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, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston. PMID: 33315046 PMCID: PMC7737157 (available on 2021-12-14 ) DOI: Item in Clipboard Effectiveness of Mindfulness Meditation vs Headache Education for Adults With Migraine: A Randomized Clinical Trial Rebecca Erwin Wells et al. JAMA Intern Med . 2020 . Show details Display options Display options Format JAMA Intern Med Actions . 2020 Dec 14;e207090. doi: 10.1001/jamainternmed.2020.7090. Online ahead of print. Authors (...) in migraine day frequency (baseline to 12 weeks). Secondary outcomes were changes in disability, quality of life, self-efficacy, pain catastrophizing, depression scores, and experimentally induced pain intensity and unpleasantness (baseline to 12, 24, and 36 weeks). Results: Most participants were female (n = 82, 92%), with a mean (SD) age of 43.9 (13.0) years, and had a mean (SD) of 7.3 (2.7) migraine days per month and high disability (Headache Impact Test-6: 63.5 [5.7]), attended class (median
by the Scottish Health Technology Council on 7 December 2020. A summary of the discussion is presented as follows: ? The Council acknowledged the severity of pain that is associated with cluster headaches and recognised the huge impact it can have on patients’ lives. ? The Council noted the importance of reviewing the use of gammaCore after 3 months to ensure that the technology is targeted to people who have responded to the treatment. ? The Council recognised that the estimated cost saving derived from (...) guidance were identified. What did the experts say? Full details of the questions asked in each round, and the anonymised responses received, can be obtained from SHTG on request. First round of questioning Nine experts responded to the first round of questioning. There was representation from neurologists, experts in headache disorders, anaesthesia and pain medicine and public health. The experts came from the following boards: NHS Greater Glasgow and Clyde, NHS Grampian, NHS Fife, NHS Lothian, NHS
. Kaniecki, M.D. Department of Neurology University of Pittsburgh Medical Center Pittsburgh, PA Matthew S. Robbins, M.D. Department of Neurology Weill Cornell Medicine New York, NY vii Management of Primary Headaches in Pregnancy Structured Abstract Objectives. This systematic review (SR) evaluates the literature on pharmacologic and nonpharmacologic interventions to prevent or treat attacks of primary headaches (migraine, tension headache, cluster headache, and other trigeminal autonomic cephalgias (...) during pregnancy. ? No indirect evidence regarding harms of nonpharmacologic interventions in pregnancy was identified. ES-2 Background and Purpose Primary headaches (i.e., conditions in which the headache itself is the disorder) are common in pregnancy and comprise four types: migraine, tension headache, cluster headache, and other trigeminal autonomic cephalgias (TACs). Although tension headaches are more common, migraine is by far the most common primary headache to present to clinical practice
as having probable TTH. Tension-type headache is further characterized as being infrequent (i.e., at least 10 headache episodes occurring 3-months), or chronic (i.e., =15-days/month on average for >3-months) and whether or not it is associated with pericranial tenderness. Cluster headache is the most common of the trigeminal autonomic cephalalgias (TACs) and is considered to be one of the most painful conditions known to man. The diagnosis of cluster headache requires at least five severe to very severe (...) and/or neck; a cranial or cervical vascular disorder; a non-vascular intracranial disorder; a substance or its withdrawal; an infection; a disorder of homeostasis; a disorder of the cranium, neck, eyes, ears, nose, sinuses, mouth, or other facial or cervical structure; or a psychiatric disorder. This CPG addresses the management of three secondary headache types including cervicogenic headache (CGH), post-traumatic headache (PTH) (headache attributed to traumatic injury to the head), and MOH. These were
Psychological therapies for the management of chronic pain (excluding headache) in adults. Chronic non-cancer pain, a disabling and distressing condition, is common in adults. It is a global public health problem and economic burden on health and social care systems and on people with chronic pain. Psychological treatments aim to reduce pain, disability and distress. This review updates and extends its previous version, published in 2012.To determine the clinical efficacy and safety (...) pain. We excluded studies of headache or malignant disease, and those with fewer than 20 participants in any arm at treatment end.Two or more authors rated risk of bias, extracted data, and judged quality of evidence (GRADE). We compared cognitive behavioural therapy (CBT), behavioural therapy (BT), and acceptance and commitment therapy (ACT) with active control or TAU at treatment end, and at six month to 12 month follow-up. We did not analyse the few trials of other psychological treatments. We
Vegas School of Medicine, Las Vegas, Nevada, USA. 4 Department of Emergency Medicine, University Medical Center of Southern Nevada, Las Vegas, Nevada, USA. PMID: 32620543 DOI: Item in Clipboard Full-text links Cite Abstract Background: Many emergency physicians use an intravenous fluid bolus as part of a 'cocktail' of therapies for patients with headache, but it is unclear if this is beneficial. The objective of this study was to determine if an intravenous fluid bolus helps reduce pain or improve (...) in the control group. The between groups difference of 0.4 mm (95% CI -16.5 to 17.3) was not statistically significant (p=0.96). Additionally, no statistically significant difference was found between groups for any secondary outcome. Conclusion: Though our study lacked statistical power to detect small but clinically significant differences, ED patients who received an intravenous fluid bolus for their headache had similar improvements in pain and other outcomes compared with those who did not. Trial
