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management of acute migraine attack

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https://www.readbyqxmd.com/read/30367814/the-traffic-light-of-headache-simplifying-acute-migraine-management-for-physicians-and-patients-using-the-canadian-headache-society-guidelines
#1
Ana Marissa Lagman-Bartolome, Christine Lay
Migraine is a disabling neurological condition and it is well described that early treatment is more effective and less likely to lead to headache recurrence. While it would seem intuitive for a migraine sufferer to treat early, despite well-established guidelines by the Canadian Headache Society, many sufferers continue to treat late. As a result, acute therapy is less effective, resulting in higher associated disability and a longer lasting attack. Pain scales can help patients determine how to treat; however, we propose a simple, easily recalled traffic light system to help patients determine which drug to use based upon how they feel...
October 27, 2018: Headache
https://www.readbyqxmd.com/read/30362524/improving-medical-communication-in-migraine-management-a-modified-delphi-study-to-develop-a-digital-migraine-tracker
#2
David W Dodick, Stewart J Tepper, Richard B Lipton, Dawn C Buse, Walter F Stewart, Martha Bayliss, Pooja Desai, Sandhya Sapra, Karla Anderson, Erin McInerney-Prichard
OBJECTIVE: This study aimed to identify the essential content and amount of information to be collected from people with migraine via a patient-facing smartphone-based migraine tracker for them to share with clinicians during live discussions to assist in optimizing migraine management. The proposed tracker is intended for use in non-interventional research to evaluate disease burden in episodic migraine and chronic migraine patients as assessed by demographic and clinical characteristics and health resource utilization in an integrated delivery network setting...
October 2018: Headache
https://www.readbyqxmd.com/read/30291554/episodic-migraine-with-and-without-aura-key-differences-and-implications-for-pathophysiology-management-and-assessing-risks
#3
REVIEW
Angeliki Vgontzas, Rebecca Burch
PURPOSE OF REVIEW: To review the pathophysiologic, epidemiologic, and clinical evidence for similarities and differences between migraine with and without aura. RECENT FINDINGS: The ICHD-3 has recently refined the diagnostic criteria for aura to include positive symptomatology, which better differentiates aura from TIA. Although substantial evidence supports cortical spreading depression as the cause of visual aura, the role (if any) of CSD in headache pain is not well understood...
October 5, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/30281343/identifying-and-managing-acute-migraine-attacks-in-adults
#4
Paul Bates
Paul Bates, Senior Lecturer/Advanced Nurse Practitioner, University of Lincoln, pbates@lincoln.ac.uk , explains the most common symptoms, triggers and treatments of migraine, and the role of the nurse in patient care.
October 4, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/30074551/headache-in-pregnancy
#5
Matthew S Robbins
PURPOSE OF REVIEW: Headache disorders are extraordinarily common and disproportionately impact women of childbearing age. This article reviews the importance of proper diagnosis, natural history, and management of headache disorders in pregnant and postpartum women. RECENT FINDINGS: Red flags for secondary headache specifically among pregnant women include elevated blood pressure and lack of a previous headache history, as well as a prolonged duration of the headache attack in those with a prior history of migraine...
August 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/30074546/the-migraine-aura
#6
Andrew Charles
PURPOSE OF REVIEW: This article discusses the basic mechanisms of migraine aura and its clinical significance based upon evidence from human studies and animal models. RECENT FINDINGS: Prospective clinical studies have reinforced the understanding that migraine aura is highly variable from one individual to the next as well as from attack to attack in an individual. While migraine with aura clearly has a higher heritability than migraine without aura, population studies have not identified specific genes that underlie this heritability for typical migraine with aura...
August 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/30074545/the-migraine-premonitory-phase
#7
Nazia Karsan, Pyari Bose, Peter J Goadsby
PURPOSE OF REVIEW: The premonitory phase of migraine is defined as the presence of nonpainful symptomatology occurring hours to days before the onset of headache. Symptoms can include neck stiffness, yawning, thirst, and increased frequency of micturition. Clinical recognition of these symptoms is important to ensure early and effective attack management. Further understanding of the clinical phenotype and neurobiological mediation of these symptoms is important in the advancement of therapeutics research in both acute and preventive treatments of migraine...
