Pub Date : 2022-01-01DOI: 10.1177/25158163221076464
O. D. Del Brutto, A. Robles, J. Laínez
To the Editor, Neurocysticercosis is the infection of the central nervous system and its coverings by the larval stage (cysticercus) of Taenia solium, the pork tapeworm. Parasites may lodge in brain parenchyma, subarachnoid space, ventricular system or spinal cord, causing a myriad of pathological changes that are responsible for the clinical pleomorphism of this disease. While epilepsy is the most common clinical presentation of neurocysticercosis, more than one-third of patients present with headache as the single or most important manifestation of the disease. Neurocysticercosis-related headaches have been mostly associated with intracranial hypertension related to either hydrocephalus, giant extraparenchymal cysts, or cysticercotic encephalitis. These forms of neurocysticercosis clearly represent the minority of cases. Most patients with calcified cysticerci in the brain parenchyma develop headache without the presence of any additional evidence of intracranial hypertension or focal neurological deficits. Mechanisms involved in the association between headache and parenchymal brain calcified cysticerci are elusive. A door-to-door epidemiological survey conducted in a community where cysticercosis is endemic, disclosed that 19 out of 57 (33%) migrainous individuals receiving head CT had calcified cysticercosis. In addition, a case-control study nested to a population-based cohort disclosed that lifetime headache prevalence, current headaches, intense headaches and, in particular, migrainous (but not tensiontype) headaches, were almost five times more frequent among patients with calcified neurocysticercosis than in their matched controls without neurocysticercosis. These studies provide grounds for the further evaluation of the association between headache and calcified neurocysticercosis, particularly with the aim to better understand pathogenetic mechanisms involved in its occurrence and potential therapeutic interventions. The pathogenesis of migrainous headaches related to calcified cysticerci is not completely understood. Calcifications represent the end stage of previously viable cysticerci that have been destroyed by either the host immune system or as the result of cysticidal drug therapy. Calcified cysticerci have been considered inert lesions. However, recent evidence strongly suggest that these lesions contain trapped antigenic parasitic membranes, which may be intermittently presented to the host immune system when structural changes in the calcifications related to remodeling mechanisms allow antigenic remnants to be in contact with neighboring cerebral tissues. This exposure induces inflammatory changes in the brain parenchyma with the subsequent breakdown in the blood-brain barrier, edema formation and oxidative stress resulting from liberation of nitric oxide and other free radicals. These events may be the pathogenetic substrate for the occurrence of seizures, which often take the form of breakthrough seizures, since they ensu
{"title":"Migrainous headaches, calcified cysticercosis and breakthrough seizures","authors":"O. D. Del Brutto, A. Robles, J. Laínez","doi":"10.1177/25158163221076464","DOIUrl":"https://doi.org/10.1177/25158163221076464","url":null,"abstract":"To the Editor, Neurocysticercosis is the infection of the central nervous system and its coverings by the larval stage (cysticercus) of Taenia solium, the pork tapeworm. Parasites may lodge in brain parenchyma, subarachnoid space, ventricular system or spinal cord, causing a myriad of pathological changes that are responsible for the clinical pleomorphism of this disease. While epilepsy is the most common clinical presentation of neurocysticercosis, more than one-third of patients present with headache as the single or most important manifestation of the disease. Neurocysticercosis-related headaches have been mostly associated with intracranial hypertension related to either hydrocephalus, giant extraparenchymal cysts, or cysticercotic encephalitis. These forms of neurocysticercosis clearly represent the minority of cases. Most patients with calcified cysticerci in the brain parenchyma develop headache without the presence of any additional evidence of intracranial hypertension or focal neurological deficits. Mechanisms involved in the association between headache and parenchymal brain calcified cysticerci are elusive. A door-to-door epidemiological survey conducted in a community where cysticercosis is endemic, disclosed that 19 out of 57 (33%) migrainous individuals receiving head CT had calcified cysticercosis. In addition, a case-control study nested to a population-based cohort disclosed that lifetime headache prevalence, current headaches, intense headaches and, in particular, migrainous (but not tensiontype) headaches, were almost five times more frequent among patients with calcified neurocysticercosis than in their matched controls without neurocysticercosis. These studies provide grounds for the further evaluation of the association between headache and calcified neurocysticercosis, particularly with the aim to better understand pathogenetic mechanisms involved in its occurrence and potential therapeutic interventions. The pathogenesis of migrainous headaches related to calcified cysticerci is not completely understood. Calcifications represent the end stage of previously viable cysticerci that have been destroyed by either the host immune system or as the result of cysticidal drug therapy. Calcified cysticerci have been considered inert lesions. However, recent evidence strongly suggest that these lesions contain trapped antigenic parasitic membranes, which may be intermittently presented to the host immune system when structural changes in the calcifications related to remodeling mechanisms allow antigenic remnants to be in contact with neighboring cerebral tissues. This exposure induces inflammatory changes in the brain parenchyma with the subsequent breakdown in the blood-brain barrier, edema formation and oxidative stress resulting from liberation of nitric oxide and other free radicals. These events may be the pathogenetic substrate for the occurrence of seizures, which often take the form of breakthrough seizures, since they ensu","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43811399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/25158163221134593
