European neurology
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Biography Historical Article
Virginia Apgar (1909-1974): neurological evaluation of the newborn infant.
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The terms myofascial pain, fibromyalgia and fibrositis are critically examined. They constitute diagnostic labels for non-specific musculoskeletal aches and pains. Analysis of the evidence shows that none of these labels is substantiated by hard physical signs or by laboratory evidence of consistent pathological or biochemical abnormality. ⋯ They reflect no demonstrable pathology. It is therefore argued that none of these commonly used diagnoses represent distinct disease entities. A possible but unproven alternative hypothesis is that such symptoms relate to neural pain with both peripheral and central components, and in some instances psychological or wilful embellishment.
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Case Reports Comparative Study
Cardiac cephalalgia. Case report and review of the literature with new ICHD-II criteria revisited.
We report a patient with cardiac cephalalgia and review reported cases from the English-language literature based on the new diagnostic criteria published in the International Classification of Headache Disorders, ed 2. Twenty-two patients, including ours, with headaches of cardiac origin were reviewed. The cases fit three of the four new criteria well: Criteria B (acute myocardial ischemia has occurred, 100%), C (headache developed concomitantly with acute myocardial ischemia, 100%), and D (headache resolved and does not recur after effective medical or surgical treatment for myocardial ischemia, 83%). The cases in which we had exceptions were to the proposed headache features (criterion A), which were generally not fulfilled, with nausea as the least frequent finding (27%); this criterion might not be mandatory for diagnosis.