Post-craniotomy headache: A proposed revision of IHS diagnostic criteria

Seventy-nine patients with intracranial aneurysms were evaluated in the presurgical period, and followed up to 6 months after surgery. We compare patients who fulfilled with those that did not post-craniotomy headache (PCH) diagnostic criteria, according to the International Classification of Headache Disorders. Semistructured interviews, headache diaries, Short Form-36 and McGill Pain Questionnaire were used. Seventy-two patients (91%) had headaches during the follow-up period. The incidence of PCH according to the International Headache Society diagnostic criteria was 40%. Age, sex, type of surgery, temporomandibular disorder, vasospasm, presence and type of previous headaches, and subarachnoid haemorrhage were not related to headache classification. There were no differences in the quality of life, headache frequency and characteristics or pain intensity between patients with headache that fulfilled or not PCH criteria. We proposed a revision of the diagnostic criteria for PCH, extending the headache outset after surgery from 7 to 30 days, and including the presence of headaches after surgery in patients with no past history of headaches, or an increase in headache frequency during the first 30 days of the postsurgical period followed by a decrease over time. Using these criteria we would classify 65% of our patients as having PCH.

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A Comparison of Alcoholics with and without Coexisting Affective Disorder

The British Journal of Psychiatry ◽

10.1192/bjp.143.2.133 ◽

1983 ◽

Vol 143 (2) ◽

pp. 133-138 ◽

Cited By ~ 37

Author(s):

K. O'Sullivan ◽

P. Whillans ◽

M. Daly ◽

B. Carroll ◽

A. Clare ◽

...

Keyword(s):

Family History ◽

Affective Disorder ◽

Diagnostic Criteria ◽

Past History ◽

History Of ◽

Relationship Of ◽

The Relationship

SummaryThree hundred male Irish alcoholics were selected from 508 consecutive alcoholic admissions to hospital. Using well defined diagnostic criteria, they were divided into three subgroups (1) primary alcoholics, (2) alcoholics with secondary affective disorder and (3) those with primary affective disorder and secondary alcoholism. Although the three groups reported differences in past history and family history of affective disorder and in time spent in hospital for both alcoholism and affective disorder, there was little to distinguish them in behaviour associated with alcoholism or in family history of alcoholism. The implications of these findings and their significance for the relationship of affective disorder and alcoholism are discussed.

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Vestibular migraine of childhood and recurrent vertigo of childhood: Diagnostic criteria consensus document of the committee for the classification of vestibular disorders of the bárány society and the international headache society

Journal of Vestibular Research ◽

10.3233/ves-200003 ◽

2020 ◽

pp. 1-9

Author(s):

Raymond van de Berg ◽

Josine Widdershoven ◽

Alexandre Bisdorff ◽

Stefan Evers ◽

Sylvette Wiener-Vacher ◽

...

Keyword(s):

Diagnostic Criteria ◽

Past History ◽

International Headache Society ◽

Vestibular Migraine ◽

Future Research ◽

Vestibular Disorders ◽

Consensus Document ◽

Severe Intensity ◽

Vestibular Symptoms

This paper describes the diagnostic criteria for “Vestibular Migraine of Childhood”, “probable Vestibular Migraine of Childhood” and “Recurrent Vertigo of Childhood” as put forth by the Committee for the Classification of Vestibular Disorders of the Bárány Society (ICVD) and the Migraine Classification subgroup of the International Headache Society. Migraine plays an important role in some subgroups of children with recurrent vertigo. In this classification paper a spectrum of three disorders is described in which the migraine component varies from definite to possibly absent. These three disorders are: Vestibular Migraine of Childhood, probable Vestibular Migraine of Childhood and Recurrent Vertigo of Childhood. The criteria for Vestibular Migraine of Childhood (VMC) include (A) at least five episodes with vestibular symptoms of moderate or severe intensity, lasting between five minutes and 72 hours, (B) a current or past history of migraine with or without aura, and (C) at least half of episodes are associated with at least one migraine feature. Probable Vestibular Migraine of Childhood (probable VMC) is considered when at least three episodes with vestibular symptoms of moderate or severe intensity, lasting between five minutes and 72 hours, are accompanied by at least criterion B or C from the VMC criteria. Recurrent Vertigo of Childhood (RVC) is diagnosed in case of at least three episodes with vestibular symptoms of moderate or severe intensity, lasting between 1 minute and 72 hours, and none of the criteria B and C for VMC are applicable. For all disorders, the age of the individual needs to be below 18 years old. It is recommended that future research should particularly focus on RVC, in order to investigate and identify possible subtypes and its links or its absence thereof with migraine.

