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Goel D, Avinash PR, Shangari S, Srivastav M, Pundeer A. Chronic nonspecific multiple-sites pain [CNMSP] of unknown etiology: Biopsychosocial method of evaluation for the primary care level. J Family Med Prim Care 2024; 13:1393-1400. [PMID: 38827703 PMCID: PMC11141980 DOI: 10.4103/jfmpc.jfmpc_722_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 06/04/2024] Open
Abstract
Background Understanding and dealing with chronic nonspecific pain (CNP) is the important entity at primary care hospital. Chronic nonspecific multiple-site pain [CNMSP] of unknown etiology creates diagnostic and therapeutic challenges for primary care physicians due to lack of guidance regarding evaluation and treatment. Aims and Objectives To classify and formulate the evaluation, treatment strategies, and prediction of prognosis of patients with CNMSP of unknown etiology. Methods Patients present with CNMSP of more than 3-month duration without any obvious medical cause. The biopsychosocial [BPS] model with 3P model was applied to see the biological, psychological, and social factors behind persistence. Finally, patients were classified into four groups for evaluation response to treatment and relapse rates in 12-month follow-up. Results Of the total 243 patients of CNMSP, 243 [96.3%] were females. Sixty [24.7%] patients had short duration, and 183 [75.3%] had long duration. Headache was in 115 [47%], low back pain ± leg pain in 96 [39.4%], cervical pain ± shoulder/arm pain in 83 [34.1%], and diffuse body pain in 50 [20.5%] in various combinations. A total of 155 [63.8%] patients had high somatization-sensitization index (SSI), and 144 [59.3%] had low ferritin level. Group 1 [high SSI and low ferritin] had 37.9% of patients, group 2 [high SSI and normal ferritin] had 25.9% of patients, group 3 [low to medium SSI with low ferritin] had 21.4% of patients, and group 4 [low to medium SSI with normal ferritin] had 14.8% of patients. Response to pain symptoms was better in group 1, and relapse rate was higher in group 2. Conclusion CNMSP of unknown etiology itself is a heterogeneous entity, and assessment based on the BPS model can be very useful to understand the treatment plan and outcome of these patients.
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Affiliation(s)
- Deepak Goel
- Department of Neurology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Priya R. Avinash
- Department of Psychiatry, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Sushant Shangari
- Department of Neurology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Malini Srivastav
- Department of Clinical Psychology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Ashwani Pundeer
- Department of Clinical Psychology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
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Singh RK, Kaushik RM, Goel D, Kaushik R. Association between iron deficiency anemia and chronic daily headache: A case-control study. Cephalalgia 2023; 43:3331024221143540. [PMID: 36739514 DOI: 10.1177/03331024221143540] [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: 02/06/2023]
Abstract
OBJECTIVE We aimed to determine the association between iron deficiency anemia and chronic daily headache. METHODS This case-control study was conducted in a tertiary care center in Dehradun, India. One hundred patients with chronic daily headache were randomly selected for the study with an equal number of controls. Subsets of chronic daily headache were diagnosed as per the 3rd edition of the International Classification of Headache Disorders. The study participants were assessed for iron deficiency anemia. RESULTS The mean age of the patients was 51.1 ± 22.1 years. Male: female ratio was 1:1.08. Chronic migraine was present in 62 (62%), tension-type headache in 23 (23%), and new daily persistent headache in 15 (15%) patients. The majority (96%) of patients had chronic daily headache of mild to moderate severity. Chronic daily headache was of long duration in all patients. Sixty-four (64%) patients had anemia of which 51 (51%) patients had iron deficiency anemia. Iron deficiency anemia showed a significant association with chronic daily headache (p < 0.001), but not with its type, subtype, and duration. Severe iron deficiency anemia had a significant association with the severity of chronic daily headache (p = 0.021). Serum iron, ferritin, total iron-binding capacity, and transferrin saturation also had a significant association with chronic daily headache (p < 0.05 for each), but not with its type, subtype, duration, and severity. Logistic regression analysis showed that iron deficiency anemia, total iron-binding capacity, and transferrin saturation had an independent association with chronic daily headache (p < 0.05 for each). CONCLUSIONS Iron deficiency anemia had an independent association with chronic daily headache. Severe iron deficiency anemia was related to the severity of chronic daily headache.
