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Raghuraman L, Joshi SH. Application of EEG in the Diagnosis and Classification of Migraine: A Scoping Review. Cureus 2024; 16:e64961. [PMID: 39171023 PMCID: PMC11336234 DOI: 10.7759/cureus.64961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 07/19/2024] [Indexed: 08/23/2024] Open
Abstract
Migraine is a chronic debilitating disease affecting a significant number of people, more often women than men. The gold standard for diagnosis is the International Classification of Headache Disorders-3 (ICHD-3). Authors have identified multiple tight spots in the present method of diagnosis. An alternative method of diagnosis has always been coveted. Electroencephalogram (EEG) is one of the most researched of such alternatives. The visually evoked potential is the most studied; auditory evoked potentials and transcranial direct current stimulation are also being studied. Cortical hyperexcitability and habituation deficit to sensory stimuli are some of the consistent findings. Alpha oscillations are among the most frequently studied bands; spectral analysis of EEG waves has often shown more reliable and consistent results than features read off the EEG directly. EEG microstate is a novel and promising method showing characteristic identifiable features that may help diagnose Migraine patients. An alternative to the ICHD-3 criterion for diagnosing Migraines would be instrumental in promptly diagnosing the disease. EEG is one of the most explored alternatives within which enumerable features can be used to identify Migraines, of which the most promising are EEG microstates.
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Affiliation(s)
- Lakshana Raghuraman
- Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shiv H Joshi
- Community Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Tang SJ, Lee H, Cui T, Lee JM, Ahn JY, Lee S, Kim S. A Comparison of Clinical Features of Youth with and without Rhinitis Signs and Symptoms Who Are Hospitalized for Headache. CHILDREN 2022; 9:children9081241. [PMID: 36010131 PMCID: PMC9406595 DOI: 10.3390/children9081241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 11/29/2022]
Abstract
Headache and allergic rhinitis (AR) are common in children and often co-occur. We investigated the clinical characteristics of pediatric headaches and the association of AR and chronic headaches. We retrospectively reviewed the medical records of patients admitted to our pediatric inpatient and outpatient clinics with complaints of headache between January 2017 and June 2020 for headache-specific history, AR signs and symptoms, allergy skin prick test, inhalant multiple allergen simultaneous test results, laboratory and imaging findings, and medication history. The patients were divided into three subgroups: AR, non-AR, and headache groups, reporting 45.7% patients with headache alone, 13.7% with additional AR, and 31.6% with abnormal imaging findings, suggesting that headache was combined with sinusitis (24.3%) or mastoiditis (7.3%). Furthermore, 6% of the patients had both AR and sinusitis. Body mass index (BMI) differed significantly between the AR and the non-AR and headache groups (p = 0.03). The BMI differed significantly according to headache severity (p ˂ 0.001). The most common allergen was “dust or mites” (41.1%). Acetaminophen (35.9%) was the most commonly used painkiller. The coexistence of AR and headache may indicate that these conditions share a similar pathophysiology. Better management of allergies may facilitate diagnosis, treatment, and prophylaxis of headaches.
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Affiliation(s)
- Si-Jia Tang
- Graduate School, Yeungnam University College of Medicine, Daegu 42415, Korea
| | - Heejin Lee
- Department of Pediatrics, Yeungnam University Medical Center, Daegu 42415, Korea
| | - Tiantian Cui
- Graduate School, Yeungnam University College of Medicine, Daegu 42415, Korea
| | - Jae Min Lee
- Department of Pediatrics, Yeungnam University Medical Center, Daegu 42415, Korea
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu 42415, Korea
| | - Ji Young Ahn
- Department of Pediatrics, Yeungnam University Medical Center, Daegu 42415, Korea
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu 42415, Korea
| | - Sua Lee
- Department of Pediatrics, Yeungnam University Medical Center, Daegu 42415, Korea
| | - Saeyoon Kim
- Department of Pediatrics, Yeungnam University Medical Center, Daegu 42415, Korea
- Department of Pediatrics, Yeungnam University College of Medicine, Daegu 42415, Korea
- Correspondence:
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Wang X, Song J, You C. Efficacy and Safety of Galcanezumab for Migraine: Evidences From Direct and Indirect Comparisons. Int J Neurosci 2022:1-9. [PMID: 35815440 DOI: 10.1080/00207454.2022.2098732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BackgroundThe optimal dose of galcanezumab for patients with migraine remains uncertain. Therefore, we conducted a network meta-analysis to assess the comparative effectiveness of various doses of galcanezumab for this group of patients.MethodsA systematically search was implemented in several databases including the PubMed, Ovid MEDILNE, Ovid EMBASE, and Cochrane Library from inception of the databases until Aug 31, 2020. Only randomized clinical trials of adults with migraine that assessed galcanezumab therapy and reported clinical outcomes were included. The primary efficacy outcome was monthly change in migraine headache days (MHDs). The primary safety outcome was treatment-emergent adverse events (TEAEs).ResultsOverall, eight randomized clinical trials included 4,720 patients, were assessed in our systematic review. In terms of efficacy, galcanezumab 120 mg and 240 mg significantly reduced monthly MHDs (MD -2.02, 95% CrI -2.62 to -1.42; MD -2.06, 95% CrI -2.74 to -1.36, respectively) compared to the placebo. In terms of safety, galcanezumab 120 mg, 150 mg, and 240 mg significantly increased incidences of adverse events (RR 1.11, 95% CrI 1.03 to 1.20; RR 1.85, 95% CrI 1.27 to 2.81; RR 1.15, 95% CrI 1.06 to 1.24, respectively).ConclusionsGalcanezumab 240 mg offers the first level in terms of efficacy outcomes and galcanezumab 150 mg ranks the first level in terms of increasing treatment-emergent adverse events among adult patients with migraine. Attention should be devoted to the potential risk of adverse events, especially for injection site pain when the drug is administered subcutaneously.
