J; Peatfield, R C; Rose, F C; Merrett, T G

    1983-01-01

    Highly sensitive and specific methods for assaying IgE and IgG4 for antibodies in serum have been developed in order to test a recent suggestion that food allergy is a major cause of migraine. Sera were collected from 208 adults--74 with dietary migraine, 45 with non-dietary migraine, 29 with cluster headache and 60 controls. No significant differences were identified between any of the groups with the one exception that cluster headache patients had significantly raised levels of total serum...

  20. Maternal stress and childhood migraine: a new perspective on management

    Directory of Open Access Journals (Sweden)

    Esposito M

    2013-03-01

    Full Text Available Maria Esposito,1 Beatrice Gallai,2 Lucia Parisi,3 Michele Roccella,3 Rosa Marotta,4 Serena Marianna Lavano,4 Antonella Gritti,5 Giovanni Mazzotta,6 Marco Carotenuto11Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical, and Preventive Medicine, Second University of Naples, Naples, 2Unit of Child and Adolescent Neuropsychiatry, University of Perugia, Perugia, 3Child Neuropsychiatry, Department of Psychology, University of Palermo, Palermo, 4Department of Psychiatry, "Magna Graecia" University of Catanzaro, Catanzaro, 5Suor Orsola Benincasa University, Naples, 6Unit of Child and Adolescent Neuropsychiatry, Azienda Sanitaria Locale 4, Terni, ItalyBackground: Migraine without aura is a primary headache which is frequent and disabling in the developmental age group. No reports are available concerning the prevalence and impact of migraine in children on the degree of stress experienced by parents. The aim of this study was to evaluate the prevalence of maternal stress in a large pediatric sample of individuals affected by migraine without aura.Methods: The study population consisted of 218 children (112 boys, 106 girls of mean age 8.32 ± 2.06 (range 6–13 years suffering from migraine without aura and a control group of 405 typical developing children (207 boys, 198 girls of mean age 8.54 ± 2.47 years. Mothers of children in each group answered the Parent Stress Index-Short Form (PSI-SF questionnaire to assess parental stress levels.Results: The two groups were matched for age (P = 0.262, gender (P = 0.983, and body mass index adjusted for age (P = 0.106. Mothers of children with migraine without aura reported higher mean PSI-SF scores related to the Parental Distress domain (P < 0.001, Dysfunctional Parent-Child Interaction domain (P < 0.001, Difficult Child subscale (P < 0.001, and Total Stress domain than mothers of controls (P < 0.001. No differences between the two groups were

  1. Migraine, cerebrovascular disease and the metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Alexandra J Sinclair

    2012-01-01

    Full Text Available Evidence is emerging that migraine is not solely a headache disorder. Observations that ischemic stroke could occur in the setting of a migraine attack, and that migraine headaches could be precipitated by cerebral ischemia, initially highlighted a possibly association between migraine and cerebrovascular disease. More recently, large population-based studies that have demonstrated that migraineurs are at increased risk of stroke outside the setting of a migraine attack have prompted the concept that migraine and cerebrovascular disease are comorbid conditions. Explanations for this association are numerous and widely debated, particularly as the comorbid association does not appear to be confined to the cerebral circulation as cardiovascular and peripheral vascular disease also appear to be comorbid with migraine. A growing body of evidence has also suggested that migraineurs are more likely to be obese, hypertensive, hyperlipidemic and have impaired insulin sensitivity, all features of the metabolic syndrome. The comorbid association between migraine and cerebrovascular disease may consequently be explained by migraineurs having the metabolic syndrome and consequently being at increased risk of cerebrovascular disease. This review will summarise the salient evidence suggesting a comorbid association between migraine, cerebrovascular disease and the metabolic syndrome.

  2. Volumetric abnormalities of the brain in a rat model of recurrent headache.

    Science.gov (United States)

    Jia, Zhihua; Tang, Wenjing; Zhao, Dengfa; Hu, Guanqun; Li, Ruisheng; Yu, Shengyuan

    2018-01-01

    Voxel-based morphometry is used to detect structural brain changes in patients with migraine. However, the relevance of migraine and structural changes is not clear. This study investigated structural brain abnormalities based on voxel-based morphometry using a rat model of recurrent headache. The rat model was established by infusing an inflammatory soup through supradural catheters in conscious male rats. Rats were subgrouped according to the frequency and duration of the inflammatory soup infusion. Tactile sensory testing was conducted prior to infusion of the inflammatory soup or saline. The periorbital tactile thresholds in the high-frequency inflammatory soup stimulation group declined persistently from day 5. Increased white matter volume was observed in the rats three weeks after inflammatory soup stimulation, brainstem in the in the low-frequency inflammatory soup-infusion group and cortex in the high-frequency inflammatory soup-infusion group. After six weeks' stimulation, rats showed gray matter volume changes. The brain structural abnormalities recovered after the stimulation was stopped in the low-frequency inflammatory soup-infused rats and persisted even after the high-frequency inflammatory soup stimulus stopped. The changes of voxel-based morphometry in migraineurs may be the result of recurrent headache. Cognition, memory, and learning may play an important role in the chronification of migraines. Reducing migraine attacks has the promise of preventing chronicity of migraine.

  3. Headache in Schoolchildren : Epidemiology, Pain Comorbidity and Psychosocial Factors

    OpenAIRE

    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...

  4. Pathophysiology of Headaches with a Prominent Vascular Component

    Directory of Open Access Journals (Sweden)

    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.

  5. Classification and clinical features of headache patients: an outpatient clinic study from China.

    Science.gov (United States)

    Wang, Yunfeng; Zhou, Jiying; Fan, Xiaoping; Li, Xuelian; Ran, Li; Tan, Ge; Chen, Lixue; Wang, Kuiyun; Liu, Bowen

    2011-10-01

    This study aimed to analyze and classify the clinical features of headache in neurological outpatients. A cross-sectional study was conducted consecutively from March to May 2010 for headache among general neurological outpatients attending the First Affiliated Hospital of Chongqing Medical University. Personal interviews were carried out and a questionnaire was used to collect medical records. Diagnosis of headache was according to the International classification of headache disorders, 2nd edition (ICHD-II). Headache patients accounted for 19.5% of the general neurology clinic outpatients. A total of 843 (50.1%) patients were defined as having primary headache, 454 (27%) secondary headache, and 386 (23%) headache not otherwise specified (headache NOS). For primary headache, 401 (23.8%) had migraine, 399 (23.7%) tension-type headache (TTH), 8 (0.5%) cluster headache and 35 (2.1%) other headache types. Overall, migraine patients suffered (1) more severe headache intensity, (2) longer than 6 years of headache history and (3) more common analgesic medications use than TTH ones (p headaches than migraine patients, and typically headache frequency exceeded 15 days/month (p headache patients were defined as chronic daily headache. Almost 20% of outpatient visits to the general neurology department were of headache patients, predominantly primary headache of migraine and TTH. In outpatient headaches, more attention should be given to headache intensity and duration of headache history for migraine patients, while more attention to headache frequency should be given for the TTH ones.

