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https://www.readbyqxmd.com/read/29768938/double-blind-placebo-controlled-randomized-clinical-trial-of-ginger-zingiber-officinale-rosc-addition-in-migraine-acute-treatment
#1
Laís Bhering Martins, Ana Maria Dos Santos Rodrigues, Débora Fernandes Rodrigues, Luana Caroline Dos Santos, Antônio Lúcio Teixeira, Adaliene Versiani Matos Ferreira
Background Previous studies have demonstrated the analgesic effects of ginger in different conditions, but evidence about its efficacy in migraine treatment is scarce. Objective This study aimed to evaluate the potential of ginger to improve acute migraine as an add-on strategy to standard treatment. Methods A double-blind placebo-controlled randomized clinical trial in the emergency room of a general hospital was conducted. Patients who sought medical care at the time of migraine attack were enrolled in this study...
January 1, 2018: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29744871/the-effectiveness-of-greater-occipital-nerve-blockade-in-treating-acute-migraine-related-headaches-in-emergency-departments
#2
O Korucu, S Dagar, Ş K Çorbacioglu, E Emektar, Y Cevik
OBJECTIVE: This study aimed to evaluate the effectiveness of a greater occipital nerve (GON) blockade against a placebo and classical treatments (non-steroidal anti-inflammatory drugs + metoclopramide) among patients who were admitted to the emergency department (ED) with acute migraine headaches. METHOD: This prospective-randomized controlled study was conducted on patients with acute migraine headaches. The patients were randomly assigned to 3 treatment groups: the GON blockade group (nerve blockade with bupivacaine), the placebo group (injection of normal saline into the GON area), and the intravenous (IV) treatment group (IV dexketoprofen and metoclopramide)...
May 10, 2018: Acta Neurologica Scandinavica
https://www.readbyqxmd.com/read/29662527/stimulant-withdrawal-in-a-child-with-autism-spectrum-disorder-and-adhd-a-case-report
#3
Aneta Krakowski, Abel Ickowicz
Objective: To consider whether the concepts of tolerance and withdrawal to stimulant medications apply to a preadolescent female, affected by autism spectrum disorder (ASD) and treated for associated attention-deficit/hyperactivity disorder (ADHD). Methods: We describe the case history and review scientific English language literature pertaining to acute withdrawal effects associated with methylphenidate and amphetamine derivatives in children. Results: An 11-year-old female with ASD and ADHD referred to our clinic experienced vomiting, headaches, and light sensitivity following abrupt discontinuation of methylphenidate; she subsequently presented with migraines and marked malaise immediately after a dose reduction in lisdexamfetamine...
April 2018: Journal of the Canadian Academy of Child and Adolescent Psychiatry
https://www.readbyqxmd.com/read/29661036/when-migraine-mimics-stroke-a-systematic-review
#4
Alberto Terrin, Giulia Toldo, Mario Ermani, Federico Mainardi, Ferdinando Maggioni
Background Migraine with aura may mimic an acute ischemic stroke, so that an improper administration of thrombolytic treatment can expose migrainous patients to severe adverse effects. Methods This systematic review quantifies the relevance of migraine with aura among stroke mimics, checking for thrombolysis' safety in these patients. We reviewed the literature after 1995, distinguishing from studies dealing with stroke mimics treated with systemic thrombolysis and those who were not treated with systemic thrombolysis...
January 1, 2018: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29643708/evidence-based-review-and-appraisal-of-the-use-of-droperidol-in-the-emergency-department
#5
REVIEW
Pei-Chun Lai, Yen-Ta Huang
Droperidol is a short-acting, potent dopamine D2 antagonist that can pass through the blood-brain barrier. A black box warning was issued for droperidol by the United States Food and Drug Administration in 2001 because of a risk of development of torsades de pointes induced by QT prolongation. Many experts feel that the incidence of arrhythmia is overestimated, and low-dose droperidol is almost always used by anesthesiologists for postoperative nausea and vomiting. In this review, we used evidence-based analysis to appraise high-quality studies with a low risk of bias published after 2001 on the use of droperidol in the emergency department (ED)...
