Current opinion in neurology
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This review examines currently available therapeutic strategies for Parkinson's disease, emphasizing evidence-based data as well as a patient-centered approach to the treatment of motor and nonmotor symptoms. ⋯ Numerous clinical trials have provided evidence that health-related quality of life can be substantially improved with early diagnosis and institution of exercise and other physical measures, appropriate timing of dopaminergic therapy, and strategies to delay and treat levodopa-related motor complications and nonmotor Parkinson's disease-related symptoms.
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This review provides an update on our knowledge regarding prevention and management of medication overuse headache (MOH). ⋯ A brochure and/or the SDS should be used to prevent MOH. Withdrawal is the cornerstone of MOH management. Short advice on MOH is the current most cost effective management method, a method that can be applied anywhere including third world countries.
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Curr. Opin. Neurol. · Jun 2012
ReviewNeurostimulation therapies for primary headache disorders: present and future.
Most pharmacological treatments of primary headache disorders are partially effective and have cumbersome side effects. Therapies with better efficacy and tolerance are needed. Neurostimulation techniques may have this potential. This is an attempt to summarize the latest clinical trial results published in the field. ⋯ Neurostimulation therapies inaugurate a new era in headache management and offer a promising alternative to medications. Future studies are necessary to provide evidence-based efficacy data, knowledge on their mode of action and information about their pharmaco-economic advantages.
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Recent evidence supports the suggestion that migraine is a chronic disorder with episodic attacks that increase in frequency in a subgroup of patients, transforming migraine into a refractory chronic condition with poor outcome and severe impact. Among the risk factors for migraine chronification depression figures notably. Early diagnosis and management of risk factors in migraineurs prevent migraine chronification and its consequences. The scope of this article is to review depression as a potential cofactor for migraine chronification. ⋯ We suggest that clinicians consider depression as part of migraine management in order to optimize treatment and avoid migraine progression.