Headache
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Randomized Controlled Trial Multicenter Study
A double-blind placebo-controlled pilot study of sublingual feverfew and ginger (LipiGesic™ M) in the treatment of migraine.
Therapeutic needs of migraineurs vary considerably from patient to patient and even attack to attack. Some attacks require high-end therapy, while other attacks have treatment needs that are less immediate. While triptans are considered the "gold standard" of migraine therapy, they do have limitations and many patients are seeking other therapeutic alternatives. In 2005, an open-label study of feverfew/ginger suggested efficacy for attacks of migraine treated early during the mild headache phase of the attack. ⋯ Sublingual feverfew/ginger appears safe and effective as a first-line abortive treatment for a population of migraineurs who frequently experience mild headache prior to the onset of moderate to severe headache.
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Review
Spinal manipulations for cervicogenic headaches: a systematic review of randomized clinical trials.
The objective of this systematic review was to assess the effectiveness of spinal manipulations as a treatment option for cervicogenic headaches. Seven databases were searched from their inception to February 2011. All randomized trials which investigated spinal manipulations performed by any type of healthcare professional for treating cervicogenic headaches in human subjects were considered. ⋯ There are few rigorous RCTs testing the effectiveness of spinal manipulations for treating cervicogenic headaches. The results are mixed and the only trial accounting for placebo effects fails to be positive. Therefore, the therapeutic value of this approach remains uncertain.
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We aimed to report 6 new cases of bifocal nummular headache (NH), showing their clinical characteristics and comparing them with those formerly described. ⋯ Although not frequently found, some patients may have bifocal or multifocal NH.
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Comparative Study
Cost of health care among patients with chronic and episodic migraine in Canada and the USA: results from the International Burden of Migraine Study (IBMS).
To evaluate and compare healthcare resource use and related costs in chronic migraine and episodic migraine in the USA and Canada. ⋯ Chronic migraine was associated with higher medical resource use and total costs compared to episodic migraine. Therapies that reduce headache frequency could become important approaches for containing or reducing headache-related medical costs.
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Chronic migraine (CM) is the most disabling of the 4 types of primary chronic daily headache (CDH) of long duration, a syndrome defined by primary headaches 15 or more days per month for at least 3 months with attacks that last 4 hours or more per day on average. CDH of long duration includes CM, chronic tension-type headache, new daily persistent headache, and hemicrania continua. CM affects approximately 2% of the adult population in Western countries, imposing substantial burdens on individual sufferers and their families and, more broadly, upon society. ⋯ In addition, patients with CM were nearly twice as likely to have anxiety, chronic pain, or depression. Furthermore, patients with CM had higher cardiovascular and respiratory risk, were 40% more likely to have heart disease and angina, and were 70% more likely to have a history of stroke. These findings highlight the paramount importance of clinical vigilance, accurate diagnosis, and appropriate, effective management - including treatment or referrals - to improve patient outcomes.