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Migraine treatment

H MacPherson, E A Vertosick, N E Foster, G Lewith, K Linde, K J Sherman, C M Witt, A J Vickers
There is uncertainty regarding how long the effects of acupuncture treatment persist after a course of treatment. We aimed to determine the trajectory of pain scores over time following acupuncture, using a large individual patient dataset from high quality randomized trials of acupuncture for chronic pain. The available individual patient dataset included 29 trials and 17,922 patients. The chronic pain conditions included musculoskeletal pain (low back, neck and shoulder), osteoarthritis of the knee and headache/migraine...
October 17, 2016: Pain
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
Gianni Allais, Chiara Benedetto
Migraine is a common neurovascular disorder, affecting millions of people worldwide. Current guidelines recommend triptans as first-line treatment for moderate-to-severe migraine attacks. Frovatriptan is a second-generation triptan with a longer terminal elimination half-life in blood than other triptans (~26 hours). Three double-blind, randomized crossover preference studies have been recently conducted, assessing efficacy and safety of frovatriptan versus rizatriptan, zolmitriptan, and almotriptan, respectively...
2016: Drug Design, Development and Therapy
Mengqian Wu, Nanya Hao, Dong Zhou
BACKGROUND: Topiramate (TPM) is a broad-spectrum antiepileptic drug used for a variety of clinical conditions, including migraine prophylaxis and mood disorders. Spermatorrhea accompanied by loss of libido severely lowers quality of life for men, but had never been reported as a possible adverse effect of TPM. CASE PRESENTATION: Here, we present a case of a 39-year-old Chinese man who was diagnosed with partial epilepsy and treated with TPM (100 mg/d). Eleven days after initiating TPM treatment, he began to experience spermatorrhea every 2 to 3 days, accompanied by loss of libido, lack of energy, lassitude, irascibility, weakness, poor appetite, frequent urination, and nocturia...
October 14, 2016: Clinical Neuropharmacology
Lin Shi
According to the seventh report of Joint National Committee (JNC 7), hypertensive emergency (HE), a kind of hypertensive crisis, is defined as a sudden and abrupt elevation in blood pressure so as to cause acute target organ dysfunctions, including central nervous system, cardiovascular system or kidneys. Patients with HE require immediate reduction in markedly elevated blood pressure. Currently, there are no international guidelines for children HE, so the JNC definition is commonly used. Hypertensive emergency in children is rare but a life-threatening emergency...
September 2016: Journal of Hypertension
Inna E Tchivileva, Richard Ohrbach, Roger B Fillingim, Joel D Greenspan, William Maixner, Gary D Slade
While cross-sectional studies have demonstrated an association between headache and temporomandibular disorder (TMD), whether headache can predict the onset of TMD is unknown. The aims of this study were to evaluate contribution of headache to the risk of developing TMD and describe patterns of change in headache types over time. An initially TMD-free cohort of 2,410 persons with low frequency of headache completed quarterly questionnaires assessing TMD and headache symptoms over a median 3.0-year follow-up period...
September 29, 2016: Pain
A Ernst, I Todt, J Wagner
BACKGROUND: Dehiscence syndromes of the semicircular canals are a relatively new group of neurotological disorders. They have a variety of symptoms with hearing/balance involvement. Younger patients have clinically relevant symptoms in only about one third of cases. In addition to etiology and pathogenesis, the present paper describes diagnostic and therapeutic possibilities using a patient series of the authors. MATERIALS AND METHODS: This nonrandomized prospective study included 52 patients with uni-/bilateral dehiscence syndromes of the superior and/or posterior canal (SCDS/PCDS), diagnosed with high-resolution computed tomography (HR-CT) of the petrous bone...
October 14, 2016: HNO
Ronald Zielman, Rudmer Postma, Aswin Verhoeven, Floor Bakels, Willebrordus P J van Oosterhout, Axel Meissner, Arn M J M van den Maagdenberg, Gisela M Terwindt, Oleg A Mayboroda, Michel D Ferrari
BACKGROUND: Migraine is a common episodic brain disorder. Treatment options and diagnosis are hampered by an incomplete understanding of disease pathophysiology and the lack of objective diagnostic markers. The aim of this study was to identify biochemical differences characteristic for different subtypes of migraine in cerebrospinal fluid (CSF) of migraine patients using an exploratory (1)H-NMR-based metabolomics approach. METHODS: CSF was obtained, in between migraine attacks, via lumbar puncture from patients with hemiplegic migraine, migraine with aura, migraine without aura, and healthy controls...
