The journal of headache and pain
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Chronic daily headache (CDH) is a debilitating disorder that becomes a treatment challenge in patients refractory to the treatment. We hereby report our experience with topiramate treatment in patients with refractory CDH. The study design was a prospective, protocol-based follow-up and retrospective analysis of headache diaries. ⋯ Slowly increasing the drug at moderate increments resulted in high tolerability of topiramate. We found topiramate to be an effective long-standing treatment option for patients with refractory CDH. Slow increments of the dosage contributed to high tolerability of the drug.
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Acupuncture is a popular complementary treatment for various pain syndromes. Some studies claim efficacy in the treatment of primary headache syndromes. However, data on the frequency of acupuncture use by patients with headache prior to neurological referral have not been identified. In this study, 12% of patients with headache attending general neurology outpatient clinics had already received acupuncture; of the remainder, 73% said they would be willing to try it.
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Case Reports
Cluster-like headache after surgical crystalline removal and intraocular lens implant: a case report.
Cluster headache (CH) is a well characterized primary headache disorder. Nevertheless, symptomatic CH has been reported in association with various underlying diseases. Symptomatic cluster headache related to ocular pathologies have been rarely described. We report a case consequent to a surgical operation for cataract.
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Clinical Trial
The present role of percutaneous cervical cordotomy for the treatment of cancer pain.
The results obtained by percutaneous cervical cordotomy (PCC) were analysed in 43 terminally ill cancer patients treated in our institution from 1998 to 2001. We wished to determine whether there is still a place for PCC in the actual clinical situation with its wide choice of pain therapies. All patients had severe unilateral pain due to cancer, resistant to opioids and co-analgesics. ⋯ In general, complications were mild and mostly subsided within 3-4 days. There was one case of partial paresis of the ipsilateral leg. PCC remains a valuable treatment in patients with treatment-resistant cancer pain and still deserves a place in the treatment of terminal cancer patients with severe unilateral neuropathic or incidence pain.