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Affiliation(s)
- Xing Wang
- West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Jinlei Song
- West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Chao You
- West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China.,West China Brain Research Centre, Sichuan University, Chengdu, Sichuan 610041, PR China
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Schembri E, Barrow M, McKenzie C, Dawson A. The evolving classifications and epidemiological challenges surrounding chronic migraine and medication overuse headache: a review. Korean J Pain 2022; 35:4-13. [PMID: 34966007 PMCID: PMC8728549 DOI: 10.3344/kjp.2022.35.1.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/15/2021] [Indexed: 11/05/2022] Open
Abstract
Changes in diagnostic criteria, for example, the various International Classification of Headache Disorders criteria, would lead to changes in the outcomes of epidemiological studies. International Classification of Headache Disorders-1 was based mainly on expert opinion, yet most of the diagnostic criteria were reliable and valid, but it did not include chronic migraine. In its second version, the classification introduced chronic migraine, but this diagnosis resembled more a high-frequency migraine rather than the actual migraine transformation process. It also introduced medication overuse headache, but it necessitated analgesic withdrawal and subsequent headache improvement to be diagnosed as such. Hence patients having medication overuse headache could only be diagnosed in retrospect, which was an awkward situation. Such restrictive criteria for chronic migraine and medication overuse headache omitted a high proportion of patients. International Classification of Headache Disorders-3 allows a diagnosis of medication overuse headache due to combination analgesics if taken for at least 10 days per month for more than three months. Hence the prevalence rate of medication overuse headache and chronic migraine can increase compared to the previous version of the headache classification. Different criteria have been used across studies to identify chronic migraine and medication overuse headache, and therefore the information acquired from previous studies using earlier criteria becomes uncertain. Hence much epidemiological research would need to be interpreted cautiously or repeated with the most updated criteria, since the subjects in studies that apply the latest criteria may be phenotypically different from those in older studies.
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Affiliation(s)
| | - Michelle Barrow
- Pain Management Centre, Overdale Hospital, St. Helier, Jersey
| | - Christopher McKenzie
- Department of Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Edinburgh, UK
| | - Andrew Dawson
- Department of Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Edinburgh, UK
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Vandenbussche N, Laterza D, Lisicki M, Lloyd J, Lupi C, Tischler H, Toom K, Vandervorst F, Quintana S, Paemeleire K, Katsarava Z. Medication-overuse headache: a widely recognized entity amidst ongoing debate. J Headache Pain 2018; 19:50. [PMID: 30003412 PMCID: PMC6043466 DOI: 10.1186/s10194-018-0875-x] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 06/13/2018] [Indexed: 12/30/2022] Open
Abstract
Medication overuse in primary headache disorders is a worldwide phenomenon and has a role in the chronification of headache disorders. The burden of disease on individuals and societies is significant due to high costs and comorbidities. In the Third Edition of the International Classification of Headache Disorders, medication-overuse headache is recognized as a separate secondary entity next to mostly primary headache disorders, although many clinicians see the disease as a sole complication of primary headache disorders. In this review, we explore the historical background of medication-overuse headache, its epidemiology, phenomenology, pathophysiology and treatment options. The review explores relevant unanswered questions and summarizes the current debates in medication-overuse headache.
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Affiliation(s)
- Nicolas Vandenbussche
- Headache Group, Department of Basic and Clinical Neuroscience, King’s College London, and NIHR-Wellcome Trust King’s Clinical Research Facility, King’s College Hospital, Denmark Hill, London, SE5 9PJ UK
| | - Domenico Laterza
- Department of Neuroscience, St. Agostino Estense Hospital, University of Modena and Reggio Emilia, via P. Giardini 1355, 41100 Modena, Italy
| | - Marco Lisicki
- Headache Research Unit, Université de Liège, Liège, Belgium
| | - Joseph Lloyd
- Headache Research-Wolfson CARD, King’s College London, London, UK
| | - Chiara Lupi
- Headache Centre, Careggi University Hospital, Health Sciences Department, University of Florence, Viale Pieraccini 6, 50139 Florence, Italy
| | - Hannes Tischler
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Kati Toom
- Department of Neurology, Tartu University Clinics, Tartu, Estonia
- Estonian Headache Society, Tartu, Estonia
| | | | - Simone Quintana
- Headache Center, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Koen Paemeleire
- Department of Neurology, Ghent University Hospital, Corneel Heymanslaan 10, B-9000 Ghent, Belgium
| | - Zaza Katsarava
- Evangelical Hospital Unna and University of Duisburg-Essen, Duisburg, Germany
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Cianchetti C, Avanzini G, Dainese F, Guidetti V. The complex interrelations between two paroxysmal disorders: headache and epilepsy. Neurol Sci 2017; 38:941-948. [DOI: 10.1007/s10072-017-2926-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 03/16/2017] [Indexed: 01/03/2023]
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Ashina S, Olesen J, Lipton RB. How Well Does the ICHD 3 (Beta) Help in Real-Life Migraine Diagnosis and Management? Curr Pain Headache Rep 2016; 20:66. [DOI: 10.1007/s11916-016-0599-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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