C-fibers may modulate adjacent A δ-fibers through axon-axon CGRP signaling at nodes of Ranvier in the trigeminal system

ConclusionWe observed a close relationship between the CGRP containing C-fibers and the A δ-fibers containing the CGRP-receptor elements, suggesting a point of axon-axon interaction for the released CGRP and a site of action for gepants and the novel mAbs to alleviate migraine.
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research

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CONCLUSIONS: The sequential application of these three surgical procedures succeeded in reversing the serious situation of chronic CR refractory to an episodic CR in 93% of patients with acceptable surgical morbidity. PMID: 31753322 [PubMed - as supplied by publisher]
Source: Medicina Clinica - Category: General Medicine Tags: Med Clin (Barc) Source Type: research
AbstractTwo main contributors of sterile neurogenic inflammation underlying migraine pain, calcitonin gene –related peptide (CGRP), and meningeal mast cells (MMCs) play a key role in the activation of the inflammatory cascade resulting in the sensitization of trigeminal nociceptors. It is well established that phytochemical agent thymoquinone exhibits multiple anti-inflammatory effects in different in vitro and in vivo models of neuroinflammation. But its effects on the CGRP release and meningeal mast cells are unknown. In the present study, we investigated the effects of thymoquinone on the CGRP release in migraine-...
Source: Inflammation - Category: Allergy & Immunology Source Type: research
In this study, we aimed to assess the safety and efficacy of sphenopalatine ganglion stimulation for treatment of chronic cluster headache.MethodsWe did a randomised, sham-controlled, parallel group, double-blind, safety and efficacy study at 21 headache centres in the USA. We recruited patients aged 22 years or older with chronic cluster headache, who reported a minimum of four cluster headache attacks per week that were unsuccessfully controlled by preventive treatments. Participants were randomly assigned (1:1) via an online adaptive randomisation procedure to either stimulation of the sphenopalatine ganglion or a sham ...
Source: The Lancet Neurology - Category: Neurology Source Type: research
This study reports a challenging case of a severe complication during the ultrasound-guided stellate ganglion block. Patient concerns: A 28-year-old male patient with refractory migraine complained episodic pulsatile pain with photophobia, haphalgesia of the scalp for 3 years. Interventions: Ultrasound-guided stellate ganglion block with 4 ml of 1% lidocaine was administrated. Outcomes: A sudden loss of consciousness and tonic–clonic seizure was occurred after negative aspiration and test dose. Further sonographic examination revealed a variation in the left vertebral artery, which remained unrecognized du...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Authors: Yoshida K Abstract AIMS: To examine the effectiveness and safety of using a CAD/CAM-derived injection guide for botulinum neurotoxin block of the sphenopalatine ganglion for trigeminal neuralgia treatment. METHODS: Ten patients with second-division trigeminal neuralgia who did not respond to submucosal administration of botulinum neurotoxin were enrolled in this study. The target point around the sphenopalatine fossa was determined after fusion of computed tomography data with a scan of a maxillary model using a software program for dental implant surgery. A CAD/CAM-derived injection guide was fabricat...
Source: Journal of Orofacial Pain - Category: ENT & OMF Tags: J Oral Facial Pain Headache Source Type: research
CONCLUSION: This review summarizes the only prospectively collected efficacy and safety data regarding the use of botulinum toxin in cluster headache. Off-label use should be considered in certain cases. Further study is warranted to better characterize injection paradigms and patient selection, given the encouraging but limited data available. PMID: 31560734 [PubMed - as supplied by publisher]
Source: Journal of Orofacial Pain - Category: ENT & OMF Tags: J Oral Facial Pain Headache Source Type: research
AbstractWe performed a study of the safety and efficacy of percutaneous pulsed radiofrequency (PRF) treatment directed at C1 and C2 levels as performed at our local pain clinic in refractory chronic cluster headache (CCH) patients. We identified 21 CCH patients treated with PRF (240  s, max. 45 V, max. 42 °C) directed at the ganglion and/or nerve root of C1 and C2. Data were collected through retrospective analysis of patients’ files and include demographic variables, onset and duration of the headache, mean attack frequency, and prior pharmacological treatment. Safety an d reduction of attack freq...
Source: Acta Neurologica Belgica - Category: Neurology Source Type: research
(Reg Anesth Pain Med. 2018;43(8):880–884) Postdural puncture headache (PDPH) is a severe and debilitating complication after regional anesthesia in the obstetric population. Approximately 80% of patients suffer from this type of headache after an accidental dural puncture. A PDPH can limit postpartum mother-baby interactions, extend hospital stays, and raise health care costs. The gold standard treatment for postpartum PDPH is an epidural blood patch (EBP). This retrospective study aimed to compare the effectiveness of treatment with EBP to treatment with a sphenopalatine ganglion block (SPGB).
Source: Obstetric Anesthesia Digest - Category: Anesthesiology Tags: Mechanisms, Equipment, Hazards Source Type: research
ConclusionsThese results are promising, despite the limited evidence available. We consider it essential for research to continue into the safety and efficacy of SPG stimulation for patients with refractory chronic cluster headache. In cases where this intervention may be indicated, treatment should be closely monitored.ResumenIntroducciónEl objetivo es evaluar la eficacia y seguridad de los neuroestimuladores periféricos del ganglio esfenopalatino (GEP) para el tratamiento de la cefalea en racimos crónica refractaria al tratamiento.DesarrolloRevisión sistemática de la literatura cient&ia...
Source: Neurologia - Category: Neurology Source Type: research
ConclusionThese results suggest that ES decreases theIA in small-sized TG neurons and increases P/Q- and T-type Ca2+ currents in the IB4− subpopulation of TG neurons, which might contribute to neuronal hyperexcitability in a rat model of ES-induced migraine.
Source: The Journal of Headache and Pain - Category: Neurology Source Type: research
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