European neurology
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Review Randomized Controlled Trial Clinical Trial
The clinical profile of sumatriptan: cluster headache.
Cluster headache is a rare form of severe idiopathic headache characterized by unilateral short-lasting episodes of excruciating pain in association with autonomic disturbances. Subcutaneous sumatriptan has been investigated as an acute treatment for cluster headache in two randomized, double-blind, placebo-controlled, crossover trials. ⋯ The need for rescue medication (100% oxygen by inhalation) at 15 min was significantly lower after sumatriptan treatment as were the severity of functional disability and incidence of non-headache symptoms. Results of a long-term study indicate that the tolerability and efficacy of sumatriptan 6 mg is maintained in long-term use, and that there is no evidence of tachyphylaxis.
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In 12 adults with typical Lennox-Gastaut syndrome and partial epilepsies with secondary bilateral synchrony unsatisfactorily controlled by current antiepileptic drugs, the following computerized background EEG parameters were studied before and during beneficial antiepileptic effect of lamotrigine addition: absolute and relative spectral power density; alpha/theta index; dominant frequency of occipital alpha, theta and delta bands. The only significant influence of lamotrigine addition was a moderate decrease of the median and mean absolute delta power (p < 0.01). We concluded there was a poor influence of therapeutic doses of lamotrigine on the background diffuse slow dysrhythmias characteristic to severe early encephalopathies which engender both severe secondary epilepsies and different degrees of mental handicap.
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The objective of the study was to evaluate the relation between every-night (habitual) snoring, sleep apnea and cognitive complaints (concentration and memory problems) in an adult population-based sample. In the Dan-MONICA (MONItoring trends in CArdiovascular diseases) 1,504 males and females aged 30, 40, 50 and 60 years were classified according to their snoring habits. Nocturnal respiration was measured in 748 participants. ⋯ The main conclusion drawn from this study is that cognitive complaints show a high correlation to mood, insomnia, and hypersomnia. Habitual snoring and sleep apnea show a correlation to concentration problems, but not to memory complaints. This suggests that part of the association between snoring, sleep apnea and cognitive dysfunction is related to the presence of sleep disturbances and daytime sleepiness.
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Case Reports
Hemorrhagic and ischemic cerebrovascular complications of active infective endocarditis of native valve.
Cerebrovascular events complicate the management of infective endocarditis. The purpose of this study is to analyze clinical features of cerebrovascular complications in infective endocarditis and to establish the appropriate time schedule of chemotherapy and cardiosurgical intervention. We studied the clinical data of 123 patients with active infective endocarditis of native valves retrospectively. ⋯ The remaining patients undertaking cardiac surgery did all survive; in whom there were chemotherapeutic intervals of 11 days after ischemic events or of 23 days after hemorrhagic events. These medical records suggest that early cardiosurgical intervention, if necessary, needs at least 2-3 weeks of preceding chemotherapy. In cases undergoing more than 1 month of chemotherapy, cerebrovascular complications may be well managed by medical treatment alone.