October 13, 2016: Molecular BioSystems
Richard B Lipton, Sagar Munjal, Dawn C Buse, Kristina M Fanning, Alix Bennett, Michael L Reed
BACKGROUND: Pain freedom at 2 hours and sustained pain response at 24 hours are important outcomes of acute migraine therapy. Some studies have examined rates and predictors of successful treatment outcomes for single attacks in clinical trials. However, little is known about predictors of typical response to acute treatment over multiple attacks in the population. OBJECTIVES: To identify sociodemographic features, headache characteristics, comorbidities and treatment-related factors that predict acute treatment success or failure at 2 hours and 24 hours post dose in a US population sample of persons with episodic migraine...
October 12, 2016: Headache
Christina L Szperka, Amy A Gelfand, Andrew D Hershey
OBJECTIVE: To describe current patterns of use of nerve blocks and trigger point injections for treatment of pediatric headache. BACKGROUND: Peripheral nerve blocks are often used to treat headaches in adults and children, but the available studies and practice data from adult headache specialists have shown wide variability in diagnostic indications, sites injected, and medication(s) used. The purpose of this study was to describe current practice patterns in the use of nerve blocks and trigger point injections for pediatric headache disorders...
October 12, 2016: Headache
Yaser Ghavami, Yarah M Haidar, Kasra N Ziai, Omid Moshtaghi, Jay Bhatt, Harrison W Lin, Hamid R Djalilian
OBJECTIVE: Mal de debarquement syndrome (MdDS) is a balance disorder that typically starts after an extended exposure to passive motion, such as a boat or plane ride. Management is typically supportive (e.g. physical therapy), and symptoms that persist beyond 6 months have been described as unlikely to remit. This study was conducted to evaluate the response of patients with MdDS to management with migraine prophylaxis, including lifestyle changes and medical therapy. STUDY DESIGN: Prospective review...
October 12, 2016: Laryngoscope
Paul Owusu Donkor, Ying Chen, Liqin Ding, Feng Qiu
ETHNOPHARMACOLOGICAL RELEVANCE: Ligusticum species (Umbelliferae) have been widely used in traditional Chinese medicine, Korean folk medicine and Native American medicine for their medicinal and nutritional value. Decoctions of the rhizomes are used in treatment and prophylaxis of migraine, anaemia and cardiovascular conditions including stroke. AIM OF STUDY: This review is intended to fully compile the constituents of locally and traditionally used Ligusticum species, present their bioactivities and highlight potential leads for future drug design, and thus, provide a reference for further research and application of these species...
October 8, 2016: Journal of Ethnopharmacology
Yosuke Kunishi, Yuri Iwata, Mitsuyasu Ota, Yuichi Kurakami, Mao Matsubayashi, Masatomo Kanno, Yoriko Kuboi, Koichiro Yoshie, Yoshio Kato
A 52-year-old woman presented with recurrent, severe abdominal pain. Laboratory tests and imaging were insignificant, and treatment for functional dyspepsia was ineffective. The poorly localized, dull, and severe abdominal pain, associated with anorexia, nausea, and vomiting, was consistent with abdominal migraine. The symptoms were relieved by loxoprofen and lomerizine, which are used in the treatment of migraine. We herein report a case of abdominal migraine in a middle-aged woman. Abdominal migraine should be considered as a cause of abdominal pain as it might easily be relieved by appropriate treatment...
2016: Internal Medicine
J Stone, S Aybek
Functional (psychogenic) limb weakness describes genuinely experienced limb power or paralysis in the absence of neurologic disease. The hallmark of functional limb weakness is the presence of internal inconsistency revealing a pattern of symptoms governed by abnormally focused attention. In this chapter we review the history and epidemiology of this clinical presentation as well as its subjective experience highlighting the detailed descriptions of authors at the end of the 19th and early 20th century. We discuss the relevance that physiological triggers such as injury and migraine and psychophysiological events such as panic and dissociation have to understanding of mechanism and treatment...
