DOCSLIB.ORG

International Headache Society Abstracts

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
International Headache Society Abstracts Abstracts Cephalalgia 2015, Vol. 35(6S) 1–296 ! International Headache Society 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0333102415581304 cep.sagepub.com International Headache Society abstracts ScS1-1 IS02 Special Session I – Headache Trainees Excellence Tournament Special Session I – Headache Trainees Excellence Tournament Propagation of cortical spreading depression reduced by 5HT1 receptors alternation Altered white matter tract integrity in patients with prolonged post-concussion symptoms A. Karimi Goudarzi1, M. Ahmadi2, B. Khodaie2, 1 1 A. Lotfinia2, M. Lotfinia2 C. Chong , T.J. Schwedt 1 1Basic Sciences, Islamic Azad University Karaj Branch, Neurology, Mayo Clinic, Phoenix, USA KARAJ, Iran Introduction: Routine structural neuroimaging is typic- 2 Neurophysiology, Shefa Neuroscience Research Center, ally normal following concussion, even in patients who Tehran, Iran have a multitude of post-concussion symptoms. The migraine attack has been observed to be associated with cortical spreading depression (CSD) associated with Diffusion Tensor Imaging (DTI), which allows for the inter- low level of serotonin (5-HT). However, the mechanism rogation of white matter tract integrity, has been useful in underlying this phenomenon is still unclear. The develop- determining brain alterations in acutely concussed ment of serotonin receptor agonists in alleviation of patients, yet the existence of white matter alterations in migraine pain in clinical trials, further implicates the role patients with prolonged post-concussion symptoms (>1 of serotonin as a key molecule in migraine. In this regard, month) remains controversial. present study evaluated the role of 5-HT1 receptor on electrophysiological parameter of the cortical spreading Methods: Using global probabilistic DTI tractography, we depression (CSD). Wistar rats (n ¼ 28) were injected examined the integrity of several major fiber tracts in 12 interventricular with fluoxetine (5, 10, 20 mg/kg) and/or concussed patients (age ¼ 36.0; SD ¼ 15.9) who continued saline. CSD was recorded immediately after KCl (3 mM; to be symptomatic at least 1 month post-concussion but 10–15 ml) injection. In addition, all groups were CSD- had normal routine T1 and T2 imaging and in 12 healthy, recorded for 60–70 min. The interventricular fluoxetine age-matched control subjects (age ¼ 38.9 SD ¼ 13.0). injection effect was reverted after flushing the treated region with saline. Fluoxetine applied during the CSD- Results: Concussed patients showed higher axial diffusiv- induction period. CSD-velocities reduced significantly in ity (AD) but unchanged fractional anisotropy (FA) in the 10 and 20 mg/kg (P < 0.05). Also amplitude and duration right (AD: p ¼ .043; FA: p ¼ .545) and left (AD: p ¼ .022; of CSD waves were significantly decreased in 5, 10, and FA; p ¼ .066) superior longitudinal fasciculi and higher AD 20 mg/kg of fluoxetine (P < 0.05). The present effect of (p ¼ .035) and lower FA (p ¼ .044) in the forceps major fluoxetine, supports the hypothesis of a serotoninergic relative to controls. No significant group differences in influence on CSD, as previously suggested in experiments tract FA and AD were found for the left (AD: p ¼ .706; using other serotoninergic drugs. FA: p ¼ .485) and right (AD: p ¼ .673; FA: p ¼ .904) uncin- ate fasciculus. Exploratory post-hoc analyses indicated that Keywords: Serotonin, Migraine, Electrophysiology, patients with multiple concussions (n ¼ 6) had higher FA in Spreading Depolarization the left superior longitudinal fasciculus (p ¼ .02) relative to ! International Headache Society 2015 2 Cephalalgia 35(6S) Figure. Fmajor ¼ forceps major; Unc ¼ uncinate fasciculusl; Slft ¼ superior longitudinal fasciculus. patients with one concussion (n ¼ 6). No other tract antimigraine drug, sumatriptan, in different components metric differences were identified. of the trigeminovascular system in FHM1 mice with the R192Q missense mutation. Conclusion: In patients with persistent symptoms, white matter tract integrity is altered beyond 1 month following Method: Dura mater, trigeminal ganglion (TG) and tri- concussion. Tract damage might be more extensive in geminal nucleus caudalis (TNC) were isolated from adult patients with multiple concussions. R192Q mice. Tissues