scholarly journals Migraine headaches in a nutshell

2017 ◽  
Vol 59 (2) ◽  
pp. 12-14
Author(s):  
Natalie Schellack ◽  
O Mogole ◽  
N Magongwa ◽  
F Makola
Keyword(s):  
Neurological Disorder ◽  
Migraine Headache ◽  
Nausea And Vomiting ◽  
Migraine Headaches ◽  
Prophylactic Measures ◽  
Abortive Treatment ◽  
Acute Attacks ◽  
High Level ◽  
Classification Management ◽  
Severe Migraine

This article aims to provide a concise, high-level overview of the classification, management and treatment of migraine. Migraine is a common, debilitating neurological disorder that is characterised by the presence of severe headaches, which may last anything from a few hours to a few days (4–72 hours). Thus, the condition is characterised by episodes of severe migraine headache, frequently accompanied by nausea and vomiting. These headaches may be unilateral or bilateral, and patients may also experience a range of associated features. Acute attacks require rapid, abortive treatment and the rate of recurrence needs to be reduced and managed using effective prophylactic measures.

Migraine Abortive Treatment in Children and Adolescents in Israel

2021 ◽  
Author(s):  
Jacob Genizi ◽  
Dana Lahoud ◽  
Rony Cohen
Keyword(s):  
Children And Adolescents ◽  
Migraine Attack ◽  
Migraine Headache ◽  
Pediatric Population ◽  
Improvement Rate ◽  
Pediatric Neurology ◽  
Migraine Headaches ◽  
Headache Episode ◽  
Neurology Clinic ◽  
Abortive Treatment

Abstract Migraine headaches in children may cause attacks that require abortive treatment. This study evaluated the incidence and efficacy of medications used for relieving migraine headache attacks in the pediatric population in Israel. Children 6–18 years of age who were diagnosed in our pediatric neurology clinic as having migraine headaches were enrolled into the study. Children and their parents recorded the children response to abortive treatment during three consecutive migraine attacks. Fifty children, with 116 migraine attacks, were included in the study (30 females; mean age 12; range 6–18). Forty-seven (94%) reported on abortive treatment on the first migraine attack, 43 (86%) on a second migraine attack and 26 (52%) on a third migraine attack. During the first recorded migraine attack, 41 children (87.5%) reported taking only one type of medication for each headache episode, mainly ibuprofen or acetaminophen; less than a quarter used dipyrone. The improvement rate after two hours was 65.4%±27 for ibuprofen, 59.8±35.3 for acetaminophen and 50.9±27.4 for dipyrone. In conclusion, Children with migraine in Israel mainly use a single medication for each headache episode. Ibuprofen is the most commonly used abortive treatment; however, acetaminophen was associated with a better response.

scholarly journals Intravenous caffeine versus intravenous ketorolac for the management of moderate to severe migraine headache

2016 ◽  
Vol 11 (2) ◽  
pp. 428 ◽  
Author(s):  
Alireza Baratloo ◽  
Sara Arab Bafarani ◽  
Mohammad Mehdi Forouzanfar ◽  
Behrooz Hashemi ◽  
Benjamin Wolkin Friedman ◽  
...  
Keyword(s):  
Pain Score ◽  
Migraine Headache ◽  
Double Blind Study ◽  
First Line ◽  
Therapeutic Success ◽  
Double Blind ◽  
Migraine Headaches ◽  
Caffeine Citrate ◽  
Severe Migraine ◽  
Intravenous Ketorolac

<p class="Abstract">The aim of this study was to determine if intravenous caffeine is as effective as intravenous ketorolac for the treatment of moderate to severe migraine headaches. Eligible patients randomly received 60 mg caffeine citrate or 60 mg ketorolac infused intravenously. Their pain score were measured at baseline, one hour and two hours after infusion. Therapeutic success was defined as decreasing of at least 3 points on the pain score. In total 110 patients were enrolled (75.5% women). Therapeutic success after 60 min was achieved by 63.6% of patients in the caffeine and 70.1% of patients in the ketorolac group (p = 0.23). After 120 min, 87.3% of the caffeine group and 83.6% of the ketorolac group achieved therapeutic success (p = 0.49). In this multi-center, randomized double blind study, intravenous caffeine was as effective as intravenous ketorolac for first line abortive management of acute migraine.</p><p> </p>

scholarly journals Migraine headaches triggered by palpation of chronic facial folliculitis: a peripheral and central interaction in migraine

