Episodic Migraine and POTS
AbstractPurpose of ReviewMigraine is prevalent in patients with postural orthostatic tachycardia syndrome (POTS). The purpose of this review is to summarize and interpret studies that examine stress response systems in patients with migraine, focusing on their relevance to the pathologies associated with POTS. Important structural and functional components of the stress response network are also reviewed.Recent FindingsIn patients with migraine, studies examining the autonomic nervous system have demonstrated interictal sympathetic hypofunction and ictal sympathetic hyperfunction, while those focusing on the hypothalamic â...
Source: Current Pain and Headache Reports - October 7, 2023 Category: Neurology Source Type: research
The Gut-brain Connection and Episodic Migraine: an Update
AbstractPurpose of reviewHistorical evidence suggests a shared underlying etiology for migraine and gastrointestinal (GI) disorders that involves the gut-brain axis. Here we provide narrative review of recent literature on the gut-brain connection and migraine to emphasize the importance of tailoring treatment plans for patients with episodic migraine who experience GI comorbidities and symptoms.Recent findingsRecent population-based studies report the prevalence of migraine and GI disorders as comorbidities as well as overlapping symptomology. American Headache Society (AHS) guidelines have integrated GI symptoms as part ...
Source: Current Pain and Headache Reports - October 4, 2023 Category: Neurology Source Type: research
Update of Gepants in the Treatment of Chronic Migraine
AbstractPurpose of ReviewDespite the unmet therapeutic needs of patients with chronic migraine (CM) and/or medication overuse, available treatment options are limited. Recently, four calcitonin gene-related peptide receptor antagonists, known as gepants, have been approved for the treatment of migraine. This review focuses on the preventive treatment of CM with gepants and highlights recent findings.Recent FindingsTwo randomized controlled trials (RCTs) have shown promising results for rimegepant and atogepant as preventive treatments for CM. In an RCT targeting patients with CM, atogepant demonstrated a significant reduct...
Source: Current Pain and Headache Reports - October 1, 2023 Category: Neurology Source Type: research
Primary Cough Headache
AbstractPurpose of ReviewIn this review article, we summarize the most recent findings and observations in patients experiencing primary cough headache.Recent FindingsRecent studies draw attention to further characterization of patients with primary cough headache in a pulmonology clinic. There have also been recent case studies describing new therapy considerations, including noninvasive vagus nerve stimulation and lumbar punctures.SummaryPrimary cough headache has been a recognized entity since as early as 1932. Patients generally report a sudden onset, sharp headache lasting a few hours that is precipitated by Valsalva ...
Source: Current Pain and Headache Reports - September 25, 2023 Category: Neurology Source Type: research
Analgesic Techniques for Rib Fractures —A Comprehensive Review Article
AbstractPurpose of ReviewRib fractures are a common traumatic injury that has been traditionally treated with systemic opioids and non-opioid analgesics. Due to the adverse effects of opioid analgesics, regional anesthesia techniques have become an increasingly promising alternative. This review article aims to explore the efficacy, safety, and constraints of medical management and regional anesthesia techniques in alleviating pain related to rib fractures.Recent FindingsRecently, opioid analgesia, thoracic epidural analgesia (TEA), and paravertebral block (PVB) have been favored options in the pain management of rib fract...
Source: Current Pain and Headache Reports - September 25, 2023 Category: Neurology Source Type: research
Electronic Health Record Recording of Patient Pain: Challenges and Discrepancies
AbstractPurpose of ReviewIn the present review, various categories of pain, clinician-observed pain scales, and patient-reported pain scales are evaluated to better understand factors that impact patient pain perceptions. Additionally, the expansion of areas that require further research to determine the optimal way to evaluate pain scale data for treatment and management are discussed.Recent FindingsElectronic health record (EHR) data provides a starting point for evaluating whether patient predictors influence postoperative pain. There are several ways to assess pain and choosing the most effective form of pain treatment...
Source: Current Pain and Headache Reports - September 23, 2023 Category: Neurology Source Type: research
Current Neurostimulation Therapies for Chronic Pain Conditions
AbstractPurpose of ReviewNeurostimulation treatment options have become more commonly used for chronic pain conditions refractory to these options. In this review, we characterize current neurostimulation therapies for chronic pain conditions and provide an analysis of their effectiveness and clinical adoption. This manuscript will inform clinicians of treatment options for chronic pain.Recent FindingsNon-invasive neurostimulation includes transcranial direct current stimulation and repetitive transcranial magnetic stimulation, while more invasive options include spinal cord stimulation (SCS), peripheral nerve stimulation ...
Source: Current Pain and Headache Reports - September 20, 2023 Category: Neurology Source Type: research
Simulation-Based Education in Acute and Chronic Pain Training
AbstractPurpose of ReviewThe use of simulation-based education (SBE) in medical training has expanded greatly and has grown to include high fidelity and task simulation along with hybrid models using patient actors to enhance education and training of critical events as well as technical skills.Recent FindingsIn the field of anesthesiology, SBE has been particularly useful for crisis resource management and rare critical scenarios and new research into the use of SBE using task simulation for procedural skill development has been done highlighting the benefits to subspecialty procedural training.SummaryMedical simulation h...
