Funct Neurol
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Clinical Trial
C2/C3 nerve blocks and greater occipital nerve block in cervicogenic headache treatment.
In the diagnosis of cervicogenic headache, greater occipital nerve (GON), cervical nerve, minor occipital nerve, and cervical facet joint blocks are used. In our study we compared the GON and C2/C3 nerve blocks in the diagnosis and treatment of cervicogenic headache. In both cases, repeated blocks proved to have a long-lasting effect in the treatment of this disorder, with both GON and C2/C3 blocks being found to be equally effective.
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Gabapentin (GBP) is a new, well-tolerated antiepileptic drug found to be effective for painful paroxysmal symptoms (PS) in multiple sclerosis (MS). The aim of this study was to obtain a neurophysiological evaluation of the effects of GBP on the nociceptive system of MS patients suffering PS. We studied 10 MS patients, 6 males, 4 females (mean age 47.3 years), suffering PS (3 had trigeminal neuralgia, 1 painful tonic spasms and 6 dysesthetic or paresthetic symptoms). ⋯ R3 nociceptive reflex was recorded after 2 weeks' treatment. R3 thresholds and latencies were evaluated and a statistical analysis was performed. A significant variation was found in R3 thresholds between the values recorded before and during GBP treatment; no significant variation was observed in R3 latencies.
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Prospective and retrospective studies showed that headaches (migraine and tension-type) with childhood or adolescent onset have age-related characteristics and change over time, with high rate of type changing, remission or improvement. The reasons are unknown. On the other hand, several studies focused on factors that may be precursors of childhood headaches. ⋯ Familial (genetic?) influence, hyperreactivity, periodic syndromes and anxiety in childhood are factors that may predict headache onset, against the background of developmental modulation of pain. Biological and psychological factors are probably reciprocally involved, although the link is unclear. The identification of prognostic factors could allow a better framing of headaches and, from an integrated perspective, have important implications as regards clarifying the "nature" of headache.
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Review Randomized Controlled Trial Comparative Study Clinical Trial
The effectiveness of combined oral lysine acetylsalicylate and metoclopramide (Migpriv) in the treatment of migraine attacks. Comparison with placebo and oral sumatriptan.
In two, double-blind, randomised, clinical, trials (RCTs), oral lysine acetylsalicylate (1620 mg, equivalent to 900 mg aspirin) combined with metoclopramide (10 mg) (LAS + MTC) was compared with placebo, and with oral sumatriptan (100 mg) in one of these RCTs. In both RCTs the LAS + MTC combination was superior to placebo with therapeutic gains (percentage relief after active treatment minus percentage relief after placebo) of 30% and 31% for the first treated attack. These therapeutic gains are in the same range as those found for 100 mg oral sumatriptan, and in the comparative RCT the LAS + MTC combination was quite comparable to 100 mg sumatriptan, with success rates for the first attack of 57% and 53%, respectively.