2020 ◽  
Author(s):  
Zi-Ru Deng ◽  
Han-Li Li ◽  
Juan Zhang ◽  
Qi-Bing Sun ◽  
Xin Chen ◽  
...  
Keyword(s):  
Effective Treatment ◽  
Migraine Headache ◽  
Case Reports ◽  
Migraine Headaches ◽  
Central Interaction ◽  
Regional Area ◽  
Underlying Mechanisms ◽  
Severe Migraine ◽  
New Onset

Abstract Objective To report a case of severe migraine without aura (MwoA) headaches triggered by palpation of the folliculitis around a unilateral nosewing and the folliculitis was chronic before effective treatment for migraine, and to discuss its underlying mechanisms. Background Multiple studies have shown that peripheral mechanisms may be involved in migraine generation and there are few case reports supporting this speculation. But a clinical case demonstrating a reciprocal action between migraine headache and peripheral pathology has never been reported. Methods A case of new onset migraine headache triggered by palpation of the regional facial folliculitis which was chronic but responsive to an effective treatment for migraine was reported. We briefly reviewed the peripheral mechanisms of migraine and the reciprocal action between migraine headache and peripheral pathology. Results A 45-year-old man with chronic folliculitis around the left nosewing of which palpation, each time, would trigger an episode of headache fulfilling the criteria for MwoA by the International Classification of Headache Disorders 3rd edition (ICHD-3). And the episode of headache would be solely triggered by palpating the facial folliculitis. His chronic folliculitis around the left nosewing did not relieve after treatment with only antibiotics but resolved in the setting of no triggered migraine headache after treatment with sodium valproate. Conclusions In the setting of chronic facial folliculitis, palpating regional area can trigger migraine headache, and in particular, resolution of the chronic facial folliculitis was associated with effective therapy for migraine. This indicates that there is a peripheral and central interaction associated with neurogenic immunomodulation in migraine.

Premorbid migraine history as a risk factor for vestibular and oculomotor baseline concussion assessment in pediatric athletes

2019 ◽  
Vol 23 (4) ◽  
pp. 465-470 ◽  
Author(s):  
Ryan N. Moran ◽  
Tracey Covassin ◽  
Jessica Wallace
Keyword(s):  
Risk Factor ◽  
Smooth Pursuit ◽  
Migraine Headache ◽  
Visual Motion ◽  
Assessment Tools ◽  
Motion Sensitivity ◽  
Ocular Reflex ◽  
Migraine Headaches ◽  
Vestibular Ocular Reflex ◽  
History Of

OBJECTIVEMigraine history has recently been identified as a risk factor for concussion and recovery. The authors performed a cross-sectional study examining baseline outcome measures on newly developed and implemented concussion assessment tools in pediatrics. The purpose of this study was to examine the effects of premorbid, diagnosed migraine headaches as a risk factor on vestibular and oculomotor baseline assessment in pediatric athletes.METHODSPediatric athletes between the ages of 8 and 14 years with a diagnosed history of migraine headache (n = 28) and matched controls without a history of diagnosed migraine headache (n = 28) were administered a baseline concussion assessment battery, consisting of the Vestibular/Ocular Motor Screening (VOMS), near point of convergence (NPC), and the King-Devick (K-D) tests. Between-groups comparisons were performed for vestibular symptoms and provocation scores on the VOMS (smooth pursuit, saccades, convergence, vestibular/ocular reflex, visual motion sensitivity), NPC (average distance), and K-D (time).RESULTSIndividuals diagnosed with migraine headaches reported greater VOMS smooth pursuit scores (p = 0.02), convergence scores (p = 0.04), vestibular ocular reflex scores (p value range 0.002–0.04), and visual motion sensitivity scores (p = 0.009). Differences were also observed on K-D oculomotor performance with worse times in those diagnosed with migraine headache (p = 0.02). No differences were reported on NPC distance (p = 0.06) or headache symptom reporting (p = 0.07) prior to the VOMS assessment.CONCLUSIONSPediatric athletes diagnosed with migraine headaches reported higher baseline symptom provocation scores on the VOMS. Athletes with migraine headaches also performed worse on the K-D test, further illustrating the influence of premorbid migraine headaches as a risk factor for elevated concussion assessment outcomes at baseline. Special consideration may be warranted for post-concussion assessment in athletes with migraine headaches.

