scholarly journals Clinical features of episodic migraine and transformed migraine: a comparative study

2002 ◽  
Vol 60 (4) ◽  
pp. 912-916 ◽  
Author(s):  
José Carlos Busto Galego ◽  
José Paulo Cipullo ◽  
José Antonio Cordeiro ◽  
Waldir Antonio Tognola
Keyword(s):  
Time History ◽  
Episodic Migraine ◽  
Transformed Migraine ◽  
Headache Onset ◽  
Group Time ◽  
History Of ◽  
Daily Headache ◽  
Nocturnal Awakening ◽  
The Mean ◽  
Headache Patients

Transformed migraine (TM) is one of the most frequent types of chronic daily headache. Eighty patients: 40 with episodic migraine (EM) and 40 with TM with ages ranging from 18 to 60 years old were studied. Females were the majority. At first examination, the mean age was similar in both groups. The initial age of migraine attacks was significantly smaller in the TM group. Time history of episodic attacks was similar in both groups. In the EM group, the headache was predominantly located on only one side of the head; whereas in the TM group, on more than one side. There was variation in the character of pain and intensity in the TM group. Nocturnal awakening with headache, aura and family history did not show significant association with EM or TM. The TM was distinguished from the EM in relation to the frequency, location and pain intensity of the headache. Patients with early migraine headache onset may exhibit a further risk of developing TM.

Chronic Daily Headaches: Clinical Profile in Indian Patients

Cephalalgia ◽  
2003 ◽  
Vol 23 (5) ◽  
pp. 348-355 ◽  
Author(s):  
A Chakravarty
Keyword(s):  
Present Report ◽  
Episodic Migraine ◽  
Tension Type Headache ◽  
Primary Headaches ◽  
Average Dose ◽  
Transformed Migraine ◽  
History Of ◽  
Daily Headache ◽  
Therapy Withdrawal ◽  
Type Headache

Chronic daily headache (CDH) remains a relatively unexplored entity in India. Misconceptions are common, unnecessary investigations often done and inappropriate therapy prescribed. Analgesic overuse is seldom recognized. The present report appears to be the first of its kind from India. CDH has been defined as headaches occurring more than 15 days per month for more than 3 months (secondary causes excluded). Over 2 years (1998-1999) 849 cases (49.6% of all primary headaches) were seen. More than 1 year's follow-up data were available in 205 subjects (M 34; F 171). The distribution of these was as follows: (i), chronic tension-type headache (CTH), 33 (16.1%); (ii), chronic/transformed migraine (TM), 169 (82.4%); (iii), new persistent CDH, 3 (1.5%). There were 169 cases of TM (M:F 1:4.7; age 26-58 years). History of past episodic migraine was present in all. Transformation had been gradual (89.4%) or acute (10.6%). Possible factors in transformation included psychological stress (44.4%), analgesic overuse (28.4%), ergot overuse (4.1%). HRT seemed to be implicated in three female subjects. Analgesic overuse was limited between intake of 600 and 2400 mg of aspirin equivalent per day (mean 735 mg). Ergot overuse varied between 1 and 3 mg/day of ergotamine for ≥ 3 days/week. With medical therapy approximately 70% TM and 40% CTH patients noted significant improvement. About 80% of these relapsed on therapy withdrawal. CDH in India is not uncommon. Analgesic/ergot overuse needs to be recognized early. The average dose of analgesic implicated in CDH seems much less compared with that reported in the West.

Stationary and Transient Response of Cylindrical Shells Under Random Excitation

1988 ◽  
Vol 110 (2) ◽  
pp. 205-209
Author(s):  
A. V. Singh
Keyword(s):  
Transient Response ◽  
Random Vibration ◽  
Time History ◽  
Wide Band ◽  
Random Excitation ◽  
Mode Shapes ◽  
The Finite Element Method ◽  
History Of ◽  
The Mean ◽  
Random Vibration Analysis

This paper presents the random vibration analysis of a simply supported cylindrical shell under a ring load which is uniform around the circumference. The time history of the excitation is assumed to be a stationary wide-band random process. The finite element method and the condition of symmetry along the length of the cylinder are used to calculate the natural frequencies and associated mode shapes. Maximum values of the mean square displacements and velocities occur at the point of application of the load. It is seen that the transient response of the shell under wide band stationary excitation is nonstationary in the initial stages and approaches the stationary solution for large value of time.

Transformed migraine

Cephalalgia ◽  
1993 ◽  
Vol 13 (12_suppl) ◽  
pp. 78-83 ◽  
Author(s):  
Ninan T Mathew
Keyword(s):  
Chronic Daily Headache ◽  
Tension Type Headache ◽  
Drug Induced ◽  
Chronic Tension Type Headache ◽  
Transformed Migraine ◽  
Mixed Features ◽  
History Of ◽  
Daily Headache ◽  
International Headache Classification ◽  
Type Headache

Chronic tension-type headache, which is included in the International Headache Classification, is present in only a minority of patients who present with chronic daily headache. The majority have what is termed transformed migraine, with a history of distinct episodes of migraine in the initial years which progresses into chronic daily headache. These patients with transformed migraine exhibit mixed features of migraine and chronic tension-type headache. Two distinct types of transformed migraine are identifiable, namely those related to excessive intake of medications (drug-induced transformed migraine) and those unrelated to excessive use of medications. The clinical features of transformed migraine and the drug-induced variety are described. The need for revision of the International Classification to include chronic daily headache and the subtypes of transformed migraine is pointed out.

