The role of K-channels in the formation of a nociceptive signal in the rat trigeminal nerve

The central problem of this work is to elucidate the mechanisms of pain in migraine and to establish the role of Kv channels in regulating the excitability of meningeal afferents of the trigeminal nerve that form a pain signal in migraine. The study was conducted on a preparation of an isolated rat skull. It was found that Kv-channel inhibitors 4-aminopyridine (100 microns and 1 mM) and tetraethylammonium (5mm) lead to an increase in the excitability of trigeminal nerve afferents, at the same time, this effect was partially removed by a nonsteroidal anti–inflammatory agent - naproxen, and was not sensitive to sumatriptan, a classic anti-migraine drug. Key words: migraine, K-channels, trigeminal nerve, 4-aminopyridine, tetraethylammonium, naproxen, sumatriptan.

The effect of temperature on the activity of the trigeminal nerve in the rat meningeal sheath

Migraine is a debilitating neurological disorder that affects approximately 1 billion people worldwide. It is known that migraine is associated with the activity of the trigeminal nerve, therefore, many studies are aimed at studying changes in the activity of the meningeal nerve fibers. It is known that inflammatory processes accompanied by temperature rise are often accompanied by headaches. Therefore, we investigated the effect of temperature increase on trigeminal nerve activity. It turned out that temperature increase leads to a significant increase in the frequency of action potentials in the trigeminal nerve. Key words: migraine, trigeminal nerve, cluster analysis, action potential.

Effect of Maternal Migraine during Gestation and Delivery Outcomes

Background: Migraine is defined as a condition accompanied with head ache, nausea, visual and sound sensitivity. Objective: To determine the effect of migraine on maternal and neonatal health. Study Design: Case control study Place and Duration of Study: Department of Obstetrics & Gynaecology, Sandeman Provincial Hospital, Quetta from 1st August 2018 to 31st August 2021. Methodology: One hundred pregnant women divided into migraine and non-migraine groups were enrolled. Both groups were assessed for their sociodemographic, clinical and biochemical status. Their information was documented. Results: Group I females were above 36 years of age and were in their first trimester. There were 56% women who did not presented visual aura. More irritability, pre-term labour and preeclampsia, risk of C section and hypertension was noticed in group I than Group II. Conclusion: Migraine is linked with higher risk of hypertension, preeclampsia, C section and low birth weight new born. Key words: Migraine, Pregnancy, Low birth weight

Headache

Headaches are one of the most common complaints of patients seen by emergency physicians. They can be classified as primary headaches, which have no identifiable underlying cause, and secondary headaches, which are classified according to their cause. The majority of headaches are benign in origin, and most patients with headache can be treated successfully in the emergency department and discharged home; however, some have potentially life-threatening causes, and consideration of a broad differential diagnosis for all patients is essential. This review covers the primary headache disorders, pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes. The figure shows areas of the brain sensitive to pain. Tables review differential diagnosis of headache, International Headache Society primary headache criteria, clinical characteristics of secondary headaches, high-risk clinical characteristics among patients with a headache peaking in intensity within 1 hour, drugs associated with headache, and parenteral treatment of acute migraine. This review contains 1 figure, 9 tables, and 58 references. Key words: migraine, calcitonin gene related peptide, greater occipital nerve block, venous sinus thrombosis, reversible cerebral vasoconstriction syndrome, Ottawa, subarachnoid, cluster headache, trigeminal autonomic cephalalgias, post-traumatic headache

Headache

Headaches are one of the most common complaints of patients seen by emergency physicians. They can be classified as primary headaches, which have no identifiable underlying cause, and secondary headaches, which are classified according to their cause. The majority of headaches are benign in origin, and most patients with headache can be treated successfully in the emergency department and discharged home; however, some have potentially life-threatening causes, and consideration of a broad differential diagnosis for all patients is essential. This review covers the primary headache disorders, pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes. The figure shows areas of the brain sensitive to pain. Tables review differential diagnosis of headache, International Headache Society primary headache criteria, clinical characteristics of secondary headaches, high-risk clinical characteristics among patients with a headache peaking in intensity within 1 hour, drugs associated with headache, and parenteral treatment of acute migraine. This review contains 1 figure, 9 tables, and 58 references. Key words: migraine, calcitonin gene related peptide, greater occipital nerve block, venous sinus thrombosis, reversible cerebral vasoconstriction syndrome, Ottawa, subarachnoid, cluster headache, trigeminal autonomic cephalalgias, post-traumatic headache

Headache

Headaches are one of the most common complaints of patients seen by emergency physicians. They can be classified as primary headaches, which have no identifiable underlying cause, and secondary headaches, which are classified according to their cause. The majority of headaches are benign in origin, and most patients with headache can be treated successfully in the emergency department and discharged home; however, some have potentially life-threatening causes, and consideration of a broad differential diagnosis for all patients is essential. This review covers the primary headache disorders, pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes. The figure shows areas of the brain sensitive to pain. Tables review differential diagnosis of headache, International Headache Society primary headache criteria, clinical characteristics of secondary headaches, high-risk clinical characteristics among patients with a headache peaking in intensity within 1 hour, drugs associated with headache, and parenteral treatment of acute migraine. This review contains 1 figure, 9 tables, and 58 references. Key words: migraine, calcitonin gene related peptide, greater occipital nerve block, venous sinus thrombosis, reversible cerebral vasoconstriction syndrome, Ottawa, subarachnoid, cluster headache, trigeminal autonomic cephalalgias, post-traumatic headache