  6. Adherence to Biobehavioral Recommendations in Pediatric Migraine as Measured by Electronic Monitoring: The Adherence in Migraine (AIM) Study.

    Science.gov (United States)

    Kroon Van Diest, Ashley M; Ramsey, Rachelle; Aylward, Brandon; Kroner, John W; Sullivan, Stephanie M; Nause, Katie; Allen, Janelle R; Chamberlin, Leigh A; Slater, Shalonda; Hommel, Kevin; LeCates, Susan L; Kabbouche, Marielle A; O'Brien, Hope L; Kacperski, Joanne; Hershey, Andrew D; Powers, Scott W

    2016-07-01

    The purpose of this investigation was to examine treatment adherence to medication and lifestyle recommendations among pediatric migraine patients using electronic monitoring systems. Nonadherence to medical treatment is a significant public health concern, and can result in poorer treatment outcomes, decreased cost-effectiveness of medical care, and increased morbidity. No studies have systematically examined adherence to medication and lifestyle recommendations in adolescents with migraine outside of a clinical trial. Participants included 56 adolescents ages 11-17 who were presenting for clinical care. All were diagnosed with migraine with or without aura or chronic migraine and had at least 4 headache days per month. Medication adherence was objectively measured using electronic monitoring systems (Medication Event Monitoring Systems technology) and daily, prospective self-report via personal electronic devices. Adherence to lifestyle recommendations of regular exercise, eating, and fluid intake were also assessed using daily self-report on personal electronic devices. Electronic monitoring indicates that adolescents adhere to their medication 75% of the time, which was significantly higher than self-reported rates of medication adherence (64%). Use of electronic monitoring of medication detected rates of adherence that were significantly higher for participants taking once daily medication (85%) versus participants taking twice daily medication (59%). Average reported adherence to lifestyle recommendations of consistent noncaffeinated fluid intake (M = 5 cups per day) was below recommended levels of a minimum of 8 cups per day. Participants on average also reported skipping 1 meal per week despite recommendations of consistently eating three meals per day. Results suggest that intervention focused on adherence to preventive treatments (such as medication) and lifestyle recommendations may provide more optimal outcomes for children and adolescents with

  7. The complex interrelations between two paroxysmal disorders: headache and epilepsy.

    Science.gov (United States)

    Cianchetti, Carlo; Avanzini, Giuliano; Dainese, Filippo; Guidetti, Vincenzo

    2017-06-01

    The interrelations between headache/migraine and epileptic seizures are an interesting topic, still lacking a systematization, which is the objective of the present revision. We organize the general setting on: (a) a distinction between pre-ictal, ictal, post-ictal and inter-ictal headaches, assuming "ictal" as epileptic seizure, and (b) the kind of headache, if it is of migraine type or not. Concerning pre-ictal migraine/headache, the necessity of its differentiation from an epileptic headache presenting as an aura of a seizure is stressed; this is connected with the indefiniteness of the term "migralepsy". The term "migraine aura-triggered seizure" should be used only in front of a proven triggering effect of migraine. Epileptic headache (called also "ictal epileptic headache") is a well-characterized entity, in which different types of head pain may occur and an ictal EEG is necessary for the diagnosis. It may present as an isolated event ("isolated epileptic headache"), requiring a differential diagnosis from other kinds of headache, or it may be uninterruptedly followed by other epileptic manifestations being in this case easily identifiable as an epileptic aura. Hemicrania epileptica is a very rare variant of epileptic headache, characterized by the ipsilaterality of head pain and EEG paroxysms. Ictal non-epileptic headache needs to be differentiated from epileptic headache. Post-ictal headaches are a frequent association of headache with seizures, particularly in patients suffering also from inter-ictal headache-migraine. The reported systematization of the topic led us to suggest a classification which is shown in Appendix.

  8. Why is migraine so common?

    Science.gov (United States)

    Edmeads, J

    1998-08-01

    Migraine is clearly a very common biological disorder, but this knowledge has not been sufficient as yet to ensure completely effective treatment strategies. There appears to be discrepancy between what migraine patients desire as the outcome of consultations and what doctors think patients want. Patients seem, from Packard's selective study (11), to want explanation and reassurance before they get pain relief, whereas doctors view pain relief as the most important aim of management. It is possible that doctors still have underlying assumptions about psychological elements of migraine which color their perceptions of their patients. Communicating the relevance of scientific progress in migraine to neurologists and PCPs is an important challenge, as is calling attention to the patient's expectations from treatment. To be effective in improving education in this area, perhaps we should first ascertain the level of knowledge about the biology and treatment of headache among general neurologists.

  9. Endovascular thrombectomy and post-procedural headache.

    Science.gov (United States)

    Khan, Sabrina; Amin, Faisal Mohammad; Holtmannspötter, Markus; Hansen, Klaus; Florescu, Anna Maria; Fakhril-Din, Zainab; Petersen, Julie Falkenberg; Ghanizada, Hashmat; Ayata, Cenk; Gaist, David; Ashina, Messoud

    2017-12-01

    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. 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 persisted at interview time for subjects with migraine. Out of 12 subjects with peri-procedural complications, 2 had a history of migraine with aura. Thrombectomy leads to a significant decrease in previously known migraine, and new onset of headache in a small subset of patients. A history of migraine does not appear to predispose to peri-procedural complications.