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Affiliation(s)
- Rohit Kumar Singh
- Department of General Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Rajeev Mohan Kaushik
- Department of General Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Deepak Goel
- Department of Neurology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Reshma Kaushik
- Department of General Medicine, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
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Magdy R, Hussein M, Ragaie C, Abdel-Hamid HM, Khallaf A, Rizk HI, Dahshan A. Characteristics of headache attributed to COVID-19 infection and predictors of its frequency and intensity: A cross sectional study. Cephalalgia 2020; 40:1422-1431. [PMID: 33146038 PMCID: PMC7645600 DOI: 10.1177/0333102420965140] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To study the characteristics of headache attributed to COVID-19 infection and predictors of its severity. METHODS A cross-sectional study involved 172 individuals who had headache due to COVID-19 infection. A detailed analysis of such headache was done through a face-to-face interview. Patients with any other form of secondary headache were excluded. Labs, including lymphocytic count, C-reactive protein, D-dimer and ferritin and chest imaging, were made available. RESULTS: THE majority of our patients had a diffuse headache (52.9%). It was pressing in 40.7%, with median intensity of 7 (assessed by visual analogue scale) and median frequency of 7 days/week. Patients with preexisting primary headache (52.9%) had significantly more frequent COVID-19 related headache than those without (47.1%) (p = 0.001). Dehydrated patients (64.5%) had more frequent COVID-19 related headache than those who were not dehydrated (35.5%) (p = 0.029). Patients with fever (69.8%) had significantly higher frequency and intensity of COVID-19 related headache compared to those without fever (30.2%) (p = 0.003, 0.012). Patients with comorbidities (19.8%) had significantly higher frequency and intensity of headache than those without comorbidities (80.2%) (p = 0.006, 0.003). After multiple linear regression, primary headache disorders, dehydration and comorbidities were considered predictors of frequency of COVID-19 related headache. Meanwhile, fever and dehydration were predictors of pain intensity. CONCLUSION Healthcare providers of COVID-19 patients need to be aware of frequency and intensity predictors of COVID-19 related headache: Primary headache disorders, fever, dehydration, and comorbidities.
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Affiliation(s)
- Rehab Magdy
- Department of Neurology, Cairo University, Cairo, Egypt
| | - Mona Hussein
- Department of Neurology, Beni-Suef University, Beni-Suef, Egypt
| | | | | | - Ahmed Khallaf
- Department of Neurology, Beni-Suef University, Beni-Suef, Egypt
| | - Hoda I Rizk
- Public Health and Community Medicine, Cairo University, Cairo, Egypt
| | - Ahmed Dahshan
- Department of Neurology, Cairo University, Cairo, Egypt
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Şahin S, Diler Durgut B, Dilber B, Acar Arslan E, Kamaşak T, Cansu A. Increased Hemoglobin and Plateletcrit Levels Indicating Hemoconcentration in Pediatric Patients with Migraine. J Pediatr Neurosci 2020; 15:99-104. [PMID: 33042239 PMCID: PMC7519736 DOI: 10.4103/jpn.jpn_73_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 11/18/2019] [Accepted: 03/29/2020] [Indexed: 01/03/2023] Open
Abstract
Introduction Fluid intake was reported to reduce migraine attacks. This may be due to its effect on hemoconcentration. Hemoconcentration may manifest itself by increasing in the hemoglobin and platelet-related values. This study aimed to reveal hemoconcentration by evaluating complete blood cell counts in attack-free periods of pediatric patients with migraine. Materials and Methods Consecutive children with migraine (n = 70) and tension-type headache (TTH) (n = 65) were compared with the control groups. Control 1 (n = 70) and control 2 (n = 60) groups consisted of age- and gender-matched patients, respectively. Control 2 group patients had gastrointestinal symptoms leading to fluid loss, which may have caused hemoconcentration. To evaluate hemoglobin and platelets together, the M1-value was created by multiplying hemoglobin level by plateletcrit. Results The M1-value was higher in the migraine group than in control 1 and TTH groups (P = 0.017 and 0.034) and the hemoglobin and hematocrit levels were also higher in the migraine group than in control 2 group (P = 0.013 and 0.012). Female patients with migraine had higher hemoglobin levels as compared to the female patients in control group 1 (P = 0.041). Male patients with migraine had higher M1-values than the male patients in control group 1 (P = 0.034). In the subgroup of migraine with aura (n = 10), folic acid was significantly lower than the other patients with migraine (P = 0.02). Conclusion This study suggests that migraine may be accompanied with hemoconcentration in children.