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Altered brain network functional connectivity patterns in patients with vestibular migraine diagnosed according to the diagnostic criteria of the Bárány Society and the International Headache Society

Journal of Neurology ◽

10.1007/s00415-021-10868-0 ◽

2021 ◽

Author(s):

Zhe-Yuan Li ◽

Li-Hong Si ◽

Bo Shen ◽

Xu Yang

Keyword(s):

Functional Connectivity ◽

Diagnostic Criteria ◽

International Headache Society ◽

Brain Network ◽

Vestibular Migraine ◽

Caloric Test ◽

Cingulate Gyrus ◽

Sensorimotor Network ◽

Connectivity Patterns ◽

History Of

Abstract Background Vestibular migraine (VM) is considered one of the most common causes of episodic central vestibular disorders, the mechanism of VM is currently still unclear. The development of functional nuclear magnetic resonance (fMRI) in recent years offers the possibility to explore the altered functional connectivity patterns in patients with VM in depth. The study aimed to investigate altered patterns of brain network functional connectivity in patients with VM diagnosed based on the diagnostic criteria of the Bárány Society and the International Headache Society, and hope to provide a scientific theoretical basis for understanding whether VM is a no-structural central vestibular disease, i.e., functional central vestibular disease with altered brain function. Methods Seventeen patients with VM who received treatment in our hospital from December 2018 to December 2020 were enrolled. Eight patients with migraine and 17 health controls (HCs) were also included. Clinical data of all patients were collected. Blood pressure, blood routine tests and electrocardiography were conducted to exclude other diseases associated with chronic dizziness. Videonystagmography, the vestibular caloric test, the video head impulse test and vestibular-evoked myogenic potentials were measured to exclude peripheral vestibular lesions. MRI was utilized to exclude focal lesions and other neurological diseases. All subjects underwent fMRI. The independent component analysis was performed to explore changes in intra- and inter-network functional connectivity in patients with VM. Results Among 17 patients with VM, there were 7 males and 10 females with an average age of 39.47 ± 9.78 years old. All patients had a history of migraine. Twelve (70.6%) patients had recurrent spontaneous vertigo, 2 (11.7%) patients had visually induced vertigo, and 3 (17.6%) patients had head motion-induced vertigo. All 17 patients with VM reported worsening of dizziness vertigo during visual stimulation. The migraine-like symptoms were photophobia or phonophobia (n = 15, 88.2%), migraine-like headache (n = 8, 47.1%), visual aura during VM onset (n = 7, 41.2%). 5 (29.4%) patients with VM had hyperactive response during the caloric test, and 12 (70.6%) patients had caloric test intolerance. Eleven (64.7%) patients had a history of motion sickness. Totally 13 independent components were identified. Patients with VM showed decreased functional connectivity in the bilateral medial cingulate gyrus and paracingulate gyrus within sensorimotor network (SMN) compared with HCs. They also showed weakened functional connectivity between auditory network (AN) and anterior default mode network (aDMN) compared with HCs, and enhanced functional connectivity between AN and the salience network (SN) compared with patients with migraine. Conclusion Patients with vestibular migraine showed obvious altered functional connectivity in the bilateral medial cingulate gyrus and paracingulate gyrus within the SMN. The median cingulate and paracingulate gyri may be impaired, the disinhibition of sensorimotor network and vestibular cortical network may result in a hypersensitivity state (photophobia/phonophobia). Altered functional connectivity between AN and DMN, SN may lead to increased sensitivity to vestibular sensory processing.

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External validation and updating of a prediction model for the diagnosis of gestational diabetes mellitus

10.1101/2021.12.05.21267329 ◽

2021 ◽

Author(s):

Shamil D. Cooray ◽

Kushan De Silva ◽

Joanne Enticott ◽

Shrinkhala Dawadi ◽

Jacqueline A. Boyle ◽

...