scholarly journals Effect of galcanezumab on severity and symptoms of migraine in phase 3 trials in patients with episodic or chronic migraine

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Michael Ament ◽  
Kathleen Day ◽  
Virginia L Stauffer ◽  
Vladimir Skljarevski ◽  
Mallikarjuna Rettiganti ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Migraine Headache ◽  
Randomized Clinical Trials ◽  
Episodic Migraine ◽  
Double Blind Study ◽  
Double Blind ◽  
Prodromal Symptoms ◽  
Link Type ◽  
Associated Symptoms ◽  
Severe Migraine

Abstract Background Galcanezumab, a humanized monoclonal antibody that binds calcitonin gene-related peptide, has demonstrated a significant reduction in monthly migraine headache days compared with placebo. Here, we analyze data from 3 randomized clinical trials (2 episodic trials [EVOLVE-1, EVOLVE-2] and 1 chronic trial [REGAIN]), to examine if galcanezumab also alleviates the severity and symptoms of migraine. Methods The episodic migraine trials were 6-month, double-blind studies in patients with episodic migraine (4–14 monthly migraine headache days). The chronic migraine trial was a 3-month, double-blind study in patients with chronic migraine (≥ 15 headache days per month, where ≥ 8 met criteria for migraine). Patients (18–65 years) were randomized to placebo or galcanezumab 120 mg with a 240-mg loading dose or 240 mg. Patients recorded headache characteristics, duration, severity, and presence of associated symptoms with each headache. The outcomes analyzed were changes from baseline in number of monthly migraine headache days with nausea and/or vomiting, photophobia and phonophobia, aura, and prodromal symptoms other than aura. Additional outcomes analyzed included the number of moderate-to-severe monthly migraine headache days, number of severe migraine headache days, and mean severity of remaining migraine headache days. Change from baseline in the proportion of days with nausea and/or vomiting and the proportion of days with photophobia and phonophobia among the remaining monthly migraine headache days were also analyzed. Results Galcanezumab was superior to placebo in reducing the frequency of migraine headache days with associated symptoms of migraine such as nausea and/or vomiting, photophobia and phonophobia, and prodromal symptoms. Galcanezumab reduced the frequency of migraine headache days with aura in the episodic migraine studies. There was a significant reduction in the proportion of remaining migraine headache days with nausea and/or vomiting for the episodic and chronic migraine studies, and with photophobia and phonophobia for the episodic migraine studies. Galcanezumab was superior to placebo in reducing the number of monthly moderate-to-severe migraine headache days and the overall and monthly severe migraine headache days. Conclusions Galcanezumab reduces the frequency of migraine headache days and can alleviate potentially disabling non-pain symptoms on days when migraine is present in patients with episodic or chronic migraine. Trial registration NCT, NCT02614183 (EVOLVE-1), registered 25 November 2015; NCT, NCT02614196, (EVOLVE-2), registered 25 November 2015; NCT, NCT02614261 (REGAIN), registered 25 November 2015.

scholarly journals The Public’s Perception of Interventions for Migraine Headache Disorders: A Crowdsourcing Population-Based Study

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Orr Shauly ◽  
Daniel J Gould ◽  
Ketan M Patel
Keyword(s):  
Migraine Headache ◽  
Treatment Options ◽  
The United States ◽  
Cost Of Care ◽  
Adverse Outcomes ◽  
Amazon Mechanical Turk ◽  
Cross Sectional ◽  
Economic Productivity ◽  
Migraine Headaches ◽  
Patient Reported