January 2018: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29627349/recurrent-ethylene-glycol-poisoning-with-elevated-lactate-levels-to-obtain-opioid-medications
#6
Matthew Zuckerman, Tim Vo
BACKGROUND: Malingering is when a patient feigns illness for secondary gain. While most patients with malingering manufacture or exaggerate symptoms, some patients may induce illness. Previous reports of malingering patients inducing illness include sepsis, kidney pain, migraine, and chest pain. However, acute poisoning as a manifestation of malingering appears to be rare. CASE REPORT: We describe the case of a 39-year-old man who presented to the emergency department complaining of diffuse body pain...
April 4, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29616830/cgrp-a-target-for-acute-therapy-in-migraine-clinical-data
#7
Roberta Messina, Peter J Goadsby
Background A better understanding of the mechanisms underlying the migraine attack has reinforced the concept that migraine is a complex brain disease, and has paved the way for the development of new migraine specific acute treatments. In recent years, targeting the calcitonin gene-related peptide and its receptors has been one of the most promising pharmacological strategies for both acute and preventive treatment of migraine. Findings Randomized double-blind placebo-controlled trials have demonstrated the superiority of small molecule calcitonin gene-related peptide receptor antagonists (gepants) over placebo in treating acute migraine attacks measured as the two-hour pain free endpoint...
January 1, 2018: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29616493/non-pharmacological-approaches-for-migraine
#8
REVIEW
Francesca Puledda, Kevin Shields
Migraine is one of the most common and debilitating neurological disorders. However, the efficacy of pharmacological therapies may have unsatisfactory efficacy and can be poorly tolerated. There is a strong need in clinical practice for alternative approaches for both acute and preventive treatment. Occasionally, this need might arise in the context of low-frequency migraneurs who are not keen to use medication or fear the potential side effects. At the opposite end of the spectrum, clinicians might be faced with patients who have proven refractory to numerous medications...
April 3, 2018: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/29575082/somatic-sprouts-of-the-purkinje-cells-in-a-patient-with-multiple-system-atrophy
#9
Kenji Sakai, Chiho Ishida, Yuko Kato-Motozaki, Atsuro Tagami, Kiyonobu Komai, Masahito Yamada
We describe the post mortem case of a 71-year-old Japanese woman diagnosed as having multiple system atrophy (MSA), showing somatic sprouting formation of Purkinje cells. The patient had suffered from frequent falling episodes and clumsiness of the left hand since the age of 67 years. Orthostatic hypotension and parkinsonism subsequently emerged. Typical neuropathological features of MSA, including degeneration of the striatum, pontine base and cerebellum with abundance of phosphorylated α-synuclein-positive neuronal and glial cytoplasmic and nuclear inclusions in the brain, were observed...
March 25, 2018: Neuropathology: Official Journal of the Japanese Society of Neuropathology
https://www.readbyqxmd.com/read/29556965/targeted-cgrp-small-molecule-antagonists-for-acute-migraine-therapy
#10
REVIEW
Philip R Holland, Peter J Goadsby
Migraine is a highly prevalent, severe, and disabling neurological condition with a significant unmet need for effective acute therapies. Patients (~50%) are dissatisfied with their currently available therapies. Calcitonin gene-related peptide (CGRP) has emerged as a key neuropeptide involved in the pathophysiology of migraines. As reviewed in this manuscript, a number of small molecule antagonists of the CGRP receptor have been developed for migraine therapy. Incredibly, the majority of the clinical trials conducted have proven positive, demonstrating the importance of this signalling pathway in migraine...