were triggered with 60 mM KCl in the absence or presence of sumatriptan (30 mM). Supernatant was collected for CGRP measurements. IS03 Data are expressed as relative stimulated CGRP release (mean Æ s.e.m). This study is approved by the ethics com- Special Session I – Headache Trainees Excellence mittee of the Erasmus Medical Center in Rotterdam Tournament Results: We found no difference in KCl-induced CGRP Trigeminovascular cgrp release in familial release in different components of the trigeminovascular hemiplegic migraine type 1 knockin mice system between R192Q (dura mater: 5.8 Æ 2.0, TG: 5.0 Æ K. Chan1, S. Labruijere1, I. Garrelds1, K. Ibrahimi1, 1.9, TNC:4.9 Æ 1.1) and wildtype (dura mater: 16.1 Æ 5.7, A. Danser1, A. van den Maagdenberg2, TG:5.9 Æ 1.7, TNC:6.4 Æ 1.2) mice. Sumatriptan only A. MaassenVanDenBrink1 inhibited the CGRP release in the TNC (control: 4.7 Æ 1.1, sumatriptan: 2.6 Æ 1.0) and dura mater (control: 1Internal Medicine. Div of Vascular Medicine and 5.7 Æ 3.3, sumatriptan: 0.8 Æ 0.1) of wildtype but not in Pharmacology, Erasmus Medical Center, Rotterdam, R192Q (TNC; control: 5.3 Æ 1.3, sumatriptan: 3.4 Æ 1.0 Netherlands and dura mater; control: 4.8 Æ 2.2, sumatriptan: 5.6 Æ 2Neurology and Human Genetics, Leiden University Medical 3.2) mice. Center, Leiden, Netherlands Background: Neuronal hyperexcitability has been shown Conclusion: KCl-induced CGRP release seems unaf- in transgenic knockin mice carrying the familial hemiplegic fected by the R192Q mutation, in contrast with earlier migraine type 1 (FHM1) mutations in the Cacna1a gene. findings in TG of younger R192Q mice (Fioretti et al. However, the effects of FHM1 mutations on the trigemi- (2011), J. Physiol, 589.23). Interestingly, sumatriptan novascular system and the release of neuropeptides are reduced trigeminovascular activation in the wildtype but largely unknown. not in the R192Q mice, suggesting a disinhibition of the trigeminovascular system. Aim: To investigate the release of calcitonin gene-related peptide (CGRP) in the absence and presence of the ! International Headache Society 2015 Abstracts 3 IS04 83.3%, specificity 85.7%) was reached when separating patients with from those without aura. Special Session I – Headache Trainees Excellence Tournament Conclusion: The data support the view that migraine is a brain disorder with distinctive cortical/ subcortical ana- Feasibility of using structural brain data for tomical features. Although the diagnostic accuracy cur- diagnosing migraine rently remains too low for clinical practice, it is a good L. Gaetano1, S. Magon1,A.May2, A. Stankewitz2, starting point for a future supplementary diagnostic tool. P.J. Goadsby3, A.R. Tso3, M. Ashina4, F.M. Amin4, C.L. Seifert5, M. Chakravarty6, T. Sprenger7 IS05 1Department of Neurology, University Hospital Basel, Basel, Switzerland Special Session I – Headache Trainees Excellence 2Department of Systems Neuroscience, University Medical Tournament Center Hamburg-Eppendorf, Hamburg, Germany 3Headache Group-Department of Neurology, University of Pain related cortical and subcortical grey California San Francisco, San Francisco, USA matter changes in cluster headache 4 Danish Headache Center and Department of Neurology, 1,2 1 1 1 1 N. Szabo´ , A. Kira´ly , P. Farago´ , G. Csete ,E.To´th , University of Copenhagen, Copenhagen, Denmark 1 1 1 1,3 A. Pa´rdutz , D. Szok , J. Tajti ,L.Ve´csei , 5Department of Neurology, Technische Universitaet Z.T. Kincses1,2 Muenchen, Munich, Germany 6Department of Psychiatry, McGill University, Montreal, 1Department of Neurology, Albert Szent-Gyo¨rgyi Clinical Canada Center University of Szeged, Szeged, Hungary 7Department of Neurology, DKD Helios Klinik, Wiesbaden, 2International Clinical Research Center, St. Anne’s University Germany Hospital Brno, Brno, Czech Republic 3MTA-SZTE Neuroscience Research Group, Szeged, Background: Migraine is diagnosed using operational cri- Hungary teria according to ICHD II/III-beta. Changes in brain struc- ture or function, or other biomarkers are not currently Background: Subcortical structures, like the basal gang- considered in the diagnostic process. lia, thought to have a crucial role in pain processing, which was underlined by neuroimaging studies detected activa- Aim: Using multicenter high-resolution structural MRI tion in these areas in acute and chronic pain. data, we tested the ability of a machine learning technique to