A hybrid fuzzy clustering approach for diagnosing primary headache disorder

Abstract Clustering is one of the most fundamental and essential data analysis tasks with broad applications. It has been studied in various research fields: data mining, machine learning, pattern recognition and in engineering, economics and biomedical data analysis. Headache is not a disease that typically shortens one’s life, but it can be a serious social as well as a health problem. Approximately 27 billion euros per year are lost through reduced work productivity in the European community. This paper is focused on a new strategy based on a hybrid model for combining fuzzy partition method and maximum likelihood estimation clustering algorithm for diagnosing primary headache disorder. The proposed hybrid system is tested on two data sets for diagnosing headache disorder collected from Clinical Centre of Vojvodina in Serbia.

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Effectiveness of paranasal air suction on acute migraine using portable air sucker – a randomized, double blind study

BMC Neurology ◽

10.1186/s12883-021-02203-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

S. M. R. Bandara ◽

S. Samita ◽

A. M. Kiridana ◽

H. M. M. T. B. Herath

Keyword(s):

Clinical Trial ◽

Side Effects ◽

Sri Lanka ◽

Primary Headache ◽

Headache Disorder ◽

Low Pressure ◽

Outcome Variable ◽

Double Blind ◽

Primary Headache Disorder ◽

Before And After

Abstract Background Migraine is a primary headache disorder and is the most common disabling primary headache disorder that occurs in children and adolescents. A recent study showed that paranasal air suction can provide relief to migraine headache. However, in order to get the maximum benefit out of it, an easy to use effective air sucker should be available. Aiming to fulfil the above requirement, a randomized, double blind control clinical trial was conducted to investigate the efficacy of a recently developed low–pressure portable air sucker. Methods Eighty-six Sri Lankan school children of age 16–19 years with migraine were enrolled for the study. They were randomly allocated into two groups, and one group was subjected to six intermittent ten-second paranasal air suctions using the portable air sucker for 120 s. The other group was subjected to placebo air suction (no paranasal air suction). The effect of suction using portable air sucker was the primary objective but side of headache, type of headache, and gender were also studied as source variables. The primary response studied was severity of headache. In addition, left and right supraorbital tenderness, photophobia, phonophobia, numbness over the face and scalp, nausea and generalized tiredness/weakness of the body were studied. The measurements on all those variables were made before and after suction, and the statistical analysis was performed based on before and after differences. As a follow–up, patients were monitored for 24-h period. Results There was a significant reduction in the severity of headache pain (OR = 25.98, P < 0.0001), which was the primary outcome variable, and other migraine symptoms studied, tenderness (left) (OR = 289.69, P < 0.0001), tenderness (right) (OR > 267.17, P < 0.0001), photophobia (OR = 2115.6, P < 0.0001), phonophobia (OR > 12.62, P < 0.0001) nausea (OR > 515.59, P < 0.0001) and weakness (OR = 549.06, P < 0.0001) except for numbness (OR = 0.747, P = 0.67) in the treatment group compared to the control group 2 min after the suction. These symptoms did not recur within 24-h period and there were no significant side effects recorded during the 24-h observation period. Conclusion This pilot study showed that low–pressure portable air sucker is effective in paranasal air suction, and suction for 120 s using the sucker can provide an immediate relief which can last for more than 24-h period without any side effects. Trail registration Clinical Trial Government Identification Number – 1548/2016. Ethical Clearance Granted Institute – Medical Research Institute, Colombo, Sri Lanka (No 38/2016). Sri Lanka Clinical Trial Registration No: SLCTR/2017/018. Date of registration = 29/ 06/2017. Approval Granting Organization to use the device in the clinical trial– National Medicines Regulatory Authority Sri Lanka (16 Jan 2018), The device won award at Geneva international inventers exhibition in 2016 and President award in 2018 in Sri Lanka. It is a patented device in Sri Lanka and patent number was SLKP/1/18295. All methods were carried out in accordance with CONSORT 2010 guidelines.

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Diagnosis and management of migraine in ten steps

Nature Reviews Neurology ◽

10.1038/s41582-021-00509-5 ◽

2021 ◽

Author(s):

Anna K. Eigenbrodt ◽

Håkan Ashina ◽

Sabrina Khan ◽

Hans-Christoph Diener ◽

Dimos D. Mitsikostas ◽

...