Keyword(s):

Prediction Model ◽

Diagnostic Criteria ◽

Prediction Models ◽

Past History ◽

Original Model ◽

Obstetric Outcomes ◽

C Statistic ◽

Temporal Validation ◽

History Of ◽

Singleton Pregnancies

ABSTRACTIntroductionThe Monash early pregnancy prediction model calculates risks of developing GDM and is internationally externally validated and implemented in practice, however some gaps remain.ObjectiveTo validate and update Monash GDM model, revising ethnicity categorisation, updating to recent diagnostic criteria, to improve performance and generalisability.MethodsRoutine health data for singleton pregnancies from 2016 to 2018 in Australia included updated GDM diagnostic criteria. The Original Model predictors were included (age, body mass index, ethnicity, diabetes family history, past-history of GDM, past-history of poor obstetric outcomes, ethnicity), with ethnicity revised. Updating model methods were: recalibration-in-the-large (Model A); re-estimation of intercept and slope (Model B), and; coefficients revision using logistic regression (Mode1 C1 with original eight ethnicity categories, and Mode1 C2 with updated 6 ethnicity categories). Analysis included ten-fold cross-validation, performance measures (c-statistic, calibration-in-the-large value, calibration slope and expected-observed (E:O) ratio) and closed testing examining log-likelihood scores and AIC compared models.ResultsIn 26,474 singleton pregnancies (4,756, 18% with GDM), we showed that temporal validation of the original model was reasonable (c-statistic 0.698) but with suboptimal calibration (E:O of 0.485). Model C2 was preferred, because of the high c-statistic (0.732), and it performed significantly better in closed testing compared to other models.ConclusionsUpdating of the original model sustains predictive performance in a contemporary population, including ethnicity data, recent diagnostic criteria, and universal screening context. This supports the value of risk prediction models to guide risk-stratified care to women at risk of GDM.Trial registration detailsThis study was registered as part of the PeRSonal GDM study on the Australian and New Zealand Clinical Trials Registry (ACTRN12620000915954); Pre-results.

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Pain is a common problem in patients with ILD

10.21203/rs.3.rs-50121/v2 ◽

2020 ◽

Author(s):

Qinxue Shen ◽

Ting Guo ◽

Min Song ◽

Wei Guo ◽

Yi Zhang ◽

...

Keyword(s):

Pain Intensity ◽

Short Form ◽

Depression Scale ◽

Brief Pain Inventory ◽

Mcgill Pain Questionnaire ◽

Healthy Controls ◽

Related Quality ◽

Health Related ◽

History Of ◽

Exposure History

Abstract Background Less is known about the prevalence and characteristics of pain in interstitial lung disease (ILD) patients.To determine the characteristics of pain in ILD patients. Methods Participants with ILD and age, gender-matched, healthy controls completed short form McGill Pain Questionnaire (SF-MPQ) and part of the Brief Pain Inventory short form(BPI) to elicit pain characteristics. ILD patients also had assessments of pulmonary function test, six minutes walking test (6MWT), modified medical research council dyspnea scale (mMRC) for state of the illness and measured health-related quality of life(HRQoL) by short form-36(SF-36)and psychological associations by hospital anxiety and depression scale(HADS). Results A total of 63 participants with ILD and 63 healthy controls(HC) were recruited in our study. The prevalence of pain was 61.9% in ILDs versus 25.3% in HC (p=0.005) and the median score of pain rank index (PRI) in ILDs was higher than in HC (P=0.014). Chest(46.1%) accounted for the highest of overall pain locations in participants with ILD. Associated clinical factors for pain intensity in ILD patients included younger age (<60 years), exposure history of ILD risk factors, longer distance of 6MWD(≥250m), higher mMRC score(2-4) and lower DLCo, % predicted(≤45%). ILD patients with pain are more likely to suffer impaired HRQoL(P=0.0014) and psychological problems(P=0.0017,P=0.044). Conclusion Pain is common in those with ILD and the pain intensity is associated with age, exposure history, 6MWD, mMRC score and DLCo, % predicted. ILD patients with pain have more possible to suffer depression, anxiety and impaired HRQoL.

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Pain is a common problem in patients with ILD

10.21203/rs.3.rs-50121/v3 ◽

2020 ◽

Author(s):

Qinxue Shen ◽

Ting Guo ◽

Min Song ◽

Wei Guo ◽

Yi Zhang ◽

...

Keyword(s):

