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Cluster headache

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https://www.readbyqxmd.com/read/29144720/cost-effectiveness-of-gammacore-non-invasive-vagus-nerve-stimulation-for-acute-treatment-of-episodic-cluster-headache
#1
Mkaya Mwamburi, Eric J Liebler, Andrew T Tenaglia
Cluster headache is a debilitating disease characterized by excruciatingly painful attacks that affects 0.15% to 0.4% of the US population. Episodic cluster headache manifests as circadian and circannual seasonal bouts of attacks, each lasting 15 to 180 minutes, with periods of remission. In chronic cluster headache, the attacks occur throughout the year with no periods of remission. While existing treatments are effective for some patients, many patients continue to suffer. There are only 2 FDA-approved medications for episodic cluster headache in the United States, while others, such as high-flow oxygen, are used off-label...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144719/real-world-health-plan-claims-analysis-of-differences-in-healthcare-utilization-and-total-cost-in-patients-suffering-from-cluster-headaches-and-those-without-headache-related-conditions
#2
Michael Polson, Todd C Lord, Themmi M Evangelatos, Maria Lopes, Briana L Santaniello
BACKGROUND: According to the World Health Organization, headache disorders are underappreciated by many health systems. These disorders have a substantial impact on quality of life, yet the true correlation between headache conditions and increased total healthcare utilization is not well understood. This study further explores the impact of headache conditions on healthcare utilization. OBJECTIVES: To assess differences in healthcare utilization and total cost in patients suffering from cluster headaches (CH) compared with patients without headache-related conditions...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144718/the-emerging-role-of-gammacore%C3%A2-in-the-management-of-cluster-headache-expert-panel-recommendations
#3
Stephen D Silberstein, Anne H Calhoun, Christina Treppendahl, David W Dodick, Alan M Rapoport, Avinash Mamidi, Peter Vargas, Thomas H Ebert, Stewart J Tepper
A panel of 9 experts, including neurologists, other headache specialists, and medical and pharmacy directors, from 4 health plans (1 integrated delivery network and 3 plans with commercial, Medicare, and Medicaid lines of business), convened to discuss cluster headache (CH). Topics covered included the current treatment landscape, treatment challenges, economic impact of disease, and gaps in care for patients with CH. One major challenge in the management of CH is that it is underrecognized and frequently misdiagnosed, leading to delays in and suboptimal treatment for patients who suffer from this painful and disabling condition...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144717/review-of-non-invasive-vagus-nerve-stimulation-gammacore-efficacy-safety-potential-impact-on-comorbidities-and-economic-burden-for-episodic-and-chronic-cluster-headache
#4
Mkaya Mwamburi, Eric J Liebler, Andrew T Tenaglia
The FDA has cleared gammaCore (non-invasive vagus nerve stimulator [nVNS]) for the treatment of episodic cluster headache (eCH). With the exception of subcutaneous sumatriptan, all other treatments are used off label and have many limitations. The FDA approval process for devices differs from that of drugs. We performed a review of the literature to evaluate new evidence on various aspects of gammaCore treatment and impact. The ACute Treatment of Cluster Headache Studies (ACT1 and ACT2), both double-blind sham-controlled randomized trials, did not meet the primary endpoints of the trials but each demonstrated significant superiority of gammaCore among patients with eCH...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29144716/mechanism-of-action-of-non-invasive-cervical-vagus-nerve-stimulation-for-the-treatment-of-primary-headaches
#5
Bruce Simon, Justyna Blake
Stimulation of the cervical vagus nerve with implanted vagus nerve stimulation (iVNS) has been used clinically for more than 20 years to treat patients with epilepsy. More recently, a non-invasive cervical vagus nerve stimulation (nVNS), gammaCore, was developed, which has been purported to also stimulate the vagus nerve without the cost and morbidity associated with an iVNS system. gammaCore has been used to acutely treat various types of primary headaches, including migraine and cluster headaches (CH), and for the prevention of episodic, chronic, and menstrual migraines and CH...
November 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29139130/less-cortical-thickness-in-patients-with-persistent-post-traumatic-headache-compared-with-healthy-controls-an-mri-study
#6
Catherine D Chong, Visar Berisha, Chia-Chun Chiang, Katherine Ross, Todd J Schwedt
OBJECTIVE: To investigate differences in cortical thickness in patients with persistent post-traumatic headache (PPTH) relative to healthy controls and to interrogate whether cortical morphology relates to headache burden (headache frequency, years with post-traumatic headache, PTH) in patients with PPTH. BACKGROUND: PTHs are one of the most common symptoms following concussion. In some patients, PTHs continue for longer than three months and are classified as PPTH...