Anything but a shocking solution – the effectiveness of Cefaly® in non-migrainous headache

2017 ◽  
pp. 138-139
Author(s):  
Pedro André Kowacs ◽  
Paulo Sergio Faro Santos ◽  
Elcio Juliato Piovesan ◽  
Helio Afonso Ghizoni Teive
Keyword(s):  
Episodic Migraine ◽  
Therapeutic Approaches ◽  
Resting Tremor ◽  
Upper Trapezius ◽  
History Of ◽  
Daily Headache ◽  
The Right ◽  
Migrainous Headache ◽  
Ct And Mri

Background: The transcutaneous supraorbital nerve stimulation with the Cefaly® device has demonstrated safety and efficacy for the prevention of episodic migraine. However, there isn't description of its efficacy in other headaches. Case report: A 78-year-old man was seen because of a 55-year history of daily headache. His medical history revealed Parkinson's disease, dyslipidemia and mild cognitive impairment. Physical examination revealed bradykynesia and asymmetric resting tremor of both arms, the right more affected than the left. There was mild pain on palpation of both upper trapezius muscles adjacent to the occipital bone. Cervical spine X-ray, CT and MRI: no findings. Various therapeutic approaches were done, but without success, so it was decided to prescribe Cefaly®. At his three-month follow-up, he reported an improvement of about 80%. Conclusion: The case described here shows that Cefaly® may be effective in headaches other than migraine.

scholarly journals 089 Breaking the cycle of chronic daily headache with a low-dose subcutaneous lignocaine and ketamine infusion

2019 ◽  
Vol 90 (e7) ◽  
pp. A28.3-A29
Author(s):  
Christopher JF Rofe ◽  
Raymond Garrick ◽  
David Burke ◽  
Bruce J Brew ◽  
Susan E Tomlinson
Keyword(s):  
Chronic Migraine ◽  
Episodic Migraine ◽  
Management Plan ◽  
Motor Axons ◽  
Ketamine Infusion ◽  
Pain Pathways ◽  
History Of ◽  
Observational Cohort ◽  
Daily Headache ◽  
Rebound Headache

IntroductionManagement of chronic migraine includes correcting analgesic rebound headache and implementing suitable medication for prevention and acute episodes. However, in many cases this management paradigm oversimplifies the complexity of chronic migraine, particularly the entrenched central pathways that perpetuate chronic migraine. Intravenous lignocaine can curtail chronic migraine and analgesic rebound headache (1). Further, ketamine provides short-term analgesia and enables reduction in central sensitisation of pain pathways, particularly in the setting of codeine/opiod overuse (2). This paper describes use of subcutaneous lignocaine and ketamine infusion in chronic migraine.MethodsA prospective observational cohort study was undertaken in patients with chronic migraine. Patients received a prolonged subcutaneous lignocaine and ketamine infusion (mean duration 11 days) and underwent evaluation at four-time points over six months. The effects on the excitability of motor axons in the median nerve were documented using standard procedures.ResultsFourteen patients were recruited. The infusion was well tolerated; no major side effects were seen. There were no significant long-term changes in the excitability of motor axons. At six months, 13/14 patients had sustained benefit. Three of 4 patients remained free of analgesic rebound headache. One patient remained headache-free. Conversion to episodic migraine occurred in 6/14. Improvement in chronic migraine was reported by 6/14. Three of six were able to return to work, with 1 returning to studies. Benefit was greater in those with depression and history of opiod/codeine use.ConclusionSubcutaneous lignocaine and ketamine can help break entrenchment in chronic migraine as part of a structured management plan.

Time Progression of Hemolysis of Erythrocyte Populations Exposed to Supraphysiological Temperatures

1979 ◽  
Vol 101 (3) ◽  
pp. 213-217 ◽  
Author(s):  
N. A. Moussa ◽  
E. N. Tell ◽  
E. G. Cravalho
Keyword(s):  
Statistical Model ◽  
Distribution Curve ◽  
Time History ◽  
Kinetic Scheme ◽  
First Order ◽  
Arrhenius Dependence ◽  
History Of ◽  
The Mean ◽  
Two Parameters ◽  
Microscope Stage

Populations of erythrocytes in solution were heated “instantaneously” to and maintained at temperatures in the range of 44 to 60°C on a microscope stage specifically designed for this purpose. Simultaneously, the visually observed hemolysis-time history of these cells was measured. The results were successfully correlated on the basis of two models: 1) a kinetic scheme assuming two sequential, first-order reactions by which the cells are first reversibly altered and then irreversibly damaged; and 2) a statistical model for which the number of cells that are damaged at each instant is assumed to be normally distributed. From the experimental data the rate constants for the two reactions in the kinetic model were determined and were found to have an Arrhenius dependence on temperature. By applying the statistical model to the data, we were able to determine the mean and standard deviation of the distribution curve for this model. The logarithms of these latter two parameters vary with temperature in a linear fashion.