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Affiliation(s)
- Sevim Şahin
- Division of Pediatric Neurology, Department of Pediatrics, School of Medicine, Karadeniz Technical University, Trabzone, Turkey
| | - Betül Diler Durgut
- Division of Pediatric Neurology, Maternity and Children Diseases Education and Research Hospital, Giresun University, Giresun, Turkey
| | - Beril Dilber
- Division of Pediatric Neurology, Department of Pediatrics, School of Medicine, Karadeniz Technical University, Trabzone, Turkey
| | - Elif Acar Arslan
- Division of Pediatric Neurology, Department of Pediatrics, School of Medicine, Karadeniz Technical University, Trabzone, Turkey
| | - Tülay Kamaşak
- Division of Pediatric Neurology, Department of Pediatrics, School of Medicine, Karadeniz Technical University, Trabzone, Turkey
| | - Ali Cansu
- Division of Pediatric Neurology, Department of Pediatrics, School of Medicine, Karadeniz Technical University, Trabzone, Turkey
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Poyrazoğlu HG, Öztürk AB. Predictive value of laboratory parameters in childhood migraine. Acta Neurol Belg 2020; 120:907-914. [PMID: 30840223 DOI: 10.1007/s13760-019-01106-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2018] [Accepted: 02/26/2019] [Indexed: 12/20/2022]
Abstract
Migraine is a neurovascular disease characterized by inflammation of the cerebral and extra cerebral vessels and appears in the form of attacks. Although the pathophysiology of migraine is not fully known, the data obtained because of long-term studies reliably support the presence of a potential relationship between migraine pathogenesis and platelet biology. The aim of this study was to investigate the effect of migraine on MPV and other blood parameters as well as the relationship between the hematologic parameters and characteristics of the headache and whether they possess diagnostic value as inflammation and platelet biology play a fundamental role in the disorder. The study group consisted of 56 patients who were followed up and treated with a diagnosis of migraine and 45 healthy patients. The median creatinine, CRP and TSH values of the children in the migraine group were found to be statistically significantly higher than the healthy control group. Serum iron levels of the migraine group were found to be statistically significantly lower than the control group. No statistically significant difference was found between the two groups in terms of MPV. However, when we examined only the patient group, we found MPV to be statistically significantly higher in girls. Increased MPV and decreased serum iron levels may be related to migraine. More comprehensive studies including a larger population are required to evaluate the specific parameters that may guide the follow-up and treatment of the disorder with simple tests to be used in routine practice and to elucidate the underlying pathophysiology.
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Popescu C. Cluster-Like Headache Revealing Polycythemia Vera: A Case Report. Case Rep Neurol 2020; 12:184-188. [PMID: 32595481 PMCID: PMC7315213 DOI: 10.1159/000508356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 05/02/2020] [Indexed: 11/19/2022] Open
Abstract
Herein, we report on a 44-year-old man who presented with cluster headache (CH)-like pain triggered by polycythemia vera (PV). He had severe unilateral head pain attacks lasting about 30 min not associated with cranial autonomic symptoms. After the exclusion of secondary etiologies, the patient was screened for a neoplastic process through biological markers, and the diagnosis of PV was established. The results of the initial laboratory examination showed hemoglobin at 18.1 g/L and Hct at 54%. JAK2 mutation analysis was positive at 54%, and marrow biopsy confirmed the hematopoietic clonal expansion, without myelofibrosis. He was treated with aspirin and ruxolitinib due to intolerance to interferon and the ineffectiveness of hydroxyurea. The treatment by venesection improved substantially the headaches. Oxygen inhalation was very effective in treating the CH attacks. In contrast, sumatriptan was inefficient at the very beginning of the disease. Among the pathophysiological mechanisms that we can propose to explain these cluster-like headaches are the prolonged hypoxia involving nitric oxide and calcitonin gene-related peptide release.
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Affiliation(s)
- Cyprian Popescu
- *Cyprian Popescu, Victor Pauchet Clinic, FR–80090 Amiens (France),
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Goel D, Garg S, Srivastav M, Gupta S, Kaur A. Biomarkers of chronic nonspecific pain syndrome: A cross-sectional hospital-based pilot study. INDIAN JOURNAL OF PAIN 2020. [DOI: 10.4103/ijpn.ijpn_4_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Partial empty sella in a woman with cerebral venous sinus thrombosis: A rare presentation of polycythaemia rubra vera. J Clin Neurosci 2019; 66:275-277. [PMID: 31101584 DOI: 10.1016/j.jocn.2019.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/08/2019] [Accepted: 05/08/2019] [Indexed: 11/20/2022]
Abstract
We report the case of a 59 year old woman who presented with a six week history of worsening bifrontal headache. On CT brain the only abnormal finding was a partially empty sella potentially indicative of increased intracranial pressure. MRI found a large cerebral venous sinus thrombosis in the superior sagittal sinus. Blood tests and a bone marrow biopsy revealed a diagnosis of JAK2 positive primary polycythaemia rubra vera. The lack of sensitivity and specificity of CT in the diagnosis of CVST should engender a low threshold for MRI in patients with risk factors and/or non-diagnostic abnormalities on initial CT. Management of this dual pathology involves both the immediate treatment of the thrombus with heparin bridging to warfarin and the long treatment for polycythaemia involving repeat venesections and cytoreductive therapy.
