Acta neurologica Scandinavica. Supplementum
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Acta Neurol. Scand., Suppl.c · Jan 2011
Randomized Controlled Trial Multicenter StudyA randomized controlled trial on medication-overuse headache: outcome after 1 and 4 years.
Different opinions exist regarding the optimal treatment of patients with medication-overuse headache (MOH). Few studies have evaluated the long-term prognosis among these patients, and there are no standard measures of outcome in such studies. ⋯ Early introduction of prophylactic medication was an effective way to reduce headache days during the first 3 months, and the notion that patients with MOH need withdrawal of analgesics to respond to preventive medication seems to be incorrect. The long-term prognosis during the 4-year follow-up was relatively favorable as there was a steady decline in headache, one-third of the patients with MOH having ≥50% reduction in headache frequency from baseline and two-thirds being without medication overuse.
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Acta Neurol. Scand., Suppl.c · Jan 2011
ReviewCardiovascular and urological dysfunction in spinal cord injury.
A spinal cord injury (SCI) above the sixth thoracic vertebra interrupts the supraspinal control of the sympathetic nervous system causing an imbalance between the sympathetic and the parasympathetic nervous system. This article focuses on the symptoms, treatment and examination of autonomic disturbances of the cardiovascular and the urinary system after a SCI. ⋯ Patients with SCI have a high risk of cardiovascular complications, AD and urinary autonomic dysfunction both in the acute phase and later, affecting their prognosis and quality of life. Knowledge of cardiovascular and urological complications after SCI is important for proper diagnosis and treatment.
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Acta Neurol. Scand., Suppl.c · Jan 2011
What initiates a migraine attack? Conclusions from four longitudinal studies of quantitative EEG and steady-state visual-evoked potentials in migraineurs.
Quantitative electroencephalograpic (QEEG) frequency spectra and steady-state visual-evoked potentials (SSVEP) are indicators of corticothalamic excitability (e.g., arousal). Increased interictal excitability is suggested to be an important element in the migraine pathophysiology. In this paper, we summarize our results from four studies of QEEG and SSVEP recordings in migraineurs interictally and in the days before an attack with the intention to shed light on attack-initiating mechanisms. ⋯ A general tendency toward EEG slowing and depression of photic responses characterized the migraine group. This pattern was also related to increased severity of symptoms. A change in cortical activity occurred within 36 h before attacks. Our results indicate that thalamocortical hypoexcitability is associated with attack initiation and sensory hypersensitivity in migraine.