Cephalalgia : an international journal of headache
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Case Reports
Reversible cerebral vasoconstriction syndrome: Is it more than just cerebral vasoconstriction?
Systemic vascular alterations have not been described in reversible cerebral vasoconstriction syndrome (RCVS). We present a case series of RCVS patients having cardiac dysfunction during ictus, with a subset showing complete resolution of cardiomyopathy. ⋯ Although the exact pathophysiology of the cardiomyopathy is uncertain, it may be related to localized coronary vasoconstriction causing myocardial ischemia/infarction. Vasoconstriction may not be limited to the cerebral vasculature and may involve extracerebral organs. Cardiac ventricular abnormalities may be a part of the RCVS spectrum.
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The objectives of this article are to compare interictal and ictal visual sensitivity between migraine and controls using two published questionnaires, and to correlate responses with a physiologic measure of visual cortex activation. ⋯ Increased interictal visual sensitivity is present both in MWA and MwoA. However, the correlation with ictal visual sensitivity and with cortical hyper-responsivity varies between MWA and MwoA, suggesting underlying differences between groups.
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Between attacks, migraine is associated with hypersensitivities to sensory stimuli. The objective of this study was to investigate hypersensitivity to pain in migraineurs between attacks. ⋯ This study provides evidence that migraineurs have low heat pain thresholds between migraine attacks. Mechanisms underlying these lower pain thresholds could also predispose migraineurs to their next migraine attack, a hypothesis supported by finding positive correlations between pain thresholds and time to next migraine attack.
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Case Reports
Application of the capsaicin 8% cutaneous patch in neuropathic pain of the head and face: A case series.
Treatment of neuropathic or neuralgic head and facial pain due to dental, traumatic or surgical nerve lesions or post-herpetic neuropathy is often challenging. ⋯ Treatment with the capsaicin 8% patch seems to be effective and safe for application to the facial and head region. The capsaicin 8% patch might be an additional treatment option if first-line treatment with anticonvulsants or antidepressants was ineffective or limited by side effects.
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Occipital nerve stimulation (ONS) results in beneficial outcomes, with marked pain relief, in otherwise intractable chronic migraine (CM) and chronic cluster headache (CCH). Some studies have reported that a positive response to occipital nerve block (ONB) administered prior to ONS predicts a positive response to ONS. However, other studies concerned with proper patient selection claimed no predictive value for ONB. The aim of this study was to re-evaluate the usefulness and predictive value of ONB prior to ONS. ⋯ Current literature suggests that ONB does not sufficiently predict ONS responsiveness in patients with refractory CM and CCH; this important issue requires further investigation.