Headache
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Clinical Trial
Botulinum toxin type-A (BOTOX) in the treatment of occipital neuralgia: a pilot study.
To determine the efficacy of occipital nerve blocks using reconstituted botulinum toxin type-A (BTX-A) in providing significant and prolonged pain relief in chronic occipital neuralgia. ⋯ Our results indicate that BTX-A improved the sharp/shooting type of pain most commonly known to be associated with occipital neuralgia. Additionally, the quality of life measures assessing burden and long-term impact of the headaches, further corroborated improvement seen in daily head pain.
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To describe the use of mexiletine in the treatment of chronic daily headache in a refractory headache population. ⋯ The preliminary study suggests mexiletine is a useful preventative treatment for some patients with chronic daily headache, including refractory patients with medication overuse or those who have failed multiple preventatives in the past.
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Female hormone genes have been investigated in migraine in recent years. Research in this field has been controversial, especially in regard to ESR1 gene findings. None of the reports have yet to approach the problem from a multigenic point of view. ⋯ We found significant association of female hormone metabolism polymorphisms under the perspective of multigene approach.
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Several studies were carried out to investigate the occurrence of headache attributed to acute stroke in patients with a lifetime history of migraine. ⋯ The high prevalence of headache attributed to stroke in (M+) patients, in a relevant proportion of cases presenting as a sentinel headache, suggests that cerebral ischemia lowers the threshold for head pain more easily in these "susceptible" patients. The most frequent involvement of the brainstem in (M+) patients with ischemic infarction concurs with recent reports that emphasized a greater headache frequency when cerebral infarctions are localized in this structure or deep brain gray matter.
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To examine whether sleep complaints reported by migraineurs can be attributed to comorbid anxiety and/or depression. ⋯ The association between sleep problems and migraine that is not solely explained by comorbid anxiety disorders or depression suggests that sleep problems should be evaluated among people with migraine.