scholarly journals Efficacy of Nutūl-i-Ḥār (Hot Irrigation), a Polyherbal Unani Formulation, in the Treatment of Shaqīqa-i-Muzmin (Chronic Migraine): An Open Single-Arm Exploratory Clinical Trial

2022 ◽  
Author(s):  
Umar Afzal ◽  
Abdul Nasir Ansari ◽  
Mohd Nayab
Keyword(s):  
Chronic Migraine ◽  
Rescue Medication ◽  
Sampling Method ◽  
Headache Frequency ◽  
Matricaria Chamomilla ◽  
Origanum Vulgare ◽  
Artemisia Absinthium ◽  
Headache Intensity ◽  
Baseline Values ◽  
Trigonella Foenum Graecum L

Shaqīqa-i-Muzmin (chronic migraine) is a type of migraine that is usually caused by cold humours (bārid akhlāṭ), specifically by phlegm (balgham) and to lesser extent by black bile (sauda). The aim of this study was to evaluate the effect of Nutul-i-Ḥār (hot irrigation) in the treatment of chronic migraine. Nutul (irrigation) therapy is widely and successfully used in diseases of head as described in Unānī system of medicine. This open, single-arm, exploratory clinical study was conducted in 30 patients of chronic migraine selected by convenient sampling method. One litre decoction prepared with 12 g each of Astragalus hamosus L. (Iklilul malik), Matricaria chamomilla L. (Babuna), Artemisia absinthium L. (Afsanteen), Origanum vulgare L. (Marznjosh) and Trigonella foenum graecum L. (Hulba) was poured over painful side of head for 45 minutes on every alternate day for a period of 30 days (15 sittings). The patients, thereafter, were followed untill 90th day of the study for various outcome measures comprising headache intensity, headache frequency, Migraine Disability Assessment Scale (MIDAS), and rescue medication. The reduction in headache frequency, MIDAS score and use of rescue medication was significant (p < 0.001) after the treatment. Reduction in headache intensity at 30th day, 60th day and 90th day was significant as compared with baseline values (p < 0.001) but not statistically significant at 90th day with respect to 60th day (p > 0.05). Statistical analysis was done using parametric (paired t-test) and non-parametric tests (Wilcoxan sign ranked test, Freidman with Dunn’s multiple comparison tests). Hot irrigation with medicated decoction was found effective in the treatment of chronic migraine.

scholarly journals Botulinum toxin in the management of chronic migraine: clinical evidence and experience

2016 ◽  
Vol 10 (2) ◽  
pp. 127-135 ◽  
Author(s):  
Claus M Escher ◽  
Lejla Paracka ◽  
Dirk Dressler ◽  
Katja Kollewe
Keyword(s):  
Chronic Migraine ◽  
Botulinum Neurotoxin ◽  
Prophylactic Treatment ◽  
Clinical Evidence ◽  
The United States ◽  
Headache Frequency ◽  
United States Food ◽  
History Of ◽  
States Food ◽  
Review Reports

Chronic migraine (CM) is a severely disabling neurological condition characterized by episodes of pulsating unilateral or bilateral headache. The United States Food and Drug Administration (FDA) approved onabotulinumtoxinA (Botox®) for the prophylactic treatment of CM in 2010. It has been shown that onabotulinumtoxinA is effective in the reduction of headache frequency and severity in patients with CM. Treatment is well tolerated by the patients. This review reports on the history of botulinum neurotoxin (BoNT) in CM and presents the current clinical evidence for the use of onabotulinumtoxinA in the treatment of CM.

Somatosensory gating is altered and associated with migraine chronification: A magnetoencephalographic study

Cephalalgia ◽  
2017 ◽  
Vol 38 (4) ◽  
pp. 744-753 ◽  
Author(s):  
Fu-Jung Hsiao ◽  
Shuu-Jiun Wang ◽  
Yung-Yang Lin ◽  
Jong-Ling Fuh ◽  
Yu-Chieh Ko ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Migraine Without Aura ◽  
Headache Frequency ◽  
Sensory Modulation ◽  
Brain Excitability ◽  
Paired Stimuli ◽  
Somatosensory Cortices ◽  
First Response ◽  
Electrical Stimuli ◽  
Somatosensory Gating

Background Brain excitability is changed in migraine but not fully characterized yet. This study explored if somatosensory gating is altered in migraine and linked to migraine chronification. Methods Paired electrical stimuli were delivered to the left index fingers of 21 patients with migraine without aura (MO), 22 patients with chronic migraine (CM), and 36 controls. The first and second responses to the paired stimuli were obtained from the contralateral primary (cSI), contralateral secondary (cSII) and ipsilateral secondary (iSII) somatosensory cortices to compute the gating ratios (second vs. first response strengths). Results The first and second cSI responses and gating ratios differed in all groups ( p < 0.05); the responses were typically smaller in the MO and CM groups. The cSI gating ratio increased as a continuum across controls (0.73 ± 0.04, p < 0.001), MO (0.83 ± 0.04) to CM (0.97 ± 0.06) and was higher in CM vs. controls ( p < 0.001). When MO and CM were combined, cSI gating ratio was associated with headache frequency (r = 0.418, p = 0.005). Paired responses and gating ratios of cSII and iSII did not differ among the groups. Conclusions Somatosensory gating is altered in migraine and associated with headache chronification. Further studies must clarify if this abnormal sensory modulation is a true gating deficit independent of low preexcitation level.

