Current pain and headache reports
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Curr Pain Headache Rep · Oct 2008
ReviewThe impact of latent trigger points on regional muscle function.
To date, most investigation of latent myofascial trigger points (LTrPs) has occurred in pain populations. Many have thought that LTrPs are clinically relevant as -potential precursors to developing active myofascial trigger points and spontaneous pain. ⋯ Fatigue and neurophysiologic studies provide evidence as to the pathways via which group III and IV afferents can alter activity of the motoneuron pool and therefore affect muscle activation and performance. This article offers suggestions as to the mechanisms via which LTrP-related pathophysiology may explain the clinical examination findings associated with LTrP-containing and functionally related muscles.
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Curr Pain Headache Rep · Oct 2008
ReviewAdolescent issues in migraine: a focus on menstrual migraine.
Migraine commonly affects adolescents, and menstrual migraine often begins in young girls. If undiagnosed or ineffectively treated, migraine can lead to disability, school absenteeism, emotional or social difficulties, and chronification of headache. Thus, recognizing and accurately diagnosing migraine and menstrual migraine, developing effective treatment strategies (both pharmacologic and nonpharmacologic), and educating both the adolescent and her parents are important in order to minimize the potential early disability of this disorder and limit the otherwise likely progression of migraine to a disabling disorder of adulthood.
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Curr Pain Headache Rep · Oct 2008
ReviewThe role of extraocular and facial muscle trigger points in cephalalgia.
Trigger points play a part in the development and maintenance of chronic headache states. This article reviews the physiology of trigger points, with a focus on the -latest understanding of their biochemistry. The importance of facial muscle and extraocular muscle trigger points is only beginning to be understood; the data exploring their role in headache are reviewed. The concept of central sensitization and the way in which it relates to trigger points and headache is explained, along with treatment strategies for helping patients with their pain.
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A history of headaches in a family is very frequently noted when evaluating a child for recurrent, episodic headaches. Oftentimes, these headaches have migraine features, although the family may deny a history of migraine. ⋯ A variety of methodology has begun to elucidate this contribution, including historical observation, population-based studies of families and twins, gene polymorphism association studies, and specific gene identification for isolated migraine subtypes. This line of investigation should progress in the future to a better understanding of migraine and clarification of the diagnostic subtypes for a genotype-phenotype association.
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Curr Pain Headache Rep · Oct 2008
ReviewComplementary and alternative treatments for childhood headaches.
Parents frequently ask health care professionals to provide "natural" migraine care for their children and often use herbs, minerals, vitamins, and supplements to treat their children's migraines, thinking that these over-the-counter alternatives are less toxic than prescription medications. The only randomized controlled trial on any alternative treatment for pediatric migraine is for magnesium, and the results were equivocal. ⋯ There is one positive uncontrolled trial each for coenzyme Q10 and Petasites for prevention of pediatric migraine. There are no trials to indicate the safety or efficacy of riboflavin or feverfew for pediatric headache.