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Acute Migraine

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https://www.readbyqxmd.com/read/30113791/-paradigm-shift-in-management-of-patients-with-vertigo-and-imbalance
#1
REVIEW
Andrea Mike, T László Tamás
Dizziness is one of the most common causes of medical visits. Management of the dizzy patient may be challenging both for the general practitioner, in emergency departments, and special clinics, as behind a seemingly homogeneous clinical presentation several very different etiologies may occur. Research of the last two century enriched our knowledge about physiology and pathophysiology of the vestibular system. Much knowledge is now available about the labyrinth being able to sense head motions and gravity, processing of afferent vestibular stimuli, reflectory oculomotor and postural control, or recovery of the vestibular system...
July 30, 2018: Ideggyógyászati Szemle
https://www.readbyqxmd.com/read/30112726/efficacy-and-safety-of-dfn-11-sumatriptan-injection-3-mg-in-adults-with-episodic-migraine-a-multicenter-randomized-double-blind-placebo-controlled-study
#2
Stephen Landy, Sagar Munjal, Elimor Brand-Schieber, Alan M Rapoport
BACKGROUND: In a previous randomized, double-blind, proof-of-concept study in rapidly escalating migraine, a 3 mg dose of subcutaneous sumatriptan (DFN-11) was associated with fewer and shorter triptan sensations than a 6 mg dose. The primary objective of the study was to assess the efficacy and safety of acute treatment with DFN-11 compared with placebo in episodic migraine. METHODS: This was a multicenter, randomized, double-blind, placebo-controlled efficacy and safety study of DFN-11 in the acute treatment of adults with episodic migraine (study RESTOR)...
August 15, 2018: Journal of Headache and Pain
https://www.readbyqxmd.com/read/30112725/efficacy-and-safety-of-dfn-11-sumatriptan-injection-3-mg-in-adults-with-episodic-migraine-an-8-week-open-label-extension-study
#3
Stephen Landy, Sagar Munjal, Elimor Brand-Schieber, Alan M Rapoport
BACKGROUND: DFN-11, a 3 mg sumatriptan subcutaneous (SC) autoinjector for acute treatment of migraine, has not been assessed previously in multiple attacks. The objective of this study was to evaluate the efficacy, tolerability, and safety of DFN-11 in the acute treatment of multiple migraine attacks. METHODS: This was an 8-week open-label extension of multicenter, randomized, double-blind, placebo-controlled US study. Subjects averaging 2 to 6 episodic migraine attacks per month were randomized to DFN-11 or placebo to treat a single attack of moderate-to-severe intensity and then entered the extension study to assess the efficacy, tolerability, and safety of DFN-11 in multiple attacks of any pain intensity...
August 15, 2018: Journal of Headache and Pain
https://www.readbyqxmd.com/read/30097147/multimodal-imaging-findings-during-severe-attacks-of-familial-hemiplegic-migraine-type-2
#4
Christian Roth, Andreas Ferbert, Monika Huegens-Penzel, Ralf Siekmann, Tobias Freilinger
BACKGROUND: Familial hemiplegic migraine (FHM) is a rare monogenic form of migraine with aura with three distinct genetic subtypes (FHM1-3). Imaging studies during acute FHM attacks are scarce in the literature. This is particularly true for the FHM2 subtype. PATIENTS AND METHODS: In this monocentric study, we retrospectively evaluated imaging data of four different patients with genetically confirmed FHM2. Analysis comprised a total of eight cMRI and two CT perfusion studies, which were obtained during a total of six different attacks...
September 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/30095163/sleep-and-migraine-assessment-and-treatment-of-comorbid-sleep-disorders
#5
Jeanetta C Rains
The relationship of sleep and migraine is unequivocal and familiarity with the nature and magnitude of these associations may inform clinical practice. Recent prospective, longitudinal, and time-series analysis has begun to unravel the magnitude and temporal patterns of sleep and migraine. Prospective evidence has shown that sleep variables can trigger acute migraine, precede and predict new onset headache by several years, and indeed, sleep disturbance and snoring are risk factors for chronification. The presence of a sleep disorder is associated with more frequent and severe migraine and portends a poorer headache prognosis...
August 10, 2018: Headache
https://www.readbyqxmd.com/read/30094686/the-risk-of-takotsubo-cardiomyopathy-in-acute-neurological-disease
#6
Nicholas A Morris, Abhinaba Chatterjee, Oluwayemisi L Adejumo, Monica Chen, Alexander E Merkler, Santosh B Murthy, Hooman Kamel
BACKGROUND: Case series have reported reversible left ventricular dysfunction, also known as stress cardiomyopathy or Takotsubo cardiomyopathy (TCM), in the setting of acute neurological diseases such as subarachnoid hemorrhage. The relative associations between various neurological diseases and Takotsubo remain incompletely understood. METHODS: We performed a cross-sectional study of all adults in the National Inpatient Sample, a nationally representative sample of US hospitalizations, from 2006 to 2014...