August 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29913626/vasoactive-intestinal-peptide-vip-and-pituitary-adenylate-cyclase-activating-polypeptide-pacap-in-the-circulation-after-sumatriptan
#8
Jakob Møller Hansen, Jan Fahrenkrug, Jesper Petersen, Troels Wienecke, Karsten Skovgaard Olsen, Messoud Ashina
Background and purpose The origin of migraine pain is still elusive, but increasingly researchers focus on the neuropeptides in the perivascular space of cranial vessels as important mediators of nociceptive input during migraine attacks. The parasympathetic neurotransmitters, pituitary adenylate cyclase activating peptide-38 (PACAP38) and vasoactive intestinal peptide (VIP) may be released from parasympathetic fibres and activate sensory nerve fibres during migraine attacks. Triptans are effective and well tolerated in acute migraine management but the exact mechanism of action is still debated...
October 1, 2013: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29862074/sphenopalatine-ganglion-block-for-the-treatment-of-acute-migraine-headache
#9
Mohamed Binfalah, Eman Alghawi, Eslam Shosha, Ali Alhilly, Moiz Bakhiet
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...
2018: Pain Research and Treatment
https://www.readbyqxmd.com/read/29574601/headache-and-its-management-in-patients-with-multiple-sclerosis
#10
REVIEW
Farhat Husain, Gabriel Pardo, Meheroz Rabadi
PURPOSE OF REVIEW: The purpose of this review was to discuss the prevalence, impact, pathophysiology, and treatment of headaches (H/As) in patients with multiple sclerosis (MS). RECENT FINDINGS: Headaches and multiple sclerosis are more common in women than in men with the ratio of female to male being 3:1. It is not entirely clear if there is a correlation or an incidental comorbidity of two neurological conditions. A review of the literature shows a variable prevalence of H/As in MS patients...
March 24, 2018: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/29238692/migraine-related-vertigo
#11
Vithal D Udagatti, Rajendran Dinesh Kumar
Migraine related vertigo (MRV) is largely accepted in the vestibular community and probably represents the second most common cause of vertigo after benign positional vertigo by far exceeding Meniere's disease. The data on vestibular migraine management is still relatively poor, despite its enormous importance in daily practice. A 55-year old male presented with history of giddiness, imbalance, sweating and sensation of nausea with severe pulsating headache of one day duration. Ear, Nose and Throat examination was normal...
December 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/29235068/migraine-treatment-current-acute-medications-and-their-potential-mechanisms-of-action
#12
REVIEW
Jonathan Jia Yuan Ong, Milena De Felice
Migraine is a common and disabling primary headache disorder with a significant socioeconomic burden. The management of migraine is multifaceted and is generally dichotomized into acute and preventive strategies, with several treatment modalities. The aims of acute pharmacological treatment are to rapidly restore function with minimal recurrence, with the avoidance of side effects. The choice of pharmacological treatment is individualized, and is based on the consideration of the characteristics of the migraine attack, the patient's concomitant medical problems, and treatment preferences...
April 2018: Neurotherapeutics: the Journal of the American Society for Experimental NeuroTherapeutics
https://www.readbyqxmd.com/read/29212383/menstrual-migraine-a-review-of-current-and-developing-pharmacotherapies-for-women
#13
REVIEW
G Allais, Giulia Chiarle, Silvia Sinigaglia, Chiara Benedetto
Migraine is one of the most common neurological disorders in the general population. It affects 18% of women and 6% of men. In more than 50% of women migraineurs the occurrence of migraine attacks correlates strongly with the perimenstrual period. Menstrual migraine is highly debilitating, less responsive to therapy, and attacks are longer than those not correlated with menses. Menstrual migraine requires accurate evaluation and targeted therapy, that we aim to recommend in this review. Areas covered: This review of the literature provides an overview of currently available pharmacological therapies (especially with triptans, anti-inflammatory drugs, hormonal strategies) and drugs in development (in particular those acting on calcitonin gene-related peptide) for the treatment of acute migraine attacks and the prophylaxis of menstrual migraine...
February 2018: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/29188160/severe-hyperthyroidism-masquerading-as-acute-bulbar-weakness
#14
Rena D Sukhdeo, Christopher Jackson, Cyrilyn Walters, Aneel Kumar
The stroke occurs in nearly 800,000 patients per year in the United States with significant morbidity if not treated and managed in a time sensitive manner. Acute bulbar weakness can be a common presenting manifestation of acute stroke and transient ischemic attack. However, up to 30% of the patients presenting with symptoms concerning for stroke could be displaying a disease process that mimics the stroke. These disorders include hypoglycemia, seizures, complicated migraines, and endocrinopathies such as thyroid disease...