distinguish migraineurs from healthy subjects on the Aim: In the current study we investigated the cortical and basis of cortical thickness and subcortical morphology. subcortical grey matter volume in cluster headache patients. Methods: T1-weighted MPRAGE data of 131 migraineurs (40 with aura; 31 Æ 9yo; 109 women; monthly attack fre- Method: High-resolution T1 weighted images were quency: 3.2 Æ 2.5; disease duration: 14 Æ 8.4y) and 115 acquired from seventeen CH patients and thirty-one age- matched healthy subjects (29 Æ 7yo; 81 women) acquired matched healthy controls. Voxel based morphometry with at four different centers at 3 Tesla were pooled. Cortical threshold-free cluster enhancement statistic and surface thickness and subcortical morphology were assessed using based subcortical segmentation analysis were
Load more

Recommended publications
  • Headache Associated with Sexual Activity—A Narrative Review of Literature
    medicina Review Headache Associated with Sexual Activity—A Narrative Review of Literature Piotr Sci´slicki´ 1, Karolina Sztuba 1, Aleksandra Klimkowicz-Mrowiec 2 and Agnieszka Gorzkowska 3,* 1 Student’s Scientific Society, Department of Neurorehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medyków 14, 40-752 Katowice, Poland; [email protected] (P.S.);´ [email protected] (K.S.) 2 Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Krakow, Poland; [email protected] 3 Department of Neurorehabilitation, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Medyków 14, 40-752 Katowice, Poland * Correspondence: [email protected] Abstract: Headache associated with sexual activity (HAWSA) has accompanied humanity since ancient times. However, it is only since the 1970s that it has become the subject of more extensive and detailed scientific interest. The purpose of this review is to provide an overview of the development of the concept of HAWSA, its clinical presentation, etiopathogenesis, diagnosis and treatment especially from the research perspective of the last 20 years. Primary HAWSA is a benign condition, whose etiology is unknown; however, at the first occurrence of headache associated with sexual activity, it is necessary to exclude conditions that are usually immediately life-threatening. Migraine, hypnic headache or hemicrania continua have been reported to co-occur with HAWSA, but their common pathophysiologic basis is still unknown. Recent advances in the treatment of HAWSA include the Citation: Sci´slicki,P.;´ Sztuba, K.; introduction of topiramate, progesterone, and treatments such as greater occipital nerve injection, Klimkowicz-Mrowiec, A.; arterial embolization, and manual therapy.
    [Show full text]
  • Headache Associated with Sexual Activity
    A Rare Primary Headache Disorder: Headache Associated With Sexual Activity Buse Cagla ARI1, Fusun Mayda Domac2, and Samiye Ulutas2 1Siirt State Hospital 2Erenkoy Mental and Nervous Diseases Training and Research Hospital May 6, 2020 Abstract Background: Primary headache associated with sexual activity is a rare type of headache mostly seen in male gender and initiates at the 3rd decade. Even though the pathophysiology is still unknown, it is a benign type of headache and must be reminded on the differential diagnosis of the secondary headache. Materials&Methods: Thirteen patients diagnosed as primary headache associated with sexual activity were evaluated by their clinical and demographic data. Results:Ten male and three female patients were evaluated. The mean age was 37.07± 7.67. Headache was usually localized at bilateral occipital area or diffuse, starting with a severe ache and sudden explosive intensity in association with preorgasm in 8 patients and orgasm in 5 patients with a mean VAS score of 7.8±1.2. The mean duration was 21.53± 15.32 minutes. Five of the patients had a history of migraine, 3 had arteriel hypertension and two were diagnosed as primary thunderclap headache with sudden beginning and high intensity ache. Conclusion: Herein we presented our cases to highlight the importance of differential diagnosis. Patients may have difficulty of explaining the problem therefore their sexual activity could be limited.Apart from pharmacological prevention, counselling and facilitation plays important role in managing. Introduction Primary headache disorders associated with sexual activity (HAS) was formerly known as benign sexu- al/intercourse headache or orgasmic cephalalgia (1).
