Nihon rinsho. Japanese journal of clinical medicine
-
Recent advances in genetic analysis of migraine headache are reviewed. Point mutations of P/Q -type Ca2+ channel alpha1 subunit(CACNA1A) gene and Na-K ATPase, alpha2 (ATP1A2) gene have been identified in the familial hemiplegic migraine (FHM-1 and FHM-2, respectively). ⋯ Genetic study of migraine is promising and will provide further understanding of the migraine pathophysiology. Discovery of the responsible or susceptible genes will open an avenue to develop new therapeutic strategy.
-
We discuss here the epidemiology of chronic headache. Headache is a widespread and costly public health problem. Few people do not experience headache: in men, the lifetime prevalence for headache of any kind is 93 %, and for women it is up to 99%. ⋯ Despite the painful, costly, and disabling impact of headache, many patients with headache do not seek medical advice. It is important to recognize the incidence of various kinds of chronic headache, and to diagnose and treat them correctly. In this article, we review the incidence, precipitating factors, regional prevalence, and age dependence of the incidence of each type of chronic headache.
-
Cluster headaches are characterized by attacks of strictly unilateral severe pain which is orbital, supraorbital, temporal or in any combination of these sites associated with one or more of the following, ipsilateral conjunctival injection, lacrimation, nasal congestion, rhinorrhea, forehead and facial sweating, miosis, ptosis, and eyelid edema. Most patients are usually unable to lie down, restless or agitated during an attack. The attacks last 15-180 minutes and occur from once every other day to 8 times a day. ⋯ Age at onset is usually 20-40 years and prevalence is 3-4 times higher in men than in women. Acute attacks involve activation of the posterior hypothalamic gray matter. Pharmacological treatment for cluster headache can be abortive, prophylactic, or a combination of both methods.