Current neurology and neuroscience reports
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Status epilepticus is a common, life-threatening medical emergency in pediatric patients. Recent medical literature has focused on identifying risks and treatment options. ⋯ It also reviews the recommended medications for first-line treatment of status epilepticus and refractory status epilepticus. Emphasis is placed on future pharmacotherapies and consideration of neurosurgical intervention when indicated.
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Curr Neurol Neurosci Rep · Mar 2009
ReviewMotor cortex and deep brain stimulation for the treatment of intractable neuropathic face pain.
Intractable neuropathic face pain is a syndrome of unremitting severe pain that stems from abnormal nociceptive processing at various levels of the trigeminal system. Treatment of this debilitating condition has long presented a challenge for physicians due to its refractoriness to standard pharmacologic therapies. With few viable treatments, surgical procedures such as motor cortex stimulation (MCS) and deep brain stimulation (DBS) provide additional options. This article reviews the current literature and practices regarding patient selection criteria, potential mechanisms of action, surgical technique, and outcome of patients with neuropathic face pain treated with MCS and DBS.
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The term medication overuse headache (MOH) was recently introduced by the International Headache Society to describe daily or nearly daily (chronic) headache that occurs after the regular intake (overuse) of any kind of antiheadache or antimigraine drug. Chronic headache is a growing problem throughout the world. ⋯ This article reviews the literature on the epidemiology, risk factors, and pathophysiology of MOH. It also summarizes current strategies for treating and preventing headache chronicity.
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Curr Neurol Neurosci Rep · Mar 2009
ReviewReversible cerebral vasoconstriction syndrome: a thunderclap headache-associated condition.
Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by a sudden, severe headache at onset, vascular narrowing involving the circle of Willis and its immediate branches, and angiographic evidence of vasoconstriction reversibility within minutes to weeks of onset. RCVS is underrecognized and often misdiagnosed; it can defy clinical detection because it can mimic common conditions such as migraine and ischemic stroke. A lack of shared nosology has hampered awareness and understanding of the syndrome. ⋯ RCVS has a number of primary and secondary associations (cerebral hemorrhage, vasoactive substances, the peripartum period, bathing, and physical exertion) but also occurs in isolation. RCVS can present in conjunction with hypertensive encephalopathy, preeclampsia, and reversible posterior leukoencephalopathy. This review provides an up-to-date account of RCVS.
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Neurostimulation has emerged as a potential treatment option for patients with chronic, disabling, intractable primary headache disorders. Although safety and efficacy data are limited in quantity, there is accumulating experience with the use of peripheral nerve stimulation for the treatment of intractable occipital neuralgia, cluster headache, migraine, and less common headache disorders. Deep brain stimulation has been used to treat intractable chronic cluster headache and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing. This article discusses the theorized mechanisms of action of these novel treatment modalities and summarizes current knowledge regarding safety and efficacy of neurostimulation for the treatment of headache.