Paroxysmal Hemicrania in Children—Symptoms, Diagnostic Criteria, Therapy and Outcome

Cephalalgia ◽  
2009 ◽  
Vol 29 (8) ◽  
pp. 873-882 ◽  
Author(s):  
M Blankenburg ◽  
T Hechler ◽  
G Dubbel ◽  
C Wamsler ◽  
B Zernikow
Keyword(s):  
Case Reports ◽  
International Headache Society ◽  
Pain Clinic ◽  
Paroxysmal Hemicrania ◽  
Validated Questionnaires ◽  
Follow Up Study ◽  
Patient Pain ◽  
International Headache Society Classification

Whereas paroxysmal hemicrania (PH) is studied extensively in adults, even case reports of PH in children are rare. We present the first prospective follow-up study on PH in children. Our aim was to investigate whether differences exist between paediatric and adult patients. We assessed all children with chronic headache who were referred to our paediatric out-patient pain clinic within 3 years based on interviews and validated questionnaires. Among 628 patients we found five children with PH (0.8%) and three with probable PH (0.5%), in total 1.3%. Pain characteristics, autonomic symptoms and treatment response to indomethacin were similar to adult PH patients. Our results demonstrate that the International Headache Society classification of PH is also applicable to children. We suspect that PH has been underdiagnosed in children and therefore suboptimally treated thus far.

scholarly journals Tolosa-Hunt syndrome - diagnostic problem of painful ophthalmoplegia

2012 ◽  
Vol 69 (7) ◽  
pp. 627-630 ◽  
Author(s):  
Jelena Paovic ◽  
Predrag Paovic ◽  
Ivica Bojkovic ◽  
Mirjana Nagulic ◽  
Vojislav Sredovic
Keyword(s):  
Optic Nerve ◽  
Cavernous Sinus ◽  
Inflammatory Process ◽  
Positive Response ◽  
Case Reports ◽  
International Headache Society ◽  
Hunt Syndrome ◽  
International Headache Society Classification ◽  
Periorbital Pain

Background. Tolosa-Hunt syndrome (THS) is an uncommon disease caused by non-specific inflammation of the cavernous sinus, superior orbital fissure and the apex of the orbit. The disease is characterized by periorbital pain, paresis of the bulbomotor and quick response to steroid treatment. The orbital process may lead to optic nerve atrophy. According to the International Headache Society Classification of 2004, the diagnostic protocol includes magnetic resonance imaging (MRI) and biopsy. Case reports. We presented 46-year old male patient, with THS. The patient had unilateral periorbital pain, inflammatory process in the cavernous sinus, the apex of the orbit and the paranasal sinuses. Inflammatory process had spread into the fascia of the bulbomotor and performed compression to the optic nerve, causing paresis of the bulbomotor, protrusion of the eyeball and atrophy of the optic nerve. Pulse doses of corticosteroids were effective. Regarding the presented patient, diagnostic dilemmas arose from nonspecific sinusitis. The initial ophthalmological diagnosis, based on periorbital pain, drop in visual acuity and the narrow chamber angle was angular glaucoma, which resulted in a delayed diagnosis of THS and the beginning of the treatment. MRI and positive response to the treatment with corticosteroids were relevant for making the diagnosis. Conclusion. According to the International Headache Society Classification of 2004, THS is an entity that occurs rarely, its etiopathogenesis is unknown, it is manifested clinically by unilateral orbital pain associated with simple or multiple oculomotor paralyses, which resolves spontaneously but may recur. MRI orbital phlebography and biopsy are the recommended methods for making diagniosis. In our patient MRI findings and positive response to the corticosteroide treatment were relevant for making the diagnosis.

Chronic Paroxysmal Hemicrania in a Patient with a Macroprolactinoma

Cephalalgia ◽  
2006 ◽  
Vol 26 (6) ◽  
pp. 738-741 ◽  
Author(s):  
M Sarov ◽  
D Valade ◽  
C Jublanc ◽  
A Ducros
Keyword(s):  
International Headache Society ◽  
Paroxysmal Hemicrania ◽  
Chronic Paroxysmal Hemicrania ◽  
International Headache Society Classification

We report a patient with headaches meeting the criteria of chronic paroxysmal hemicrania, as defined by the International Headache Society classification. Headaches were fully responsive to indomethacin during the first 3 months of treatment but recurred when daily doses were lowered. Investigations revealed a macroprolactinoma. Headaches stopped after cabergoline treatment. This report further suggests that patients with paroxysmal hemicrania should be investigated for pituitary abnormalities.