Christopher H Gottschalk, A. Basu, A. Blumenfeld, Brad Torphy, M. Marmura, J. Pavlović, Paula K. Dumas, Nim Lalvani, D. Buse
Background: Newly approved migraine preventive therapies have allowed for rapid control of migraine activity, offering potential to minimize the burden of migraine. This report summarizes a roundtable discussion convened to analyze evidence for early onset of prevention, ascertain its clinical relevance, and provide guidance for healthcare professionals in crafting goals and treatment expectations for patients with migraine initiating preventive therapy. Methods: A virtual roundtable meeting of migraine clinicians, researchers, and patient advocates convened in October 2020. Participants reviewed and discussed data summarizing patient and healthcare professional perceptions of migraine prevention and evidence from the peer-reviewed and gray literature to develop corresponding recommendations. Summary: Evidence from clinical studies of anti-calcitonin gene-related peptide monoclonal antibodies (erenumab, fremanezumab, galcanezumab, and eptinezumab) and the chemodenervation agent onabotulinumtoxinA indicate that patients may experience reduction of migraine activity within 7 days of drug administration and early attainment of disease control is associated with improvements in clinically important outcomes. The roundtable of experts proposes that early onset be defined as demonstration of preventive benefits within 1 week of treatment initiation. We recommend focusing discussion with patients around “disease control” and potential benefits of early onset of prevention, so patients can set realistic preventive therapy goals and expectations.
{"title":"The importance of an early onset of migraine preventive disease control: A roundtable discussion","authors":"Christopher H Gottschalk, A. Basu, A. Blumenfeld, Brad Torphy, M. Marmura, J. Pavlović, Paula K. Dumas, Nim Lalvani, D. Buse","doi":"10.1177/25158163221134593","DOIUrl":"https://doi.org/10.1177/25158163221134593","url":null,"abstract":"Background: Newly approved migraine preventive therapies have allowed for rapid control of migraine activity, offering potential to minimize the burden of migraine. This report summarizes a roundtable discussion convened to analyze evidence for early onset of prevention, ascertain its clinical relevance, and provide guidance for healthcare professionals in crafting goals and treatment expectations for patients with migraine initiating preventive therapy. Methods: A virtual roundtable meeting of migraine clinicians, researchers, and patient advocates convened in October 2020. Participants reviewed and discussed data summarizing patient and healthcare professional perceptions of migraine prevention and evidence from the peer-reviewed and gray literature to develop corresponding recommendations. Summary: Evidence from clinical studies of anti-calcitonin gene-related peptide monoclonal antibodies (erenumab, fremanezumab, galcanezumab, and eptinezumab) and the chemodenervation agent onabotulinumtoxinA indicate that patients may experience reduction of migraine activity within 7 days of drug administration and early attainment of disease control is associated with improvements in clinically important outcomes. The roundtable of experts proposes that early onset be defined as demonstration of preventive benefits within 1 week of treatment initiation. We recommend focusing discussion with patients around “disease control” and potential benefits of early onset of prevention, so patients can set realistic preventive therapy goals and expectations.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43629474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/25158163221131326
B. Baker, Vivienne Shen, R. Cady, A. Ettrup, F. Larsen
Objective: To report the safety, tolerability, and pharmacokinetics/pharmacodynamics (PK/PD) of eptinezumab using intravenous (IV) infusion compared to other routes of administration from two phase 1 trials. Methods: Study 1 (NCT01579383) and Study 2 (ACTRN12615000531516) were double-blind, placebo-controlled, randomized trials. Study 1 singly administered ascending doses of eptinezumab 1–1000 mg IV infusion or 100 mg subcutaneous (SC) injection to healthy adults on day 1 (n = 60); in a second part, eptinezumab 300 mg IV + sumatriptan 6 mg SC was administered to healthy adults and patients with migraine (n = 18). Study 2 administered eptinezumab 100 or 300 mg intramuscular (IM), 100 mg SC, or 100 mg IV to healthy adults on days 1 and 84 (n = 60). Results: No withdrawals due to treatment-emergent adverse events (TEAEs) were reported due to IV administration, with IV generally reporting TEAEs similar to placebo. The pharmacokinetics of eptinezumab were as expected for a monoclonal antibody, with the 100 mg and 300 mg IV doses exhibiting higher C max and shorter t max compared to identical SC and IM doses. Discussion: These phase 1 safety and tolerability data supported eptinezumab intravenous infusions at 100 and 300 mg; both were approved for migraine prevention, were well tolerated, had low immunogenicity and rapid attainment of high plasma concentrations.