  10. Primary headaches in restless legs syndrome patients

    Directory of Open Access Journals (Sweden)

    Ravi Gupta

    2012-01-01

    Full Text Available Earlier studies conducted among migraineurs have shown an association between migraine and restless legs syndrome (RLS. We chose RLS patients and looked for migraine to exclude sample bias. Materials and Methods: 99 consecutive subjects of idiopathic RLS were recruited from the sleep clinic during four months period. Physician diagnosis of headache and depressive disorder was made with the help of ICHD-2 and DSM-IV-TR criteria, respectively. Sleep history was gathered. Severity of RLS and insomnia was measured using IRLS (Hindi version and insomnia severity index Hindi version, respectively. Chi-square test, one way ANOVA and t-test were applied to find out the significance. Results: Primary headache was seen in 51.5% cases of RLS. Migraine was reported by 44.4% subjects and other types of ′primary headaches′ were reported by 7.1% subjects. Subjects were divided into- RLS; RLS with migraine and RLS with other headache. Females outnumbered in migraine subgroup (χ2 =16.46, P<0.001. Prevalence of depression (χ2 =3.12, P=0.21 and family history of RLS (χ2 =2.65, P=0.26 were not different among groups. Severity of RLS (P=0.22 or insomnia (P=0.43 were also similar. Conclusion: Migraine is frequently found in RLS patients in clinic based samples. Females with RLS are prone to develop migraine. Depression and severity of RLS or insomnia do not affect development of headache.

  11. Pediatric Inpatient Headache Therapy: What is Available.

    Science.gov (United States)

    Kabbouche, Marielle

    2015-01-01

    Status migrainosus is defined by the international classification of headache disorders (ICHD) criteria as a debilitating migraine lasting more then 72 hours. The epidemiology of status migrainosus is still unknown in adult and children, and frequently underdiagnosed. Children and adolescents often end up in the emergency room with an intractable headache that failed outpatient therapy. Six to seven percent of these children do not respond to acute infusion therapy and require hospitalization. It is imperative that more aggressive therapy is considered when patients are affected by a severe intractable headache to prevent further disability and returning the child to baseline activity. Multiple therapies are available for adults and children. Studies for acute therapy in the emergency room are available in adults and pediatric groups. Small studies are available for inpatient therapy in children and, along with available therapies for children and adolescents, are described in this review. A review of the literature shows growing evidence regarding the use of dihydroergotamine intravenously once patients are hospitalized. Effectiveness and safety have been proven in the last decades in adults and small studies in the pediatric populations. © 2015 American Headache Society.

  12. The evolution of headache from childhood to adulthood: a review of the literature.

    Science.gov (United States)

    Antonaci, Fabio; Voiticovschi-Iosob, Cristina; Di Stefano, Anna Luisia; Galli, Federica; Ozge, Aynur; Balottin, Umberto

    2014-03-18

    Headache is one of the most common disorders in childhood, with an estimated 75% of children reporting significant headache by the age of 15 years. Pediatric migraine is the most frequent recurrent headache disorder, occurring in up to 28% of older teenagers. Headaches rank third among the illness-related causes of school absenteeism and result in substantial psychosocial impairment among pediatric patients. The aim of this study was to clarify the evolution of the clinical features of primary headache in the transition from childhood to adulthood through a review of relevant data available in the PubMed and Google Scholar databases for the period 1988 to July 2013.The search strategy identified 15 published articles which were considered eligible for inclusion in the analysis (i.e., relevant to the investigation of pediatric headache outcome). All were carried out after the publication of the first version of the International Classification of Headache Disorders (ICHD-I). The availability of data on the evolution of primary headaches over a period of time is important from both a clinical and a public health perspective. The identification of prognostic factors of the evolution of headache (remission or evolution into another headache form) over time should be an objective of future headache research for the development of prevention strategies. Given that headache is a major factor contributing to school absenteeism and poorer quality of life not only in childhood but also in adolescence, understanding the natural history and the management of the different headache forms is vital for our future.

  13. The evolution of headache from childhood to adulthood: a review of the literature

    Science.gov (United States)

    2014-01-01

    Headache is one of the most common disorders in childhood, with an estimated 75% of children reporting significant headache by the age of 15 years. Pediatric migraine is the most frequent recurrent headache disorder, occurring in up to 28% of older teenagers. Headaches rank third among the illness-related causes of school absenteeism and result in substantial psychosocial impairment among pediatric patients. The aim of this study was to clarify the evolution of the clinical features of primary headache in the transition from childhood to adulthood through a review of relevant data available in the PubMed and Google Scholar databases for the period 1988 to July 2013. The search strategy identified 15 published articles which were considered eligible for inclusion in the analysis (i.e. relevant to the investigation of pediatric headache outcome). All were carried out after the publication of the first version of the International Classification of Headache Disorders (ICHD-I). The availability of data on the evolution of primary headaches over a period of time is important from both a clinical and a public health perspective. The identification of prognostic factors of the evolution of headache (remission or evolution into another headache form) over time should be an objective of future headache research for the development of prevention strategies. Given that headache is a major factor contributing to school absenteeism and poorer quality of life not only in childhood but also in adolescence, understanding the natural history and the management of the different headache forms is vital for our future. PMID:24641507

  14. 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...

  15. 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

    -one percent of soldiers with CDH screened positive for PTSD compared to only 18% of soldiers with episodic headache. The prevalence of CDH in returning U.S. soldiers after a deployment-related concussion is 20%, or 4- to 5-fold higher than that seen in the general U.S. population. CDH following a concussion usually resembles chronic migraine and is associated with onset of headaches within the first week after concussion. The mechanism and number of concussions are not specifically associated with CDH as compared to episodic headache. In contrast, PTSD symptoms are strongly associated with CDH, suggesting that traumatic stress may be an important mediator of headache chronification. These findings justify future studies examining strategies to prevent and treat CDH in military service members following a concussive injury. © 2012 American Headache Society.

  16. Symptomatic Overlap and Therapeutic Opportunities in Primary Headache.

    Science.gov (United States)

    Cady, Roger; Garas, Sandy Yacoub; Patel, Ketu; Peterson, Andrew; Wenzel, Richard

    2015-08-01

    Headache, a nearly universal experience, remains costly, disabling, and often suboptimally managed. The most common presentations in the United States are migraine, tension-type headache (TTH) and "sinus" headache, but their extensive symptomatic overlap suggests that these conditions can be approached as variations in the same underlying pathology and managed accordingly. We use case studies of patients with varying prior diagnoses (none, migraine, TTH, and sinus headache), as well as a 4-question diagnostic screening tool, to illustrate how pharmacists can use this conceptual framework to simplify identification, management, and referral of patients with primary headache conditions of uncertain etiology. © The Author(s) 2014.