scholarly journals Migraine and Vertigo

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Mehmet Karatas
Keyword(s):  
International Headache Society ◽  
Age Groups ◽  
Epidemiologic Studies ◽  
Migrainous Vertigo ◽  
Acute Attacks ◽  
Cacna1a Gene ◽  
International Headache Society Classification ◽  
Cerebellar Symptoms ◽  
Paroxysmal Positional Vertigo

Migraine and vertigo are common disorders in medicine, affecting about 14–16% and 7–10%, respectively, of the general population. Recent epidemiologic studies indicate that 3.2% of the population have both migraine and vertigo. Vertigo may occur in up to 25% of patients with migraine. Migraine is the most frequent vascular disorder causing vertigo in all age groups. Migraine leads to various central or peripheral vestibular syndromes with vertigo such as migrainous vertigo, basilar-type migraine, benign paroxysmal vertigo of childhood, and other vertigo syndromes related to migraine. Migrainous vertigo is the most common cause of spontaneous recurrent vertigo. Diagnostic criteria for migrainous vertigo have been proposed but are not included in the most recent International Headache Society classification of migraine. On the other hand, there are statistical associations between migraine and vertigo syndromes including benign paroxysmal positional vertigo, Meniere's disease, persistent cerebellar symptoms, anxiety-related dizziness, and motion sickness. Vertigo can also act as a migraine trigger. Although some mutations in the CACNA1A gene have been identified in some familial cases, the mechanism of migraine-associated vertigo is still obscure. Treatment includes vestibular suppressants for acute attacks and migraine prophylaxis for patients with frequent attacks.

A Follow-Up Study of 60 Patients After an Assumed First Period of Cluster Headache

Cephalalgia ◽  
2000 ◽  
Vol 20 (7) ◽  
pp. 653-657 ◽  
Author(s):  
C Sjöstrand ◽  
E Waldenlind ◽  
K Ekbom
Keyword(s):  
Cluster Headache ◽  
International Headache Society ◽  
Observation Time ◽  
Follow Up Study ◽  
Ihs Criteria ◽  
Lost To Follow Up ◽  
Second Period ◽  
Final Group

During 1981–96 a series of 60 consecutive out-patients was examined in relation to an assumed first period of cluster headache (CH). On follow up in 1998 we found that six were deceased at a mean age of 56.5 years (range 45–74 years), of whom one had a definitive CH diagnosis and five had one documented headache period only. Six patients were lost to follow up because they could not be reached. In the final group for evaluation ( n = 49) it was found that 13 (26.5%) patients had had one cluster period only during a mean observation time of 8.9 years. Out of 36 patients with a definitive CH diagnosis according to International Headache Society (IHS) criteria, 31 patients had episodic CH, four patients had primary chronic CH and one patient had secondary chronic CH. Of the patients with a definitive CH diagnosis, 83% on follow up had had a recurrence of a second period of CH within 3 years or continuous attacks (chronic/semichronic CH) from the onset. Evidently some patients may suffer from one cluster period only. In our patient material only 17% had a second cluster period after 3 years.

Pain clinic treatment outcome in low-back pain: A follow-up study

Pain ◽  
1990 ◽  
Vol 41 ◽  
pp. S342
Author(s):  
J. Robson ◽  
C.C. Spanswick ◽  
C.J. Main
Keyword(s):  
Low Back Pain ◽  
Treatment Outcome ◽  
Back Pain ◽  
Pain Clinic ◽  
Low Back ◽  
Follow Up Study

scholarly journals Long-Term Follow-Up of a Randomized Controlled Trial to Reduce Excessive Weight Gain in Infancy: Protocol for the Prevention of Overweight in Infancy (POI) Follow-Up Study at 11 Years (Preprint)

2020 ◽  
Author(s):  
Taiwo O Adebowale ◽  
Barry J Taylor ◽  
Andrew R Gray ◽  
Barbara C Galland ◽  
Anne-Louise M Heath ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Controlled Trial ◽  
Electronic Media ◽  
Health And Wellbeing ◽  
Validated Questionnaires ◽  
Follow Up Study ◽  
Randomized Controlled