Psychophysical testing in chronic migraine and chronic tension type headache: An observational study

Cephalalgia ◽  
2021 ◽  
pp. 033310242110603
Author(s):  
Ignacio Elizagaray-García ◽  
Gabriela F Carvalho ◽  
Tibor M Szikszay ◽  
Waclaw M Adamczyk ◽  
Gonzalo Navarro-Fernández ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Tension Type Headache ◽  
Headache Frequency ◽  
Chronic Tension Type Headache ◽  
Psychophysical Testing ◽  
Pressure Pain Thresholds ◽  
Type Headache ◽  
Neck Disability ◽  
Painful Area

Background Clinical presentation is the key to the diagnosis of patients with migraine and tension-type headache, but features may overlap when both become chronic. Psychophysical parameters may distinguish both conditions. We aimed to compare psychophysical aspects of patients with chronic migraine, chronic tension-type headache and headache-free controls, and to determine whether these can predict headache frequency. Methods An examiner blinded to the diagnosis assessed 100 participants (chronic migraine (n = 38), chronic tension-type headache (n = 31) and controls (n = 31)). Assessed variables included painful area, pressure pain thresholds, temporal summation, cervical range of motion, neck posture, headache and neck impact, quality of life, and kinesiophobia. Comparison between groups was performed with one-way ANOVA and multiple linear regression was used to assess the headache frequency predictors. Results We found differences of both headache groups compared to controls ( p < 0.01), but not between headache groups. Neck disability was a significant predictor of headache frequency for chronic tension-type headache (adjusted R2 = 0.14; β = 0.43; p = 0.03) and chronic migraine (adjusted R2 = 0.18; β = 0.51; p < 0.01). Conclusions Chronic tension-type headache and chronic migraine showed similar psychophysical results, but were significantly worse when compared to controls. The psychophysical examination did not discriminate between headache types. The variable best explaining headache frequency for both headache types was neck disability.

Toward a pragmatic migraine model for drug testing: 1. Cilostazol in healthy volunteers

Cephalalgia ◽  
2015 ◽  
Vol 36 (2) ◽  
pp. 172-178 ◽  
Author(s):  
Emma Katrine Hansen ◽  
Song Guo ◽  
Messoud Ashina ◽  
Jes Olesen
Keyword(s):  
Physical Activity ◽  
Healthy Volunteers ◽  
Migraine Headache ◽  
Drug Testing ◽  
Rescue Medication ◽  
No Reduction ◽  
Healthy Individuals ◽  
Double Blind ◽  
Headache Intensity ◽  
Accompanying Symptoms

Background A model for the testing of novel antimigraine drugs should ideally use healthy volunteers for ease of recruiting. Cilostazol provokes headache in healthy volunteers with some migraine features such as pulsating pain quality and aggravation by physical activity. Therefore, this headache might respond to sumatriptan, a requirement for validation. The hypothesis of the present study was that sumatriptan but not placebo is effective in cilostazol-induced headache in healthy individuals. Methods In a double-blind, randomized, cross-over design, 30 healthy volunteers of both sexes received cilostazol 200 mg on two separate days, each day followed by oral self-administered placebo or sumatriptan 50 mg. Headache response and accompanying symptoms were registered in a questionnaire by the participants themselves. Results Cilostazol induced a reproducible headache in 90% of the participants. The headache had several migraine-like features in most individuals. Median peak headache score was 2 on the sumatriptan day and 3 on the placebo day ( p = 0.17). There was no reduction in headache intensity two hours after sumatriptan ( p = 0.97) and difference in AUC 0 to four hours between two experimental days was not significant ( p = 0.18). On the placebo day eight participants took rescue medication compared to 3 on the sumatriptan day ( p = 0.13). Conclusion Despite similarities with migraine headache, cilostazol-induced headache in healthy volunteers does not respond to sumatriptan.

