Headache
-
Comparative Study
Chronic daily headache: correlation between the 2004 and the 1988 International Headache Society diagnostic criteria.
In a previous study, we compared the 1988 International Headache Society (IHS) criteria and the Silberstein-Lipton criteria (S-L) in a subspeciality clinic sample of 638 patients with chronic daily headache (CDH) assessed both clinically and with headache diaries. Both systems allowed for the classification of most patients with CDH. The 1988 IHS classification required multiple diagnoses and was more complex to apply. ⋯ We conclude that the 2004 IHS criteria facilitate the classification of NDPH without medication overuse and HC. For subjects with TM according to the S-L system, the new IHS criteria are complex to use and require multiple diagnoses. Very few patients with TM in the S-L system could be classified with a single diagnosis in the 2004 IHS classification. In fact, CM was so rare that it would be virtually impossible to conduct clinical trials of this entity using the 2004 IHS criteria. Clinical trials of this entity should therefore be conducted using the S-L criteria. Finally, we propose that in the 3rd edition of the IHS classification, the diagnosis of NDPH be revised so as not to exclude migraine features.
-
To assess the reasons for switching triptans within migraine patients presenting to a specialty clinic. ⋯ A variety of treatment attributes are important in determining the reasons involved in switching a triptan. To assess this attributes can provide additional information to supplement the traditional tests of efficacy provided by randomized clinical trials.
-
Clinical Trial Controlled Clinical Trial
Early treatment of migraine with rizatriptan: a placebo-controlled study.
To evaluate the efficacy of rizatriptan when administered early during a migraine attack. ⋯ Rizatriptan is significantly more likely than placebo to produce a pain-free response within 2 hours when the drug is administered early in the migraine attack, when pain is mild rather than moderate or severe.
-
A 36-year-old man without significant past medical history presented with recurrent explosive headache at the time of orgasm. Magnetic resonance angiography showed focal mid-basilar artery narrowing. Despite receiving no specific therapy, the patient's headaches and vascular narrowing had resolved completely on follow-up six months later. While a number of pharmacologic agents have been proposed to be of benefit in orgasmic headache, this case suggests that spontaneous resolution may also occur.