scholarly journals Medication Overuse Headache in a Patient with Myasthenia Gravis: a Case Report on Successful Intervention by an Acupuncturist

2021 ◽  
Author(s):  
Matsuura Yuto ◽  
Shoko Izaki ◽  
Tomokazu Kikuchi ◽  
Satoru Yamaguchi
Keyword(s):  
Case Report ◽  
Myasthenia Gravis ◽  
Potential Role ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Over The Counter ◽  
Headache Management ◽  
Medical Care Team ◽  
Attending Physician

In this case of medication overuse headache in a patient with myasthenia gravis, an acupuncturist identified the use of an over-the-counter analgesic that was not revealed to the attending physician. This case highlights the potential role of an acupuncturist as part of the medical care team involved in headache management.

Involvement of Corticotrophin-Releasing Factor and Orexin-A in Chronic Migraine and Medication-Overuse Headache: Findings From Cerebrospinal Fluid

Cephalalgia ◽  
2008 ◽  
Vol 28 (7) ◽  
pp. 714-722 ◽  
Author(s):  
P Sarchielli ◽  
I Rainero ◽  
F Coppola ◽  
C Rossi ◽  
ML Mancini ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Potential Role ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Orexin A ◽  
Compensatory Response ◽  
Corticotrophin Releasing Factor ◽  
Response To Stress ◽  
The Brain

The study set out to investigate the role of corticotrophin-releasing factor (CRF) and orexin-A in chronic migraine (CM) and medication-overuse headache (MOH). Twenty-seven patients affected by CM and 30 with MOH were enrolled. Control CSF specimens were obtained from 20 age-matched subjects who underwent lumbar puncture for diagnostic purposes, and in all of them CSF and blood tests excluded central nervous system or systemic diseases. Orexin-A and CRF were determined by radioimmunoassay methods. Significantly higher levels of orexin-A and CRF were found in the CSF of MOH and to a lesser extent in patients with CM compared with control subjects (orexin-A: P < 0.001 and P < 0.02; CRF: P < 0.002 and P < 0.0003). A significant positive correlation was also found between CSF orexin-A values and those of CRF ( R = 0.71; P < 0.0008), monthly drug intake group ( R = 0.39; P < 0.03) and scores of a self-completion 10-item instrument to measure dependence upon a variety of substances, the Leeds Dependence Questionnaire (LDQ) in the MOH group ( R = 0.68; P < 0.0003). The significantly higher orexin-A levels found in CM and MOH can be interpreted as a compensatory response to chronic head pain or, alternatively, as an expression of hypothalamic response to stress due to chronic pain. A potential role for orexin-A in driving drug seeking in MOH patients through activation of stress pathways in the brain can also be hypothesized.

scholarly journals The role of psychological interventions in chronic headache management: a case report

2017 ◽  
Vol 11 (1) ◽  
Author(s):  
Rosario Iannacchero ◽  
Alessandra Sansalone ◽  
Amerigo Costa ◽  
Ermanno Pisani ◽  
Antonio Siniscalchi
Keyword(s):  
Chronic Headache ◽  
Biopsychosocial Model ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Psychosocial Interventions ◽  
Health Condition ◽  
Psychological Interventions ◽  
Headache Patient ◽  
Headache Management

According to the biopsychosocial model, biological, psychological, and social factors entwine and influence each other bi-directionally concerning health conditions. Therefore, especially in disorders such as chronic headache, where behavioral and environmental factors are prominent risk factors and triggers, psychosocial interventions might contribute to reduce the burden of the health condition and related affective disorders and disability.We present the case of a Medication Overuse Headache patient self-reporting psychosocial and cognitive issues, that prompted further clinical-psychological and neuro-cognitive assessment and eventually psychological interventions targeted at headache management in conjunction with medical treatment. Psychological interventions were tailored to the patient’s features and presentation and were successful in reducing headache attacks in terms of intensity, frequency, and debilitation, thereby resulting also in a better perceived general health.

Potential role of thymoma and other mediastinal tumors in the pathogenesis of myasthenia gravis

1993 ◽  
Vol 44 (2) ◽  
pp. 171-176 ◽  
Author(s):  
Makoto Matsui ◽  
Hiromi Wada ◽  
Mitsuhiro Ohta ◽  
Yasuo Kuroda
Keyword(s):  
Myasthenia Gravis ◽  
Potential Role ◽  
Mediastinal Tumors

scholarly journals The potential role of HER 2 upregulation in metastatic breast cancer to the uterus: a case report

2016 ◽  
Vol 4 (10) ◽  
pp. 928-934 ◽  
Author(s):  
Melissa Y. Y. Moey ◽  
Omer A. Hassan ◽  
Christos N. Papageorgiou ◽  
Stephanie L. Schnepp ◽  
John T. Hoff
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Case Report ◽  
Potential Role ◽  
Metastatic Breast ◽  
Her 2

scholarly journals Potential role of post‑treatment follow‑up FDG‑PET CT to detect mandibular osteoradionecrosis: A case report

2017 ◽  
Author(s):  
Masaya Akashi ◽  
Satoshi Wanifuchi ◽  
Junya Kusumoto ◽  
Megumi Kishimoto ◽  
Yasumasa Kakei ◽  
...  
Keyword(s):  
Case Report ◽  
Fdg Pet ◽  
Potential Role ◽  
Post Treatment ◽  
Pet Ct ◽  
Fdg Pet Ct

scholarly journals Pathophysiology of medication overuse headache: Insights and hypotheses from preclinical studies

