Headache
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Review
Episodic Syndromes That May Be Associated With Migraine: A.K.A. "the Childhood Periodic Syndromes".
Previously called "childhood periodic syndromes that are commonly precursors of migraine" in International Headache Classification of Headache Disorders (ICHD)-II, these disorders were renamed "episodic syndromes that may be associated with migraine" in ICHD-III beta. The specific disorders reviewed in this article include: benign paroxysmal torticollis, benign paroxysmal vertigo, abdominal migraine, and cyclical vomiting syndrome, as well as infantile colic, which was recently added under the appendix section in ICHD-III beta.
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Randomized Controlled Trial
Pilot Randomized Controlled Trial of Internet-Delivered Cognitive-Behavioral Treatment for Pediatric Headache.
To evaluate the feasibility and preliminary effectiveness of an Internet-delivered cognitive-behavioral therapy (CBT) intervention for adolescents with chronic headache. ⋯ Although adjunctive Internet CBT did not lead to additional benefit in this population, future research should evaluate whether it is an effective intervention for adolescents with headache who are unable to access specialized headache treatment.
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Randomized Controlled Trial
Age But Not Sex Is Associated With Efficacy and Adverse Events Following Administration of Intravenous Migraine Medication: An Analysis of a Clinical Trial Database.
Migraine prevalence is associated with both sex and age. Differences in efficacy of parenteral migraine medication administration based on the sex and age of the patient have not been explored in the published literature. ⋯ Sex was not associated with response to parenteral acute migraine medication. Age was associated with both efficacy and adverse events.
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This cross-sectional study investigated potential differences in cervical musculature in groups of migraine headaches vs. non-headache controls. Differences in cervical muscle strength and antagonist coactivation during maximal isometric voluntary contraction (MIVC) were analyzed between individuals with migraine and non-headache subjects and relationships between force with migraine and neck pain clinical aspects. ⋯ Patients with chronic migraine exhibit altered muscle performance, took longer to reach peak of force during some cervical movements, and had higher coactivation of the splenius capitis during maximal isometric cervical flexion contraction. Finally, patients with migraine reported the presence of neck and head pain complaints during maximal isometric voluntary cervical contractions.
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Physicians report increasing rates of career dissatisfaction and professional burnout, which may be related to the practice environment and subspecialty. There has never been a survey of professional burnout among headache medicine specialists. ⋯ Headache medicine specialists have one of the highest rates of burnout compared to other physician specialists, which is twice the rate of working adults. Physicians' age and practice environment and experience are related with their career satisfaction and professional burnout. Some attributes of career satisfaction can decrease burnout by reducing emotional exhaustion and depersonalization and by enhancing personal accomplishment. There is widespread dissatisfaction with the practice environment. These findings may portend decreasing access to headache medicine specialists in the future if specialists cut back on hours and patients seen, accelerate their retirement plans, and fewer neurologists are attracted to headache medicine.