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basilar migraine

Louise Dunphy, Prashanth Shetty, Rabinder Randhawa, Kharil Amir Rani, Yaw Duodu
A 39-year-old man, born in India but resident in the UK for 10 years, was travelling in America when he became feverish with an altered mentation. He reported a 10-day history of fever, photophobia, headache and fatigue. His medical history included hypothyroidism and migraine. He was a non-smoker, did not consume alcohol and denied a history of drug use. He was transferred to the emergency department. Laboratory investigations confirmed hyponatraemia (sodium 128 mmol/L). A chest radiograph confirmed no focal consolidation...
October 7, 2016: BMJ Case Reports
Mi Ji Lee, Min Kyung Chu, Hanna Choi, Hyun Ah Choi, Chungbin Lee, Chin-Sang Chung
OBJECTIVE: To assess longitudinal changes in cerebral blood flow velocities (ΔCBFVs) according to the clinical course of migraine. METHODS: We retrospectively included migraine patients with two or more attacks per month at baseline who were followed up within 2 years with transcranial Doppler in a tertiary headache clinic. ΔCBFVs were analyzed in relation to clinical courses, defined as remission (0-1 headache days/month), persistence (2-14/month), or progression (≥15/month) in episodic migraine (EM), and conversion to EM (<15/month) and persistence (≥15/month) in chronic migraine (CM)...
July 4, 2016: Cephalalgia: An International Journal of Headache
Paul G Mathew, Regina Krel, Bhuvin Buddhdev, Hossein Ansari, Shivang G Joshi, Warren D Spinner, Brad C Klein
BACKGROUND: Patients with basilar migraine (BM) and hemiplegic migraine (HM) have been excluded from triptan and DHE clinical trials due to a potential risk of ischemic vascular events, and the FDA mandates that package labeling state that they are contraindicated in BM and HM. The objective of this study was to demonstrate that triptans and DHE can be used for the abortive treatment of BM and HM without significant adverse ischemic vascular events. METHODS: A retrospective chart review of patients with BM features or HM who received acute abortive treatment with either triptans or DHE was conducted at 4 headache centers to assess the frequency of ischemic vascular events after administration...
April 8, 2016: Headache
Badr E Mostafa, Ayman O El Kahky, Hisham M Abdel Kader, Michael Rizk
Introduction Vertigo can be due to a variety of central and peripheral causes. The relative incidence of central causes is underestimated. This may have an important impact of the patients' management and prognosis. Objective The objective of this work is to determine the incidence of central vestibular disorders in patients presenting to a vestibular unit in a tertiary referral academic center. It also aims at determining the best strategy to increase the diagnostic yield of the patients' visit. Methods This is a prospective observational study on 100 consecutive patients with symptoms suggestive of vestibular dysfunction...
July 2014: International Archives of Otorhinolaryngology
N L Kunel'skaia, M V Tardov, E V Baĭbakova, M A Chugunova, Z O Zaoeva
The objective of the present study was to improve diagnostics of basilar type migraine (BTM) based on the results of neurological, vestibulometric, and audiological studies of 11 patients. Peculiarities of the clinical picture of this disease and the medical histories of these patients are described. The pathogenetic role of labyrinthine hydrops and the difficulties encountered in diagnostics of Meniere's disease are discussed.
2014: Vestnik Otorinolaringologii
Aimee F Luat, Deepak Kamat, Lalitha Sivaswamy
There are a wide variety of paroxysmal nonepileptic events (PNEEs) in children that can mimic seizures. The type of PNEEs that need to be considered in the differential diagnosis depends on the age of symptom onset and the clinical features. In infants and toddlers, conditions that are relatively common in clinical practice such as apnea, jitteriness, shuddering attacks, and breath-holding spells may not present much of a diagnostic conundrum, whereas unusual conditions such as hyperekplexia may cause concern...