March 19, 2018: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/29500071/transient-regional-cerebral-hypoperfusion-during-a-paroxysmal-hemiplegic-event-in-glut1-deficiency-syndrome
#11
Mohamed Almuqbil, Michael J Rivkin, Masanori Takeoka, Edward Yang, Lance H Rodan
GLUT1 deficiency syndrome (GLUT1DS) is a well described neurometabolic disorder that results from impaired glucose transport into the central nervous system. GLUT1DS classically presents with infantile-onset epilepsy, progressive microcephaly, developmental delay, ataxia, dystonia, and spasticity, but a minority of patients may manifest with paroxysmal non-epileptic phenomena including hemiparesis (Wang et al., 2002). We report for the first time cerebral perfusion changes during an acute episode of hemiparesis in a 9 year old child with GLUT1DS...
May 2018: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/29461426/emergent-management-of-primary-headache-a-review-of-current-literature
#12
Farnia Naeem, Chris Schramm, Benjamin W Friedman
PURPOSE OF REVIEW: The current article reviews recent data on treatment of acute headache patients in the acute care setting. RECENT FINDINGS: Intravenous fluid hydration, a common component of emergency department (ED) migraine therapy, does not improve pain outcomes and leads to longer ED lengths of stay. Therefore, intravenous fluids should be administered only to migraine patients with clinical evidence of dehydration. Similarly, intravenous ketamine has garnered interest as a treatment for acute pain but does not provide substantial relief to migraine patients...
June 2018: Current Opinion in Neurology
https://www.readbyqxmd.com/read/29446070/a-hospital-based-retrospective-study-of-acute-postpartum-headache
#13
Angeliki Vgontzas, Matthew S Robbins
OBJECTIVE: To describe acute headache diagnoses in women presenting emergently in the postpartum period and to determine which factors may be associated with secondary vs primary headache. BACKGROUND: Hormonal, vascular, and procedural factors elevate the risk for both secondary and primary headache disorders in the postpartum period. Differentiating between these can be a diagnostic challenge, particularly among the most severe patients referred for urgent neurological consultation...
February 15, 2018: Headache
https://www.readbyqxmd.com/read/29429783/pediatric-stroke-and-its-mimics-limitations-of-a-pediatric-stroke-clinical-pathway
#14
Amy M DeLaroche, Lalitha Sivaswamy, Ahmad Farooqi, Nirupama Kannikeswaran
BACKGROUND: Acute stroke protocols improve delivery of care but it is unclear whether these resource intensive protocols are able to differentiate stroke from mimics in children. The aim of this study is to describe our institution's experience with stroke mimics identified through our pediatric stroke clinical pathway (PSCP). METHODS: The PSCP was implemented in our level 1 pediatric emergency department in June 2014 for children aged one month to 18 years. For patients managed using the PSCP from June 2014 to December 2016, demographic and clinical data were compared for patients diagnosed with stroke or a stroke mimic...
March 2018: Pediatric Neurology
https://www.readbyqxmd.com/read/29414151/migrainous-aura-as-stroke-mimic-the-role-of-perfusion-computed-tomography
#15
Mariana Ridolfi, Antonio Granato, Paola Polverino, Giovanni Furlanis, Maja Ukmar, Irene Zorzenon, Paolo Manganotti
OBJECTIVES: The acute-onset of migrainuos aura (MA) can be erroneously diagnosed in Emergency Department (ED) as acute stroke (AS) and it can be classified as "stroke mimic" (SM). Perfusion computer tomography (PCT) may be useful to improve detection of infarcts. The aim of the study was to investigate the role in ED of PCT in improving diagnosis of migrainous aura. Data were compared with the well-defined perfusion patterns in patients with acute ischemic stroke. PATIENTS AND METHODS: A standardized Stroke Protocol was planned...