Keyword(s):

Clinical Decision Making ◽

Consensus Statement ◽

Preventive Treatment ◽

Primary Headache ◽

Headache Disorder ◽

Clinical Decision ◽

Diagnosis And Management ◽

Primary Headache Disorder ◽

Management Of Complications ◽

European Headache Federation

AbstractMigraine is a disabling primary headache disorder that directly affects more than one billion people worldwide. Despite its widespread prevalence, migraine remains under-diagnosed and under-treated. To support clinical decision-making, we convened a European panel of experts to develop a ten-step approach to the diagnosis and management of migraine. Each step was established by expert consensus and supported by a review of current literature, and the Consensus Statement is endorsed by the European Headache Federation and the European Academy of Neurology. In this Consensus Statement, we introduce typical clinical features, diagnostic criteria and differential diagnoses of migraine. We then emphasize the value of patient centricity and patient education to ensure treatment adherence and satisfaction with care provision. Further, we outline best practices for acute and preventive treatment of migraine in various patient populations, including adults, children and adolescents, pregnant and breastfeeding women, and older people. In addition, we provide recommendations for evaluating treatment response and managing treatment failure. Lastly, we discuss the management of complications and comorbidities as well as the importance of planning long-term follow-up.

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Topiramate Versus Propranolol in the Prophylaxis of Migraine in Bangladeshi Population

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v18i2.47764 ◽

2020 ◽

Vol 18 (2) ◽

pp. 12-17

Author(s):

Muhammad Tayeb ◽

Md Hasanuzzaman ◽

Abul Mansur Md Rezaul Karim ◽

Mohammad Sanaullah ◽

Md Ashraful Islam

Keyword(s):

Migraine Attack ◽

Divided Dose ◽

Low Dose ◽

Primary Headache ◽

Headache Disorder ◽

Treatment Groups ◽

Primary Headache Disorder ◽

Significant Difference ◽

The Mean ◽

Bangladeshi Population

Background : Migraine is primary headache disorder characterized by recurring attacks of pain and associated symptoms. The management modality is still unsatisfactory due to poor understanding of its cause and pathogenesis. To assess the efficacy and safety of low dose Topiramate vs Propranolol in migraine prophylaxis. Materials and methods : A randomized clinical trial including 130 patients with frequent migraine headache >5 attacks per month was performed in the out patients Department of Medicine and Neurology, CMCH for a period of 12 weeks. The patients were randomly divided into two treatment groups – treated by Topiramate 50mg/day and Propranolol 80mg/day respectively. Topiramate started with 25mg/day for 7 days then increased up to 50mg/day in two divided dose. Propranolol started with 40mg/day for 7 days then increased up to 80mg/day in two divided dose. The patients were assessed at 0, 8 and 12 weeks of the study. Results: The Topiramate group showed a reduction in the mean (±SD) of frequency of migraine attack from 6.95(±2.88) to 1.75(±1.08) episode per month, headache days per month from 7.62(±4.14) to 1.83(±1.10), intensity of headache per attack from 8.98(±1.05) to 6.10(±2.50) based on VAS scale, duration of headache per episode from 11.56(±9.16) to 5.40(±2.97) per hour and MIDAS score from 16.19(±3.91) to 8.14(±3.93). In patient treated with Propranolol, the mean (±SD) of monthly frequency of migraine attack declined from 7.09(±2.87) to 1.92(±0.98) episode per month, headache days per month from 8.17(±4.52) to 1.86(±o.83), intensity of headache per attack from 8.47(±1.10) to 6.03(±2.05) based on VAS scale, duration of headache per episode from 11.16(±8.08) to 5.97(±3.45), MIDAS score from 15.48(±3.55) to7.77(±3.49). Pre- and post-treatment values were significantly different for individual groups but no significant difference observed between groups. Conclusion: This study demonstrated that both low dose Topiramate and propranolol could significantly reduce migraine frequency, intensity and duration. Chatt Maa Shi Hosp Med Coll J; Vol.18 (2); July 2019; Page 12-17

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Case series of sixteen patients with nummular headache

Cephalalgia ◽

10.1177/0333102410368445 ◽

2010 ◽

Vol 30 (12) ◽

pp. 1527-1530 ◽

Cited By ~ 20

Author(s):

Justin Moon ◽

Kamran Ahmed ◽

Ivan Garza

Keyword(s):