2017: Handbook of Clinical Neurology
Sally Mannix, Anne Skalicky, Dawn C Buse, Pooja Desai, Sandhya Sapra, Brian Ortmeier, Katherine Widnell, Asha Hareendran
BACKGROUND: Migraine is characterized by headache with symptoms such as intense pain, nausea, vomiting, photophobia, and phonophobia that significantly impact individuals' lives. The objective of this study was to develop a strategy to measure outcomes from the patients' perspectives for use in evaluating preventive treatments for migraine. METHODS: This study used a multi-stage process. The first stage included concept identification research through literature review, patient-reported outcome (PRO) instrument content review, and clinician interviews, and resulted in a list of concepts relevant to understand the migraine experience...
October 6, 2016: Health and Quality of Life Outcomes
Christoph J Schankin, Michele Viana, Peter J Goadsby
Visual disturbances in migraineurs, such as visual aura, are typically episodic, that is, associated with the headache attack, and overlaid by head pain and other symptoms that impact the patient. In some patients, however, visual symptoms are dominant due to frequency (migraine aura status), duration (persistent migraine aura and other persistent positive visual phenomena), or complexity (visual snow syndrome). These syndromes are more rare and challenging to classify in clinical practice resulting in a lack of systematic studies on pathophysiology and treatment...
October 7, 2016: Headache
Furkan U Ertem, Wenqian Zhang, Kyle Chang, Wan Mohaiza Dashwood, Praveen Rajendran, Deqiang Sun, Ala Abudayyeh, Eduardo Vilar, Maen Abdelrahim, Roderick H Dashwood
Intervention strategies in familial adenomatous polyposis (FAP) patients and other high-risk colorectal cancer (CRC) populations have highlighted a critical need for endoscopy combined with safe and effective preventive agents. We performed transcriptome profiling of colorectal adenomas from FAP patients and the polyposis in rat colon (Pirc) preclinical model, and prioritized molecular targets for prevention studies in vivo. At clinically relevant doses in the Pirc model, the drug Clotam (tolfenamic acid, TA) was highly effective at suppressing tumorigenesis both in the colon and in the small intestine, when administered alone or in combination with Sulindac...
October 5, 2016: International Journal of Cancer. Journal International du Cancer
Kelsey Merison, Howard Jacobs
While the diagnosis of migraine in children is generally straightforward, treatment can seem complex with a number of medication choices, many of which are used "off label." Patients with intermittent migraines can often be managed with ibuprofen or naproxen taken as needed. Unfortunately, by the time that children present to our practice, they have often tried these medications without improvement. Triptans are frequently prescribed to these patients with good success. It is important to make the patient aware of the possible associated serotonergic reactions...
November 2016: Current Treatment Options in Neurology
Xiaojian Zhang, Chengwu Shen, Shujun Zhai, Yukun Liu, Wen-Wei Yue, Li Han
Adrenergic β-blockers are drugs that bind to, but do not activate β-adrenergic receptors. Instead they block the actions of β-adrenergic agonists and are used for the treatment of various diseases such as cardiac arrhythmias, angina pectoris, myocardial infarction, hypertension, headache, migraines, stress, anxiety, prostate cancer, and heart failure. Several meta-analysis studies have shown that β-blockers improve the heart function and reduce the risks of cardiovascular events, rate of mortality, and sudden death through chronic heart failure (CHF) of patients...
October 2016: Experimental and Therapeutic Medicine
Sylvie Streel, Anne-Françoise Donneau, Nadia Dardenne, Axelle Hoge, Adelin Albert, Jean Schoenen, Michèle Guillaume
BACKGROUND: Metabolic syndrome (MetS) and migraine are known to be associated. This study assessed the risk of MetS and its clinical characteristics in migraine with aura (MA) and without aura (MO) based on a large-scale cross-sectional survey. METHODS: The study material consisted of 751 participants in the Nutrition, Environment and CardioVascular Health (NESCaV) survey. Diagnosis of migraine was based on the ef-ID migraine questionnaire and MetS was defined according to the Revised-Adult Treatment Panel III criteria...
October 4, 2016: Cephalalgia: An International Journal of Headache
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