Abstract Background Migraine disorders are a leading cause of morbidity and decreased economic productivity in the United States among both men and women. As such, it is important to consider patient opinions, and have an accurate representation of the burden and sentiment toward currently available interventions among those suffering from migraines. Objectives The aim of the study was to assess patient options regarding adverse outcomes of the various treatment options available for migraine headaches. Methods A prospective cross-sectional study of volunteers recruited through an internet crowdsourcing service, Amazon Mechanical Turk©, was conducted. Surveys were administered to collect patient-reported opinions regarding adverse outcomes of both surgical and nonsurgical treatment options for migraine headaches. Results The prevalence of migraine headache across all study participants was 15.6% and varied slightly across participant demographics. Individuals ages 35–44 (2.73 migraines per month) experienced the fewest migraine and with the lowest severity. Those individuals ages 45+ experienced the most severe headaches (Visual Analog Scale = 44.23 mm). Additionally, the greatest migraine frequency and severity existed among those households with yearly income of $75,000–$100,000. The lowest injection therapy utility scores were obtained for adverse outcomes of hematoma (47.60 mm) and vertigo (54.40 mm). Conclusions Migraine headaches remains a significant problem among the US population, with an overall prevalence of 15.6% (approximately 50 million Americans). Additionally, physicians interesting in offering minimally invasive or surgical treatment for migraine headaches should focus on mitigating patient fears regarding clinical outcomes and cost of care.

scholarly journals Comparison of efficacy and safety of three drugs levetiracetam, sodium valproate, and nortriptyline in the prevention of migraine headache

2020 ◽  
pp. 336-343
Keyword(s):  
Sodium Valproate ◽  
Severe Headache ◽  
Migraine Treatment ◽  
Chi Square ◽  
Migraine Headaches ◽  
Neurology Clinic ◽  
Quasi Experimental ◽  
The Mean ◽  
Acute Attacks ◽  
Mild Headache

Background and Aim: Headache is the most common cause of referral to a physician. Two approaches of the migraine treatment include: treat the acute attacks and prevent future attacks. In this regard, the aim of this study was to investigate the effect of three drugs lutiracetam, sodium valproate and nortriptyline in the control of migraine headaches in patients with migraine in Birjand Neurology Clinic. Materials and Methods: This study is a quasi-experimental study. According to the physician, 120 migraine patients were divided into one of three groups: Lutiracetam with a daily dose of 250 mg, sodium valproate 500 mg and nortriptyline 25 mg for 4 weeks. Patientschr('39') information was collected through a questionnaire. Then the data were analyzed by SPSS) Version 16) software by using chi-square, paired t-test, and ANOVA. Results: 120 patients were divided into three groups of 40 patients. The mean age of the subjects was 33±11 years, 53.3% of them were female and 46.7% of them were male. In total, 46.7% of patients had severe headache before taking these three drugs. None of them had severe headache after taking the drug and 77.5% of them had mild headache. Lutiracetam group showed the greatest decrease in headache intensity. (P=0.01). Conclusion: Levetiracetam appears to be more effective than the other two drugs, especially sodium valproate, in reducing different degrees of headache.

scholarly journals Recurrent headache and migraine within the family

Genetika ◽  
2011 ◽  
Vol 43 (1) ◽  
pp. 101-112
Author(s):  
Marija Knezevic-Pogancev
Keyword(s):  
Ethnic Groups ◽  
Clinical Picture ◽  
Migraine Headache ◽  
Nuclear Family ◽  
Family Data ◽  
Northern Province ◽  
Place Of Birth ◽  
Recurrent Headache ◽  
Migraine Headaches ◽  
The Family

