Headache
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Migraine is frequently associated with menstruation in female migraineurs, and consequently it is commonly referred to as menstrually associated migraine. The trigger thought to be partially responsible for menstrually associated migraine is a significant drop in circulating estrogen that is noted during 2-3 days prior to onset of menses. ⋯ Understanding the biological basis of migraine associated with menses will facilitate an accurate diagnosis and help patients recognize time susceptible to migraine exacerbations. This paper will review the biological bases for the hormonal changes that occur during the menstrual cycle and review the prevalence and burden of menstrual migraine among female headache sufferers.
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Clinical Trial
Correlation of increase in phosphene threshold with reduction of migraine frequency: observation of levetiracetam-treated subjects.
To correlate the reduction in migraine frequency with change in phosphene threshold of transcranial magnetic stimulation during levetiracetam treatment. ⋯ Phosphene threshold increased during treatment with levetiracetam. At the 10% significance level, headache frequency and phosphene threshold were negatively correlated.
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To develop and validate a brief questionnaire to screen for menstrual migraine (MM), and to estimate MM prevalence in an obstetrics and gynecology (OB/GYN) setting in a pilot study. ⋯ The MM screener MMAT exhibits sufficient sensitivity and specificity to assess this frequently disabling condition presenting at the OB/GYN office.
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Clinical Trial
Botulinum toxin type-A (BOTOX) in the treatment of occipital neuralgia: a pilot study.
To determine the efficacy of occipital nerve blocks using reconstituted botulinum toxin type-A (BTX-A) in providing significant and prolonged pain relief in chronic occipital neuralgia. ⋯ Our results indicate that BTX-A improved the sharp/shooting type of pain most commonly known to be associated with occipital neuralgia. Additionally, the quality of life measures assessing burden and long-term impact of the headaches, further corroborated improvement seen in daily head pain.