if the headache is exacerbated by rotating the head horizontally two or three times per second. A 1991 observational study initially reported high sensitivity of this examination to predict pleocytosis. Pleocytosis, an abnormally high cerebrospinal fluid sample white cell count, is an accepted indicator of nervous system infection or inflammation. Jolt accentuation of headache may therefore accurately rule out meningitis without the use of lumbar puncture. However, more recent cross-sectional studies have (...) Diagnostic test accuracy of jolt accentuation for headache in acute meningitis in the emergency setting. Meningitis is inflammation of the meninges, the layers that protect the brain and spinal cord. Acute meningitis is an emergent disease that develops over the course of hours to several days. Delay in treatment can lead to serious outcomes. Inflammation of the meninges is assessed by analysing cerebrospinal fluid. Identifying the pathogen in cerebrospinal fluid is another way to diagnose
be treated? 7) Can relapse after successful treatment of MOH be prevented? PICO question 1: Are information and education effective for the prevention of MOH in patients at risk? Medication-overuse headache is, in principle, pre- ventable. However, few studies have investigated pre- ventive strategies among patients at risk of MOH. Based on epidemiological studies, suggested risk fac- tors for the development of MOH are primary head- ache disorders, female gender, high headache frequency, frequent use (...) headache to exam- ine the impact of a 3-week outpatient interdisciplinary program that included medical interventions address- ing long-term preventive medications, intravenous bridge therapies such as intravenous dihydroergo- tamine and optimization of acute migraine and head- ache management strategies. Outcome parameters were physical functioning and psychological impair- ment. Assessments of headache severity, psychological status and functional impairment were completed by 371 subjects (97.8
morphine 150 µg or normal saline. The primary outcome was the incidence of post-dural puncture headache. Secondary outcomes included onset, duration, and severity of post-dural puncture headache, the presence of cranial nerve symptoms and the type of treatment the patient received. Results: Sixty-one women were included in the study. The incidence of post-dural puncture headache was 21 of 27 (78%) in the intrathecal morphine group and 27 of 34 (79%) in the intrathecal saline group (difference, -1%; 95 (...) % CI, -25% to 24%). There were no differences between groups in the onset, duration, or severity of headache, or presence of cranial nerve symptoms. Epidural blood patch was administered to 10 of 27 (37%) of subjects in the intrathecal morphine and 11 of 21 (52%) of the intrathecal saline group (difference 15%; 95% CI, -18% to 48%). Conclusions: The present findings suggest that a single prophylactic intrathecal morphine dose of 150 µg administered shortly after delivery does not decrease
of COVID-19. In medical practice, treatment guidelines are based on clinical studies. NSAIDS, especially ibuprofen, naproxen, diclofenac and tolfenamic acid, have proven efficacy and safety in clinical trials of symptomatic treatment of migraine and therefore are recommended for acute treatment. Furthermore, indomethacin, is the only available treatment for some Trigeminal Autonomic Cephalalgias. In general, NSAIDs are of great therapeutic value in headaches. The FDA recently released advice (...) Covid-19: HeadacheHEADACHE IN COVID-19 PANDEMIC - eanpages COVID-19 May 13, 2020 COVID-19 May 13, 2020 COVID-19 May 6, 2020 COVID-19 May 6, 2020 COVID-19 May 13, 2020 COVID-19 May 13, 2020 COVID-19 May 6, 2020 COVID-19 May 6, 2020 Executive Page May 1, 2020 Executive Page April 1, 2020 Executive Page March 1, 2020 Executive Page February 1, 2020 Country of the Month May 1, 2020 Country of the Month April 5, 2020 Country of the Month March 1, 2020 Country of the Month February 1, 2020 Paper
; Headache and Facial Pain Program, University of Texas Southwestern Medical Center, Dallas, TX, USA. 8 Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, TX, USA; Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA. 9 Dent Headache Center, Dent Neurologic Institute, Buffalo, NY, USA. 10 Department of Otolaryngology-Head & Neck Surgery, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, Buffalo (...) 7 (3), 162-8. May 2014. PMID 24790646. - Review Cluster headache is a severe, debilitating disorder with pain that ranks among the most severe known to humans. Patients with cluster headaches have few therapeutic optio … D Fontaine et al. J Pain Res 11, 375-381. 2018. PMID 29497328. - Review Cluster headache (CH) is a primary headache and considered as one of the worst pains known to man. The sphenopalatine ganglion (SPG) plays a pivotal role in cranial auton … Show more similar articles
is provided with each new RFID card. Additional gel can be provided at no extra cost. Inno Innovativ vative e aspects aspects gammaCore is currently the only technology that uses non-invasive stimulation of the vagus nerve to treat cluster headache. Intended Intended use use The instructions for using gammaCore state that gammaCore should be used regularly throughout the day to prevent cluster headache attacks and acutely to reduce pain during an attack. gammaCore is intended to be self-administered (...) . In all other studies gammaCore was used in addition to standard of care treatments. The studies show that gammaCore can reduce the frequency of The studies show that gammaCore can reduce the frequency of cluster headache attacks and the intensity of pain during an cluster headache attacks and the intensity of pain during an attack attack 3.3 The evidence for gammaCore comprises a small number of studies which include comparative, non-comparative and observational studies. The external gammaCore