August 9, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/30094042/case-report-the-role-of-oct-in-examination-of-a-patient-with-topiramate-induced-acute-angle-closure-acute-myopia-and-macular-striae
#7
Matías Osaba, Víctor Eduardo Reviglio
This work reports on a clinical case of a female who presented with headache, bilateral eye pain and vision loss. Intraocular pressures were 40 mm Hg in the right eye and 45 mm Hg in the left eye. Optical Coherence Tomography examination shows the iridocorneal angle was collapsed and macular striae were also observed. The patient had been on topiramate due to migraines 7 days before presentation. Diagnosis for topiramate-induced acute angle closure was made in both eyes. The patient showed improvement in symptoms a few days after treatment initiation and images confirmed that the iridocorneal angle had been enlarged and macular striae had disappeared...
July 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/30079481/effects-of-systemic-inhibitors-of-acid-sensing-ion-channels-1-asic1-against-acute-and-chronic-mechanical-allodynia-in-a-rodent-model-of-migraine
#8
Clément Verkest, Emilie Piquet, Sylvie Diochot, Mélodie Dauvois, Michel Lanteri-Minet, Eric Lingueglia, Anne Baron
BACKGROUND AND PURPOSE: Acid-Sensing Ion Channels (ASICs) are neuronal proton sensors emerging as potential therapeutic targets in pain of the orofacial region. Amiloride, a non-specific ASIC blocker, has been shown to exert beneficial effects in animal models of migraine and in patients. We explored the involvement of the ASIC1-subtype in cutaneous allodynia, a hallmark of migraine affecting cephalic and extra-cephalic regions in about 70% of migrainers. EXPERIMENTAL APPROACH: We investigated the effects on cephalic and extra-cephalic mechanical sensitivity of systemic injections of amiloride and mambalgin-1, a specific inhibitor of ASIC1a- and ASIC1b-containing channels, in a rodent model of acute and chronic migraine induced by intraperitoneal injections of isosorbide dinitrate...
August 5, 2018: British Journal of Pharmacology
https://www.readbyqxmd.com/read/30074552/pediatric-and-adolescent-headache
#9
Amy A Gelfand
PURPOSE OF REVIEW: This article provides the practicing neurologist with a comprehensive, evidence-based approach to the diagnosis and management of headache in children and adolescents, with a focus on migraine. RECENT FINDINGS: Four triptans are now labeled by the US Food and Drug Administration (FDA) for acute migraine treatment in adolescents, and rizatriptan is labeled for use in children age 6 and older. For preventive migraine treatment, the Childhood and Adolescent Migraine Prevention trial demonstrated that approximately 60% of children and adolescents with migraine will improve with a three-pronged treatment approach that includes: (1) lifestyle management counseling (on sleep, exercise, hydration, caffeine, and avoidance of meal skipping); (2) optimally dosed acute therapy, specifically nonsteroidal anti-inflammatory drugs and triptans; and (3) a preventive treatment that has some evidence for efficacy...
August 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/30074551/headache-in-pregnancy
#10
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/30074549/preventive-therapy-of-migraine
#11
Todd J Schwedt
PURPOSE OF REVIEW: This article reviews the preventive therapy of migraine, including indications, strategies for use, and available treatments. RECENT FINDINGS: Lifestyle modifications and migraine trigger avoidance are recommended as preventive measures for all individuals with migraine. The decision to recommend additional migraine preventive therapy should consider the frequency of migraine attacks and headaches, extent of migraine-associated disability, frequency of using acute migraine treatments and the responsiveness to such treatments, and patient preferences...
August 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/30074548/acute-treatment-of-migraine
#12
Bert B Vargas
PURPOSE OF REVIEW: This article provides a framework to help providers formulate a plan for the acute treatment of migraine. Topics covered include the cost-effective patient-centered approach known as stratified care and a summary of evidence-based treatment options that are currently available. Strategies for improving treatment response, troubleshooting suboptimal results, and addressing the needs of special populations are also reviewed. RECENT FINDINGS: Both the American Headache Society and the Canadian Headache Society have released evidence-based assessments and reviews of acute treatments for migraine that can be used to help guide treatment decisions...