Need for Analgesics/drugs of Abuse: A Comparison Between Headache Patients and Addicts by the Leeds Dependence Questionnaire (LDQ)

Cephalalgia ◽  
2006 ◽  
Vol 26 (2) ◽  
pp. 187-193 ◽  
Author(s):  
A Ferrari ◽  
AFG Cicero ◽  
A Bertolini ◽  
S Leone ◽  
G Pasciullo ◽  
...  
Keyword(s):  
Chronic Headache ◽  
Substance Dependence ◽  
Drugs Of Abuse ◽  
Well Being ◽  
Drug Addicts ◽  
Analgesic Drug ◽  
Episodic Headache ◽  
Daily Headache ◽  
The Mean ◽  
Headache Patients

Our aim was to compare the need for analgesics/drugs of abuse between headache patients—chronic and episodic headache sufferers—and addicts, by the Leeds Dependence Questionnaire (LDQ). This is a self-completion 10-item instrument to measure dependence upon a variety of substances. We administered the LDQ questionnaire to 122 chronic daily headache (CDH) sufferers who had been taking one dose of analgesic drug every day for at least 1 year; 71 subjects suffering from episodic headache (EH) using analgesics only occasionally; 115 consecutive drug addicts (DA) with a diagnosis of substance dependence. The mean LDQ total score was similar in the CDH (11.58 ± 6.35) and DA (10.37 ± 6.51) groups, and for both it was significantly higher than the score in the EH (5.61 ± 3.00) group ( P < 0.001). The CDH group had the highest scores, and higher scores than the DA group (Z = −8.18, P < 0.001) in item 8, assessing the primacy of effect over the kind of analgesic used, and in item 10 (Z = −5.03, P < 0.001), asking if it is difficult to live without the analgesic; the DA group had the highest scores, and higher scores than the CDH group, in item 9 (Z = −5.07, P < 0.001) addressing the need for the continued administration of the drug to maintain well-being, and in item 3 (Z =−2.39, P < 0.05), exploring compulsion to start the use of the drug. The EH group had lower scores in all items ( P < 0.05) except for item 9, where there was no difference from CDH group; the EH group had also lower scores ( P < 0.001) than the DA group, except for item 8, where, instead, the score was higher than in the DA group (Z = −5.33, P < 0.001). A strong link develops between chronic headache patients and the analgesics they use. This sort of ‘dependence’ appears to be a consequence of headache, originating from the necessity for the analgesic to cope with everyday life.

Field Testing Alternative Criteria for Chronic Migraine

Cephalalgia ◽  
2006 ◽  
Vol 26 (4) ◽  
pp. 477-482 ◽  
Author(s):  
ME Bigal ◽  
SJ Tepper ◽  
FD Sheftell ◽  
AM Rapoport ◽  
RB Lipton
Keyword(s):  
Chronic Migraine ◽  
Chronic Daily Headache ◽  
Medication Overuse ◽  
Field Testing ◽  
Episodic Migraine ◽  
Headache Disorders ◽  
Transformed Migraine ◽  
Daily Headache ◽  
Probable Migraine

The criteria for chronic migraine (CM), as proposed by the Second Edition of the International Classification of Headache Disorders (ICHD-2) is very restrictive, excluding most patients that evolve from episodic migraine. In this study we empirically tested three recent proposals for revised criteria for CM. We included individuals with transformed migraine (TM) with or without medication overuse, according to the criteria proposed by Silberstein and Lipton. All individuals had headache calendars for at least three consecutive months. We assessed the proportion of subjects that fulfilled ICHD-2 criteria for CM or probable chronic migraine with probable medication overuse (CM+). We also tested three proposals for making the CM criteria more inclusive. In proposal 1, CM/CM+ would require at least 15 days of migraine or probable migraine per month. Proposal 2 suggests that CM/CM+ would be classified in those with ≥15 days of headache per month, where at least 50% of these days are migraine or probable migraine. Proposal 3 suggests that CM/CM+ would be classified in those with chronic daily headache and at least 8 days of migraine or probable migraine per month. Among TM sufferers, 399 (62.5%) had TM with medication overuse, and just 10.2% were classified as CM+ 158 (37.5%) had TM without medication overuse; just nine (5.6%) met current ICHD-2 criteria for CM. Using the alternative criteria, proposal 1 included 48.7% of patients with TM without medication overuse; proposal 2 captured 88%, and proposal 3 classified 94.9% of these patients. For TM with medication overuse, the proportions for proposals 1-3 were, respectively, 37%, 81% and 91%. The differences were statistically significant, favouring proposal 3. Consistently, criteria for CM and CM+ should be revised to require at least 8 days of migraine or probable migraine per month, in individuals with 15 or more days of headache per month.

Sign in / Sign up

Export Citation Format

Share Document