The pain of a migraine
Publication date: Available online 12 July 2019Source: The Lancet NeurologyAuthor(s): Jules Morgan
ConclusionsThis study evaluated the efficacy characteristics of seven kinds of triptans and their different dosage forms. The present findings provide necessary quantitative information for migraine medication guidelines.
The trigeminal autonomic cephalalgias (TACs) are a group of primary headache syndromes all marked by unilateral headache and ipsilateral cranial autonomic features. The TACs include cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing, and hemicrania continua. Pathophysiology includes the trigeminal pain system, autonomic system, hypothalamus, and more recently an identified role for the vagus nerve. Diagnosis is made after looking at headache frequency, duration, and accompanying symptoms. Each TAC has its own unique treatment, which is discussed in depth.
CONCLUSION: Patients with IBS in Germany are likely not receiving sufficient diag- nostic evaluation in conformity with the relevant guidelines. The high prevalence of comorbid mental disorders and other pain syndromes implies that the complaints of patients with IBS need to be more comprehensively evaluated and treated. PMID: 31431234 [PubMed - in process]
Sagittal imbalance in the cervical spine is a major cause of neck pain, headache, fatigue, and disability. While parameters such as C2-C7 lordosis and C2-C7 sagittal vertical axis have been extensively studied, they do not fully characterize cervical sagittal balance. T1 is an important new parameter of both cervical as well as global spinal sagittal balance. However, the T1 superior end plate can be difficult to visualize on standard lateral radiographs due to overlying anatomical structures. C7 slope has therefore been proposed as a potential substitute for T1 slope when the T1 superior end plate is not well visualized.
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Headache is one of the most common pain symptoms in childhood having a negative impact on many aspects of the lives of affected children, both short-term and long-term. Therefore, it is important to document s...
This article reviews the published criteria and proposes a new set of criteria. The epidemiology, pathophysiology and management options are also reviewed.
DiscussionA major strength of this study is its pragmatic nature, where the active treatment group receives chiropractic manipulation according to their individual needs, while both groups continue their use of medication for headache according to their pre-trial habits. Other strengths include an elaborate sham procedure and the weekly outcome reports, reducing recall bias.If it is possible to develop effective treatment for headache in children, a life course of recurring problems may be altered with potential positive implications for both individuals and society.Trial registrationClinicalTrials.gov, identifierNCT02684916.
A 67-year-old white female patient with metastatic breast cancer presented with 2 weeks of painless reduced vision in her right eye (OD), without headache, photophobia, diplopia, or eye pain, with placoid yellow choroidal lesions with ill-defined borders and subretinal fluid in each eye (OU). What is the diagnosis and what would you do next?