November 15, 2017: Headache
https://www.readbyqxmd.com/read/29125368/societal-burden-of-cluster-headache-in-the-united-states-a-descriptive-economic-analysis
#7
Janet H Ford, Damion Nero, Gilwan Kim, Bong Chul Chu, Robert Fowler, Jonna Ahl, James M Martinez
AIM: To estimate direct and indirect costs in patients with a diagnosis of cluster headache in the US. METHODS: Adult patients (18 - 64 years of age) enrolled in the Marketscan Commercial and Medicare Databases with ≥ 2 non-diagnostic outpatient (≥ 30 days apart between the two outpatient claims) or ≥ 1 inpatient diagnoses of cluster headache (ICD-9-CM code 339.00, 339.01, or 339.02) between January 1, 2009 and June 30, 2014, were included in the analyses...
November 10, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/29110978/mumps-an-emergency-medicine-focused-update
#8
Chelsea Bockelman, Thomas C Frawley, Brit Long, Alex Koyfman
BACKGROUND: Mumps is a Paramyxoviridae virus. This disease was rampant prior to introduction of the measles, mumps, and rubella vaccine, resulting in decreased incidence. This disease has demonstrated several outbreaks. OBJECTIVE: This review provides a focused evaluation of mumps, an update on outbreaks, management recommendations, and ways to decrease transmission. DISCUSSION: Clusters of mumps outbreaks continue to occur. The virus is a paramyxovirus, a single-stranded RNA virus...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29110775/primary-headaches
#9
Gerrit L J Onderwater, Robin M Van Dongen, Ronald Zielman, Gisela M Terwindt, Michel D Ferrari
Headache disorders, characterized by recurrent headache, are among the most common disorders of the nervous system. Primary headache disorders are by definition not the result of any other underlying disease or process. In this chapter the current status of cerebrospinal fluid (CSF) research and applications for clinical practice for the three main primary headaches - migraine, cluster headache, and tension-type headache - will be described. Primary headaches are clinically diagnosed disorders, with typically normal routine CSF measurements...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/29110503/cgrp-a-target-for-preventive-therapy-in-migraine-and-cluster-headache-systematic-review-of-clinical-data
#10
Sabrina Khan, Astrid Olesen, Messoud Ashina
Introduction Migraine and cluster headache are challenging to manage, with no tailored preventive medications available. Targeting the calcitonin gene-related peptide (CGRP) pathway to treat these headaches may be the first focused therapeutic option to date, with the potential for promising efficacy. Methods We systematically searched PubMed and clinicaltrials.gov for randomized controlled trials investigating the preventive potential of monoclonal antibodies against the CGRP pathway in the treatment of migraine and cluster headache...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29105279/sphenopalatine-ganglion-stimulation-induces-changes-in-cardiac-autonomic-regulation-in-cluster-headache
#11
Mads Barloese, Anja S Petersen, Song Guo, Messoud Ashina, Jesper Mehlsen, Rigmor H Jensen
INTRODUCTION: Cluster headache is characterized by attacks of severe unilateral pain accompanied by cranial and systemic autonomic changes. Our knowledge of the latter is imperfect. This study aimed to investigate the effect of low-frequency sphenopalatine ganglion stimulation on cardiac autonomic regulation. MATERIALS AND METHODS: In a double-blind, randomized, sham-controlled crossover design, patients received low-frequency and sham stimulation. RR intervals were recorded, and heart rate variability was analysed (time-domain, frequency-domain, nonlinear parameters)...
November 3, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/29082827/influences-on-headache-trigger-beliefs-and-perceptions
#12
Dana P Turner, Timothy T Houle
Background Previous headache trigger studies have primarily utilized checklists to measure beliefs about triggers. While this work has defined the diversity of beliefs across headache sufferers, the strength of association and the frequency at which these triggers are encountered remain unexplored. Objective To measure the strength of association, frequency of encounter, and influences on trigger beliefs and perceptions using a laboratory assessment task. Methods This cross-sectional observational study, part of the HACOGS project, included adult current migraine, tension-type, or cluster headache sufferers...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29082825/cluster-headache-and-the-trigeminal-autonomic-reflex-driving-or-being-driven
#13
Peter J Goadsby
No abstract text is available yet for this article.