The aim of this research was to determine risk for family appearance of the recurrent headache (non-migraine and migraine). The recurrent headache can be understood as being a heterogeneous state, consisting of some more, still not found, hereditary disposition factors which altogether, interacting with surrounding factors give the recognizable clinical picture. The current heredity concept suggests multifactor heredity. The research was conducted in Vojvodina, the Northern Province of Serbia. The population of Vojvodina is around 2 million people belonging to more than 20 different ethnic groups. During the 20 years period (1988-2008), 30363 children aged 3 to 17 years were tested, independent of the place of birth. The presence of headaches similar to those tested was compared among all the members of the family within three generations. Positive family data of the recurrent headaches was detected among 98,6% children with migraine headaches, 64,7% children with non- migraine headaches, and 32,4% children without recurrent headaches. The relation among the members of the nuclear family (contingency quotient of 0,429) is significantly stronger than the relation to the members of wider family (contingency quotient of 0,338). The probability of a child having the migraine headache, and not the non-migraine one, is 0,664 for a mother, 0,644 for a father, 0,411 for a father`s mother, - 0,175 for a mother`s mother, 0,165 for a mother`s father, and - 0,102 for a father`s father having similar recurrent headaches.

scholarly journals Associations between adherence to MIND diet and severity, duration and frequency of migraine headaches among migraine patients

2020 ◽  
Author(s):  
Moein Askarpour ◽  
Habib yarizadeh ◽  
Ali Sheikhi ◽  
Faezeh Khorsha ◽  
Khadijeh Mirzaei
Keyword(s):  
Neurological Disorder ◽  
Lower Score ◽  
Migraine Headaches ◽  
Unbearable Pain ◽  
Diet Score ◽  
Mind Diet

Abstract Objectives: Migraine is a neurological disorder causing unbearable pain. Dietary approach is proposed as a preventive way of reducing the severity of migraine headaches. The present study aimed to examine the association between MIND diet and migraine headaches.Results: We found that participants with higher score of MIND diet compared to those with lower score, were less likely to have severe headaches (OR= 0.67; 95% CI: 0.43, 0.94; P= 0.01). Moreover, our results showed an inversed correlation between mind diet score and duration (β= -0.15, 95% CI: -1.44, -0.11, P=0.02) and frequency of headaches (β= -0.12, 95% CI: -0.96, -0.02, P= 0.04).

scholarly journals Multi gene panel testing for hereditary breast cancer - is it ready to be used?

2019 ◽  
Author(s):  
Andreea Catana ◽  
Adina Patricia Apostu ◽  
Razvan-Geo Antemie
Keyword(s):  
Breast Cancer ◽  
Hereditary Breast Cancer ◽  
Gene Panel ◽  
Variants Of Uncertain Significance ◽  
Panel Testing ◽  
Brca Genes ◽  
Prophylactic Measures ◽  
Gene Panel Testing ◽  
Uncertain Significance ◽  
High Level

Breast cancer is one of the most common malignancies and the leading cause of death among women worldwide. About 20% of breast cancers are hereditary. Approximately 30% of the mutations have remained negative after testing BRCA1/2 even in families with a Mendelian inheritance pattern for breast cancer. Additional non-BRCA genes have been identified as predisposing for breast cancer. Multi gene panel testing tries to cover and explain the BRCA negative inherited breast cancer, improving efficiency, speed and costs of the breast cancer screening. We identified 23 studies reporting results from individuals who have undergone multi gene panel testing for hereditary breast cancer and noticed a prevalence of 1-12% of non-BRCA genes, but also a high level of variants of uncertain significance. A result with a high level of variants of uncertain significance is likely to be more costly than bring benefits, as well as increase the anxiety for patients. Regarding further development of multi gene panel testing, more research is required to establish both the optimal care of patients with cancer (specific treatments like PARP inhibitors) and the management of unaffected individuals (chemoprevention and/or prophylactic surgeries). Early detection in these patients as well as prophylactic measures will significantly increase the chance of survival. Therefore, multi gene panel testing is not yet ready to be used outside clear guidelines. In conclusion, studies on additional cohorts will be needed to better define the real prevalence, penetrance and the variants of these genes, as well as to describe clear evidence-based guidelines for these patients. 

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