Current neurology and neuroscience reports
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The neuralgias are characterized by pain in the distribution of a cranial or cervical nerve. While most often brief, severe, and paroxysmal, continuous neuropathic pain may occur. ⋯ These disorders may be mimicked by structural and inflammatory/infectious neurologic disease, along with other primary headache disorders (eg, primary stabbing headache). The approach to diagnosis and treatment of this group of headache disorders is reviewed.
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Curr Neurol Neurosci Rep · Jun 2014
ReviewThe use of targeted temperature management for elevated intracranial pressure.
The use of hypothermia for treatment of intracranial hypertension is controversial, despite no other medical therapy demonstrating consistent improvements in morbidity or mortality. Much of this may be the result of negative results from randomized controlled trials. ⋯ Therefore, therapies may have more benefit in some diseases, less in others. This review focuses on the effect on outcome of intracranial hypertension in common disease processes in the neurocritical care unit, and identifies who is most likely to benefit from the use of hypothermia.
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Migraine headache is a significant health problem affecting women more than men. In women, the hormonal fluctuations seen during pregnancy and lactation can affect migraine frequency and magnitude. ⋯ Pregnancy and lactation can complicate treatment options for women with migraine because of the risk of certain medications to the fetus. This review includes details of the workup and then provides treatment options for migraine during pregnancy and lactation.
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Thunderclap headache (TCH) is a sudden severe headache that peaks to maximum intensity within 1 minute. Subarachnoid hemorrhage is the most commonly identified etiology for this headache, however, other secondary etiologies should be considered. ⋯ MR brain, CT angiogram, MR angiogram, or CT/MR venogram may need to be performed if the initial investigations are negative. Treatment and prognosis depend on the etiology of the TCH.
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The special relationship between migraine and epilepsy has been recognized for centuries and was formally acknowledged by Gowers in his 1906 lecture "Borderland of Epilepsy." The term migralepsy was introduced by Lennox and Lennox in 1960, with multiple cases described in the literature since that time. In the ensuing years, the relationship between migraine and epilepsy has proven complex. The 2 conditions have been found to be comorbid with each other, suggesting a common underlying mechanism or genetic tendency. ⋯ The terms "hemicrania epileptica" and "migraine triggered seizure" were defined by the International Headache Society, formalizing the concept that one can lead to the other. However, case reports and case series in the literature reveal that distinguishing between the 2 entities can be challenging. The concept of migralepsy is likely to evolve as greater understanding of both conditions is gained.