  17. Myofascial trigger points in cluster headache patients: a case series

    Directory of Open Access Journals (Sweden)

    Rico-Villademoros Fernando

    2008-12-01

    Full Text Available Abstract Active myofascial trigger points (MTrPs have been found to contribute to chronic tension-type headache and migraine. The purpose of this case series was to examine if active trigger points (TrPs provoking cluster-type referred pain could be found in cluster headache patients and, if so, to evaluate the effectiveness of active TrPs anaesthetic injections both in the acute and preventive headache's treatment. Twelve patients, 4 experiencing episodic and 8 chronic cluster headache, were studied. TrPs were found in all of them. Abortive infiltrations could be done in 2 episodic and 4 chronic patients, and preemptive infiltrations could be done in 2 episodic and 5 chronic patients, both kind of interventions being successful in 5 (83.3% and in 6 (85.7% of the cases respectively. When combined with prophylactic drug therapy, injections were associated with significant improvement in 7 of the 8 chronic cluster patients. Our data suggest that peripheral sensitization may play a role in cluster headache pathophysiology and that first neuron afferent blockade can be useful in cluster headache management.

  18. Frequency of Migraine as a Chief Complaint in Otolaryngology Outpatient Practice

    Science.gov (United States)

    Muhammad Ali, Maria; Al Zayer, Maha

    2015-01-01

    Objective. To identify the frequency of typical (headache and dizziness) and common atypical (ear fullness, pressure, pain, tinnitus, facial fullness, and nasal congestion) migraine symptoms as chief complaints among patients presenting to otolaryngology clinic. Methods. This is a descriptive study of prospectively collected data from a general otolaryngology practice. Typical migraine presentations were diagnosed by applying international headache society (IHS) criteria for migraine headache and Neuhauser's criteria for migrainous vertigo. Atypical otologic and rhinologic migraine symptoms were diagnosed using individualized criteria. Charts were reviewed at 6-month interval from the first presentation. Results. Out of 1002 consecutive patients, 10.8% presented with “migrainous chief complaint.” All migrainous chief complaint patients had a history of headache but not all of them presented with headache. Corrected female to male ratio in the migraine group was 3 to 1; age distributions were significantly different between the migraine and nonmigraine groups by applying t-test. Out of the atypical complaints, 86% of the patients had a history of concomitant typical presentation. Conclusion. Actual diagnostic criteria for migraine do not satisfy the diversity of its presentation. Investigating the history of migraine is enough to diagnose most atypical presentations. Sound knowledge about migraine seems essential for any ENT practitioner. PMID:25695049

  19. 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.

  20. 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...

  1. 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

  2. Characteristics of menstrual versus non-menstrual migraine during pregnancy: a longitudinal population-based study.

    Science.gov (United States)

    Petrovski, Beáta Éva; Vetvik, Kjersti G; Lundqvist, Christofer; Eberhard-Gran, Malin

    2018-04-02

    Migraine is a common headache disorder that affects mostly women. In half of these, migraine is menstrually associated, and ranges from completely asymptomatic to frequent pain throughout pregnancy. The aim of the study was to define the pattern (frequency, intensity, analgesics use) of migrainous headaches among women with and without menstural migraine (MM) during pregnancy, and define how hormonally-related factors affect its intensity. The analysis was based upon data from 280 women, 18.6% of them having a self-reported MM. Women with MM described a higher headache intensity during early pregnancy and postpartum compared those without MM, but both groups showed improvement during the second half of pregnancy and directly after delivery. Hormonal factors and pre-menstrual syndrome had no effect upon headache frequency, but may affect headache intensity. Individual treatment plan is necessary for women with migrainous headaches during pregnancy, especially for those suffering highest symptoms load.

  3. Effectiveness of preventive and treatment interventions for primary headaches in the workplace: A systematic review of the literature.

    Science.gov (United States)

    Lardon, Arnaud; Girard, Marie-Pier; Zaïm, Chérine; Lemeunier, Nadège; Descarreaux, Martin; Marchand, Andrée-Anne

    2017-01-01

    Aim The purpose of this systematic literature review is to assess the benefits of workplace-based occupational therapies and interventions, including acute and preventive medication, on headache intensity and frequency, related disability as well as work-related outcomes. Methods A search of the literature was conducted in PubMed, MEDLINE, Cochrane library, CINAHL and Embase using terms related to headache, workplace and occupational health. The Cochrane Collaboration's risk of bias assessment tool was used on individual studies to assess internal validity and the Grading of Recommendations Assessment, Development, and Evaluation system was applied to studies by clinical outcome and used to rate quality of evidence. Results Fifteen articles were included in the systematic review. None of them were classified as low risk of bias according to the Cochrane Collaboration's tool for assessing risk of bias. This systematic review found preliminary low-quality evidence suggesting that exercise and acupuncture can reduce workers' headache pain intensity, frequency and related disability. Conclusion Although this systematic review provided preliminary low evidence in favour of work-based intervention, studies with more rigorous designs and methodologies are needed to provide further evidence of the effectiveness of workplace-based headache management strategies.

  4. Validation of The 3-Question Headache Screen in The Diagnosis of ...

    African Journals Online (AJOL)

    diagnosed and undertreated. A rapid diagnostic method is desirable so that treatment can be initiated early. We compared the 3-question headache screen with the International Headache Society (IHS) criteria in the diagnosis of migraine among ...

  5. Calcitonin gene-related peptide does not cause the familial hemiplegic migraine phenotype

    DEFF Research Database (Denmark)

    Hansen, J.M.; Thomsen, L.L.; Olesen, J.

    2008-01-01

    Objective: The neuropeptide calcitonin gene-related peptide (CGRP) is a migraine trigger that plays a crucial role in migraine pathophysiology, and CGRP antagonism is efficient in the treatment of migraine attacks. Familial hemiplegic migraine (FHM) is a dominantly inherited subtype of migraine w...... without aura. This indicates that the pathophysiologic pathways underlying migraine headache in FHM may be different from the common types of migraine and questions whether CGRP antagonists would be effective in the treatment of FHM patients Udgivelsesdato: 2008/9/9...

  6. Migraine & paediatric obesity: a plausible link?

    Directory of Open Access Journals (Sweden)

    Sarit Ravid

    2014-01-01

    Full Text Available Obesity and migraine are both highly prevalent disorders in the general population, influenced by genetic and environmental risk factors. In recent studies, obesity was found to be a strong risk factor for transformed migraine and, among migraineurs, obesity was associated with frequent headaches and higher disability scores. Suggested mechanisms included: (i obesity as a pro-inflammatory state may be associated with neurovascular inflammation in patients with migraine; (ii elevated levels of plasma calcitonin gene-related peptide (CGRP in obese individuals may play a role as an important post-synaptic mediator of trigeminovascular inflammation in migraine; (iii dismodulation in the hypothalamic neuropeptide, orexin, in obese persons may be associated with increased susceptibility to neurogenic inflammation causing migraine attacks; and (iv leptin and adiponectin can activate proinflammatory cytokine release that is involved in the pathogenesis of migraine. In addition, both conditions are associated with psychiatric co-morbidities, such as depression and anxiety, that can further increase headache frequency and disability. Therefore, the effect of obesity on migraine outcome is important. Weight and BMI should be measured and calculated in all children presenting with migraine, and weight control should be a part of the treatment.