February 2015: Pediatric Annals
Roopa Rajan, Dheeraj Khurana, Vivek Lal
BACKGROUND: Although systemic endothelial function is unimpaired in migraine, it is unknown whether cerebral endothelial function impairment exists in migraineurs. MATERIALS AND METHODS: We conducted a prospective study to assess endothelial function in migraineurs (n=45) and healthy volunteers (n=44). Cerebral endothelial function was assessed by Breath Holding Index (BHI) on transcranial Doppler in bilateral middle cerebral artery (MCA at 30-60 mm), posterior cerebral artery (PCA at 60-80 mm) and basilar artery (BA at 80-120 mm) using bilateral monitoring probes fixed on headband...
November 2015: Journal of Neurology, Neurosurgery, and Psychiatry
Dana Li, Anne F Christensen, Jes Olesen
INTRODUCTION: In 2013 the International Headache Society published the third International Classification of Headache Disorders beta-version, ICHD-3 beta. Its structure is identical to that of the present proposed version of the International Classification of Diseases (ICD-11), although slightly abbreviated to fulfill the needs of ICD-11. In the following, only ICHD-3 beta is mentioned, but findings regarding the validity of ICHD-3 beta categories are equally relevant to the forthcoming ICD-11...
August 2015: Cephalalgia: An International Journal of Headache
Elizabeth Loehrer, Meike W Vernooij, Aad van der Lugt, Albert Hofman, M Arfan Ikram
INTRODUCTION: Observations that migraine increases risk of cardiovascular disease and ischemic brain changes may suggest sustained vascular differences between migraineurs and controls. In a population-based setting, we compared cerebral blood flow between migraineurs in the attack-free period and controls. METHODS: Between 2006 and 2008, 2642 participants, aged 45-65, from the Rotterdam Study completed a migraine questionnaire and had complete usable MRI data. Participants were classified into controls (N = 2033), probable migraine (N = 153), or migraine (N = 456)...
February 2015: Cephalalgia: An International Journal of Headache
Jay G Capone, Valentina Simioni, Maria R Tola
We report a case of midbrain malformation characterized by right deviation of the medulla oblongata associated with elongation and ectasia of the basilar and left vertebral arteries in a patient with a long history of migraine-like headache with autonomic symptoms.
May 2014: Headache
Guomin Ying, Wen Fan, Nan Li, Jing Wang, Wangwen Li, Ge Tan, Jiying Zhou
OBJECTIVES: The aim of this study was to investigate the prevalence and clinical characteristics of basilar-type migraine in the neurology outpatient clinic of a university hospital in China. METHODS: This cross-sectional study was conducted in the neurology outpatient of a tertiary care hospital in Chongqing between January 2010 and December 2011. All consecutive patients citing headache as their chief complaint were asked to complete a face-to-face interview by a qualified headache specialist using a detailed questionnaire for headache...
July 2014: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
I D Stulin, N L Kunel'skaia, M V Tardov, E V Baĭbakova, M A Chugunova, Z O Zaoeva, I M Tardova
The work is devoted to the description of neurological, vestibulometric and audiologic data obtained in the examination of 11 patients with basilar type migraine. The features of the disease (neck injuries before the disease, prolonged aura, protracted attacks, similarity with the clinical picture of stroke, occipital pain, cervical root syndrome, muscle-tonus phenomena and others) are described. A role of cervical pathology and labyrinthine hydrops in the disease pathogenesis as well as difficulties of differential diagnosis with Ménière's disease and Barre-Lieou syndrome are discussed...
2014: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Tamara L Deaton, Laurie S Mauro
OBJECTIVE: To evaluate the currently published data pertaining to the efficacy and safety of topiramate for prophylaxis of classic and common migraine in pediatric patients. DATA SOURCES: The literature was identified via PubMed (through April 2013) and Iowa Drug Information System (through April 2013). References from identified articles were also reviewed. STUDY SELECTION AND DATA EXTRACTION: Data were included from studies of efficacy and safety in pediatric patients experiencing migraine (with or without aura), as defined by the International Headache Society...
May 2014: Annals of Pharmacotherapy
Hidetoshi Matsukawa, Masaki Shinoda, Motoharu Fujii, Osamu Takahashi, Akihiro Uemura, Yasunari Niimi
BACKGROUND AND PURPOSE: Spontaneous intradural vertebral artery dissection (siVAD) primarily causes stroke in young and middle-aged individuals; however, data on the relationship between vertebrobasilar morphology and the progression of siVAD are limited. METHODS: We retrospectively reviewed the data of 77 adult patients who were diagnosed with unruptured siVAD and treated conservatively. We analysed the clinical characteristics, vertebrobasilar morphologies and progression...
