Headache
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Multicenter Study Clinical Trial
Long-term evaluation of sumatriptan and naproxen sodium for the acute treatment of migraine in adolescents.
To evaluate the long-term safety, tolerability, effectiveness, impact on quality of life, and medication satisfaction of sumatriptan/naproxen sodium in the acute treatment of migraine headache in adolescents. ⋯ In adolescent migraineurs, after up to 12 months and over 12,000 exposures to sumatriptan/naproxen sodium, there were no new or clinically significant findings in the safety parameters, including the frequency and nature of adverse events, as compared to the individual components or to the adverse event profile in adults. In addition, sumatriptan/naproxen sodium provided freedom from pain over time, improvements in quality of life and medication satisfaction.
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Randomized Controlled Trial Multicenter Study
OnabotulinumtoxinA for treatment of chronic migraine: pooled analyses of the 56-week PREEMPT clinical program.
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To ascertain and characterize the point prevalence of dizziness or vertigo in migraineurs presenting for routine appointments at a specialty headache clinic. ⋯ Subjective complaints of dizziness or vertigo appear to be relatively common accompaniments of migraine, particularly migraine with aura, and prevalence increases with age. Disequilibrium symptoms have a strong and positive association with the severity of migraine pain. With co-occurrence higher than expected by chance, the relationship either reflects comorbidity or these symptoms may be part of the migraine presentation. With a point prevalence of 15.7%, and factors that link expression both to the intensity of migraine pain and to migraine aura, the authors believe that the true relationship may prove to be the latter.
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It has been proposed that desaturation of oxygen during an apnea event is the trigger for cluster headache. Obstructive sleep apnea has been associated with a higher than normal cardiovascular morbidity and mortality. Some obstructive sleep apnea syndrome patients lack the sleep-related, nocturnal decrease, or "dip" in blood pressure, which is seen in normal individuals. ⋯ The high incidence (50%) of non-dipper pattern in both processes, cluster headache and obstructive sleep apnea syndrome, provides support for the hypothesis of a relationship between theses 2 disorders.
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This article is the second of 2 articles reviewing neurostimulation for primary headaches. In Part 1, we described methods, pathophysiology and anatomy, and history of neuromodulation in the treatment of headache, as well as reviewing the literature on peripheral neuromodulation for primary headaches. ⋯ Central stimulation targets include vagus nerve and deep brain structures. Part 2 also analyzes overall therapeutic efficacy, safety, cost, patient selection, and recommendations for further research of neurostimulation modalities based on available data.