March 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29404713/long-term-study-of-the-efficacy-and-safety-of-onabotulinumtoxina-for-the-prevention-of-chronic-migraine-compel-study
#16
Andrew M Blumenfeld, Richard J Stark, Marshall C Freeman, Amelia Orejudos, Aubrey Manack Adams
BACKGROUND: OnabotulinumtoxinA is approved for the prevention of headache in those with chronic migraine (CM); however, more clinical data on the risk-benefit profile for treatment beyond one year is desirable. METHODS: The Chronic Migraine OnabotulinuMtoxinA Prolonged Efficacy open Label (COMPEL) Study ( ClinicalTrials.gov , NCT01516892) is an international, multicenter, open-label long-term prospective study. Adults with CM received 155 U of onabotulinumtoxinA (31 sites in a fixed-site, fixed-dose paradigm across 7 head/neck muscles) every 12 weeks (±7 days) for 9 treatment cycles (108 weeks)...
February 5, 2018: Journal of Headache and Pain
https://www.readbyqxmd.com/read/29395695/a-new-diagnostic-approach-to-the-adult-patient-with-acute-dizziness
#17
Jonathan A Edlow, Kiersten L Gurley, David E Newman-Toker
BACKGROUND: Dizziness, a common chief complaint, has an extensive differential diagnosis that includes both benign and serious conditions. Emergency physicians must distinguish the majority of patients with self-limiting conditions from those with serious illnesses that require acute treatment. OBJECTIVE OF THE REVIEW: This article presents a new approach to diagnosis of the acutely dizzy patient that emphasizes different aspects of the history to guide a focused physical examination with the goal of differentiating benign peripheral vestibular conditions from dangerous posterior circulation strokes in the emergency department...
January 31, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29395284/safety-and-efficacy-of-intravenous-lidocaine-for-pain-management-in-the-emergency-department-a-systematic-review
#18
REVIEW
Lucas Oliveira J E Silva, Kristin Scherber, Daniel Cabrera, Sergey Motov, Patricia J Erwin, Colin P West, M Hassan Murad, M Fernanda Bellolio
STUDY OBJECTIVE: We evaluate the safety and efficacy of intravenous lidocaine in adult patients with acute and chronic pain who are undergoing pain management in the emergency department (ED). METHODS: We searched Ovid CENTRAL, Ovid EMBASE, and Ovid MEDLINE databases for randomized controlled trials and observational studies from inception to January 2017. Efficacy outcomes included reduction in pain scores from baseline to postintervention and need for rescue analgesia...
January 29, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29338150/the-role-of-cannabinoids-in-pain-control-the-good-the-bad-and-the-ugly
#19
Joseph V Pergolizzi, Jo Ann Lequang, Robert Taylor, Robert B Raffa, Daniel Colucci
Cannabinoids appear to possess many potential medical uses, which may extend to pain control. A narrative review of the literature has found a variety of studies testing botanical and synthetic cannabinoids in different pain syndromes (acute pain, cancer pain, chronic noncancer pain, fibromyalgia pain, migraine, neuropathic pain, visceral pain, and others). Results from these studies are mixed; cannabinoids appear to be most effective in controlling neuropathic pain, allodynia, medication-rebound headache, and chronic noncancer pain, but do not seem to offer any advantage over nonopioid analgesics for acute pain...
January 16, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29285572/characteristics-and-diagnoses-of-acute-headache-in-pregnant-women-a-retrospective-cross-sectional-study
#20
Bianca Raffaelli, Eberhard Siebert, Jeannette Körner, Thomas Liman, Uwe Reuter, Lars Neeb
BACKGROUND: Acute headache is one of the most frequent neurological symptoms in pregnant women. The early diagnosis of underlying secondary conditions has a major influence on patient outcome, especially in emergency settings. However, at the time being no well-established guideline for diagnostic evaluation of acute headache during pregnancy exists. In this study, we aimed to characterize acute headache in pregnant women concerning demographic, clinical, and diagnostic features, and to determine predictors of secondary headache...
December 4, 2017: Journal of Headache and Pain
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