September 27, 2017: Curēus
https://www.readbyqxmd.com/read/29171011/stroke-like-migraine-attacks-after-radiation-therapy-a-misnomer
#15
Emily Peien Fan, Gabriel Heiber, Elizabeth E Gerard, Stephan Schuele
OBJECTIVE: To understand the frequency of electrographic and clinical seizures in patients with stroke-like migraine attacks after radiation therapy (SMART), and determine whether SMART warrants comprehensive electroencephalographic (EEG) monitoring and aggressive seizure management. METHODS: We searched our magnetic resonance brain imaging report database for all patients between January 2013 and December 2015 for suspected SMART syndrome. Clinical inclusion criteria were further applied as follows: inpatient adults (>18 years of age) with history of cranial radiation presenting with acute neurologic deficits as primary admission reason who lacked evidence of recurrent or new brain malignancy, stroke, or infectious agents in cerebrospinal fluid...
January 2018: Epilepsia
https://www.readbyqxmd.com/read/29158678/efficacy-and-safety-of-dfn-15-an-oral-liquid-formulation-of-celecoxib-in-adults-with-migraine-a-multicenter-randomized-placebo-controlled-double-blind-crossover-study
#16
Sagar Munjal, Alix Bennett
Background: The objective of this proof-of-concept study was to assess the safety, efficacy, and potential for dose response of a new oral liquid formulation of celecoxib, DFN-15, in adults with migraine. Variability in patient-identified most bothersome symptom (MBS) across 3 migraine attacks was also evaluated. Methods: This was a randomized, placebo-controlled, double-blind, 3-treatment, 6-sequence, 3-period, crossover study of 3 treatments (DFN-15 120 mg, DFN-15 240 mg, and placebo) administered at the onset of moderate to severe headache...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29051065/dihydroergotamine-mesylate-loaded-dissolving-microneedle-patch-made-of-polyvinylpyrrolidone-for-management-of-acute-migraine-therapy
#17
Cetin Tas, Jessica C Joyce, Hiep X Nguyen, Padmanabhan Eangoor, Jennifer S Knaack, Ajay K Banga, Mark R Prausnitz
Migraine is a widespread neurological disease with negative effects on quality of life and productivity. Moderate to severe acute migraine attacks can be treated with dihydroergotamine mesylate (DHE), an ergot derivative that is especially effective in non-responders to triptan derivatives. To overcome limitations of current DHE formulations in subcutaneous injection and nasal spray such as pain, adverse side effects and poor bioavailability, a new approach is needed for DHE delivery enabling painless self-administration, quick onset of action, and high bioavailability...
December 28, 2017: Journal of Controlled Release: Official Journal of the Controlled Release Society
https://www.readbyqxmd.com/read/28947248/-cyclic-vomiting-syndrome-in-children
#18
F Brezin, A Wiedemann, F Feillet
Cyclic vomiting syndrome (CVS) is a misrecognized and probably underdiagnosed disease that can affect up to 1.9% of the pediatric population and can occupy 15% of these children's time. It is characterized by acute attacks of vomiting, occurring with such a strict frequency that some parents can predict the date of their child's next attack. The pathophysiology of CVS is unclear, although the literature recognizes a common origin with migraine headaches, which has the same acute and prophylactic treatment. CVS is now included in the larger group of diseases called "episodic symptoms related to migraine" previously known as "childhood periodic syndromes...
November 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28808924/a-critical-evaluation-on-moh-current-treatments
#19
REVIEW
Andrea Negro, Martina Curto, Luana Lionetto, Simona Guerzoni, Luigi Alberto Pini, Paolo Martelletti
Migraine is the most frequent neurological disorder observed in clinical practice characterized by moderate to severe pain attacks associated with neurological, gastrointestinal, and dysautonomic symptoms. Each year, 2.5% of patients with episodic migraine develop chronic migraine (CM). CM is characterized by high frequency of the attacks that may result into chronic intake of abortive medications. Nearly, the 70% of CM patients referring to tertiary head centers show acute pain medications overuse that may lead to the development of medication overuse headache (MOH)...
August 15, 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28527086/non-invasive-vagus-nerve-stimulation-nvns-as-symptomatic-treatment-of-migraine-in-young-patients-a-preliminary-safety-study
#20
Licia Grazzi, Gabriella Egeo, Eric Liebler, Anna Maria Padovan, Piero Barbanti
Recent clinical experiences and clinical trials have demonstrated the safety, tolerability, and efficacy of non-invasive vagus nerve stimulation (nVNS; gammaCore® ) for the acute and prophylactic treatment of migraine. nVNS has a favorable adverse event profile, making it an attractive option for sensitive patient populations. We explored the safety, tolerability, and efficacy of nVNS as acute migraine treatment in adolescents. A group of adolescent patients suffering from migraine without aura were trained to use gammaCore to manage their migraine attacks...
May 2017: Neurological Sciences
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