    [Show full text]
  • The Man Who Was Afraid to Have Sex
    CHAPTER 23 THE MAN WHO WAS AFRAID TO HAVE SEX LAWRENCE C. NEWMAN,MD Case History •How would the work-up differ had the patient not pre- sented so soon after his most recent headache? A 28-year-old male presents to your office complaining •How do you assuage his fears of sexual intimacy? of a 2-week history of a “new” type of headache, the most •What are the treatment options for this patient? recent of which occurred the previous night. Over the past 2 weeks, the patient reports that he has had four episodes of a severe global headache. The pain is throb- Case Discussion bing in quality, instantly reaches maximum intensity, and In general, patients complaining of headaches that occur persists for approximately 2 hours. He denies photo-, with a sudden explosive onset, or in which the head pain phono-, or osmophobia, autonomic symptoms, fever, is precipitated by exertion, coughing, straining, or during nuchal rigidity, or the presence of any neurologic deficits sexual activity, should be thoroughly evaluated for a sec- associated with the head pain. On two occasions, he ondary cause. Also, patients who experience a change in an reports that he was nauseated during the headache but established pattern of headaches should undergo an eval- denies vomiting. Upon further questioning, the patient uation to rule out organic causes of their headache. The admits that all four of these headaches have occurred differential diagnosis of headaches of sudden onset during sexual intercourse with his wife, always at the includes subarachnoid and other types of intracerebral moment of orgasm.
    [Show full text]
  • R Ev Iew R Ev Iew R Ev Iew R Ev Iew a Rticle a Rticle a Rticle a Rticle
    British Journal of Medical Practitioners, March 2010, Volume 3, Number 1 BJMP 2010;3(1):304 What if the ‘sexual headache’ is not a joke? ArticleArticle Margaret J Redelman ArticleArticle Margaret J Redelman Abstract Headaches and sexual activity are often treated with humour as a typical way for women to reject male advances. However, headaches associated with sexual activity can be anything but a joke. HSA (headaches associated with sexual activity) are by definition benign conditions but the symptoms can be the same as in serious life threatening cerebral conditions and these need to be quickly excluded at the first presentation. Most sexual headaches are of a benign nature. However, the first time an HSA ReviewReview ReviewReview occurs it can be a traumatic, frightening occurrence for the patient. HSA are capricious in nature with poorly understood pathophysiology and uncertain course of the condition. Patients need to have the situation clearly explained to them so that management can be optimal. However, good overall management of a patient with HSA should also include discussions about possible negative sexual consequences of the HSA experience. Sexuality can be affected by HSA both during the active condition and subsequently. Sexuality must be addressed by the treating physician if the patient/couple are not to be left with an ongoing negative effect on their future sex life as a consequence of the HSA. Keywords sexual headache, sex, sexuality, headache Headaches associated with or occurring around sexual activity sexual headache after coitus, which is present on standing, eased have been recognized since the time of Hippocrates [1, 2] .
    [Show full text]
  • Hyper Insulinemia in an Hemicrania Continua Patient with Sexual Headache: Hypothesizing the Basis for This Unusual Association
    www.neurologyindia.com Case Report Hyper insulinemia in an hemicrania continua patient with sexual headache: Hypothesizing the basis for this unusual association Sanjay Prakash Department of Neurology, Medical College, Baroda, Gujarat-390 001, India Abstract Address for correspondence: Dr. Sanjay Prakash, The coexistence of hemicrania continua with another primary headache disorder is a O-19, Doctor’s Quarter, Jail Road, Baroda, Gujarat-390 001, India. very rare event. We report a male patient with both hemicrania continua of 16- year E-mail: [email protected] duration and pre-orgasmic headache of three-year duration. Both headache disorders responded to indomethacin. The patient had also in addition persistent elevation of fasting serum insulin. PMID: *** Hemicrania continua, hyperinsulinemia, sexual headache DOI: 10.4103/0028-3886.68689 Key words: Introduction seven times a week. The exacerbations were associated with lacrimation and rhinorrhea. The patient denied The coexistence of different types of primary headache the presence of aura, nausea, vomiting, photophobia, disorders in the patient is rare, but not uncommon. phonophobia or agitation during the exacerbations. He “Other primary headache disorders” are included in developed another type of headache since two to three Group 4 of International Headache Society Classification years. The headache, exclusively felt during sexual (HIS). Some of the common other primary headache activity, was band-like and holocranial, especially disorders include cluster headache, paroxysmal localized to occipital and neck areas. The headache was hemicrania, short-lasting unilateral neuralgiform noted in about 50% of sexual activities and used to start headache with conjunctival injection and tearing gradually after a few minutes of foreplay.