  7. Cluster headache in women: relation with menstruation, use of oral contraceptives, pregnancy, and menopause

    Science.gov (United States)

    van Vliet, J A; Favier, I; Helmerhorst, F M; Haan, J; Ferrari, M D

    2006-01-01

    In contrast with migraine, little is known about the relation between cluster headache and menstrual cycle, oral contraceptives, pregnancy, and menopause. A population based questionnaire study was performed among 224 female cluster headache patients, and the possible effect of hormonal influences on cluster headache attacks studied. For control data, a similar but adjusted questionnaire was sent to healthy volunteers and migraine patients. It was found that menstruation, use of oral contraceptives, pregnancy, and menopause had a much smaller influence on cluster headache attacks than in migraine. Cluster headache can, however, have a large impact on individual women, for example to refrain from having children. PMID:16407458

  8. Gendering the migraine market: do representations of illness matter?

    Science.gov (United States)

    Kempner, Joanna

    2006-10-01

    Migraine is a common, debilitating and costly disorder. Yet help-seeking for and rates of diagnosis of migraine are low. Drawing on ethnographic observations of pharmaceutical marketing practices at professional headache conferences and a content analysis of migraine advertising, principally in the USA, this paper demonstrates: (1) that the pharmaceutical industry directs its marketing of migraine medication to women; and (2) as part of this strategy, pharmaceutical advertisements portray women as the prototypical migraine sufferer, through representations that elicit hegemonic femininity. This strategy creates the impression that migraine is a "women's disorder", which, in turn, exacerbates gender bias in help seeking and diagnosis of migraine and reifies presumptions about the epidemiology of the disorder. I conclude that these pharmaceutical marketing practices have a paradoxical effect: even as they educate and raise awareness about migraine, they also create barriers to help seeking and diagnosis.

  9. Repetitive transcranial magnetic stimulation versus botulinum toxin injection in chronic migraine prophylaxis: a pilot randomized trial

    Directory of Open Access Journals (Sweden)

    Shehata HS

    2016-10-01

    Full Text Available Hatem S Shehata, Eman H Esmail, Ahmad Abdelalim, Shaimaa El-Jaafary, Alaa Elmazny, Asmaa Sabbah, Nevin M Shalaby Neurology Department, Faculty of Medicine, Cairo University, Cairo, Egypt Background: Chronic migraine is a prevalent disabling disease, with major health-related burden and poor quality of life. Long-term use of preventive medications carries risk of side effects. Objectives: The aim of this study was to compare repetitive transcranial magnetic stimulation (rTMS to botulinum toxin-A (BTX-A injection as preventive therapies for chronic migraine. Methods: A pilot, randomized study was conducted on a small-scale sample of 29 Egyptian patients with chronic migraine, recruited from Kasr Al-Aini teaching hospital outpatient clinic and diagnosed according to ICHD-III (beta version. Patients were randomly assigned into two groups; 15 patients received BTX-A injection following the Phase III Research Evaluating Migraine Prophylaxis Therapy injection paradigm and 14 patients were subjected to 12 rTMS sessions delivered at high frequency (10 Hz over the left motor cortex (MC, M1. All the patients were requested to have their 1-month headache calendar, and they were subjected to a baseline 25-item (beta version Henry Ford Hospital Headache Disability Inventory (HDI, Headache Impact Test (HIT-6, and visual analogue scale assessment of headache intensity. The primary efficacy measures were headache frequency and severity; secondary measures were 25-item HDI, HIT-6, and number of acute medications. Follow-up visits were scheduled at weeks 4, 6, 8, 10, and 12 after baseline visit. Results: A reduction in all outcome measures was achieved in both the groups. However, this improvement was more sustained in the BTX-A group, and both the therapies were well tolerated. Conclusion: BTX-A injection and rTMS have favorable efficacy and safety profiles in chronic migraineurs. rTMS is of comparable efficacy to BTX-A injection in chronic migraine

  10. Nitroglycerin-induced headache is not dependent on histamine release

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg; Olesen, J

    1994-01-01

    The molecular mechanisms of migraine pain have not yet been clarified. Monoamine and the peptide neurotransmitters involved in neurogenic inflammation do not cause significant head pain. Our previous studies of glyceryl trinitrate (GTN) and histamine-induced headaches have suggested that nitric...... in the cascade of intracellular reactions triggered by NO. These novel observations change current views on vascular headache mechanisms and the importance of NO as an initiator of the migraine attacks dictates new approaches to the pharmacological treatment of migraine and other vascular headaches....

  11. 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

  12. Didactic Migraine Education in US Doctor of Pharmacy Programs

    Science.gov (United States)

    Padiyara, Rosalyn S.; Schommer, Jon C.

    2010-01-01

    Objective To compare didactic migraine education in doctor of pharmacy (PharmD) programs in the United States with the Headache Consortium's evidence-based migraine treatment recommendations. Methods A self-administered survey instrument was mailed to all 90 Accreditation Council for Pharmacy Education (ACPE) approved PharmD programs in the United States. Results Seventy-seven programs responded (86%) and 69 useable survey instruments were analyzed. Fifty-five percent of programs discussed the Consortium's guidelines, 49% discussed the selection of nonprescription versus prescription agents, 45% recommended a butalbital-containing product as migraine treatment, and 20% educated students about tools for assessing migraine-related debilitation. At least 50% of programs taught information consistent with the remaining Consortium recommendations. Conclusion Approximately half of the PharmD programs teach concepts about migraine headache treatment consistent with the US Headache Consortium's recommendations. PMID:20221355

  13. 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 ...

