Headache
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Randomized Controlled Trial
Evaluation of carisbamate for the treatment of migraine in a randomized, double-blind trial.
This study explored the dose-response relationship of carisbamate administered at doses of 100 mg per day, 300 mg per day, or 600 mg per day, in the prevention of migraine. ⋯ Carisbamate was not more efficacious in migraine prophylaxis than placebo in this well-controlled study that included a suitable population. However, carisbamate monotherapy was well tolerated at doses up to 600 mg per day.
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Idiopathic intracranial hypertension (IIH) is usually considered to result from deficient intracranial absorption of cerebrospinal fluid, but has also been suggested to be caused by decreased cranial venous flow because of increased intrathoracic pressure resulting from intra-abdominal obesity. To test this hypothesis, cerebrospinal fluid pressure (Pcsf), extracranial venous pressure (Pvf), intracranial venous pressure, and body mass index (BMI) were studied in patients with IIH with papilledema compared with patients with chronic tension-type headache (CTTH). ⋯ Chronic tension-type headache patients may be prone to have Pcsf > 200 mm water and BMI > 25. Papilledema because of intracranial hypertension occurred in the present study at Pcsf > 350 mm water. The findings of Pvfc and Pcsf being similar in all CTTH patients support the suggestion that the techniques used for measuring intracranial venous pressure are adequate. The findings of similar BMI in the CTTH and the IIH patients who differed significantly as to Pcsf refute the hypothesis that obesity precedes, and is the cause of, intracranial hypertension in IIH. The difference between Pcsf and Pvfc in 6 of the IIH patients also does not support such a hypothesis but may indicate that IIH is due to deficient intracranial cerebrospinal fluid absorption. Since a relationship between intracranial hypertension and obesity is established and obesity is not found to cause intracranial hypertension in IIH, intracranial hypertension may be suggested to be the primary cause of weight increase in IIH. Obesity, however, may secondarily increase the preexistent IIH.
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Few studies in adolescents deal with the level of agreement between questionnaire and interview information in relation to headache symptoms. ⋯ The results indicate that our self-administered questionnaire may be an acceptable instrument in determining the prevalence of migraine sufferers in the northeast Italy adolescent population, useful in identifying subjects with "definite" migraine.
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Case Reports
Intravenous lidocaine infusion for the treatment of post-acoustic neuroma resection headache: a case report.
Presentation of a case report of a 47-year-old male with a post-acoustic neuroma resection intractable headache responding to intravenous lidocaine infusion. The patient was then switched to mexiletine, with good response.
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To investigate a clinical population of patients with hemicrania continua (HC), looking at the diagnostic problems they have encountered and their use of healthcare resources and at issues relating to the effectiveness of treatments. ⋯ Hemicrania continua may be misdiagnosed and mistreated even by neurologists. There is a need for greater awareness and understanding of this condition.