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Atyabi AS, Nejatbakhsh F, Kenari HM, Eghbalian F, Ayati MH, Shirbeigi L. Persian medicine non-pharmacological therapies for headache: phlebotomy and wet cupping. J TRADIT CHIN MED 2018. [DOI: 10.1016/s0254-6272(18)30639-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Abstract
BACKGROUND A growing body of literature suggests that migraineurs, particularly those with aura, have an increased risk for ischemic stroke, but not via enhanced atherosclerosis. The theory that micro-emboli induced ischemia provokes cortical spreading depression (ie, symptomatic aura) in migraineurs but transient ischemic attacks in others highlights a potential role for hypercoagulability as a link between migraine (with aura) and stroke. AIM Our objective is to summarize the literature evaluating the association of migraine with various acquired or inheritable thrombophilic states, including those related to elevated estrogen levels, endothelial activation and dysfunction, antiphospholipid antibodies (aPL), deficiency of coagulation inhibitors, and presence of certain genetic polymorphisms. FINDINGS Although definitive studies are lacking, a preponderance of available evidence links migraine, and especially aura, to increased levels of estradiol (eg, oral contraceptive pill [OCP] use, pregnancy), thrombo- and erythrocytosis, von Willebrand factor (vWF) antigen, fibrinogen, tissue plasminogen activator (tPA) antigen, and endothelial microparticles. Studies of a link to migraine are conflicting for aPL, homocysteine, Protein S, and the methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism. No association with migraine was found in meta-analyses of Factor V Leiden, and of prothrombin gene mutation. Within a large, young ischemic stroke sample, migraine with aura was associated with a thrombophilic state and with patent foramen ovale (PFO). In the non-stroke population, meta-analyses show an association of PFO and migraine with aura (MA), but two population-based studies do not support the link. RECOMMENDATIONS For persons with MA and (1) a personal history or family history of thrombosis, or (2) MRI evidence of micro-vascular ischemia or of stroke, an evaluation for hypercoagulability is warranted. In cases of MA alone, consider screening for markers of endothelial activation (eg, vWF, high sensitivity c-reactive protein [hs CRP], and fibrinogen). Rigorous management of other stroke risk factors is paramount, but efficacy of anti-thrombotic agents in the treatment of migraine is unproven. Closure of PFO is not routinely recommended based on negative randomized trials.
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Affiliation(s)
- Gretchen E Tietjen
- Department of Neurology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Stuart A Collins
- Department of Neurology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
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Karabulut KU, Egercioglu TU, Uyar M, Ucar Y. The change of neutrophils/lymphocytes ratio in migraine attacks: A case-controlled study. Ann Med Surg (Lond) 2016; 10:52-6. [PMID: 27551404 PMCID: PMC4983641 DOI: 10.1016/j.amsu.2016.07.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 07/25/2016] [Accepted: 07/25/2016] [Indexed: 02/08/2023] Open
Abstract
Objective As commonly seen symptoms, headaches are among the most frequently encountered health challenges in emergency rooms by healthcare professionals. Among one of the most commonly seen and primary headaches is migraine. Migraines are mostly accompanied by functional deficits. Aims To observe the changes of neutrophil/lymphocyte ratio occurring during migraine attacks. Method This is a retrospective study where hospital records of patients previously diagnosed with migraine and admitted to the emergency with the complaints of attacks between May 2014 and January 2015 were investigated. All patients in the study were evaluated as to age, gender and complete blood count. Additionally, a healthy control group was formed with individuals with no disorders. By also evaluating the same features in the controls, the values found in the patients and controls alike were compared. Results The values of white blood cell, lymphocyte, neutrophil, hemoglobin, thrombocyte and neutrophil/lymphocyte ratio determined in the patient group (n = 92) were statistically compared with those of the controls (n = 67). Neutrophil/lymphocyte ratio during the attacks was found higher in the patients, compared to the controls. Conclusion Neutrophil/lymphocyte ratio is a sign of inflammation, and we consider that this ratio will also increase during migraine attacks, as with other inflammatory and acute processes. A migraine headache is a frequent reason for emergency departments. During migraine attacks it is not fully understood that there is an inflammatory process. We think that the role of inflamation during attack. We think that this inflamation process increases the severity of the pain.
