Headache
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Randomized Controlled Trial Multicenter Study
Effect of early intervention with almotriptan vs placebo on migraine-associated functional disability: results from the AEGIS Trial.
To investigate the effect of early acute migraine intervention with almotriptan vs placebo on functional disability and health-related quality of life (HRQoL) indicators. ⋯ Early treatment with almotriptan within 1 hour of migraine pain onset significantly reduced levels of functional disability at 2 and 4 hours posttreatment compared with placebo. Consistency in improvement of HRQoL indicators was observed across 3 headaches treated.
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Randomized Controlled Trial Multicenter Study
Randomized controlled trial of intravenous dexamethasone to prevent relapse in acute migraine headache.
Migraine headache is a common presentation in the emergency department (ED). Inflammation is thought to play a role in the pathophysiology of migraine and there is conflicting evidence regarding the effect of corticosteroids on reducing early recurrences. We conducted a randomized clinical trial to test the hypothesis that dexamethasone (DEX) reduced headaches after discharge and examine the factors associated with relapse. ⋯ The overall relapse rate differed from those previously reported; however, DEX failed to reduce headache relapses after ED discharge. Relapse was closely associated with incomplete pain relief at discharge. Further research is needed to determine the factors associated with migraine relapse.
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Randomized Controlled Trial
Traditional acupuncture in migraine: a controlled, randomized study.
To check the effectiveness of a true acupuncture treatment according to traditional Chinese medicine (TCM) in migraine without aura, comparing it to a standard mock acupuncture protocol, an accurate mock acupuncture healing ritual, and untreated controls. ⋯ TA was the only treatment able to provide a steady outcome improvement in comparison to the use of only Rizatriptan, while RMA showed a transient placebo effect at T1.
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Comparative Study
Results of screening with the brief headache screen compared with a modified IDMigraine.
Patients with chronic migraine and chronic daily headache syndromes have greater morbidity than patients with episodic migraine, and are less frequently diagnosed. A screening tool which identifies daily headache syndromes as well as migraine would promote more patients receiving appropriate treatment, including prophylaxis. ⋯ The BHS and a modified IDM(TM) are concordant in screening for migraine in 82.6% of a primary care population who endorsed the symptom of headache. However, the BHS screens effectively not only for migraine but also for chronic daily headache and medication overuse. A screening paradigm based on headache frequency and the frequency of medication use can rapidly and sensitively identify migraine, daily headache syndromes, and medication overuse. This paradigm may improve clinical care by identifying patients who merit preventive as well as acute therapy for migraine.
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To evaluate whether migraine patients exhibit less inhibition to painful stimuli when distracted from pain as compared to healthy subjects, testing the spatial discrimination of painful stimuli, the performance during the mental arithmetic task used to contrast the discrimination performance and the behavior of N1 and N2-P2 laser-evoked potentials (LEPs) amplitudes during spatial discrimination and during distraction. ⋯ Migraine patients exhibited reduced inhibition by attentional modulation of pain processing, accompanied by impaired spatial discrimination of painful stimuli.