Subjective Cognitive Symptoms During a Migraine Attack: A Prospective Study of a Clinic-Based Sample

Background: A migraine attack aggregates a range of different symptoms, besides pain, that contribute to attack-related disability. Cognitive dysfunction is an unacknowledged part of the migraine attack. Objective: To provide a profile of the frequency and character of migraine attack-related cognitive symptoms occurring during the headache phase of the attack. Study Design: Cross-sectional survey. Setting: Clinical-based sample of episodic migraine patients. Methods: Sequential patients were screened about the occurrence of cognitive symptoms during migraine attacks using an open-ended question followed by a self-fulfilled symptom checklist. Results: Of 165 migraine patients (15 men, age average 37.3 ± 10.7 years), 89.7% described cognitive symptoms during the headache phase of the migraine attack. On average 2.5 ± 1.6 symptoms were reported per patient, uninfluenced by demographic or disease-related variables. The most common spontaneous symptoms related to executive functions, such as poor ability to concentrate (37%), difficulty in reasoning (25%), and thinking (23%). The pattern of responses on the symptoms checklist corroborated with those reported spontaneously and quantitative scores of the checklist were higher in patients with spontaneous symptoms. Limitations: Open-ended questions tend to overestimate frequency; data accuracy may be influenced by the population chosen (clinical-based, some using prophylactic treatment). Conclusions: This study detailed the frequency and characteristics of migraine attackrelated subjective cognitive symptoms and found its frequency to be similar to reports of other migraine defining symptoms (ex. nausea, photophobia) in recent clinical series. Patients’ reports were consistent and dominated by complaints of attention difficulties, diminished cognitive efficiency, and processing speed impairment. Key Words: Migraine, cognitive symptoms, executive dysfunction, disease impact

Peripheral Nerve Stimulation for the Treatment of Chronic Intractable Headaches: Long-term Efficacy and Safety Study

Background: Despite the various modalities available for treating headaches, typical therapy does not provide adequate pain relief for some patients. Objectives: This study explored the efficacy and safety of long-term peripheral nerve stimulation (PNS) for intractable chronic headaches. Study Design: Retrospective study of refractory headache patients at academic pain center. Methods: The medical records of all patients (N = 46) permanently implanted with PNS between January 2005 and January 2012 were reviewed retrospectively. Patient records and phone interviews were used to quantify the levels of pain intensity, headache days per month, and overall patient satisfaction with treatment. The correlation between headache duration and effectiveness of PNS was also assessed. Results: Pain intensity on the 11-point Numeric Rating Scale decreased from 7.60 ± 1.73 before implantation to 3.78 ± 2.41, 3.32 ± 2.67, 3.42 ± 2.74, and 2.04 ± 2.27 at one, 6, 12, and > 12 (19 – 98) months after implantation, respectively (P < .001). The mean number of headache days per month decreased by about 14 days from the base line. No correlation (r = -.33) was found between the number of years the patients had suffered from headaches and the efficacy of treatment. Limitations: Due to the limitation of a retrospective study, the data collected via chart reviews and phone interviews are susceptible to selection and information biases. Conclusions: PNS is an effective modality in the long-term management of intractable chronic headaches. Despite long histories of chronic headaches, the majority of patients had significant reductions in pain scores and the number of headache days per month. The outcomes were not dependent on the number of years the patients had suffered from headaches before PNS treatment. Key Words: Migraine headache, refractory headache, chronic daily headache, occipital neuralgia, cluster headache, hemicranias continua, refractory headache, occipital nerve stimulation, peripheral nerve stimulation

Cognitive impairment in migraine:A systematic review

ABSTRACT Patients with migraine often report cognitive complaints, especially regarding attention and memory. Objective: To perform a systematic review of the studies available on cognitive evaluation in patients with migraine. Methods: We evaluated all articles containing the key words: "Migraine", "Cognition" and "Cognitive Impairment." Results: The search strategy resulted in 23 articles. Fifteen out of the 23 studies (65.3%) retrieved reported abnormalities on neuropsychological tests in migraine patients, notably tests of memory, attention and information processing speed. Most of the studies showing cognitive changes in migraine were carried out in neurological care facilities. Conversely, among community-based studies, migraine patients were less likely to present cognitive changes. Conclusion: Patients with migraine, especially those followed at neurology clinics, show an elevated risk of mild changes in several cognitive domains. Further studies with greater methodological refinement are warranted in order to clearly establish whether this cognitive dysfunction is associated with an underlying migraine pathophysiological process.

The Concept of Yearning to be Recognized: Caring for Women Who Suffer from Migraine

Women seeking pain relief for migraine headache from local healthcare agencies may have difficulty receiving adequate treatment. The purpose of this article is to present the concept of yearning to be recognized in relation to caring for women seeking pain relief from migraine headache. Computerized databases were searched using the key words migraine, women, nurse, suffering, communication, and acknowledgement. A synthesized definition of the concept was created and a gap in the literature was identified regarding the nursing care of patients who experience migraine headache. Acase study presenting one woman’s story, which informs the concept, will be described.