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29082824/cranial-parasympathetic-activation-induces-autonomic-symptoms-but-no-cluster-headache-attacks
#14
Song Guo, Anja Sofie Petersen, Henrik Winther Schytz, Mads Barløse, Anthony Caparso, Jan Fahrenkrug, Rigmor Højland Jensen, Messoud Ashina
Background Low frequency (LF) stimulation of the sphenopalatine ganglion (SPG) may increase parasympathetic outflow and provoke cluster headache (CH) attacks in CH patients implanted with an SPG neurostimulator. Methods In a double-blind randomized sham-controlled crossover study, 20 CH patients received LF or sham stimulation for 30 min on two separate days. We recorded headache characteristics, cephalic autonomic symptoms (CAS), plasma levels of parasympathetic markers such as pituitary adenylate cyclase-activating polypeptide-38 (PACAP38) and vasoactive intestinal peptide (VIP), and mechanical detection and pain thresholds as a marker of sensory modulation...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29082823/peripheral-provocation-of-cranial-autonomic-symptoms-is-not-sufficient-to-trigger-cluster-headache-attacks
#15
Maike Möller, Ame Abdu Haji, Jan Hoffmann, Arne May
Background Recently it has been suggested that low frequency stimulation of the sphenopalatine ganglion (SPG) may provoke cluster-like attacks in cluster headache (CH) patients. The question arises whether a robust activation of cranial autonomic symptoms is sufficient to trigger CH attacks. Methods Kinetic oscillation stimulation (KOS) of the nasal mucosa generates ipsilateral marked autonomic symptoms, among which lacrimation is quantitatively measurable. KOS was applied to 29 CH-patients, including both episodic and chronic course...
January 1, 2017: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/29071466/cardiovascular-autonomic-effects-of-vagus-nerve-stimulation
#16
REVIEW
Iñigo Garamendi-Ruiz, Juan Carlos Gómez-Esteban
The vagus nerve is responsible for the parasympathetic innervation of the major thoracic and abdominal organs. It also carries sensory afferent fibres from these viscera and reaches different brain structures. These connections have proven useful in the treatment of different diseases. Afferent stimulation of the left vagus nerve is used to treat epilepsy and major depression, and stimulation of the right vagus nerve is being tried for the treatment of heart failure. The device used for the therapy delivers intermittent stimuli...
October 25, 2017: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29066616/precommitting-to-choose-wisely-about-low-value-services-a-stepped-wedge-cluster-randomised-trial
#17
Jeffrey Todd Kullgren, Erin Krupka, Abigail Schachter, Ariel Linden, Jacquelyn Miller, Yubraj Acharya, James Alford, Richard Duffy, Julia Adler-Milstein
BACKGROUND: Little is known about how to discourage clinicians from ordering low-value services. Our objective was to test whether clinicians committing their future selves (ie, precommitting) to follow Choosing Wisely recommendations with decision supports could decrease potentially low-value orders. METHODS: We conducted a 12-month stepped wedge cluster randomised trial among 45 primary care physicians and advanced practice providers in six adult primary care clinics of a US community group practice...
October 24, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29064869/vision-and-vestibular-system-dysfunction-predicts-prolonged-concussion-recovery-in-children
#18
Christina L Master, Stephen R Master, Douglas J Wiebe, Eileen P Storey, Julia E Lockyer, Olivia E Podolak, Matthew F Grady
OBJECTIVE: Up to one-third of children with concussion have prolonged symptoms lasting beyond 4 weeks. Vision and vestibular dysfunction is common after concussion. It is unknown whether such dysfunction predicts prolonged recovery. We sought to determine which vision or vestibular problems predict prolonged recovery in children. DESIGN: A retrospective cohort of pediatric patients with concussion. SETTING: A subspecialty pediatric concussion program...
October 20, 2017: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
https://www.readbyqxmd.com/read/29045430/the-association-between-herpes-virus-infections-and-functional-somatic-symptoms-in-a-general-population-of-adolescents-the-trails-study
#19
Iris Jonker, Robert Schoevers, Hans Klein, Judith Rosmalen
BACKGROUND: FSS have been suggested to follow activation of the immune system, triggered by herpes virus infections. The aim of this study was to find out whether herpes virus infections were associated with the experience of FSS in adolescents, and whether this association was mediated by hsCRP, as a general marker of immune activation. METHODS: This study was performed in TRAILS, a large prospective population cohort of 2230 adolescents (mean age: 16.1 years, SD = ...
2017: PloS One
https://www.readbyqxmd.com/read/29030731/burden-of-migraine-in-a-kuwaiti-population-a-door-to-door-survey
#20
Jasem Yousef Al-Hashel, Samar Farouk Ahmed, Raed Alroughani
BACKGROUND: Migraine prevalence and disability imprints on Kuwaiti population are underreported. We aimed to measure the prevalence of migraine and to assess its burden in Kuwait. METHODS: A cross-sectional community-based study was conducted which included biologically unrelated Kuwaiti adult population aged 18-65 years. They were randomly recruited from all six governments of Kuwait using stratified multistage cluster sampling. Trained interviewers visited the samples in door-to-door approach...
October 13, 2017: Journal of Headache and Pain
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