{"title":"Eptinezumab administered intravenously, subcutaneously, or intramuscularly in healthy subjects and/or patients with migraine: Early development studies","authors":"B. Baker, Vivienne Shen, R. Cady, A. Ettrup, F. Larsen","doi":"10.1177/25158163221131326","DOIUrl":"https://doi.org/10.1177/25158163221131326","url":null,"abstract":"Objective: To report the safety, tolerability, and pharmacokinetics/pharmacodynamics (PK/PD) of eptinezumab using intravenous (IV) infusion compared to other routes of administration from two phase 1 trials. Methods: Study 1 (NCT01579383) and Study 2 (ACTRN12615000531516) were double-blind, placebo-controlled, randomized trials. Study 1 singly administered ascending doses of eptinezumab 1–1000 mg IV infusion or 100 mg subcutaneous (SC) injection to healthy adults on day 1 (n = 60); in a second part, eptinezumab 300 mg IV + sumatriptan 6 mg SC was administered to healthy adults and patients with migraine (n = 18). Study 2 administered eptinezumab 100 or 300 mg intramuscular (IM), 100 mg SC, or 100 mg IV to healthy adults on days 1 and 84 (n = 60). Results: No withdrawals due to treatment-emergent adverse events (TEAEs) were reported due to IV administration, with IV generally reporting TEAEs similar to placebo. The pharmacokinetics of eptinezumab were as expected for a monoclonal antibody, with the 100 mg and 300 mg IV doses exhibiting higher C max and shorter t max compared to identical SC and IM doses. Discussion: These phase 1 safety and tolerability data supported eptinezumab intravenous infusions at 100 and 300 mg; both were approved for migraine prevention, were well tolerated, had low immunogenicity and rapid attainment of high plasma concentrations.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48152698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/25158163221097352
Pankaew Yakkaphan, Jared G. Smith, P. Chana, T. Renton, G. Lambru
Background: Temporomandibular disorders (TMD) and headaches are prevalent among the global population. Patients often suffer from both conditions, and they are likely to be associated in a bidirectional way. However, the nature of the association remains unclear. Understanding the epidemiological aspects of the relationship between these conditions could have important clinical implications. Objective: To evaluate the prevalence of headaches in TMD patients as well as the prevalence of TMD in patients who suffer from headaches. Method: A systematic literature search was conducted using electronic databases. Studies published in English and those that used an acknowledged diagnostic criteria for TMD and headaches were included. Study quality was assessed using the Newcastle-Ottawa scale and meta-analyses were performed to generate pooled prevalence estimates. Result: Thirty-one studies met the selection criteria for the review; 16 studies evaluated the prevalence of headache in TMD patients and 15 studies evaluated the prevalence of TMD in headache patients. The included studies were of moderate-to-high quality. Meta-analyses revealed moderate-to-large heterogeneities across included studies. Pooled prevalence estimates from meta-analyses indicated similar rates of headaches in TMD patients and of TMD in headache patients (61.58%, 95% CI 45.26–76.66 and 59.42%, 95% CI 51.93–66.60, respectively). Migraines were more commonly observed in TMD patients (40.25%, 95% CI 35.37–45.23) compared to tension-type headaches (18.89%, 95% CI 12.36–26.44). The prevalence of headaches was particularly high in painful-TMD (82.80%, 95% CI 75.41–89.10). Conclusion: Despite large variance in prevalence rates across included studies, this review suggests headache and TMD frequently co-occur, particularly in the case of migraines and muscle related TMD. This association has important clinical, pathophysiological and therapeutic implications.