Source: Current Pain and Headache Reports - September 16, 2023 Category: Neurology Source Type: research
When Does Intervention End and Surgery Begin? The Role of Interventional Pain Management in the Treatment of Spine Pathology
AbstractPurpose of ReviewRecent advances in the field of interventional pain management (IPM) involve minimally invasive procedures such as percutaneous lumbar decompression, interspinous spacer placement, interspinous-interlaminar fusion and sacroiliac joint fusion. These developments have received pushback from surgical professional societies, who state spinal instrumentation and arthrodesis should only be performed by spine surgeons. The purpose of this review is to evaluate the validity of this claim. A literature search was conducted on Google Scholar and PubMed databases. Articles were included which examined IPM in ...
Source: Current Pain and Headache Reports - September 15, 2023 Category: Neurology Source Type: research
Spontaneous Intracranial Hypotension in Pregnancy
AbstractPurpose of ReviewSpontaneous intracranial hypotension (SIH) is a debilitating disease typically featuring orthostatic headache and caused by a spinal CSF leak. This review will describe the characteristics of SIH in pregnant patients and the associated unique management and treatment considerations.Recent FindingsHerein, a novel case is reported of a 41-year-old woman who presented with SIH pre-conception but saw marked improvement of symptoms after 5 Â weeks antepartum and symptom recurrence 2Â months post-partum. A literature review of SIH in pregnancy revealed 14 reported patients across 10 studies since 2000. A...
Source: Current Pain and Headache Reports - September 9, 2023 Category: Neurology Source Type: research
Post-stroke Headache
AbstractPurpose of ReviewStroke is a major health concern and a leading cause of long-term disability. Persistent post-stroke headache (PPSH) is a common complication of stroke yet little is known about its specific characteristics or optimal management. The purpose of this review is to discuss the epidemiology, presentation, and hypothesized pathophysiology of PPSH. Acute and preventive treatment options, as well as specific concerns regarding triptans and the newer CGRP antagonists, will be discussed in detail as well.Recent FindingsThe 2018 International Classification of Headache Disorders, 3rd edition (ICHD-3) was the...
Source: Current Pain and Headache Reports - September 7, 2023 Category: Neurology Source Type: research
Sleep Symptoms and Disorders in Episodic Migraine: Assessment and Management
AbstractPurpose of ReviewWe review research on sleep symptoms and disorders in patients with episodic migraine and propose a framework for evaluating sleep symptoms in this patient population.Recent FindingsPatients with episodic migraine consistently report poorer sleep on validated self-reports compared to those without migraine. In polysomnographic studies, children with migraine have objectively shorter sleep duration and lower percentage of REM sleep  interictally. Prospective actigraphy studies in adults and children suggest that there are no significant changes in sleep duration, efficiency, or quality in the night...
Source: Current Pain and Headache Reports - September 4, 2023 Category: Neurology Source Type: research
Overlap and Differences in Migraine and Idiopathic Intracranial Hypertension
AbstractPurpose of ReviewMigraine and idiopathic intracranial hypertension (IIH) are increasingly encountered but remain enigmatic. This review compares the similarities and differences of the diagnostic criteria, pathophysiology, and risk factors for chronic migraine and IIH.Recent FindingsWhile migraine and IIH are distinct diseases, both conditions are frequently found concurrently and may share a link. Increased intracranial pressure (ICP) in those with or without pre-existing migraine may present with migraine-like headaches and contribute to migraine chronification. Increased intracranial pressure may be a coincident...
Source: Current Pain and Headache Reports - September 1, 2023 Category: Neurology Source Type: research
New Daily Persistent Headache (NDPH): Unraveling the Complexities of Diagnosis, Pathophysiology, and Treatment
AbstractPurpose of ReviewThe current article aims to provide an overview of new daily persistent headache (NDPH), with a particular emphasis on its pathophysiology, evaluation, and current treatment options.Recent FindingsNDPH is an uncommon and heterogeneous condition associated with various comorbidities and is of great significance due to its prolonged duration and high severity. Variable causes and clinical aspects of NDPH may reflect differences in its underlying pathophysiological mechanisms, including genetics, environmental triggers, neuroinflammation, and brain changes. When assessing a patient with NDPH, potentia...
Source: Current Pain and Headache Reports - August 26, 2023 Category: Neurology Source Type: research
Chest Wall and Abdominal Blocks for  Thoracic and Abdominal Surgeries: A Review
AbstractPurpose of ReviewThe purpose of this review is to provide an up-to-date description and overview of the rapidly growing literature pertaining to techniques and clinical applications of chest wall and abdominal fascial plane blocks in managing perioperative pain.Recent FindingsClinical evidence suggests that regional anesthesia blocks, including fascial plane blocks, such as pectoralis, serratus, erector spinae, transversus abdominis, and quadratus lumborum blocks, are effective in providing analgesia for various surgical procedures and have more desirable side effect profile when compared to traditional neuraxial t...
Source: Current Pain and Headache Reports - August 25, 2023 Category: Neurology Source Type: research