Medication Overuse ◽

Age Of Onset ◽

Medication Overuse Headache ◽

Case Series ◽

Primary Headache ◽

Headache Disorder ◽

Therapeutic Interventions ◽

Nummular Headache ◽

Primary Headache Disorder ◽

History Of

Introduction: Nummular headache is a rare primary headache disorder described by a focal circumscribed area of pain (2–6 cm in diameter). Literature on this disorder is sparse. Patients and methods: Here, we describe a case series of 16 patients (6 men, 10 women) seen at the Mayo Clinic. Results: Mean age of onset was 50 years (range, 19–79 years) and mean duration of headache was 7.9 years (range, 0.33–40 years). Location of headache varied and was found to be an average of 3.9 cm in diameter (range, 2–10 cm). Headache was episodic (<15 days/month) in four patients and chronic (>15 days/month) in 12 patients. Attention was paid to therapeutic interventions. Resolution was seen in 38% of patients. Migraine was present in the history of 56% of patients and medication overuse headache was found in 25%. Conclusions: Our series results support previous findings. In our population, no specific therapy was identified to be effective in more than one patient.

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Genetics of cluster headache

Cephalalgia ◽

10.1177/0333102418815503 ◽

2019 ◽

Vol 39 (10) ◽

pp. 1298-1312 ◽

Cited By ~ 8

Author(s):

Kate F Gibson ◽

Anita Dos Santos ◽

Nunu Lund ◽

Rigmor Jensen ◽

Ioannis M Stylianou

Keyword(s):

Cluster Headache ◽

Candidate Gene ◽

Gene Selection ◽

Association Studies ◽

Twin Studies ◽

Primary Headache ◽

Headache Disorder ◽

Genome Wide Association Studies ◽

Genetic Studies ◽

Primary Headache Disorder

Background Cluster headache is the most severe primary headache disorder. A genetic basis has long been suggested by family and twin studies; however, little is understood about the genetic variants that contribute to cluster headache susceptibility. Methods We conducted a literature search of the MEDLINE database using the PubMed search engine to identify all human genetic studies for cluster headache. In this article we provide a review of those genetic studies, along with an overview of the pathophysiology of cluster headache and a brief review of migraine genetics, which have both been significant drivers of cluster headache candidate gene selection. Results The investigation of cluster headache genetic etiology has been dominated by candidate gene studies. Candidate selection has largely been driven by the pathophysiology, such as the striking rhythmic nature of the attacks, which spurred close examination of the circadian rhythm genes CLOCK and HCRTR2. More recently, unbiased genetic approaches such as genome-wide association studies (GWAS) have yielded new genetic avenues of interest including ADCYAP1R1 and MME. Conclusions The majority of candidate genes studied for cluster headache suffer from poor reproducibility. Broader genetic interrogation through larger unbiased GWAS, exome, and whole genome studies may provide more robust candidates, and in turn provide a clearer understanding of the causes of cluster headache.

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Headache in the presentation of noncephalic acute illness

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.168425 ◽

2015 ◽

Vol 06 (04) ◽

pp. 494-498 ◽

Cited By ~ 1

Author(s):

Tomer Tzadok ◽

Ronen Toledano ◽

Lior Fuchs ◽

Carmi Bartal ◽

Victor Novack ◽

...

Keyword(s):

Medical Center ◽

Febrile Illness ◽

Primary Headache ◽

Headache Disorder ◽

Respiratory Illness ◽

Acute Illness ◽

Common Symptom ◽

Primary Headache Disorder ◽

Primary Headache Disorders ◽

Younger Age

ABSTRACT Background: Headache is a frequent symptom of many systemic diseases that do not involve cranial structures. In this observational study, we assessed factors associated with headache in the acute presentation of systemic conditions in a nonsurgical emergency department (ED). Methods: Consecutive patients, admitted to Soroka University Medical Center ED due to noncephalic illness, were prospectively surveyed using a structured questionnaire focused on the prevalence and characteristics of headache symptoms. Medical data were extracted from the patient's charts. Results: Between 1 and 6/2012, 194 patients aged 64.69 ± 19.52 years, were evaluated. Headache was reported by 83 (42.7%) patients and was more common among patients with febrile illness (77.5% vs. 22.5%, P < 0.001). Respiratory illness and level of O2saturation were not associated with headache. Headache in the presentation of a noncephalic illness was associated with younger age (58 vs. 69, P < 0.001) and with suffering from a primary headache disorder (48.2% vs. 10.8%, P < 0.001). Headache was also associated with higher body temperature and lower platelets count. Conclusions: Headache is a common symptom in acute noncephalic conditions and was found to be associated with younger age and febrile disease on presentation. Patients who present with primary headache disorders are more prone to have headache during acute illness. Acute obstructive respiratory disease, hypercarbia or hypoxemia were not associated with headache.