BACKGROUND The Prevention of Overweight in Infancy (POI) randomized controlled trial assessed the effect of a more conventional food, physical activity, and breastfeeding intervention, with a more novel sleep intervention on weight outcomes at 2 years of age. The trial had 58% uptake at recruitment, and retention was 86% at age 2 years, 77% at age 3.5 years, and 69% at age 5 years. Children who received the brief sleep intervention in infancy had just half the risk of obesity at 2 years of age compared to those who did not receive the sleep intervention. Importantly, this substantially reduced risk was still apparent at our follow-up at 5 years of age. OBJECTIVE The primary aim of this follow-up at age 11 years is to determine whether differences in BMI z-score and obesity risk remain apparent now that it is at least 9 years since cessation of the sleep intervention. Several secondary outcomes of interest will also be examined including 24-hour movement patterns, mental health and wellbeing, and use of electronic media, particularly prior to sleep. METHODS We will seek renewed consent from all 734 of the original 802 POI families who expressed interest in further involvement. Children and parent(s) will attend 2 clinics and 1 home appointment to obtain measures of anthropometry and body composition (dual-energy x-ray absorptiometry scan), 24-hour movement patterns (sleep, sedentary time, and physical activity measured using an AX3 accelerometer), mental health and wellbeing (validated questionnaires), family functioning (validated questionnaires), use of electronic media (wearable and stationary cameras, questionnaires), and diet and eating behaviors (24-hour recall, questionnaires). RESULTS This follow-up study has full ethical approval from the University of Otago Human Ethics Committee (H19/109) and was funded in May 2019 by the Health Research Council of New Zealand (grant 19/346). Data collection commenced in June 2020, and first results are expected to be submitted for publication in 2022. CONCLUSIONS Long-term outcomes of early obesity intervention are rare. Despite the growing body of evidence linking insufficient sleep with an increased risk of obesity in children, interventions targeting improvements in sleep have been insufficiently explored. Our initial follow-up at 5 years of age suggested that an early sleep intervention may have long-term benefits for effective weight management in children. Further analysis in our now preteen population will provide much-needed evidence regarding the long-term effectiveness of sleep interventions in infancy as an obesity prevention approach. CLINICALTRIAL ClinicalTrials.gov NCT00892983; https://tinyurl.com/y3xepvxf INTERNATIONAL REGISTERED REPORT DERR1-10.2196/24968

Multivariate Prediction of Third Grade Academic Performance from De Hirsch Index Score

1975 ◽  
Vol 41 (3) ◽  
pp. 735-739
Author(s):  
George R. Holmes ◽  
Anna L. Stout ◽  
Arthur L. Rosenkrantz ◽  
D. Wayne Bickham ◽  
Robert C. Schnackenberg
Keyword(s):  
Academic Performance ◽  
Function Analysis ◽  
Hirsch Index ◽  
Predictive Index ◽  
Academic Risk ◽  
Follow Up Study ◽  
Multivariate Prediction ◽  
High Risk Children

A 3-yr. follow-up study, using 5 dependent measures of academic performance, was accomplished on 42 of the original 50 5 1/2-yr.-old youngsters used in the Adkins, et al. (1971) study. A preliminary comparison of the de Hirsch method of classification of children as of potentially high academic risk clearly suggests the possibility of using discriminant function analysis with the de Hirsch Predictive Index. A strategy for evaluating interventions on high-risk children is suggested.

The International Headache Society Classification of Chronic Daily and Near-Daily Headaches

Cephalalgia ◽  
1996 ◽  
Vol 16 (6) ◽  
pp. 407-411 ◽  
Author(s):  
J Olesen ◽  
BK Rasmussen
Keyword(s):  
Chronic Daily Headache ◽  
International Headache Society ◽  
Sudden Onset ◽  
Hemicrania Continua ◽  
Transformed Migraine ◽  
Ihs Classification ◽  
Daily Headache ◽  
Future Revision ◽  
International Headache Society Classification

The classification of the International Headache Society (IHS) published in 1988 has been positively received throughout the world. However, the classification of headaches occurring daily or almost daily has been criticized repeatedly. This criticism is discussed in the present review. It is possible to classify virtually all chronic headache patients using the IHS Classification and there seems to be more need for emphasizing a correct application of the classification than for a revision in this regard. The entity of transformed migraine is disputed and so is the existence of hemicrania continua. Neither of these syndromes has been adequately defined nor studied. Chronic daily headache of sudden onset (new persistent daily headache) is not adequately classified at present and should be included as a separate entity in the next edition of the IHS Classification. In a future revision it should also be possible to classify drug-related headache simply on the basis of drug consumption and without mandatory demands for withdrawal. Better longitudinal studies of patients with chronic daily headache are necessary to evaluate finally whether a revision of the classification of these headache syndromes is necessary. Eventually the ongoing discovery of migraine genes is likely to change radically the classification of migraine.ÿ

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