Cephalalgia ◽  
2011 ◽  
Vol 31 (7) ◽  
pp. 851-860 ◽  
Author(s):  
Ian D Meng ◽  
David Dodick ◽  
Michael H Ossipov ◽  
Frank Porreca
Keyword(s):  
Migraine Headache ◽  
Potential Role ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Ergot Alkaloids ◽  
Opioid Analgesics ◽  
Primary Headache ◽  
Frequent Use ◽  
Underlying Mechanisms ◽  
Pain Inhibition

Introduction: Medication overuse headache (MOH) is a clinical concern in the management of migraine headache. MOH arises from the frequent use of medications used for the treatment of a primary headache. Medications that can cause MOH include opioid analgesics as well as formulations designed for the treatment of migraine, such as triptans, ergot alkaloids, or drug combinations that include caffeine and barbiturates. Literature review: Gathering evidence indicates that migraine patients are more susceptible to development of MOH, and that prolonged use of these medications increases the prognosis for development of chronic migraine, leading to the suggestion that similar underlying mechanisms may drive both migraine headache and MOH. In this review, we examine the link between several mechanisms that have been linked to migraine headache and a potential role in MOH. For example, cortical spreading depression (CSD), associated with migraine development, is increased in frequency with prolonged use of topiramate or paracetamol. Conclusions: Increased CGRP levels in the blood have been linked to migraine and elevated CGRP can be casued by prolonged sumatriptan exposure. Possible mechanisms that may be common to both migraine and MOH include increased endogenous facilitation of pain and/or diminished diminished endogenous pain inhibition. Neuroanatomical pathways mediating these effects are examined.

Psychiatric Comorbidity in the Evolution From Migraine to Medication Overuse Headache

Cephalalgia ◽  
2005 ◽  
Vol 25 (7) ◽  
pp. 519-522 ◽  
Author(s):  
F Radat ◽  
C Creac'h ◽  
JD Swendsen ◽  
M Lafittau ◽  
S Irachabal ◽  
...  
Keyword(s):  
Psychiatric Disorders ◽  
Odds Ratio ◽  
Psychiatric Comorbidity ◽  
Medication Overuse ◽  
Medication Overuse Headache ◽  
Anxiety And Depression ◽  
Psychoactive Substances ◽  
Addictive Disorders ◽  
Substance Related Disorders

We set out to study the role of psychiatric comorbidity in the evolution of migraine to medication overuse headache (MOH) by a comparative study of 41 migraineurs (MIG) and 41 patients suffering from MOH deriving from migraine. There was an excess risk of suffering from mood disorders [odds ratio (OR) = 4.5, 95% confidence interval (CI) 1.5, 13.5], anxiety (OR = 5, 95% CI 1.2, 10.7) and disorders associated with the use of psychoactive substances other than analgesics (OR = 7.6, 95% CI 2.2, 26.0) in MOH compared with MIG. Retrospective study of the order of occurrence of disorders showed that in the MOH group, psychiatric disorders occurred significantly more often before the transformation from migraine into MOH than after. There was no crossed-family transmission between MOH and psychiatric disorders, except for substance-related disorders. MOH patients have a greater risk of suffering from anxiety and depression, and these disorders may be a risk factor for the evolution of migraine into MOH. Moreover, MOH patients have a greater risk of suffering from substance-related disorders than MIG sufferers. This could be due to the fact that MOH is part of the spectrum of addictive disorders.

scholarly journals Case Report: Dual nebulised antibiotics among adults with cystic fibrosis and chronic Pseudomonas infection

F1000Research ◽  
2017 ◽  
Vol 6 ◽  
pp. 2079
Author(s):  
Nina Mann ◽  
Shirley Murray ◽  
Zhe Hui Hoo ◽  
Rachael Curley ◽  
Martin J. Wildman
Keyword(s):  
Cystic Fibrosis ◽  
Case Report ◽  
Adverse Effects ◽  
Best Practice ◽  
Potential Role ◽  
Concomitant Administration ◽  
Intravenous Antibiotics ◽  
Inhaled Antibiotics ◽  
Pseudomonas Infection

Pulmonary exacerbations in adults with cystic fibrosis (CF) and chronic Pseudomonas aeruginosa (Psae) infection are usually treated with dual intravenous antibiotics for 14 days, despite the lack of evidence for best practice. Intravenous antibiotics are commonly associated with various systemic adverse effects, including renal failure and ototoxicity. Inhaled antibiotics are less likely to cause systematic adverse effects, yet can achieve airway concentrations well above conventional minimum inhibitory concentrations. Typically one inhaled antibiotic is used at a time, but dual inhaled antibiotics (i.e. concomitant use of two different inhaled antibiotics) may have synergistic effect and achieve better results in the treatment of exacerbations. We presented anecdotal evidence for the use of dual inhaled antibiotics as an acute treatment for exacerbations, in the form of a case report. A female in her early thirties with CF and chronic Psae infection improved her FEV1 by 5% and 2% with two courses of dual inhaled antibiotics to treat exacerbations in 2016. In contrast, her FEV1 changed by 2%, –2%, 0% and 2%, respectively, with four courses of dual intravenous antibiotics in 2016. Baseline FEV1 was similar prior to all six courses of treatments. The greater FEV1 improvements with dual inhaled antibiotics compared to dual intravenous antibiotics suggest the potential role of using dual inhaled antibiotics to treat exacerbations among adults with CF and chronic Psae infection, especially since a greater choice of inhaled anti-pseudomonal antibiotics is now available. A previous study in 1985 has looked at the concomitant administration of inhaled tobramycin and carbenicillin, by reconstituting antibiotics designed for parenteral administration. To our knowledge, this is the first literature to describe the concomitant use of two different antibiotics specifically developed for delivery via the inhaled route.

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