  14. The prevalence and impact of headache in Brazil.

    Science.gov (United States)

    Queiroz, Luiz P; Silva Junior, Ariovaldo A

    2015-02-01

    In Brazil, several epidemiological studies on headache have been produced, most with an emphasis on prevalence and the association of primary headaches with some sociodemographic characteristics of the population. Data on the burden of headache, however, are scarce. The aim of this paper is to review all Brazilian population-based studies on headache, as well as to analyze the Migraine Disability Assessment Score (MIDAS) data collected with the PhD thesis of the senior author (LPQ). A literature review was performed using the keywords ("headache" or "migraine") and ("epidemiology" or "prevalence") and (Brazil). Another part of this paper will look at unpublished data on disability (MIDAS), collected with the prevalence data of the Brazilian nationwide epidemiological study of headache. There are 6 published epidemiological studies of headache in Brazil. The mean 1-year prevalence of headache in Brazil is 70.6%, of migraine 15.8%, of tension-type headache (TTH) 29.5%, and of chronic daily headache (CDH) 6.1%. Disability is significantly higher: in females compared to males; in patients with migraine and CDH compared to patients with TTH; and in those with headaches ≥15 days per month rather than those with episodic headaches. There was also a positive relationship between pain intensity and severity of disability. Patients with higher disability used more both abortive and prophylactic medication. The mean prevalence of headache in Brazil, and some of its subtypes, is similar to the rates described in other countries of the world. Disability is higher in females, in patients with migraine, in individuals with headaches ≥15 days per month, and in those with severe head pain. © 2015 American Headache Society.

  15. 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....

  16. 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.

  17. 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.

  18. 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.

  19. Association between Body Mass Index and Migraine: A Survey of Adult Population in China

    Directory of Open Access Journals (Sweden)

    Qingqing Huang

    2018-01-01

    Full Text Available Both migraine and obesity are prevalent disorders in the general population, which are characterized by disability and impaired quality of life. Although so many researches had studied the association between migraine and obesity, there are still no full knowledge of the relationship between body mass index (BMI and migraine, especially chronic migraine (CM. In this study, we analyzed a previous epidemiological survey data of primary headache patients in Chongqing, which surveyed consecutive neurological outpatients through face-to-face interview with physicians using a headache questionnaire. 166 episodic migraine (EM patients and 134 chronic migraine (CM patients were included in the study out of 1327 primary headache patients. And 200 healthy adults from the physical examination center were included as a control group. Finally, we found that the patients with migraine (EM and CM were more likely to be overweight, obese, or morbidly obese compared to those in the healthy group. Significant difference was found between BMI and frequency of migraine attacks but not severity or duration of headache onset. And no significant difference was found in severity and duration of headache onset between episodic and chronic migraine among different BMI classifications. Such may update our knowledge about the clinical features of migraine and BMI, revealing that the frequency of attacks may be associated with being overweight, obese, or morbidly obese in patients with migraine and that the extent of being overweight, obese, or morbidly obese in CM patients was lower than that in EM patients.

  20. Stress as a major determinant of migraine in women aged 25-65 years

    Directory of Open Access Journals (Sweden)

    Woro Riyadina

    2014-08-01

    Full Text Available Background Migraine is a primary headache causing substantial disability in patients. The prevalence of migraine in women is still high. Menarche, menstruation, pregnancy, menopause, and the use of hormonal contraceptives and hormone replacement treatment may influence migraine occurrence. The aim of this study was to determine the major determinants of migraine in adult women aged 25-65 years. Methods A cross-sectional study of 2,747 women from the baseline study “Cohort Study of Risk Factors for Non-Communicable Diseases”. The dependent variable was migraine based on the diagnosis of health providers or symptoms. Independent variables were demographic (age, marital status, education and behavioral (smoking, diet, and stress characteristics, metabolic disorders (obesity, hypertension, dyslipidemia, and hormonal factors (contraception and hormone therapy. Data were collected through interviews (characteristics, health and hormonal status, diet, measurement (anthropometrics, blood pressure, and health examination (blood specimens, neurology. Data were analyzed by chi-square test and multiple logistic regression. Results Migraine in adult women was found in 710 cases (25.8% with symptoms of worsening with activity (15%, nausea and vomiting (13%, and photophobia/phonophobia (4.1%. The main determinant of migraine in adult women was stress with a 2.47-fold risk [95% CI = 2.07 to 2.95] as compared with no stress, after controlling for smoking, menstruation and hormonal drug consumption. Conclusion Stress is a major determinant of migraine in adult women, therefore health programs should be instituted through health promotion, prevention and education to control stress.

  1. The comparison of sleep disturbances between the subjects with headache and healthy subjects

    Directory of Open Access Journals (Sweden)

    Arash Bostani

    2015-11-01

    Full Text Available Background: Headache is one of the most common complaints of the patients referring to the treatment centers. Also, some studies have reported the correlation of sleep disturbances with migraine and tension headaches. This study was aimed to analyze the association of sleep disturbances with migraine and tension headaches. Methods: In this cross-sectional study, 1005 students of Kermanshah University of Medical Sciences were selected by stratified random sampling during the academic year 2013-2014. Having attracted the participation and cooperation of the participants, sleep disorder and symptoms of headache (migraine and tension tests were administered. Results: The overall prevalence of headache, migraine headache and tension headache in students of medical science were 73.8 %, 16.7 % and 30.9 %, respectively. 20.3% of medical students had sleep disorder. Difficulty in sleep onset, daytime fatigue, apnea and sadness and anxiety were associated with headache. Total sleep disorder was directly associated with migraine headache (P<0.05.Conclusion: There was a correlation between sleep disorders and headache, especially migraine headache. Considering the importance of sleep in the incidence of headaches, sleep hygiene education and changes in the quality and patterns of sleep are essential for students, which can greatly affect their individual and social life.

  2. Migraines: Simple Steps to Head Off the Pain

    Science.gov (United States)

    ... that a certain food — such as aged cheese, chocolate, caffeine or alcohol — is triggering your migraines, eliminate ... headache: A randomized control trial. Behaviour Research and Therapy. 2014;61:1. July 08, 2015 Original article: ...

  3. Sleep terrors antecedent is common in adolescents with migraine

    Directory of Open Access Journals (Sweden)

    Libânia Melo Nunes Fialho

    2013-02-01

    Full Text Available Migraines and sleep terrors (STs are highly prevalent disorders with striking similarities. The aim of this study was to evaluate the effect of the antecedent of STs by comparing adolescents suffering from migraines with healthy controls in a large consecutive series. METHODS: All patients were subjected to a detailed headache questionnaire and were instructed to keep a headache diary during a two-month period. The age range was 10 to 19 years. The diagnosis of STs was defined according to the International Classification of Sleep Disorders. RESULTS: A total of 158 participants were evaluated. Of these participants, 50 suffered from episodic migraines (EMs, 57 had chronic migraines (CMs and 51 were control subjects (CG. Participants who had a history of STs had significantly more migraines than participants who did not. CONCLUSIONS: Migraine is strongly associated with a history of STs in the adolescent population independent of demographics and pain intensity.

