Headache
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Cluster headache remains substantially underdiagnosed and undertreated. Early neurologic referral is indicated in patients with a suspected diagnosis of cluster headache (CH) so that management can be optimized and unnecessary procedures avoided. ⋯ This 2-item questionnaire could be a useful tool for screening CH cases in tertiary centers.
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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.