September 2014: Journal of Neurology, Neurosurgery, and Psychiatry
Junpei Kobayashi, Shoichiro Sato, Kosuke Okumura, Fumio Miyashita, Akihiko Ueda, Yukio Ando, Kazunori Toyoda
The location of white matter lesions, especially in the anterior temporal poles (ATP), is helpful in the diagnosis of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). We report a 49-year-old man with CADASIL who developed migraine with atypical aura, silent lacunar infarcts, and leukoencephalopathy without involvement of the ATP. The prevalence of migraine with aura in subjects with CADASIL is several times greater than that in the general population. Particularly in patients with CADASIL, the aura is often atypical (hemiplegic, basilar, or prolonged)...
March 2014: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Peter Kraft, Wolfgang Müllges
A 12-year-old girl presented with headache, nausea, decreased level of consciousness, and diplopia. Brain MRI, arteriography (figure e-1 on the Neurology® Web site at, vasculitic markers, and CSF were normal, as were EEGs and ECGs. Transcranial color-coded ultrasonography of the basilar artery revealed typical musical murmurs ("seagull cry") indicative of a hemodynamically significant stenosis (video).(1) Sumatriptan provided symptomatic relief; basilar flow normalized on ultrasonography (figure e-2)...
November 19, 2013: Neurology
Amre Nouh, Sean Ruland, Michael J Schneck, David Pasquale, José Biller
Reversible cerebral vasoconstriction syndrome (RCVS) has been associated with exposure to vasoactive substances and few reports with cervical arterial dissections (CADs). We evaluated a 32-year-old woman with history of depression, migraines without aura, and cannabis use who presented with a thunderclap headache unresponsive to triptans. She was found to have bilateral occipital infarcts, bilateral extracranial vertebral artery dissections, bilateral internal carotid artery dissecting aneurysms, and extensive distal multifocal segmental narrowing of the anterior and posterior intracranial circulation with a "sausage on a string-like appearance" suggestive of RCVS...
February 2014: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Yuta Inoue, Takao Yabe
We report a rare case of benign paroxysmal vertigo (BPV) of childhood transitioning into basilar migraine (BM) that was effectively treated with lomerizine. A 6-year-old male visited our hospital complaining of repeated attacks of vertigo for 3 months. The patient's vertigo attacks lasted for several hours and were accompanied by nausea, vomiting, intense fear and loss of consciousness. No nystagmus was observed during the vertigo attacks. Blood tests and imaging examinations revealed no abnormal findings. The results of electronystagmography and the caloric test were unremarkable...
June 2013: Experimental and Therapeutic Medicine
Renate Pichler, Isabel Heidegger, Gerald Klinglmair, Alexander Kroiss, Christian Uprimny, Rudolf Wolfgang Gasser, Georg Schäfer, Hannes Steiner
Extra-adrenal paraganglioma with isolated localization in the urinary bladder is a rare neuroendocrine tumor. Although the typical symptoms like headache, nausea, weight loss, flushing, heart palpitation or paroxysmal hypertension during micturition are well established, we present an unusual case of bladder paraganglioma, 'misdiagnosed' with basilar-type migraine due to headache for the past 8 years. As urologists linked the presence of a tumor (by CT) and symptoms connected with micturition, no cystoscopy and no transurethral resection of the bladder was performed prior to detailed diagnostic workup...
2014: Urologia Internationalis
D Cologno, F d'Onofrio, O Castriota, V Petretta, G Casucci, A Russo, G Bussone
Five years ago we reported the case of three patients affected by basilar-type migraine (BM) responsive to lamotrigine. At that time, proven treatment options for BM are rather limited and lamotrigine has been tested in BM patients because it was a widely tested treatment for migraine with aura. That positive 1-year experience leaded us to suggest that lamotrigine could be a preventive therapeutic option for BM patients, with and without menstruation association. We now report the five-year follow-up of the same patients to confirm and underlie the possible role of lamotrigine to induce BM attacks remission...
May 2013: Neurological Sciences
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