  4. Are headache and temporomandibular disorders related? A blinded study

    DEFF Research Database (Denmark)

    Ballegaard, V.; Thede-Schmidt-Hansen, P.; Svensson, P.

    2008-01-01

    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...

  5. A basic diagnostic headache diary (BDHD) is well accepted and useful in the diagnosis of headache. a multicentre European and Latin American study

    DEFF Research Database (Denmark)

    Jensen, Rigmor Højland; Tassorelli, C; Rossi, P

    2011-01-01

    Aims: We tested the usability and usefulness of the basic diagnostic headache diary (BDHD) for the diagnosis of migraine, tension-type headache and medication-overuse headache in European and Latin American countries. Methods: Patients were subdivided into two groups according to a 1:1 randomizat......Aims: We tested the usability and usefulness of the basic diagnostic headache diary (BDHD) for the diagnosis of migraine, tension-type headache and medication-overuse headache in European and Latin American countries. Methods: Patients were subdivided into two groups according to a 1...

  6. Evolution of migraine after a 10-year follow-up.

    Science.gov (United States)

    Nachit-Ouinekh, Fatima; Dartigues, Jean-François; Chrysostome, Virginie; Henry, Patrick; Sourgen, Christophe; El Hasnaoui, Abdelkader

    2005-01-01

    To assess the evolution of headaches in a workplace cohort over a 10-year period. Migraine headaches are associated with significant handicap in everyday activities and poor quality of life. The prevalence of migraine shows a bell-shaped age distribution with a peak during the third and fourth decades. However, there is little longitudinal data available on the natural history of this condition. A prospective health survey undertaken in a large workplace cohort since 1989 provides an opportunity to assess the evolution of migraine and other headache syndromes over a 10-year period. A sample of 2500 subjects who reported regular headaches was chosen at random from those with headache identified in a cohort of 46,244 employees of the French national power company aged between 35 and 50 years in 1989 participating in a yearly health survey. In 1993, all subjects were sent a headache questionnaire to complete and return. In 2003, an identical questionnaire was sent to all subjects who had returned exploitable data in 1993. Headache diagnosis was assigned retrospectively using the International Headache Society (IHS) criteria to migraine (IHS categories 1.1 and 1.2), migrainous disorder (IHS category 1.7), or other episodic headaches. Of 2500 subjects sampled, 2051 (82%) returned exploitable data for the first questionnaire in 1993. In 2003, 1250 (61%) of these provided a second data set. In 1993, 623 (30.4%) of subjects fulfilled diagnostic criteria for migraine. However, only 37% of these retained the diagnosis 10 years later. In contrast, the proportion of subjects with other forms of episodic headache rose from 23.7% to 31.6%. In 2003, 9.5% of the sample were headache-free. Retention or acquisition of a diagnosis of migraine was more common in women than in men, and age was associated with evolution to a less severe headache syndrome. In those subjects who continued to have headaches, frequency and severity were lower at the second assessment. Only a minority of

  7. [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.

  8. Amitriptyline and aerobic exercise or amitriptyline alone in the treatment of chronic migraine: a randomized comparative study

    Directory of Open Access Journals (Sweden)

    Michelle Dias Santos Santiago

    2014-11-01

    Full Text Available To compare the preventive treatment benefits of amitriptyline and aerobic exercise or amitriptyline alone in patients with chronic migraine. Method Sixty patients, both genders, aged between 18 and 50 years, with a diagnosis of chronic migraine, were randomized in groups called amitriptyline and aerobic exercise or amitriptyline alone. The following parameters were evaluated: headache frequency, intensity and duration of headache, days of the analgesic medication use, body mass index (BMI, Beck Depression Inventory (BDI and Beck Anxiety Inventory (BAI scores. Results In the evaluated parameters, was observed decrease in headache frequency (p=0.001, moderate intensity (p=0.048, in headache duration (p=0.001, the body mass index (p=0.001, Beck Depression Inventory (p=0.001 and Beck Anxiety Inventory scores (p=0.001, when groups were compared in the end of third month. Conclusion In this study, the amitriptyline was an effective treatment for chronic migraine, but its efficacy was increased when combined with aerobic exercise.

  9. Acupuncture for migraine prophylaxis

    Directory of Open Access Journals (Sweden)

    Klaus Linde

    Full Text Available ABSTRACT BACKGROUND: Acupuncture is often used for migraine prophylaxis but its effectiveness is still controversial. This review (along with a companion review on 'Acupuncture for tension-type headache' represents an updated version of a Cochrane review originally published in Issue 1, 2001, of The Cochrane Library. OBJECTIVES: 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 patients with migraine. METHODS: Search methods: The Cochrane Pain, Palliative & Supportive Care Trials Register, CENTRAL, MEDLINE, EMBASE and the Cochrane Complementary Medicine Field Trials Register were searched to January 2008. Selection criteria: We included randomized trials with a post-randomization observation period of at least 8 weeks that compared the clinical effects of an acupuncture intervention with a control (no prophylactic treatment or routine care only, a sham acupuncture intervention or another intervention in patients with migraine. Data collection and analysis: Two reviewers checked eligibility; extracted information on patients, interventions, methods and results; and assessed risk of bias and quality of the acupuncture intervention. Outcomes extracted included response (outcome of primary interest, migraine attacks, migraine days, headache days and analgesic use. Pooled effect size estimates were calculated using a random-effects model. MAIN RESULTS: Twenty-two trials with 4419 participants (mean 201, median 42, range 27 to 1715 met the inclusion criteria. Six trials (including two large trials with 401 and 1715 patients compared acupuncture to no prophylactic treatment or routine care only. After 3 to 4 months patients receiving acupuncture had higher response rates and fewer headaches. The only study with long-term follow up saw no evidence that effects dissipated up

  10. Temporomandibular disorders, sleep bruxism, and primary headaches are mutually associated.

    Science.gov (United States)

    Fernandes, Giovana; Franco, Ana Lúcia; Gonçalves, Daniela Aparecida; Speciali, José Geraldo; Bigal, Marcelo Eduardo; Camparis, Cinara Maria