August 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/30074546/the-migraine-aura
#13
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
#14
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/30073201/loss-of-blood-brain-barrier-integrity-in-a-kcl-induced-model-of-episodic-headache-enhances-cns-drug-delivery
#15
Karissa E Cottier, Emily A Galloway, Elisa C Calabrese, Margaret E Tome, Erika Liktor-Busa, John Kim, Thomas P Davis, Todd W Vanderah, Tally M Largent-Milnes
Cortical spreading depression (CSD) in the CNS is suggested as a common mechanism contributing to headache. Despite strong evidence for CNS involvement in headache disorders, drug development for headache disorders remains focused on peripheral targets. Difficulty in delivering drugs across the blood-brain barrier (BBB) may partially account for this disparity. It is known, however, that BBB permeability is increased during several CNS pathologies. In this study, we investigated BBB changes in response to KCl-induced CSD events and subsequent allodynia in rats...
July 2018: ENeuro
https://www.readbyqxmd.com/read/30067102/characteristics-of-headache-and-relationship-to-acute-mountain-sickness-at-4559-meters
#16
Michael Schneider, Peter Bärtsch
Schneider, Michael, and Peter Bärtsch. Characteristics of headache and relationship to acute mountain sickness at 4559 meters. High Alt Med Biol. 00:000-000, 2018.-The goals of this study were to characterize headache at high altitude in relation to the severity of acute mountain sickness (AMS), to investigate whether a history of migraine or nonmigrainous headache at low altitude is a risk factor for AMS and to estimate its effect size in relation to established major risk factors. We performed a secondary, extended analysis of data obtained from 1320 mountaineers staying overnight at the Capanna Margherita (4559 m)...
August 1, 2018: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/30059368/emergency-department-use-of-intravenous-prochlorperazine-for-acute-migraine
#17
Calli Cook, Brittany Newberry
The Research to Practice Column is designed to improve translational research critique skills of nurse practitioners (NPs). In this issue, the article "Randomized study of IV prochlorperazine plus diphenhydramine vs IV hydromorphone for migraine" is discussed in the context of a patient with an acute headache presenting to the emergency department (ED). The study was designed to assess the efficacy of intravenous prochlorperazine and diphenhydramine as compared with intravenous hydromorphone for patients with acute migraine in the ED...
July 2018: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/30056002/stroke-mimics-transported-by-emergency-medical-services-to-a-comprehensive-stroke-center-the-magnitude-of-the-problem
#18
Joel Neves Briard, Rahel T Zewude, Mahesh P Kate, Brian H Rowe, Brian Buck, Ken Butcher, Laura C Gioia
BACKGROUND: Despite the use of validated prehospital stroke scales, stroke mimics are frequent among patients transported by Emergency Medical Services to the Emergency Department. We aimed to describe the frequency and characteristics of neurological and non-neurological mimics transported to a comprehensive stroke center for acute stroke evaluation. METHODS: This was a retrospective analysis of a database consisting of all consecutive patients with suspected stroke transported to the Emergency Department of a comprehensive stroke center during an 18-month period...
July 26, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/30054753/headache-in-transient-ischemic-attacks
#19
Elena R Lebedeva, Natalia M Gurary, Jes Olesen
BACKGROUND: Headache is a common feature in acute cerebrovascular disease but no studies have evaluated the prevalence of specific headache types in patients with transient ischemic attacks (TIA). The purpose of the present study was to analyze all headaches within the last year and the last week before TIA and at the time of TIA. METHODS: Eligible patients with TIA (n = 120, mean age 56.1, females 55%) had focal brain or retinal ischemia with resolution of symptoms within 24 h without presence of new infarction on MRI with DWI (n = 112) or CT (n = 8)...
July 27, 2018: Journal of Headache and Pain
https://www.readbyqxmd.com/read/30050283/photodynamic-therapy-in-combination-with-intravitreal-ziv-aflibercept-and-aflibercept-injection-in-patients-with-chronic-or-repeatedly-recurrent-acute-central-serous-chorioretinopathy-a-single-center-retrospective-study
#20
Juliane Maria Doepfner, Stephan Michels, Nicole Graf, Matthias Dieter Becker, Florentina Joyce Freiberg
Purpose: The objective of the study was to assess the effect of off-label photodynamic therapy (PDT) in combination with intravitreal off-label ziv-aflibercept or off-label aflibercept injection in patients with chronic or repeatedly recurrent acute central serous chorioretinopathy (CSC). Patients and methods: Changes in best corrected visual acuity (BCVA) and subfoveal subretinal fluid (sSRF) and maximum subretinal fluid (mSRF) were retrospectively analyzed in a single-center cohort study of 17 patients (18 eyes) with persistent subretinal fluid for more than 3 months of duration of CSC...
2018: Clinical Ophthalmology
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