Current pain and headache reports
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Tension-type headache (TTH) is the most prevalent form of primary headache in the general population. In this article, the diagnostic challenges of TTH are discussed. The classification of these headaches according to the second edition of the International Classification of Headache Disorders (ICHD-2) and the main differences between the ICHD-2 and the first edition of the classification (ICHD-1, 1988) are discussed. ⋯ Finally, the differential diagnosis of episodic and chronic TTH, emphasizing the situations more likely to raise doubts, is discussed. The wide clinical spectrum of TTH frequently challenges the physician's diagnostic acumen. A structured approach to the patient and a better comprehension of this variability of presentation should translate into better quality of care and a more specific diagnosis for TTH sufferers.
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Curr Pain Headache Rep · Dec 2005
ReviewTargeting cytokines beyond tumor necrosis factor-alpha and interleukin-1 in rheumatoid arthritis.
Targeting tumor necrosis factor-a has proven of considerable value in treatment for rheumatoid arthritis, with substantial benefits achieved in a proportion of treated patients. However, a significant number of patients do not achieve sufficient improvement and as a result there remains considerable unmet clinical need. ⋯ We review recent data that support the notion that some or all of these moieties offer therapeutic potential. The possibility that some may be useful in partial responders to tumor necrosis factor blocking agents or in synergy with the latter is discussed.
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Tension-type headache (TTH) is a very common problem that usually causes only minimal to moderate discomfort and little disability. If episodic TTH evolves to chronic TTH, then the morbidity in terms of discomfort, disability, and use of medication escalates dramatically. ⋯ There is a modest increase in prevalence between the ages of 30 and 50 years and a decrease to 25% to 35% prevalence after the age of 60 years. TTH appears to remain a problem for most sufferers throughout their lives.
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Curr Pain Headache Rep · Oct 2005
Review Case ReportsReview of the Chinese medical approach to the management of fibromyalgia.
Traditional Chinese medicine (TCM) has a long history of efficacy in treating chronic illness. TCM views fibromyalgia and related conditions as disorders in the movement of energy (Qi) and body fluids (including blood) in the body and gets excellent treatment results using acupuncture, herbal medicine, massage, diet, and exercise to restore the proper flow of Qi and fluids. This article briefly introduces the TCM model of human physiology and TCM diagnostics and describes the TCM pathophysiology and treatment models for fibromyalgia.
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Curr Pain Headache Rep · Oct 2005
ReviewManagement of migraine in children and adolescents in the emergency department and inpatient setting.
Migraine is a chronic disorder that can be debilitating, especially when the attacks are severe and frequent. Children and adolescents are significantly affected. The prevalence of migraine in this age group is higher than predicted due to more recognition of the disease in this population throughout the past century. ⋯ Multiple medications are used to break an acute attack. Most approaches are based on outpatient treatments and include the use of over-the-counter medications and triptans and narcotics. This manuscript reviews most of the available therapies for acute treatment of primary headache that did not respond to outpatient management.