    2013-01-01

    To investigate the association among temporomandibular disorders (TMD), sleep bruxism, and primary headaches, assessing the risk of occurrence of primary headaches in patients with or without painful TMD and sleep bruxism. The sample consisted of 301 individuals (253 women and 48 men) with ages varying from 18 to 76 years old (average age of 37.5 years). The Research Diagnostic Criteria for Temporomandibular Disorders were used to classify TMD. Sleep bruxism was diagnosed by clinical criteria proposed by the American Academy of Sleep Medicine, and primary headaches were diagnosed according to the International Classification of Headache Disorders-II. Data were analyzed by chi-square and odds ratio tests with a 95% confidence interval, and the significance level adopted was .05. An association was found among painful TMD, migraine, and tension-type headache (P headache (3.7; 1.59-8.75). With regard to sleep bruxism, the association was significant only for chronic migraine (3.8; 1.83-7.84). When the sample was stratified by the presence of sleep bruxism and painful TMD, only the presence of sleep bruxism did not increase the risk for any type of headache. The presence of painful TMD without sleep bruxism significantly increased the risk in particular for chronic migraine (30.1; 3.58-252.81), followed by episodic migraine (3.7; 1.46-9.16). The association between painful TMD and sleep bruxism significantly increased the risk for chronic migraine (87.1; 10.79-702.18), followed by episodic migraine (6.7; 2.79-15.98) and episodic tension-type headache (3.8; 1.38-10.69). The association of sleep bruxism and painful TMD greatly increased the risk for episodic migraine, episodic tension-type headache, and especially for chronic migraine.

  11. Sleep terrors antecedent is common in adolescents with migraine

    OpenAIRE

    Libânia Melo Nunes Fialho; Ricardo Silva Pinho; Jaime Lin; Thais Soares Cianciarullo Minett; Maria Sylvia de Souza Vitalle; Mauro Fisberg; Mario Fernando Prieto Peres; Luiz Celso Pereira Vilanova; Marcelo Rodrigues Masruha

    2013-01-01

    Migraines and sleep terrors (STs) are highly prevalent disorders with striking similarities. The aim of this study was to evaluate the effect of the antecedent of STs by comparing adolescents suffering from migraines with healthy controls in a large consecutive series. METHODS: All patients were subjected to a detailed headache questionnaire and were instructed to keep a headache diary during a two-month period. The age range was 10 to 19 years. The diagnosis of STs was defined according to t...

  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. 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.

  14. 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)

  15. CGRP may play a causative role in migraine

    DEFF Research Database (Denmark)

    Lassen, L H; Haderslev, P A; Jacobsen, V B

    2002-01-01

    Calcitonin gene-related peptide (CGRP) has been detected in increased amounts in external jugular venous blood during migraine attacks. However, it is unknown whether this is secondary to migraine or whether CGRP may cause headache. In a double-blind crossover study, the effect of human alphaCGRP...... attacks may play a causative role....

  16. A naturalistic glyceryl trinitrate infusion migraine model in the rat

    DEFF Research Database (Denmark)

    Ramachandran, Roshni; Bhatt, Deepak Kumar; Ploug, Kenneth Beri

    2012-01-01

    Glyceryl trinitrate (GTN) infusion is a reliable method to provoke migraine-like headaches in humans. Previous studies have simulated this human model in anaesthetized or in awake rodents using GTN doses 10,000 times higher than used in humans. The relevance of such toxicological doses to migraine...

  17. There is room for improvement in the prevention and treatment of headache after lumbar puncture

    DEFF Research Database (Denmark)

    Stendell, Line; Fomsgaard, Jonna S; Olsen, Karsten S

    2012-01-01

    The incidence of post dural puncture headache (PDPH) after lumbar puncture (LP) can be reduced from 36% to 0-9% by use of an atraumatic needle size 24 gauge (G)/0.56 mm rather than a traumatic needle size 22 G/0.7 mm. The evidence supporting some of the prophylactic and therapeutically treatments...

  18. Migraine - Prophylactic Treatment

    Directory of Open Access Journals (Sweden)

    Chowdhury Debashish

    2002-01-01

    Full Text Available Preventive therapy in migraine constitutes an important aspect of migraine management especially in patients who are not controlled or have significant disability despite taking drugs for acute management. In spite of te recent advances in understanding of the pathophysiology of migraine, the mechanisms of action of many preventive drugs are largely unknown. Further, these provide only about 50% reduction in frequency in about 2/3rds of migraine sufferers. Hence, risk-benefit ratio must be considered while prescribing these agents. Recent efforts to undertake large-scale meta-analysis to assess the efficacy of these agents have been rewarding and consensus guidelines have evolved. Propanolol, metoprolol, amitriptyline, sodium valproate, flunarizine and lisuride have emerged as first line drugs. The role of newer anti-convulsants and botox injections in refractory cases are being investigated. Availability, co-morbidities, medical contraindications, concomitant acute therapy and costs are important determinants for choosing a particular agent. This article reviews the guidelines to be followed in choosing the prophylactic treatment options for migraine.

  19. Prevalence and characteristics of migraine in medical students and its impact on their daily activities

    Directory of Open Access Journals (Sweden)

    Bindu Menon

    2013-01-01

    Full Text Available Background: Migraine is a common neurological disorder with significant impact on quality of life. The aim of this study was to investigate the prevalence and characteristics of migraine headaches in medical students, to measure its impact on their life, and to assess their knowledge about the ailment. Information about lifestyle variables was also collected. Materials and Methods: All medical students who confirmed of having headache for more than 1 year formed the study group. Students filled a detailed questionnaire focusing on demographics, pain characteristics, accompanying factors, triggers, and family history of migraine. Lifestyle variables were enquired and migraine associated disability was assessed by MIDAS (Migraine Disability Assessment. The diagnosis of migraine was made according to the International Headache Society criteria. Results are expressed in n = numbers and percentage. Results: Sixty-eight percent of medical students had headache. The prevalence of migraine in the whole cohort was 28%; however, of the headache group, migraine constituted 42%. There was a female preponderance. One-fourth of the students had weekly or daily attacks with 31% students reporting increase in their headache intensity and frequency. Forty-four percent of students had severe headaches. Dizziness, allodynia, and neck stiffness were reported as accompanying symptoms. Trigger factors were identified in 99% students, predominant of which were poor sleep hygiene, environmental changes, head movements, and mental stress. Only 4% of students did regular exercise. Twenty-seven percent of students reported self-medication use of analgesics. One-fourth of the students had migraine-associated disability but only 6% realized that they had migraine. Conclusion: Our study found a high prevalence of headache with migraine in medical students. The students′ awareness of the disease was very low with one-fourth of the students resorting to self-medication. Our

  20. 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 he