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Affiliation(s)
- Keziban Ucar Karabulut
- Department of Emergency Medicine, Baskent University, Faculty of Medicine, Ankara, Turkey
- Corresponding author. Baskent Universitesi, Konya Hastanesi, Hocacihan mah, Saray caddesi No:1, Selcuklu, Konya 42080 Turkey. Tel.: +90 3322570606.Baskent UniversitesiKonya HastanesiHocacihan mahSaray caddesi No:1SelcukluKonya42080Turkey
| | | | - Mehmet Uyar
- Department of Pubic Health, Necmettin Erbakan University, Meram Medical Faculty, Konya, Turkey
| | - Yildiz Ucar
- Department of Pulmonary Dissease, Diyarbakır Memorial Hospital, Diyarbakır, Turkey
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Hagen K, Stovner LJ, Zwart JA. Potentials and Pitfalls in Analytical Headache Epidemiological Studies—Lessons to be Learned from the Head-HUNT Study. Cephalalgia 2016; 27:403-13. [PMID: 17448178 DOI: 10.1111/j.1468-2982.2007.01302.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The number of epidemiological headache studies is rapidly increasing, and has accentuated the need to improve the quality of the way studies are performed and how results are interpreted. The aims of this review were to summarize the main findings from the Head-HUNT study, to describe strengths and limitations of the Head-HUNT approach and to discuss the significance of some of our findings. Head-HUNT included a large sample size of 51 383 participants that gave the opportunity to make analyses also of relatively rare conditions. The wide range of health-related information made it possible to adjust for many potential confounding variables. Blood samples for future genetic headache studies are available for a non-selected large group of individuals. The data show that among several factors that have been evaluated, age and gender were the two most clearly related to migraine, whereas analgesic overuse and the presence of some comorbid conditions were most strongly associated with the prevalence of chronic headache. Interesting relationships to blood pressure and thyroidstimulating hormone levels were also found. Methodological problems in headache epidemiological studies are discussed and, in particular, problems with causal inferences. Despite the limitations of the head-HUNT study, we believe that the results so far have provided clues to causes and preventive factors of headache that should be explored in other populations and in prospective studies.
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Affiliation(s)
- K Hagen
- Department of Clinical Neuroscience, Faculty of medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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Rainero I, Rubino E, Rivoiro C, Valfrè W, Binello E, Zampella E, De Martino P, Gentile S, Fenoglio P, Savi L, Gallone S, Pinessi L. Haemochromatosis Gene (HFE) Polymorphisms and Migraine: An Association Study. Cephalalgia 2016; 27:9-13. [PMID: 17212677 DOI: 10.1111/j.1468-2982.2006.01231.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Several studies have suggested that iron metabolism may be involved in the pathogenesis of migraine. Using a case-control design, we performed an association study in a cohort of Italian migraine patients to evaluate whether a particular allele or genotype of the haemochromatosis gene ( HFE) would modify the occurrence and clinical features of the disease. We genotyped 256 migraine patients and 237 healthy age-, sex- and ethnicity-matched controls for the C282Y and H63D polymorphisms of the HFE gene. Phenotype and allele frequencies of both polymorphisms were similarly distributed in migraine patients and controls. The patients carrying the DD genotype of the H63D polymorphism showed a later age at onset of the disease and an increased number of migraine attacks. Our data suggest that the HFE gene is not a major disease gene for migraine. However, the H63D polymorphism of the HFE gene may be considered a modifying genetic factor in migraine.
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Affiliation(s)
- I Rainero
- Neurology II, Headache Centre, Department of Neuroscience, University of Torino, Torino, Italy.