{"title":"Temporomandibular disorder and headache prevalence: A systematic review and meta-analysis","authors":"Pankaew Yakkaphan, Jared G. Smith, P. Chana, T. Renton, G. Lambru","doi":"10.1177/25158163221097352","DOIUrl":"https://doi.org/10.1177/25158163221097352","url":null,"abstract":"Background: Temporomandibular disorders (TMD) and headaches are prevalent among the global population. Patients often suffer from both conditions, and they are likely to be associated in a bidirectional way. However, the nature of the association remains unclear. Understanding the epidemiological aspects of the relationship between these conditions could have important clinical implications. Objective: To evaluate the prevalence of headaches in TMD patients as well as the prevalence of TMD in patients who suffer from headaches. Method: A systematic literature search was conducted using electronic databases. Studies published in English and those that used an acknowledged diagnostic criteria for TMD and headaches were included. Study quality was assessed using the Newcastle-Ottawa scale and meta-analyses were performed to generate pooled prevalence estimates. Result: Thirty-one studies met the selection criteria for the review; 16 studies evaluated the prevalence of headache in TMD patients and 15 studies evaluated the prevalence of TMD in headache patients. The included studies were of moderate-to-high quality. Meta-analyses revealed moderate-to-large heterogeneities across included studies. Pooled prevalence estimates from meta-analyses indicated similar rates of headaches in TMD patients and of TMD in headache patients (61.58%, 95% CI 45.26–76.66 and 59.42%, 95% CI 51.93–66.60, respectively). Migraines were more commonly observed in TMD patients (40.25%, 95% CI 35.37–45.23) compared to tension-type headaches (18.89%, 95% CI 12.36–26.44). The prevalence of headaches was particularly high in painful-TMD (82.80%, 95% CI 75.41–89.10). Conclusion: Despite large variance in prevalence rates across included studies, this review suggests headache and TMD frequently co-occur, particularly in the case of migraines and muscle related TMD. This association has important clinical, pathophysiological and therapeutic implications.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45296387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/25158163221131323
S. S. Gharehbagh, Nina Nguyen, Dagmar Beier
Background: Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a possible long term consequence of cranial beam radiation therapy and may present as a perfect mimic of migraine with or without aura. Methods and Results: We present a 57-year-old man suffering from diffuse astrocytoma and presenting with SMART syndrome perfectly mimicking his antecedent migraine with visual aura. He was treated with intravenous steroid therapy inducing rapid response. Conclusion: SMART syndrome is a rare complex delayed complication of brain radiation therapy, which may present as an isolated migraine with or without aura even decades after cranial radiation. Thus, a sudden intensification or relapse of a previous migraine in a patient with remote cranial radiotherapy constitutes a red flag even decades after cranial irradiation and cured or stable tumor disease on a recent brain MRI. Moreover, SMART syndrome adds to the list of secondary headaches not yet listed in the current International Classification of Headache Disorders, 3rd edition (ICHD3).
{"title":"Stroke-like migraine attacks after radiation therapy (SMART) syndrome presenting as a migraine copycat: A case report","authors":"S. S. Gharehbagh, Nina Nguyen, Dagmar Beier","doi":"10.1177/25158163221131323","DOIUrl":"https://doi.org/10.1177/25158163221131323","url":null,"abstract":"Background: Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a possible long term consequence of cranial beam radiation therapy and may present as a perfect mimic of migraine with or without aura. Methods and Results: We present a 57-year-old man suffering from diffuse astrocytoma and presenting with SMART syndrome perfectly mimicking his antecedent migraine with visual aura. He was treated with intravenous steroid therapy inducing rapid response. Conclusion: SMART syndrome is a rare complex delayed complication of brain radiation therapy, which may present as an isolated migraine with or without aura even decades after cranial radiation. Thus, a sudden intensification or relapse of a previous migraine in a patient with remote cranial radiotherapy constitutes a red flag even decades after cranial irradiation and cured or stable tumor disease on a recent brain MRI. Moreover, SMART syndrome adds to the list of secondary headaches not yet listed in the current International Classification of Headache Disorders, 3rd edition (ICHD3).","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43537262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/25158163221119265
{"title":"Corrigendum to “Temporomandibular disorder and headache prevalence: A systematic review and meta-analysis”","authors":"","doi":"10.1177/25158163221119265","DOIUrl":"https://doi.org/10.1177/25158163221119265","url":null,"abstract":"","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46942908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/25158163221128183
H. Pohl
Objective: To summarise the history of cluster headache evolving concepts and growing insights. Background: Excruciating pain, activation of the parasympathetic nervous system, and circadian rhythmicity characterise cluster headache attacks. Results: We find the oldest descriptions of patients suffering from the disorder in case reports of the 17th and 18th centuries. Only in the 19th and early 20th centuries did physicians start hypothesizing its cause. Initially, many researchers suspected the origin of the pain in peripheral nerves or blood vessels. However, eventually, they understood that the cause of the disease lies in the brain. In 1998, Positron emission tomography studies revealed increased activity of the posterior hypothalamus, whose role remains incompletely understood. Only recently have researchers realised that being diseased implies more than dysfunction. Recent studies analysed the consequences of cluster headache for each patient. Many struggle to deal with the disorder even in the absence of pain. Conclusion: Physicians have been aware of this type of pain for at least 300 years. Only when researchers studied pathological anatomy and physiology did knowledge accrue. A more comprehensive picture of the disease severity emerged when they also considered its consequences.