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Headache

10.1093/med/9780199658602.003.0003 ◽

2015 ◽

Cited By ~ 1

Author(s):

Peter J. Goadsby

Keyword(s):

Cluster Headache ◽

Severe Pain ◽

Primary Headache ◽

Headache Disorder ◽

Headache Disorders ◽

Important Work ◽

Pain Experience ◽

Global Impact ◽

Primary Headache Disorder ◽

The World

Headache disorders are the dominant cause of neurological disability in the world and the most common reason for neurological referral in any country studied. Yet for much of the first half the twentieth century, research was mired in peripheral mechanistic sideshows. Migraine, the most common disabling primary headache disorder, has been established as primarily a brain problem, with important advances in classification, treatment, and biological understanding. Cluster headache, perhaps the most severe pain experience of humans, has found its nidus in the diencephalon; treatments are evolving and biology being unravelled. Contributions to headache disorders resonate across humanity, so important work here has a global impact for good.

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Impact of primary headache disorder on quality of life among school students in Kuwait

The Journal of Headache and Pain ◽

10.1186/s10194-020-01124-3 ◽

2020 ◽

Vol 21 (1) ◽

Cited By ~ 2

Author(s):

Jasem Y. Al-Hashel ◽

R. Alroughani ◽

S. Shauibi ◽

A. AlAshqar ◽

F. AlHamdan ◽

...

Keyword(s):

Quality Of Life ◽

Primary Headache ◽

Headache Disorder ◽

School Students ◽

Primary Headache Disorder

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Headaches in the emergency department –a survey of patients’ characteristics, facts and needs

The Journal of Headache and Pain ◽

10.1186/s10194-019-1053-5 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 7

Author(s):

Alberto Doretti ◽

◽

Irina Shestaritc ◽

Daniela Ungaro ◽

John-Ih Lee ◽

...

Keyword(s):

Emergency Department ◽

Acute Treatment ◽

Primary Headache ◽

Headache Disorder ◽

Efficacy Rate ◽

Headache Disorders ◽

Secondary Headaches ◽

Primary Headache Disorder ◽

Life Threatening ◽

Inflammatory Drugs

Abstract Background and aim Headache is very often the cause for seeking an emergency department (ED). However, less is known about the different diagnosis of headache disorders in the ED, their management and treatment. The aim of this survey is to analyse the management of headache patients in two different ED in Europe. Methods This retrospective survey was performed from September 2018 until January 2019. Patients were collected from the San Luca Hospital, Milan, Italy and the Ordensklinikum Barmherzige Schwestern, Linz, Austria. Only patients with a non-traumatic headache, as the primary reason for medical clarification, were included. Patients were analysed for their complexity and range of examination, their diagnoses, acute treatment and overall efficacy rate. Results The survey consists of 415 patients, with a mean age of 43.32 (SD ±17.72); 65% were female. Technical investigation was performed in 57.8% of patients. For acute treatment non-steroidal-anti-inflammatory drugs (NSAIDs) were the most used, whereas triptans were not given. A primary headache disorder was diagnosed in 45.3% of patients, being migraine the most common, but in 32% of cases the diagnosis was not further specified. Life-threatening secondary headaches accounted for less than 2% of cases. Conclusions The vast majority of patients attending an ED because of headache are suffering from a primary headache disorder. Life-threatening secondary headaches are rare but seek attention. NSAIDs are by far the most common drugs for treating headaches in the ED, but not triptans.

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Headache in Sports

10.1093/oxfordhb/9780199896585.013.19 ◽

2016 ◽

Author(s):

Tad Seifert

Keyword(s):

Primary Headache ◽

Headache Disorder ◽

Epidemiological Data ◽

Return To Play ◽

Secondary Headache ◽

Headache Disorders ◽

Unique Challenge ◽

Primary Headache Disorder ◽

Primary Headache Disorders ◽

Headache Type

The prevalence of primary headache disorders in the general population provides a unique challenge in the evaluation of headache occurring in the context of sport. Sport-related and exercise-related headaches are not uncommon, but there is limited epidemiological data on these types of headaches in athletes. Any primary headache type can occur in the setting of sports. These scenarios are challenging in the return to play context, as it is often unclear whether an athlete has an exacerbation of a primary headache disorder, new onset headache unrelated to trauma, or has suffered a genuine concussive injury. Through careful evaluation, the practitioner can distinguish primary headache disorders from posttraumatic headaches following concussion. This chapter reviews primary headache disorders, posttraumatic headaches, and other secondary headache disorders.

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