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https://www.readbyqxmd.com/read/28533997/metoclopramide-for-acute-migraine-treatment-in-the-emergency-department-an-effective-alternative-to-opioids
#1
REVIEW
Mejdi Najjar, Tyler Hall, Blanca Estupinan
In light of recent warnings by the United States (US) Surgeon General and Centers for Disease Control (CDC) guidelines for recommending more prudent use of opioid narcotics, the search for a non-opioid alternative for aborting acute migraines is particularly relevant. The CDC also estimates the prevalence of opioid dependence may be as high as 26% among patients prescribed opioids for chronic pain, not due to cancer, in the primary care setting. Given such staggering data, it is imperative that we, as caretakers, not foster opioid dependence but rather continue to investigate non-opioid therapies for the management of acute migraines in the emergent care settings...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28527091/raven-coloured-progressive-matrices-in-migraine-without-aura-patients
#2
Giovanna Viticchi, Lorenzo Falsetti, Marco Bartolini, Laura Buratti, Lara Pistelli, Leandro Provinciali, Mauro Silvestrini
Conflicting results emerged from studies investigating cognitive performances in migraine patients. Based on clinical and neuroradiological aspects, the possible involvement of executive functions has been especially taken into consideration. The aim of this study was to evaluate, in a population of subjects affected by migraine without aura (MwoA), frontal lobe cognitive functions. We enrolled all the consecutive patients affected by MwoA referred to our headache centre for a first evaluation. Each patient underwent a neuropsychological evaluation including Raven coloured progressive matrices (CPM)...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527090/stroke-like-attack-first-episode-of-sporadic-hemiplegic-migraine
#3
Enrico Ferrante, Valentina Prone, Marco Longoni, Elio Clemente Agostoni
Hemiplegic migraine (HM) is a rare migraine with aura; it can be familiar or sporadic. A 46-years-old man presented left migraine followed by right hemiparesis with bilateral plantar flexion of cutaneous plantar reflex (CPR). Brain CT and CT-angiography were normal. The next day patient got worse. The EEG showed left fronto-temporal cuspidate delta waves and brain MRI showed a minimal hyperintensity at T2-sequences in the left frontal cortex with a minor representation of the cortical veins at susceptibility weighted imaging sequences...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527089/pediatric-migraine-with-aura-in-an-italian-case-series
#4
Arens Taga, Marco Russo, Antonio Genovese, Maria Vittoria Paglia, Gian Camillo Manzoni, Paola Torelli
The aim of the present study was to describe the characteristics of migraine with aura (MwA) in a case series of patients with headache onset before 12 years of age. We considered all consecutive patients referred to the Parma Headache Centre between 1975 and 2015 affected by MwA, diagnosed by our team of trained neurologists; the cases were subsequently reviewed applying the ICHD3-beta criteria. We then identified those cases with headache age-of-onset <12 years (i.e., "pediatric" cases), which were compared to all remaining cases...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527085/the-use-of-nutraceutics-in-children-s-and-adolescent-s-headache
#5
R Sangermani, A Boncimino
Nutraceutics are the most used non-pharmacological remedies for migraine's prophylaxis in children and adolescents. Doctors interested in use of nutraceuticals for a complete treatment of children's headache should be adequately informed on this treatments' efficacy and safety. Actually there is a lack of official guidelines about use of nutraceuticals in migraine's prevention in children and adolescent and there are few studies with limited efficacy evidences. The most used nutraceuticals for adolescent's and children's headache prophylaxis are: magnesium, coenzyme Q10, riboflavin, butterbur, feverfew and melatonin...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527084/neurobiology-of-chronicization
#6
Gian Camillo Manzoni, Marco Russo, Arens Taga, Paola Torelli
In the past few years, research on chronicization of headache has focussed primarily on migraine, even though there are other types of primary headache that over time can turn into chronic forms. Only a minority of migraine sufferers will develop a chronic condition, with attacks that are likely to vary in their clinical features. As a result, in chronic migraine the specific diagnostic criteria for this headache type do not always exhibit the typical features of migraine. Among the factors that play a major role in favouring chronicization are a high frequency of migraine attacks since the beginning, overuse of symptomatic medication and onset of depression or arterial hypertension...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527083/shared-mechanisms-of-epilepsy-migraine-and-affective-disorders
#7
Davide Zarcone, Simona Corbetta