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Gür-Özmen S, Karahan-Özcan R. Iron Deficiency Anemia Is Associated with Menstrual Migraine: A Case–Control Study. PAIN MEDICINE 2015; 17:596-605. [DOI: 10.1093/pm/pnv029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Manandhar K, Risal A, Steiner TJ, Holen A, Linde M. The prevalence of primary headache disorders in Nepal: a nationwide population-based study. J Headache Pain 2015; 16:95. [PMID: 26554602 PMCID: PMC4641072 DOI: 10.1186/s10194-015-0580-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Accepted: 11/06/2015] [Indexed: 01/03/2023] Open
Abstract
Background Headache disorders are among the most prevalent and burdensome global public-health problems. Within countries, health policy depends upon knowledge of health within the local populations, but the South-East Asia Region (SEAR), among WHO’s six world regions, is the only one for which no national headache prevalence data are available. Methods In a cross-sectional population-based study, adults representative of the Nepali-speaking population aged 18–65 years and living in Nepal were randomly recruited using stratified multistage cluster sampling. They were visited unannounced at home by trained interviewers who used a culturally-adapted Nepali translation of the structured Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire. Results There were 2,100 participants (1,239 females [59.0 %], 861 males [41.0 %]; mean age 36.4 ± 12.8 years) with 9 refusals (participation rate 99.6 %). Over half (1,100; 52.4 %) were resident above 1,000 m and almost one quarter (470; 22.4 %) lived at or above 2,000 m. The 1-year prevalence of any headache was 85.4 ± 1.5 % (gender- and age-adjusted 84.9 %), of migraine 34.7 ± 2.0 % (34.1 %), of tension-type headache (TTH) 41.1 ± 2.1 % (41.5 %), of headache on ≥15 days/month 7.7 ± 1.1 % (7.4 %) and of probable medication-overuse headache (pMOH) 2.2 ± 0.63 % (2.1 %). There was a strong association between migraine and living at altitude ≥1,000 m (AOR = 1.6 [95 % CI: 1.3-2.0]; p < 0.001). There was a less strong association between TTH and urban dwelling (AOR = 1.3 [95 % CI: 1.1-1.6]; p = 0.003), and a possibly artefactual negative association between TTH and living above 1,000 m (AOR = 0.7 [95 % CI: 0.6-0.8]; p < 0.001). Conclusion Headache disorders are very common in Nepal. Migraine is unusually so, and strongly associated with living at altitude, which in very large part accounts for the high national prevalence: the age- and gender- standardised prevalence in the low-lying Terai is 27.9 %. Headache occurring on ≥15 days/month is also common. This new evidence will inform national health policy and provide a basis for health-care needs assessment. However, research is needed to explain the association between migraine and altitude, since it may be relevant to health-care interventions.
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Affiliation(s)
- Kedar Manandhar
- Department of Neuroscience, Norwegian University of Science and Technology, St Olavs University Hospital, Trondheim, Norway.,Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Dhulikhel, Nepal
| | - Ajay Risal
- Department of Neuroscience, Norwegian University of Science and Technology, St Olavs University Hospital, Trondheim, Norway.,Dhulikhel Hospital, Kathmandu University Hospital, Kavre, Dhulikhel, Nepal
| | - Timothy J Steiner
- Department of Neuroscience, Norwegian University of Science and Technology, St Olavs University Hospital, Trondheim, Norway.,Division of Brain Sciences, Imperial College London, London, UK
| | - Are Holen
- Department of Neuroscience, Norwegian University of Science and Technology, St Olavs University Hospital, Trondheim, Norway.,Pain Unit, St Olavs University Hospital, Trondheim, Norway
| | - Mattias Linde
- Department of Neuroscience, Norwegian University of Science and Technology, St Olavs University Hospital, Trondheim, Norway. .,Norwegian Advisory Unit on Headaches, St Olavs University Hospital, Trondheim, Norway.
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Patzig M, Laub C, Janssen H, Ertl L, Fesl G. Pseudo-subarachnoid haemorrhage due to chronic hypoxaemia: case report and review of the literature. BMC Neurol 2014; 14:219. [PMID: 25403823 PMCID: PMC4243382 DOI: 10.1186/s12883-014-0219-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 11/04/2014] [Indexed: 02/03/2023] Open
Abstract
Background The specificity of computed tomography (CT) for subarachnoid haemorrhage (SAH) is very high. However, physicians should be aware of rare false positive findings, also referred to as “pseudo-SAH”. We present an unusual case in which such a finding was caused by chronic hypoxaemia. Case presentation A 37-year-old male patient presented with headaches. His CT-scan showed multiple confluent subarachnoid hyperattenuations, which mimicked SAH. However, the headache was chronic and had no features typical for SAH. The patient suffered from severe chronic hypoxaemia due to congenital heart failure. On CT-angiography diffuse intracranial vessel proliferation was found and laboratory results revealed a highly raised level of haematocrit, which had both probably developed as compensatory mechanisms. A combination of these findings explained the subarachnoid hyperdensities. Magnetic resonance imaging (MRI) showed no signs of SAH and visualized hypoxaemia in cerebral veins. A diagnosis of pseudo-SAH was made. The patient’s symptoms were likely due to a secondary headache attributed to hypoxia and/or hypercapnia. Therapy was symptomatic. Conclusions Severe chronic hypoxaemia should be recognised as a rare cause of pseudo-SAH. Clinical evaluation and MRI help differentiate SAH from pseudo-SAH.
