The journal of headache and pain
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Acute headache is one of the most frequent neurological symptoms in pregnant women. The early diagnosis of underlying secondary conditions has a major influence on patient outcome, especially in emergency settings. However, at the time being no well-established guideline for diagnostic evaluation of acute headache during pregnancy exists. In this study, we aimed to characterize acute headache in pregnant women concerning demographic, clinical, and diagnostic features, and to determine predictors of secondary headache. ⋯ Secondary headache disorders are common during pregnancy, occurring in over one third of acute headache cases receiving neurological consultation. Most anamnestic and clinical features may not allow a clear distinction between primary and secondary headaches. Clinicians should pay attention to the presence of secondary headache history, elevated blood pressure, fever and abnormal findings in the neurological examination. Additional investigations, including laboratory tests and neuroimaging, are essential for the diagnostic process.
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A large number patients struggle with migraine which is classified as a chronic disorder. The relative efficacy, safety and tolerability of prophylactic medications for migraine play a key role in managing this disease. ⋯ Topiramate, propranolol and divalproex may be more efficacious than other prophylactic medications. Besides, the safety and tolerability of divalproex should be further verified by future studies.
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Randomized Controlled Trial Multicenter Study
The impact of onabotulinumtoxinA on severe headache days: PREEMPT 56-week pooled analysis.
OnabotulinumtoxinA has been shown to reduce headache-days among patients with chronic migraine (CM). The objective of this analysis was to determine whether onabotulinumtoxinA has an impact on headache-day severity in patients with CM among those patients who were deemed non-responders based on reduction in the frequency of headache days alone. ⋯ These results suggest that even those patients with CM who are deemed non-responders based on analysis of headache frequency alone experience clinically meaningful relief from headache intensity following treatment with onabotulinumtoxinA.
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The aim of this study was to compare a multidisciplinary approach of menstrual (related) migraine, combining the neurological and gynaecological consultation, to a mono-disciplinary approach involving neurological treatment. There is a clear relationship between the menstruation cycle and the occurrence of migraine (menstrual migraine). Nowadays the treatment of menstrual (related) migraine is performed by a neurologist. A treatment with attention to hormonal treatment seems more convenient. ⋯ A multidisicplinary treatment of women with menstrual (related) migraine gives better results compared to a mono-disciplinary approach. These results should be interpreted with caution as we performed a retrospective study with a relative small control group.
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Randomized Controlled Trial
Duration and frequency of migraines affect cognitive function: evidence from neuropsychological tests and event-related potentials.
The aim of this study was to evaluate the changes in the cognitive performance of migraine patients using a comprehensive series of cognitive/behavioral and electrophysiological tests. ⋯ Cognitive performance decreases during migraine, and cognitive dysfunction can be related to the duration and frequency of a migraine attack.