    [Show full text]
  • Arnold-Chiari Malformation Type I 50 Arterial Dissection 18, 50–1, 65–6
    Index Bold numbers indicate chapter/section headings Abdominal migraine 16, 24, Arnold-Chiari malformation Benign sex headache, see 30–1, 35 type I 50 Primary headache associated Accompanying symptoms 49, Arterial dissection 18, 50–1, with sexual activity 129, 138, 150 65–6, 70, 74, 142 Benign thunderclap headache, Acoustic neuroma 62–4, 117 Arterial hypertension 20, 107, see Primary thunderclap Acute adverse event attributed 109–10, 112 headache to medication used for other Arteriovenous malformation Benign vascular sexual indications 19, 88, 93, 144 (AVM) 18, 27, 65, 68, 71, 73, headache, see Primary Acute frontal non-pulsatile 82 headache associated with headache 130 Arteritis 18, 65–6, 68–9, 74, 120 sexual activity Acute glaucoma 21, 114, 116 Aseptic (non-infectious) Blurred vision 26, 91, 117, 122–3 Acute headache attributed to meningitis 18, 77, 80, 85, 88 Brain abscess 20, 102–4, 106, whiplash injury 17, 58, 60 Ataxia 29–30, 35, 83, 140 144 Acute post-craniotomy headache Attack of headache (or pain) Burning mouth syndrome 22, 17, 58, 61 150 126, 133, 135 Acute post-traumatic headache Attacks without aura 24, 26 15, 17, 58–60, 62–3, 66 Atypical facial pain, see Caffeine-withdrawal headache Acute post-traumatic headache Persistent idiopathic facial 20, 88, 96, 109 attributed to mild head injury pain Calcitonin gene-related peptide 17, 58–9, 62 Atypical odontalgia 133, 135 (CGRP)-induced headache 19, Acute post-traumatic headache Aura 11–12, 14–16, 24–31, 36, 25, 41, 88, 93 attributed to moderate or 38–40, 53, 57–8, 66, 68, 71–2, Cannabis-induced
    [Show full text]
  • A Review of Headache
    VIII HEADACHE Randolph W. Evans, MD Headaches are a near-universal experience, with a 1-year prevalence of 90% and a lifetime prevalence of 99%. Each Table 1 Major Categories of Headache year in the United States, 9% of adults see physicians for Disorders1 headaches and 83% self-medicate. Headaches are one of Primary Headaches the most common complaints of patients seen by primary Migraine care physicians and account for 20% of outpatient visits to Tension-type headache Cluster headache and chronic paroxysmal hemicrania neurologists. Miscellaneous headaches unassociated with structural lesion: The differential diagnosis of headaches is one of the idiopathic stabbing, external compression, cold stimulus, longest in medicine, with over 300 different types and benign cough, benign exertional, associated with sexual causes. Although most headaches are of benign (and still activity poorly understood) origin, some headaches can have serious Secondary Headaches and even potentially life-threatening causes. Thus, it is Headache associated with head trauma critical for the physician to diagnose headaches as precisely Headache associated with vascular disorder: acute ischemic as possible. cerebrovascular disorder, intracranial, hematoma, subarachnoid hemorrhage, unruptured vascular malforma- The International Headache Society (IHS) criteria, which tion, arteritis, carotid or vertebral artery pain, venous were introduced in 1988 and updated in 2004 (International thrombosis, arterial hypertension, associated with other Classifi cation of Headache Disorders Second Edition [ICHD-2]),1 vascular disorder are the worldwide standard for headache classifi cation. Headache associated with nonvascular intracranial disorder: high and low cerebrospinal fl uid pressure, intracranial IHS criteria categorize headaches as primary or secondary. infection, intracranial sarcoidosis and other noninfectious Primary headaches—those with no other underlying cause— infl ammatory disease, related to intrathecal injections, account for 90% of headaches.