Migraine

2020 ◽  
pp. 213-224
Author(s):  
Julio R Vieira ◽  
Richard B Lipton
Keyword(s):  
Chronic Migraine ◽  
Migraine With Aura ◽  
Cortical Spreading Depression ◽  
Migraine Without Aura ◽  
Spreading Depression ◽  
Headache Frequency ◽  
Motor Symptoms ◽  
Migraine Aura ◽  
Younger Age ◽  
Psychiatric Conditions

This chapter examines migraine. The incidence of migraine varies depending on multiple aspects, including age, sex, and the presence of aura. At an earlier age (younger than age ten), migraine initially affects more boys than girls, with migraine with aura (MA) occurring at a younger age than migraine without aura (MO). Later in life, when puberty starts, this relationship changes and it becomes more common in women than men. Migraine aura are focal neurological symptoms that typically occur prior to the onset of a headache due to a phenomenon called cortical spreading depression. The prevalence of migraine with aura vary between visual, sensory, or motor symptoms. It can also present as diplopia, slurred speech, aphasia, dizziness, vertigo, and hemiparesis. Moreover, the prevalence of migraine varies according to headache frequency. The chapter then looks at chronic migraine and menstrual migraine. It also explores several comorbidities associated with migraine, including many neurologic, medical, and psychiatric conditions.

scholarly journals 1151 Is Timing Of Light Exposure Different In Women With Chronic Migraine?

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A438-A439
Author(s):  
S C Dawson ◽  
M Kim ◽  
K Reid ◽  
H J Burgess ◽  
J K Wyatt ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Light Exposure ◽  
Pearson Correlation ◽  
Significant Trend ◽  
Headache Frequency ◽  
Healthy Controls ◽  
Start Time ◽  
Headache Severity ◽  
Wrist Actigraphy ◽  
Daily Headache

Abstract Introduction Light avoidance is a common coping behavior of individuals with migraine headaches. It is not known whether timing of light exposure is different in individuals with chronic migraine (CM) compared to those without migraine and how this may relate to headache frequency and severity. We tested this by examining timing of the brightest and darkest light and headaches in women with chronic migraines and healthy controls. Methods Sixteen women with CM (mean age = 33.07) and 18 female healthy controls (HC; mean age = 32.22) completed daily ratings of headache severity (0-10, severity &gt; 2 classified as headache) concurrent with light exposure measured by wrist actigraphy for approximately one month (M=28.00 days, range=21-36). Start time of each day’s 10-hour periods of maximum light (M10) and 5-hour periods of lowest light (L5) were calculated and averaged for each participant. T-tests and Cohen’s d effect sizes were used to compare groups. Pearson correlation coefficients were calculated to examine associations between M10/L5 timing and headache frequency and severity. Results M10 was earlier in the CM group compared to the HC group (07:42±00:47 vs. 08:50±00:58, t(32)=3.69, p=0.0008, d=1.08). The CM group exhibited non-significant trend towards earlier L5 compared to the HC group (12:26±00:48 vs. 01:07±01:03, t(32)=1.89, p=0.0723, d=0.62). Among individuals with CM, later M10 timing was associated with more severe average daily headache (r=0.60, p=0.0136) and more frequent headaches (r=0.55, p=0.0257). Later L5 timing was significantly associated with more severe average daily headache (r=0.66, p=0.0052) and showed a non-significant trend toward association with more frequent headaches (r=0.47, p=0.0686). Conclusion Timing of the greatest light exposure period was earlier in CM compared to HC. Within the CM group, those who had earlier light and dark periods reported lower headache severity and fewer days with headaches. These findings suggest the possibility of a role for the circadian system in chronic migraine. Support This study was supported by grant R21NS081088 from the National Institutes of Health.

Cerebrospinal Fluid Glutamate Levels in Chronic Migraine

Cephalalgia ◽  
2004 ◽  
Vol 24 (9) ◽  
pp. 735-739 ◽  
Author(s):  
MFP Peres ◽  
E Zukerman ◽  
CA Senne Soares ◽  
EO Alonso ◽  
BFC Santos ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Chronic Migraine ◽  
Glutamate Receptors ◽  
Pain Score ◽  
Clinical Data ◽  
Central Sensitization ◽  
Tender Points ◽  
Data Link ◽  
Headache Intensity ◽  
Sensitization Process

Both preclinical and clinical data link glutamate to the migraine pathophisiology. Altered plasma, platelets and cerebrospinal (CSF) glutamate levels have been reported in migraine patients. Chronic migraine is comorbid with several conditions. It has been recently shown chronic migraine comorbidity with fibromyalgia. The objective of this study was to study cerebrospinal fluid glutamate levels in chronic migraine patients with and without fibromyalgia. We studied 20 chronic migraine patients, with and without fibromyalgia, compared to age-sex matched controls. CSF glutamate levels were measured by HPLC. CSF glutamate demonstrated significantly higher levels in patients with fibromyalgia compared to those without fibromyalgia. Patients overall had higher CSF glutamate levels than controls. Mean pain score correlated with glutamate levels in chornic migraine patients. Tender points, the hallmark of fibromyalgia, can be considered as pressure allodynia, and is probably mediated by central sensitization, with increase in CSF glutamate levels. We postulate chronic migraine patients with fibromyalgia, in addition to have more disabling headaches, suffer from a more severe central sensitization process. This subtype of patients may respond to medications modulating glutamate receptors. Headache intensity correlate with glutamate levels in chronic migraine patients.