{"title":"History of cluster headache","authors":"H. Pohl","doi":"10.1177/25158163221128183","DOIUrl":"https://doi.org/10.1177/25158163221128183","url":null,"abstract":"Objective: To summarise the history of cluster headache evolving concepts and growing insights. Background: Excruciating pain, activation of the parasympathetic nervous system, and circadian rhythmicity characterise cluster headache attacks. Results: We find the oldest descriptions of patients suffering from the disorder in case reports of the 17th and 18th centuries. Only in the 19th and early 20th centuries did physicians start hypothesizing its cause. Initially, many researchers suspected the origin of the pain in peripheral nerves or blood vessels. However, eventually, they understood that the cause of the disease lies in the brain. In 1998, Positron emission tomography studies revealed increased activity of the posterior hypothalamus, whose role remains incompletely understood. Only recently have researchers realised that being diseased implies more than dysfunction. Recent studies analysed the consequences of cluster headache for each patient. Many struggle to deal with the disorder even in the absence of pain. Conclusion: Physicians have been aware of this type of pain for at least 300 years. Only when researchers studied pathological anatomy and physiology did knowledge accrue. A more comprehensive picture of the disease severity emerged when they also considered its consequences.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45919486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/25158163221084325
Ayaba Logan, I. Reid, M. Yogarajah, C. Wang, N. Greenwood, M. Edwards, H. Jarman, N. Nirmalananthan
Introduction: Detailed Emergency Department attendance data for migraine are needed for service redesign. Methods: A service evaluation was undertaken, classifying adult emergency department headache attendances using the International Classification of Headache Disorders migraine C-E criteria, evaluating attendance characteristics. Results: Migraine/Probable migraine diagnosis was documented in 58% but coded in 24% attendances by ED clinicians. 29% of patients used no analgesia before attending, 43% attended ≥4 days after onset and 19% arrived by ambulance. Conclusion: This evaluation highlights sub-optimal acute management and discrepancy between migraine coding and diagnosis contributing to underreporting. We recommend further evaluation of identified cohorts and headache proforma use.
{"title":"Migraine in the emergency department: A retrospective evaluation of the characteristics of attendances in a major city hospital in the United Kingdom","authors":"Ayaba Logan, I. Reid, M. Yogarajah, C. Wang, N. Greenwood, M. Edwards, H. Jarman, N. Nirmalananthan","doi":"10.1177/25158163221084325","DOIUrl":"https://doi.org/10.1177/25158163221084325","url":null,"abstract":"Introduction: Detailed Emergency Department attendance data for migraine are needed for service redesign. Methods: A service evaluation was undertaken, classifying adult emergency department headache attendances using the International Classification of Headache Disorders migraine C-E criteria, evaluating attendance characteristics. Results: Migraine/Probable migraine diagnosis was documented in 58% but coded in 24% attendances by ED clinicians. 29% of patients used no analgesia before attending, 43% attended ≥4 days after onset and 19% arrived by ambulance. Conclusion: This evaluation highlights sub-optimal acute management and discrepancy between migraine coding and diagnosis contributing to underreporting. We recommend further evaluation of identified cohorts and headache proforma use.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45501620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/25158163221119264
In the above-referenced article, the authors neglected to include that written consent was obtained from the patient’s legal guardians. The patient’s mother and father. The authors regret the unfortunate omission of a clarifying statement for the patient’s consent.