Since the nineteenth century several clinical features have been observed in common between migraine and epilepsy (such as episodic attacks, triggering factors, presence of aura, frequent familiarity), but only in recent years researchers have really engaged in finding a common pathogenic mechanism. From studies of disease incidence, we understand how either migraine among patients with epilepsy or epilepsy among migraine patients are more frequent than in the general population. This association may result from a direct causality, by the same environmental risk factors and/or by a common genetic susceptibility...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527081/chiari-malformation-type-1-related-headache-the-importance-of-a-multidisciplinary-study
#8
Marcella Curone, L G Valentini, I Vetrano, E Beretta, M- Furlanetto, L Chiapparini, A Erbetta, G Bussone
Chiari type 1 Malformation (CM 1) is a structural defect consisting of a displacement of the cerebellar tonsils through the foramen magnum causing obstruction of cerebrospinal fluid (CSF) outflow. CM 1 has a variety of presentation with headache being the most common symptom. The evaluation and treatment of headache related to CM 1 are often difficult, because the pain in the occipital-suboccipital region or headache that is of cough-type suggests symptomatic CM 1, but patients suffering from CM 1 can also report migraine or tension-type headache...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527080/vestibular-migraine-who-is-the-patient
#9
Bruno Colombo, Roberto Teggi
Vestibular migraine has been classified as a specific entity in which vestibular symptomatology is defined as part of the migrainous disorder. New and appropriate diagnostic criteria have been proposed by the Barany and International Headache Societies. The diagnosis of vestibular migraine mainly depends on the patient history. The NIVE project is a prospectic multicentric study on vestibular migraine. The aim of this project is to evaluate demographics, epidemiology, clinical manifestations of migraine and vertigo in a large cohort of Caucasian patients affected by vestibular migraine...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527079/endolymphatic-hydrops-in-idiopathic-intracranial-hypertension-prevalence-and-clinical-outcome-after-lumbar-puncture-preliminary-data
#10
Angelo Ranieri, Michele Cavaliere, Stefania Sicignano, Pietro Falco, Federico Cautiero, Roberto De Simone
Idiopathic intracranial hypertension is characterized by raised intracranial pressure (ICP) without any underlying pathology, presenting with (IIH) or without papilledema (IIHWOP). Headache, often on daily basis, is the most frequent symptom. Among audiovestibular symptoms, tinnitus and dizziness are commonly reported, while vertigo and hearing impairment are infrequent reports. Endolymphatic hydrops (ELH) is the typical histopathologic feature of Ménière disease, a condition featured by episodes of vertigo, dizziness, fluctuating hearing loss, tinnitus, and aural fullness...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527076/the-role-of-visual-system-in-migraine
#11
Stefania Bianchi Marzoli, Alessandra Criscuoli
The visual system is involved in different ways in migraine. Visual auras are the most common form of migraine aura. It may consist of positive or negative visual symptoms and cortical spreading depression is felt to be the phenomenon that underlies it. Even in migraine without aura, vision it is not totally excluded given that one of the major criteria for the diagnosis of migraine is photophobia. In persistent visual aura, patients refer symptoms defined as visual snow and television static. In retinal migraine unilateral decreased vision or complete visual loss occurs...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527075/intravenous-mannitol-in-status-migrainosus-treatment-a-clinical-case-series
#12
Roberto De Simone, Angelo Ranieri, Guido Ferra, Federico Cautiero
Status migrainosus (SM) is defined as a severe migraine attack, usually poorly responsive to treatments, lasting more than 72 h. Recurrent SM predicts chronic migraine (CM) development in 83.7% of cases. There is evidence that in most unresponsive CM patients a sinus stenosis-associated raised intracranial pressure is causatively involved in migraine chronification. To test the hypothesis that SM may reflect a sustained rise in intracranial pressure, we tested the efficacy of a 3-day treatment with intravenous mannitol 18% 250 ml b...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527069/clinical-and-psychosocial-features-of-frequent-relapsers-fr-among-patients-with-chronic-migraine-and-medication-overuse
#13
Alberto Raggi, Licia Grazzi, Roberta Ayadi, Matilde Leonardi, Alberto Proietti, Silvia Schiavolin, Chiara Scaratti, Susanna Usai, Domenico D'Amico
The objective was to characterize frequent relapsers (FR)-i.e. those requiring two or more withdrawals in a 3-year period-in a sample of 188 patients with chronic migraine with medication overuse (CM-MO). We tested differences between FR and non-FR for age, gender, employment status, days with headache, headache severity, type of overused medication, BDI-II, WHODAS 2.0 and MSQ. 30.8% of participants were FR: they were more frequently treated as inpatients and living alone, had a lower education, higher disability and lower QoL, higher frequency and intensity of headaches, and higher depression scores...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527067/usefulness-of-nutraceuticals-in-migraine-prophylaxis
#14
Florindo D'Onofrio, Simona Raimo, Daniele Spitaleri, Gerardo Casucci, Gennaro Bussone