scholarly journals FEIRAS LIVRES: UM ESTUDO DE CASO RELACIONADO À DISPONIBILIDADE DE PLANTAS MEDICINAIS, AROMÁTICAS E CONDIMENTARES

2020 ◽  
Vol 17 (1) ◽  
pp. 1
Author(s):  
Samuel Tadeu Tonin ◽  
Deyze Cristina Lucas ◽  
Amanda Fabres Oliveira Radunz ◽  
Ítalo Kael Gilson ◽  
Jacir Dal Magro ◽  
...  
Keyword(s):  
Citrus Sinensis ◽  
Ocimum Basilicum ◽  
Ruta Graveolens ◽  
Matricaria Chamomilla ◽  
Mentha Pulegium ◽  
Artemisia Absinthium ◽  
Malva Sylvestris ◽  
Origanum Majorana ◽  
Achyrocline Satureioides ◽  
Mikania Glomerata

Objetivou-se avaliar a organização social das feiras livres frente a disponibilidade de mudas e partes secas vegetais de plantas medicinais, aromáticas e condimentares (MAC), ofertadas aos consumidores em feiras livres do município de Chapecó-SC. Os dados foram coletados visualmente através de visitas às feiras livres, em dois diferentes momentos. Os resultados demonstram que as feiras livres do município estão disposta em 10 espaços distintos dentro da área urbana, totalizando 16 momentos de realização distribuídos entre os dias da semana. De maneira geral, os espaços ofertam diversos produtos aos consumidores, entre os quais estão as espécies MAC tano na forma de mudas quanto de partes secas, esta última representando, em média, 72% do total. A oferta da maioria das espécies não foi influenciada pela data de avaliação, sendo as mais recorrentes a Ruta graveolens, Matricaria chamomilla, Rosmarinus officinalis, Aloysia citriodora, Mentha pulegium, Plectranthus barbatus, Citrus sinensis, Mikania glomerata, Helichysum italicum, Mentha sp., Artemisia absinthium, Salvia officinalis, Ocimum basilicum, Origanum majorana, Achyrocline satureioides, Malva sylvestris, sendo encontradas tanto em mudas como partes secas.

scholarly journals Anti-CGRP monoclonal antibodies in chronic migraine with medication overuse: real-life effectiveness and predictors of response at 6 months

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Edoardo Caronna ◽  
Victor José Gallardo ◽  
Alicia Alpuente ◽  
Marta Torres-Ferrus ◽  
Patricia Pozo-Rosich
Keyword(s):  
Monoclonal Antibodies ◽  
Chronic Migraine ◽  
Medication Overuse ◽  
Real Life ◽  
Daily Practice ◽  
Headache Frequency ◽  
Electronic Diary ◽  
Life Effectiveness ◽  
Medication Intake ◽  
Acute Medication

Abstract Background In daily practice, anti-CGRP monoclonal antibodies (MAbs) may be useful in chronic migraine (CM) with medication overuse (MO), but data is limited. We evaluated their effectiveness in a real-life clinical cohort. Methods This is a prospective study conducted in CM patients with and without medication overuse treated with monthly MAbs during 6 months (erenumab/galcanezumab). We collected headache characteristics, including acute medication intake, through an electronic diary. We compared patients (1) with and without MO at baseline, (2) with and without ongoing MO after treatment, defining MO resolution as < 10 or 15 days/month of acute medication intake, according to analgesic type, during the 6-month treatment. Results Of 139 CM patients completing 6-month treatment with anti-CGRP MAbs, 71.2% (99/139) had MO at baseline. After 6 months, patients with and without MO at baseline had significant and similar proportions of ≥50% reduction in migraine days/month (MO: 63.6% vs. non-MO: 57.5%, p = 0.500). 60.6% (60/99) no longer satisfied MO definition. Reduction in headache frequency compared to baseline occurred in both MO-ongoing and MO-resolution group, although those who stopped overusing had a greater improvement (headache days/month: − 13.4 ± 7.6 vs. -7.8 ± 7.2, p < 0.0001). No differences in MO resolution were observed according to the MAbs used. Baseline lower pain severity was associated with MO resolution (OR [95%]:0.236[0.054–0.975]; p = 0.049). Conclusions In real-life anti-CGRP MAbs are as effective in CM patients with MO as in patients without it and facilitate MO cessation. Reduction in headache frequency and acute medication days/month occurs regardless of whether patients stop overusing or not.

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