    [Show full text]
  • The Complexity of Headache Management
    The Complexity of Headache Management Headache Management Bernard Abrams, MD From the seemingly endless number of headache entities, the International Classification of Headache Disorders (ICH D-2), updated in the year 2004, offers a new understanding of headache disorders. It is the key to the diagnosis and treatment of headaches. It divides headaches into primary and secondary with four primary headache categories and 8 secondary headache categories. A primary headache disorder is not due to another condition whereas a secondary headache disorder is due to another identifiable condition such as a brain tumor. The primary headache disorders are: • Migraine • Tension type headache • Cluster and other trigeminal autonomic cephalgias • Other primary headaches The secondary headache disorders are: • Head and neck trauma • Cranial or cervical vascular disorders • None vascular intracranial disorders • Substance abuse or withdrawal disorders • Infection • Disorders of homeostasis • Disorders of the cranium, neck, eyes, nose, sinuses, teeth, mouth, or other facial or cranial structures • Psychiatric Since the vast majority of headaches in pain practice are primary headaches, the majority of this monograph is devoted to them. Evaluation of headaches: The distinction between primary and secondary headaches is the key. There are two goals for any headache evaluation: 1. The recognition of primary headache syndromes for which treatment is available. 2. The recognition of secondary syndromes which may constitute a threat to life or function. The headache evaluation consists of a detailed history, pertinent information from the physical examination and pertinent diagnostic laboratory studies including imaging when indicated. Of these, the most important factor to consider is the patient history. The secondary disorders will be dealt with briefly below.
    [Show full text]
  • (IHS) the International Classification of Headache Disorders
    ICHD-3 Cephalalgia 2018, Vol. 38(1) 1–211 ! International Headache Society 2018 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0333102417738202 journals.sagepub.com/home/cep Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition Copyright Translations The 3rd edition of the International Classification of Headache Disorders (ICHD-3) may be reproduced The International Headache Society (IHS) expressly freely for scientific, educational or clinical uses by insti- permits translations of all or parts of ICHD-3 for the tutions, societies or individuals. Otherwise, copyright purposes of clinical application, education, field testing belongs exclusively to the International Headache or other research. It is a condition of this permission Society. Reproduction of any part or parts in any that all translations are registered with IHS. Before manner for commercial uses requires the Society’s per- embarking upon translation, prospective translators mission, which will be granted on payment of a fee. are advised to enquire whether a translation exists Please contact the publisher at the address below. already in the proposed language. ßInternational Headache Society 2013–2018. All translators should be aware of the need to Applications for copyright permissions should be sub- use rigorous translation protocols. Publications report- mitted to Sage Publications Ltd, 1 Oliver’s Yard, 55 ing studies making use of translations of all or any part City Road, London EC1Y 1SP, United Kingdom of ICHD-3 should include a brief description of the (tel: þ44 (0) 207 324 8500; fax: þ44 (0) 207 324 8600; translation process, including the identities of the trans- [email protected]) (www.uk.sagepub.com).
    [Show full text]
  • The International Classification of Headache Disorders 2Nd Edition
    The International Classification of Headache Disorders 2nd edition ੽ᄬᏞമॽॾ˷ᘸ ڎ஑ʠڎ̜˛ ͮដড༄ደደ๼ Ꮮമደ஢ᚍ 2004Б8̢ ڎ஑ʠڎ̜˛ ੽ᄬᏞമॽॾ˷ᘸ άᏃ ӕ //////////////////////////////////////////////////////////////////////////////////// 5ڎ̜˛ڎ஑ʙ ڎ஑ʙ ӕ ///////////////////////////////////////////////////////////////////////////////////// 6ڎ̜˛ڎ஑ʠ ڎ஑ʠ Ր ///////////////////////////////////////////////////////////////////////////////////////////// 8܉ڎ஑ʙ ڎ஑ʠ Ր ///////////////////////////////////////////////////////////////////////////////////////////// 9܉ڎ஑ʠ ڎ஑ʠ ᕚᚍ૲ᜌप ////////////////////////////////////////////////////////////////////////////////////////////////////////// : ᕚᚍʡࢷϪ౐ /////////////////////////////////////////////////////////////////////////////// 21 ڎ஑ʠڎ̜˛ Ѱˉ஢Ϫ౐ /////////////////////////////////////////////////////////////////////////////// 22ˎ ڎ஑ʠڎ࠼̜ ˷ᘸ˭஝ ///////////////////////////////////////////////////////////////////////////////////////////////////////////// 24 ЃѤպ΢௻˷ᘸ ////////////////////////////////////////////////////////////////////////////////////////////////// 26 28 ///////////////////////////////////////////// ےᏞമ˷ᘸჄ੽ᄬ቏Ρ஢ᕑ ICD-10NA ˷ᘸሆဇັ ʙăࢨവؒᏞമ (The primary headache) ////////////////////////////////////////////////////////////// 24 1. ੑᏞമ (Migraine) ////////////////////////////////////////////////////////////////////////////////////// 25 2. ႧᑻܮᏞമ (Tension-type headache) ////////////////////////////////////////////////////////// 38 ᔎവؒᏞമჄ֏͂ʭʾьݡড༄Ꮮമ .3 (Cluster headache and other trigeminal autonomic cephalalgias) //////////////////////// 45 ֏͂ࢨവؒᏞമ
    [Show full text]
  • Upcoming Issues Trigeminal Autonomic Cephalalgias: Diagnosis and Management
    ® Vol. XX, Issue 3 April 2012 Editorial Board Editor-in-Chief Trigeminal Autonomic Cephalalgias: Jane C. Ballantyne, MD, FRCA Diagnosis and Management Anesthesiology, Pain Medicine USA 1 Advisory Board Trigeminal autonomic cephalalgia (TAC) is now an accepted clinical term, first 2 Michael J. Cousins, MD, DSC proposed by Goadsby and Lipton, for a group of primary headaches with pain and Pain Medicine, Palliative Medicine autonomic involvement in the facial area of the trigeminal nerve. All these headache Australia syndromes have two features in common: short-lasting, unilateral, extremely severe Maria Adele Giamberardino, MD headache attacks accompanied by typical autonomic symptoms. The typical clinical Internal Medicine, Physiology Italy features of the TACs are highly characteristic. To date, the following syndromes are accepted as belonging to the TACs: Robert N. Jamison, PhD Psychology, Pain Assessment • Episodic and chronic cluster headache (Table I) USA • Episodic and chronic paroxysmal hemicrania (Table II) Patricia A. McGrath, PhD Psychology, Pediatric Pain • Short-lasting unilateral neuralgiform headache with conjunctival injection and Canada tearing (SUNCT syndrome) (Table III) M.R. Rajagopal, MD Pain Medicine, Palliative Medicine Why is it important for clinicians to know and recognize all the different types of India TAC, given that they are relatively rare? First of all, these disabling conditions are Maree T. Smith, PhD easy to recognize. Second, they show an excellent, but highly selective, response Pharmacology Australia to treatment. In most cases, a subclassification is possible and reasonable, because therapeutic regimens and responses differ. In 1997, Goadsby and Lipton documented Claudia Sommer, MD 2 Neurology a nosological analysis and definition of a group of short-lasting headache syndromes.
    [Show full text]
  • The Man with Recurrent Sudden Headaches
    Rapoport Ch 21.qxd 10/15/08 1:11 PM Page 117 CHAPTER 21 THE MAN WITH RECURRENT SUDDEN HEADACHES SEYMOUR SOLOMON, MD Case History be taken before sexual intercourse. This course of therapy usually prevented headaches and those headaches which A 35-year-old male physician diagnosed himself as hav- were not completely prevented were much less intense. ing a subarachnoid hemorrhage and was seen by a neu- After several months the patient began to have symptoms rologist colleague within 20 minutes of the sudden onset of upper gastrointestinal distress in spite of daily use of of a severe generalized headache; it was the first and misoprostol. When the indomethacin was discontinued, worst such headache in his life. The patient denied a pre- the headaches following sexual intercourse returned but cipitating event or triggering factor. The headache was only occasionally. throbbing but there were no other features of a migraine Within 2 years the patient had divorced his wife and or cluster headache. There were no associated symptoms married his secretary. The coital headaches did not occur or systemic features such as fever or stiffness of the neck. again. The patient had been in excellent health without a past history of important illness. He did not smoke or drink excessively. His parents and two siblings were living and Questions about This Case well, however, his mother had had migraine in her earlier • What other diagnostic considerations should be enter- years. The patient was married and had 2 children nei- tained? ther of whom had headaches. • What other laboratory studies should be considered? General physical and neurologic examinations were • Was the initial evaluation adequate? normal.
    [Show full text]