Headache
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To assess the evolution of headaches in a workplace cohort over a 10-year period. ⋯ Only a minority of subjects diagnosed with migraine or migrainous disorder retain the diagnosis 10 years later, with most subjects evolving to a less disabling headache type.
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Randomized Controlled Trial
Topiramate for migraine prevention in children: a randomized, double-blind, placebo-controlled trial.
To assess the efficacy and safety of topiramate for the prevention of pediatric migraine with or without aura in a double-blind, randomized, placebo-controlled trial. ⋯ This pilot study suggests that topiramate may be an effective migraine preventive therapy in children. Topiramate was well tolerated in this population. Further randomized studies would be required to definitively establish the efficacy of topiramate for pediatric migraine prevention.
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To evaluate the sensitivity of the new International Classification of Headache Disorders-2nd edition (ICHD-II) criteria in the diagnosis of childhood migraine and to propose specific criteria for the diagnosis of childhood migraine. ⋯ Modification of ICHD-II criteria to include bilateral headache, headache duration of 1 to 72 hours, and nausea and/or vomiting plus two of five other associated symptoms (photophobia, phonophobia, difficulty thinking, lightheadedness, or fatigue), in addition to the usual description of moderate to severe pain of a throbbing or pulsating nature worsening or limiting physical activity, improved sensitivity of migraine diagnosis to 84.4%.
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Clinical Trial
Nociceptive blink reflex and visual evoked potential habituations are correlated in migraine.
Lack of habituation, as reported in migraine patients between attacks for evoked cortical responses, was also recently found for the nociceptive blink reflex (nBR) mediated by brainstem neurons. It is not known if both brain stem and cortical habituation deficits are correlated in the same patient, which would favor a common underlying mechanism. ⋯ The positive correlation between visual evoked potential and nBR habituations is consistent with the idea that in migraine the same neurobiological dysfunction might be responsible for the habituation deficit both in cortex and brain stem. As nBR habituation increases with attack frequency, its interictal deficit is unlikely to be due to trigeminal sensitization.
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To investigate the habituation response pattern of patients with migraine to a simple standard stressor and to a more complex performance-dependent (achievement) stressor in three peripheral systems (electrodermal, vasomotor, and cardiovascular). We hypothesized that the migraine patients would show abnormal habituation in these peripheral systems, especially in response to achievement stimuli. ⋯ Our results suggest that the mental arithmetic (achievement) habituation paradigm is an important tool for demonstrating reduced habituation in several specific components of the autonomic nervous system. Further research is needed to target the covariance of central and autonomic nervous system habituation phenomena in migraine.