, acetaminophen (in children and adolescents), and triptans (mainly in adolescents) for the relief of migraine pain, although confidence in the evidence varies between agents. There is high confidence that adolescents receiving oral sumatriptan/naproxen and zolmitriptan nasal spray are more likely to be headache-free at 2 hours than those receiving placebo. No acute treatments were effective for migraine-related nausea or vomiting; some triptans were effective for migraine-related phonophobia (...) Practice guideline update summary: Acute treatment of migraine in children and adolescents: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society To provide evidence-based recommendations for the acute symptomatic treatment of children and adolescents with migraine.We performed a systematic review of the literature and rated risk of bias of included studies according to the American Academy
Practice guideline update summary: Pharmacologic treatment for pediatric migraine prevention: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society To provide updated evidence-based recommendations for migraine prevention using pharmacologic treatment with or without cognitive behavioral therapy in the pediatric population.The authors systematically reviewed literature from January 2003 (...) to August 2017 and developed practice recommendations using the American Academy of Neurology 2011 process, as amended.Fifteen Class I-III studies on migraine prevention in children and adolescents met inclusion criteria. There is insufficient evidence to determine if children and adolescents receiving divalproex, onabotulinumtoxinA, amitriptyline, nimodipine, or flunarizine are more or less likely than those receiving placebo to have a reduction in headache frequency. Children with migraine receiving
Non-pharmacological treatment of chronic neck-shoulder myofascial pain in patients with forward head posture. Introduction: Today, chronic pain remains a pressing medical and socio-economic problem, despite the rapid development of medical technologies, the presence of a vast arsenal of drug and non-drug treatments. Estimates for chronic pain prevalence ranged from 8% to 60%. At the same time, about 40% of patients report insufficient effectiveness in the treatment of chronic pain syndrome (...) . The aim of the study was to compare the effectiveness of MTrPS management by biomechanical correction of the musculoskeletal system combined with therapeutic exercises, DN and TrPs-pressure release with the effectiveness of MTrPS management by therapeutic exercises combined with DN and TrPs-pressure release in patients with chronic neck-shoulder myofascial pain and FHP.Materials and methods: 87 patients (mean age - 39±4,9 years) with chronic neck-shoulder myofascial pain and FHP were randomly assigned
the following clinical questions: (1) In the adult emergency department patient presenting with acute headache, are 60 there risk-stratification strategies that reliably identify the need for emergent neuroimaging? (2) In the adult 61 emergency department patient treated for acute primary headache, are nonopioids preferred to opioid medications? 62 (3) In the adult emergency department patient presenting with acute headache, does a normal noncontrast head 63 computed tomography scan performed within 6 hours (...) of headache onset preclude the need for further diagnostic 64 workup for subarachnoid hemorrhage? (4) In the adult emergency department patient who is still considered to be 65 at risk for subarachnoid hemorrhage after a negative noncontrast head computed tomography, is computed 66 tomography angiography of the head as effective as lumbar puncture to safely rule out subarachnoid hemorrhage? 67 Evidence was graded and recommendations were made based on the strength of the available data. 68 69 INTRODUCTION
Trial of Galcanezumab in Prevention of Episodic Cluster Headache. Episodic cluster headache is a disabling neurologic disorder that is characterized by daily headache attacks that occur over periods of weeks or months. Galcanezumab, a humanized monoclonal antibody to calcitonin gene-related peptide, may be a preventive treatment for cluster headache.We enrolled patients who had at least one attack every other day, at least four total attacks, and no more than eight attacks per day during (...) a baseline assessment, as well as a history of cluster headache periods lasting at least 6 weeks, and randomly assigned them to receive galcanezumab (at a dose of 300 mg) or placebo, administered subcutaneously at baseline and at 1 month. The primary end point was the mean change from baseline in the weekly frequency of cluster headache attacks across weeks 1 through 3 after receipt of the first dose. The key secondary end point was the percentage of patients who had a reduction from baseline of at least
are relatively similar with 83%–99% sensitivity and specificity . MRA of the neck is most commonly performed with gadolinium contrast, whereas MRA of the head is most commonly performed without contrast. MRA of the brain with contrast is generally indicated if embolization coils or intracranial stents have been placed . Headache of Trigeminal Autonomic Origin Trigeminal autonomic cephalgia is a group of primary headache disorders characterized by pain in unilateral trigeminal distribution (...) , but head MRI may be appropriate since secondary causes need to be excluded. Head MRA and CTA are not usually indicated initially. The ophthalmic form of trigeminal neuralgia may be confused with these entities [64-66]. Clusters of severe, strictly unilateral pain lasting a few hours at most characterize a cluster headache. It is often accompanied by ipsilateral Horner syndrome, tearing, and nasal congestion. The pain stays on the same side from attack to attack. The clusters typically last several