Several studies have supported the efficacy of complementary and alternative medicine approaches (physical, behavioral and nutraceutical therapies) in the treatment of headache disorders. Nutraceutical treatment consists of taking vitamins, supplements (magnesium, riboflavin, coenzyme Q10, and alpha lipoic acid) and herbal preparations (feverfew and butterbur), and its usage is frequently determined by dissatisfaction with conventional medical therapies. There is a growing body of research on nutraceutical use for migraine prophylaxis...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527066/community-pharmacies-as-epidemiological-sentinels-of-headache-first-experience-in-italy
#15
Paola Brusa, Marco Parente, Gianni Allais, Sara Rolando, Giuseppe Costa, Roberto Gnavi, Teresa Spadea, Mario Giaccone, Andrea Mandelli, Massimo Mana, Francesca Baratta, Chiara Benedetto, Gennaro Bussone
Migraine is a disabling neurovascular syndrome which affects 12-15% of the global population and it represents the third cause in years lived with disability in both males and females aged 15-49 years. Among migraineurs, the symptomatic drug abuse may be a risk factor in the development of medication overuse headache (MOH). Detecting cases of MOH is not straightforward; community pharmacists may, therefore, be in a strategic position to identify individuals who self-medicate, particularly with respect to prevent the development of MOH...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527064/treating-migraine-with-contraceptives
#16
Gianni Allais, Giulia Chiarle, Silvia Sinigaglia, Gisella Airola, Paola Schiapparelli, Fabiola Bergandi, Chiara Benedetto
At least 18% of women suffers from migraine. Clinically, there are two main forms of migraine: migraine with aura (MA) and migraine without aura (MO) and more than 50% of MO is strongly correlated to the menstrual cycle. The high prevalence of migraine in females, its correlation with the menstrual cycle and with the use of combined hormonal contraceptives (CHCs) suggest that the estrogen drop is implicated in the pathogenesis of the attacks. Although CHCs may trigger or worsen migraine, their correct use may even prevent or reduce some forms of migraine, like estrogen withdrawal headache...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527063/the-role-of-anti-cgrp-antibodies-in-the-pathophysiology-of-primary-headaches
#17
Piero Barbanti, Cinzia Aurilia, Luisa Fofi, Gabriella Egeo, Patrizia Ferroni
Calcitonin gene-related peptide (CGRP), a potent vasodilator and pain-signaling neuropeptide, is a validated therapeutic target for migraine and cluster headache. Four anti-CGRP monoclonal antibodies (mAbs) have been developed, representing the first specific, mechanism-based, migraine prophylactic treatment. CGRP mAbs demonstrated good efficacy coupled to excellent tolerability and safety in 5 phase II clinical trials. Notably, CGRP mAbs induced complete migraine remission in a patients' subset. To date, more than 20 phase III trials using CGRP mAbs for of episodic and chronic migraine and cluster headache prevention are ongoing...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527059/personality-disorders-in-cluster-headache-a-study-using-the-millon-clinical-multiaxial-inventory-iii
#18
Sylvie Hélène Marie Jeanne Piacentini, Lara Draghi, Alberto Proietti Cecchini, Massimo Leone
A great deal of studies suggests that cluster headache (CH) patients are usually comorbid to anxiety-mood spectrum disorders and psychopathological symptoms; however, the personality profiles reported in the literature strictly depend on type of assessment used. Psychiatric comorbidities have been extensively studied in migraine and they are recognized to represent a major risk factor associated with poorer outcome, playing a role in the headache chronification process at once as cause and consequence of it...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527058/headache-and-arterial-hypertension
#19
Cinzia Finocchi, Davide Sassos
Elevated blood pressure (BP) and headache have long been linked in the medical literature. Headache associated with arterial hypertension is a main concern in emergency department. It is believed that headache may be a symptom attributed to arterial hypertension only if the BP values are very high or rise quickly. Many studies support the hypothesis that migraine patients have an increased risk of developing hypertension, while hypertensive subjects do not seem to have an increased risk of migraine or other types of headache...
May 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28527057/behavioral-therapy-emotion-and-pain-a-common-anatomical-background
#20
Lauren A-M Dahlke, Jeffrey J Sable, Frank Andrasik
Emotion and pain are closely intertwined in the brain, as the human experience of pain includes both affective and nociceptive components. Although each of these components relies on a different system in the brain, the two systems converge on the anterior cingulate and insular cortices, which interact with the prefrontal cortex and other frontal structures to influence behavior. Both emotional and physical pain elicit activity in these common areas, and conditions that affect one system (e.g., drugs, neural plasticity) may affect the function of the other-ultimately altering the experience of pain...
May 2017: Neurological Sciences
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