{"title":"Corrigendum to “Tolosa-Hunt syndrome after COVID-19 infection”","authors":"","doi":"10.1177/25158163221119264","DOIUrl":"https://doi.org/10.1177/25158163221119264","url":null,"abstract":"In the above-referenced article, the authors neglected to include that written consent was obtained from the patient’s legal guardians. The patient’s mother and father. The authors regret the unfortunate omission of a clarifying statement for the patient’s consent.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45187314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/25158163221075569
J. Crespi, S. Gulati, Ø. Salvesen, D. Bratbak, D. Dodick, M. Matharu, E. Tronvik
Background: Cluster headache (CH) is one of the most painful conditions in humans and there is limited epidemiological data on this debilitating condition. Objectives: To describe the epidemiology of CH in Norway Methods: We conducted a nationwide study to investigate the prevalence, incidence, and comorbidity of CH in Norway between January 1 2008 and December 31 2016. Treatment and outcome data from the Norwegian patient registry and the Norwegian prescription database were linked on an individual basis. Results: Among 3,892,260 individuals ≥18 years old of age, we identified a total of 1891 patients with CH. The prevalence of CH was 48.6 per 100,000, and the male-to-female ratio was 1.47. The estimated incidence of CH was 3.0 per 100,000/year. Among patients with CH, increased age and sex adjusted odds ratios ([OR], all with p-values <0.0001, were observed for medication-induced headache (OR 50.7, 95% CI 36.7–69.9), migraine (OR 25.2, 95% CI 22.5–28.3), chronic posttraumatic headache (OR 22.2, 95% CI 12.8–38.45), history of cranial trauma (OR 1.9, 95% CI 1.5–2.4), somatoform disorders (OR 4.2, 95% CI 3.0–5.8), suicide attempt (OR 3.9, 95% CI 2.6–5.8), personality disorder (OR 3.6, 95% CI 2.6–4.9), bipolar disorder (OR 3.6, 95% CI 2.8–4.8), peptic ulcer (OR 2.8, 95% CI 2.3–3.3), depression (OR 2.8, 95% CI 2.4–3.1), substance abuse (OR 2.6, 95% CI 2.0–3.3), and cerebrovascular disease (OR 2.4, 95% CI 1.8–3.1). Use of opioid analgesics during the study period was more common among patients with CH compared to others (81% vs. 22%, sex and age adjusted OR 23.4, 95% CI 20.8–26.2, p < 0.0001).
背景:丛集性头痛(CH)是人类最痛苦的疾病之一，关于这种使人衰弱的疾病的流行病学数据有限。目的:描述挪威CH的流行病学方法:我们进行了一项全国性的研究，调查2008年1月1日至2016年12月31日期间挪威CH的患病率、发病率和合并症。来自挪威患者登记和挪威处方数据库的治疗和结果数据以个人为基础进行链接。结果:在3892260例年龄≥18岁的人群中，我们共发现1891例CH患者，CH患病率为48.6 / 10万，男女比例为1.47。CH的估计发病率为每10万人中3.0人/年。在CH患者中，观察到药物性头痛(OR 50.7, 95% CI 36.7-69.9)、偏头痛(OR 25.2, 95% CI 22.5-28.3)、慢性创伤后头痛(OR 22.2, 95% CI 12.8-38.45)、颅脑外伤史(OR 1.9, 95% CI 1.5-2.4)、躯体形式障碍(OR 4.2, 95% CI 3.0-5.8)、自杀企图(OR 3.9, 95% CI 2.6-5.8)、人格障碍(OR 3.6, 95% CI 2.6-4.9)、双相情感障碍(OR 3.6, p值均<0.0001)、95% CI 2.8 - 4.8)、消化性溃疡(OR 2.8, 95% CI 2.3-3.3)、抑郁症(OR 2.8, 95% CI 2.4 - 3.1)、药物滥用(OR 2.6, 95% CI 2.0-3.3)和脑血管疾病(OR 2.4, 95% CI 1.8-3.1)。在研究期间，阿片类镇痛药的使用在CH患者中比其他患者更常见(81%对22%，性别和年龄调整OR 23.4, 95% CI 20.8-26.2, p < 0.0001)。
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