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Khalil M, Yoga B, Ahmed F. Cluster-like headache responsive to phlebotomy. BMJ Case Rep 2014; 2014:bcr-2013-203057. [PMID: 24899000 DOI: 10.1136/bcr-2013-203057] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We report the first case of cluster-like headache secondary to polycythaemia vera (PV) that responded to phlebotomy as part of PV treatment.
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Affiliation(s)
- Modar Khalil
- Department of Neurology, Hull Royal Infirmary, Kingston-Upon-Hull, North Humberside, UK
| | - Bindu Yoga
- Department of Neurology, Hull Royal Infirmary, Kingston-Upon-Hull, North Humberside, UK
| | - Fayyaz Ahmed
- Department of Neurology, Hull Royal Infirmary, Kingston-Upon-Hull, North Humberside, UK
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Lippi G, Cervellin G, Mattiuzzi C. Migraine and erythrocyte biology: a review. Int J Lab Hematol 2014; 36:591-7. [DOI: 10.1111/ijlh.12199] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 01/31/2014] [Indexed: 02/01/2023]
Affiliation(s)
- G. Lippi
- Laboratory of Clinical Chemistry and Hematology; Academic Hospital of Parma; Parma Italy
| | - G. Cervellin
- Emergency Department; Academic Hospital of Parma; Parma Italy
| | - C. Mattiuzzi
- Service of Clinical Governance; General Hospital of Trento; Trento Italy
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Celikbilek A, Zararsiz G, Atalay T, Tanik N. Red cell distribution width in migraine. Int J Lab Hematol 2013; 35:620-8. [DOI: 10.1111/ijlh.12100] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Accepted: 03/27/2013] [Indexed: 11/30/2022]
Affiliation(s)
- A. Celikbilek
- Department of Neurology; Bozok University; Yozgat Turkey
| | - G. Zararsiz
- Department of Biostatistics and Medical Informatics; Erciyes University; Kayseri Turkey
| | - T. Atalay
- Department of Neurosurgery; Bozok University; Yozgat Turkey
| | - N. Tanik
- Department of Neurology; Bozok University; Yozgat Turkey
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Abstract
Headache is frequently reported as one of the neurological manifestations of essential thrombocythaemia (ET) and other myeloproliferative neoplasms. It is associated with considerable morbidity; yet, it is a frequently under-recognised symptom. In patients with ET, headaches may be attributable to the disease, to the prescribed ET treatment, or unrelated to ET. The majority of headaches in ET are self-limiting and can be managed with standard headache therapies such as paracetamol, but it is vital that the clinician managing these conditions is able to recognise the headaches with a more sinister pathology. In this article, we will review the incidence and management of headaches in ET, whether they are primarily related to the disease or a result of its treatment. Identification of specific headache types in patients with ET may enable physicians to employ the most effective headache medication. This would enhance the patient-physician relationship, increasing patient compliance and thus reducing the risk of adverse outcomes.
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Affiliation(s)
- R Frewin
- Pathology Department, Gloucester Royal Hospital, Gloucester, UK.
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21
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Can migraine prophylaxis prevent acute mountain sickness at high altitude? Med Hypotheses 2012; 77:818-23. [PMID: 21856088 DOI: 10.1016/j.mehy.2011.07.045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 06/25/2011] [Accepted: 07/19/2011] [Indexed: 11/22/2022]
Abstract
Acute mountain sickness (AMS) develops in people trekking at high altitude. The underlying mechanism is vasodilation due to low pressure of oxygen. However, individual susceptibility for AMS is unknown, thus, one cannot predict when or to whom it happens. Because AMS usually begins with headache, and because migraineurs are more vulnerable to AMS, we studied by the literatures review on the mechanism and clinical features in common, and assessed the treatment modalities for both disorders. This led to us the following hypothesis that, migraine prophylaxis may prevent or delay the onset of AMS at high altitude. Clinical features of AMS include nausea or vomiting when it progresses. Hypobaric hypoxia, dehydration or increased physical exertion trigger or aggravate both disorders. In migraine, cerebral vasodilation can happen following alteration of neuronal activity, whereas the AMS is associated with peripheral vessel dilation. Medications that dilate the vessels worsen both conditions. Acute treatment strategies for migraine overlap with to those of AMS, including drugs such as vasoconstrictors, or other analgesics. To prevent AMS, adaptation to high altitude or pharmacological prophylaxis, i.e., acetazolamide has been recommended. This carbonic anhydrase inhibitor lowers serum potassium level, and thus stabilizes membrane excitability. Acetazolamide is also effective on specific forms of migraine. Taken together, these evidences implicate that migraine prophylaxis may prevent or delay the onset of AMS by elevating the threshold for high altitude.