Pain Intensity ◽

Short Form ◽

Depression Scale ◽

Brief Pain Inventory ◽

Mcgill Pain Questionnaire ◽

Sf 36 ◽

Related Quality ◽

Health Related ◽

History Of ◽

Exposure History

Abstract Background: As it is less known about the prevalence and characteristics of pain in the patients with interstitial lung disease (ILD), this paper aims at determining the characteristics of the pain in the patients with ILD.Methods: Subjects with ILD and health controls with the matched ages and genders completed Short Form McGill Pain Questionnaire (SF-MPQ) and part of the Brief Pain Inventory (BPI) Short Form to elicit the characteristics of the pain. The patients with ILD were also assessed through Pulmonary Function Test, Six Minutes Walking Test (6MWT), modified Medical Research Council Dyspnea Scale (mMRC) for state of the illness and measured health-related quality of life (HRQoL) by Short Form-36 (SF-36) and psychological associations by Hospital Anxiety and Depression Scale (HADS).Results: A total of 63 subjects with ILD and 63 healthy controls (HC) were recruited in our study. The prevalence of the pain was 61.9% in ILD versus 25.3% in HC (p=0.005) and the median score of the pain rank index (PRI) in ILD was higher than that in HC (P=0.014). Chest (46.1%) accounted for the highest of overall pain locations in subjects with ILD. Associated clinical factors for pain intensity in the patients with ILD included exposure history of risk factors of ILD, with a longer distance of 6MWD (≥250m), and a higher mMRC score (2-4). The patients with ILD and pain are more likely to suffer impaired HRQoL (P=0.0014) and psychological problems (P=0.0017, P=0.044).Conclusion: The pain is common in those with ILD and the pain intensity is associated with exposure history, 6MWD, and mMRC score. The patients with ILD and pain were possibly to suffer depression, anxiety, and impaired HRQoL.

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Migraine Disability, Pain Catastrophizing, And Headache Severity Are Associated With Evoked Pain And Targeted By Mind-Body Therapy

10.1101/2021.07.05.21259849 ◽

2021 ◽

Author(s):

Samuel R Krimmel ◽

Michael L Keaser ◽

Darrah R Speis ◽

Jennifer A Haythornthwaite ◽

David A Seminowicz

Keyword(s):

Sleep Disturbances ◽

Pain Catastrophizing ◽

Short Form ◽

Brief Pain Inventory ◽

Small Sample ◽

Mcgill Pain Questionnaire ◽

Headache Frequency ◽

Healthy Controls ◽

Pain Ratings ◽

Body Therapy

Meta-analysis suggests migraine patients are no more sensitive to experimentally evoked pain than healthy controls. At the same time, studies have linked some migraine symptoms to Quantitative Sensory Testing (QST) profiles. Unfortunately, previous studies associating migraine symptoms and QST have important methodological shortcomings, stemming from inappropriate statistics, small sample sizes, and frequent use of univariate statistics for multivariate research questions. In the current study we seek to address these limitations by using a large sample of episodic migraine patients (n=103) and a multivariate analysis that associates pain ratings from many thermal intensities simultaneously with 12 clinical measures ranging from headache frequency to sleep abnormalities. We identified a single dimension of association between QST and migraine symptoms that relates to pain ratings for all stimulus intensities and a subset of migraine symptoms relating to disability (Headache Impact Trauma 6 and Brief Pain Inventory interference), catastrophizing (Pain Catastrophizing Scale), and pain severity (average headache pain, Brief Pain Inventory severity, and Short Form McGill Pain Questionnaire 2). Headache frequency, allodynia, affect, and sleep disturbances were unrelated to this dimension. Consistent with previous research, we did not observe any difference in QST ratings between migraine patients and healthy controls. Additionally, we found that the linear combination of symptoms that related to QST were modified by mind-body therapy. These results suggest that QST has a selective relationship with pain symptoms even in the absence of between-subjects differences between chronic pain patients and healthy controls.

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Pain is a common problem in patients with ILD

Respiratory Research ◽

10.1186/s12931-020-01564-0 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Qinxue Shen ◽

Ting Guo ◽

Min Song ◽

Wei Guo ◽

Yi Zhang ◽

...

Keyword(s):

Pain Intensity ◽

Short Form ◽

Depression Scale ◽

Brief Pain Inventory ◽

Mcgill Pain Questionnaire ◽

Sf 36 ◽

Related Quality ◽

Health Related ◽

History Of ◽

Exposure History

Abstract Background As it is less known about the prevalence and characteristics of pain in the patients with interstitial lung disease (ILD), this paper aims at determining the characteristics of the pain in the patients with ILD. Methods Subjects with ILD and health controls with the matched ages and genders completed Short Form McGill Pain Questionnaire (SF-MPQ) and part of the Brief Pain Inventory (BPI) Short Form to elicit the characteristics of the pain. The patients with ILD were also assessed through Pulmonary Function Test, Six Minutes Walking Test (6MWT), modified Medical Research Council Dyspnea Scale (mMRC) for state of the illness and measured health-related quality of life (HRQoL) by Short Form-36 (SF-36) and psychological associations by Hospital Anxiety and Depression Scale (HADS). Results A total of 63 subjects with ILD and 63 healthy controls (HC) were recruited in our study. The prevalence of the pain was 61.9% in ILD versus 25.3% in HC (P = 0.005) and the median score of the pain rank index (PRI) in ILD was higher than that in HC (P = 0.014). Chest (46.1%) accounted for the highest of overall pain locations in subjects with ILD. Associated clinical factors for pain intensity in the patients with ILD included exposure history of risk factors of ILD, with a longer distance of 6MWD (≥ 250 m), and a higher mMRC score (2–4). The patients with ILD and pain are more likely to suffer impaired HRQoL (P = 0.0014) and psychological problems (P = 0.0017, P = 0.044). Conclusion The pain is common in those with ILD and the pain intensity is associated with exposure history, 6MWD, and mMRC score. The patients with ILD and pain were possibly to suffer depression, anxiety, and impaired HRQoL.

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Lessons Learned from Psychological Autopsies in Armed Forces

Indian Journal of Psychological Medicine ◽

10.1177/0253717620950254 ◽

2020 ◽

pp. 025371762095025

Author(s):

Alok Sinha ◽

Sriniwas Gupta ◽

Madhubrata Ray ◽

Sanjay Kumar ◽

Anindya Kumar Gupta

Keyword(s):

Mental Illness ◽

Behavioral Change ◽

Past History ◽

Armed Forces ◽

Lessons Learned ◽

Psychological Autopsy ◽

Prophylactic Measures ◽

Semistructured Interviews ◽

Strategic Location ◽

History Of

Background: Suicide in armed forces is a matter of concern despite adequate prophylactic measures that have been adopted to reduce it. Military psychiatrists routinely conduct psychological autopsies. It may reveal various biopsychosocial factors leading to suicide and may be helpful in suicide prevention too. A few studies have been done in Indian Armed Forces but all of them involve cases of attempted suicide. Our study is different as it uses the methodology of psychological autopsy to find out various psychosocial factors of suicide in armed forces. Methods: The present study was carried out in a large service hospital and included all suicide cases occurring in a particular strategic location from February 2014 to July 2017. A total of 16 suicide cases were investigated, and information was collected through visiting the scene, detailed semistructured interviews, the perusal of mobile call records, social website activities, notes in a social diary, bank statements, service record, and health records. Results: The majority (nine of sixteen) of suicide victims were less than 30 years of age. The most common method of suicide (ten of sixteen) was use of firearms. Family history of mental illness/suicide was seen in three of them. Three had a past history of mental illness. Two were abusing substance in the recent past. Behavioral change was noticed in three, and suicide notes were available in three cases. Five had expressed their intent to die. Conclusions: Strain of serving in frontiers is not a common stressor associated with suicide as commonly perceived.

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Building evidence to reduce inequities in management of pain for Indigenous Australian people

Scandinavian Journal of Pain ◽

10.1515/sjpain-2021-0173 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Manasi Murthy Mittinty ◽

Joanne Hedges ◽

Lisa Jamieson

Keyword(s):

Rating Scale ◽

Numerical Rating Scale ◽

Short Form ◽

Brief Pain Inventory ◽

Mcgill Pain Questionnaire ◽

Indigenous Australian ◽

Pharmacological Management ◽

Numerical Rating ◽

History Of ◽

Trauma And Injury

Abstract Objectives Pain is a universal experience which each person encounters differently, guided by the psycho-socio-environmental context in which it occurs. Although more research is underway yet very little is known about pain from Indigenous Australian perspective. Therefore, this study aims to examine, experience of pain and coping, and utility of three measures: Brief Pain Inventory short form, McGill Pain Questionnaire and Numerical rating scale, from Indigenous South Australian people perspective. Methods Thirteen in-person interviews were conducted which lasted around 90 min and were audio-recorded. The transcripts were coded and analysed thematically with NVivo. Results Six key themes were identified; 1: Spiritual conceptualisation of pain; 2: Frequent experience of trauma and injury; 3: Influence of familial history of pain; 4: Acceptance of pain as normal; 5: Outlook on biomedical management of pain; 6: Preference for non-pharmacological management of pain. Also, the three measures did not fully capture pain from an Indigenous Australian perspective which is more deeply rooted in a bio-psycho-socio-spiritual context which is cardinal to conceptualization of health and wellbeing in Indigenous Australian communities. Conclusions Findings highlight some commonalities as well as unique differences between Indigenous experiences of pain as compared to non-Indigenous. Factors such as spiritual connection with pain, grief and loss, history of trauma and injury, fear of addiction to pain medication and exposure to pain from early childhood had important implications for how participants viewed pain.

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