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Migraine attacks, aura, and polycythemia: a vasculoneural pathogenesis? J Neural Transm (Vienna) 2010; 118:545-7. [DOI: 10.1007/s00702-010-0538-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2010] [Accepted: 11/09/2010] [Indexed: 10/18/2022]
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Gruber HJ, Bernecker C, Pailer S, Lechner A, Horejsi R, Möller R, Fazekas F, Truschnig-Wilders M. Increased dopamine is associated with the cGMP and homocysteine pathway in female migraineurs. Headache 2009; 50:109-16. [PMID: 19804388 DOI: 10.1111/j.1526-4610.2009.01533.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The group of catecholamines, which include dopamine, adrenaline, and noradrenaline, are neurotransmitters which have been considered to play a role in the pathogenesis of migraine. However, the impact of catecholamines, especially dopamine on migraine as well as the exact mechanisms is not clear to date as previous studies have yielded in part conflicting results. OBJECTIVE This study aimed to produce a comprehensive examination of dopamine in migraineurs. METHODS Catecholamines and various parameters of the homocysteine, folate, and iron metabolism as well as cyclic guanosine monophosphate (cGMP) and inflammatory markers were determined in 135 subjects. RESULTS We found increased dopamine levels in the headache free period in female migraineurs but not in male patients. Increased dopamine is associated with a 3.30-fold higher risk for migraine in women. We found no significant effects of aura symptoms or menstrual cycle phases on dopamine levels. Dopamine is strongly correlated with cGMP and the homocysteine-folate pathway. CONCLUSION We show here that female migraineurs exhibit increased dopamine levels in the headache free period which are associated with a higher risk for migraine.
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Affiliation(s)
- Hans-Jürgen Gruber
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Graz, Austria
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Marziniak M, Jung A, Guralnik V, Evers S, Prudlo J, Geisthoff UW. An Association of Migraine with Hereditary Haemorrhagic Telangiectasia Independently of Pulmonary Right-to-Left Shunts. Cephalalgia 2009; 29:76-81. [DOI: 10.1111/j.1468-2982.2008.01703.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Hereditary haemorrhagic telangiectasia (HHT) is a genetic disorder characterized by epistaxis, telangiectasia and visceral vascular manifestations. It is associated with migraine with aura due to pulmonary arteriovenous malformations (pAVMs). The aim of the study was to evaluate headache prevalence in 106 consecutive HHT patients (67 female, 39 male, age 53.5 ± 14.5 years) and age- and gender-matched controls. An extensive clinical work-up was performed and headache prevalence was determined. Lifetime prevalence of migraine was higher in HHT patients (39.6%) than in controls (19.8%) [ P < 0.001, χ2 = 12.17, odds ratio (OR) 3.0; 95% confidence interval 1.6 < OR < 5.7]. A positive association was confirmed between HHT patients with pAVMs and migraine with aura (38.5% vs. 10%). Furthermore, HHT patients without pAVMs had a higher prevalence of migraine without aura (11.5% vs. 26.3%; χ2 = 11.85; d.f. = 2; P = 0.003). We speculate that pathophysiological mechanisms, including dysfunction of the transforming growth factor-beta pathways and resulting vascular changes, contribute to the higher prevalence of migraine without aura in HHT patients without pAVMs.
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Affiliation(s)
- M Marziniak
- Department of Neurology, University of Münster, Münster, Germany
- Department of Neurology, Saarland University, Homburg/Saar, Germany
| | - A Jung
- Department of Neurology, University of Münster, Münster, Germany
- Department of Neurology, Saarland University, Homburg/Saar, Germany
| | - V Guralnik
- Department of Neurology, Saarland University, Homburg/Saar, Germany
| | - S Evers
- Department of Neurology, University of Münster, Münster, Germany
| | - J Prudlo
- Department of Neurology, Saarland University, Homburg/Saar, Germany
| | - UW Geisthoff
- Department of Otorhinolaryngology, Saarland University, Homburg/Saar, and Hospitals of the City of Cologne, Cologne, Germany
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Hirth A, Nightingale S, Wilmshurst P, Disney P, Thorne S. Prevalence of Migraine in Adults with Cyanotic Congenital Heart Disease. CONGENIT HEART DIS 2008; 3:124-7. [DOI: 10.1111/j.1747-0803.2008.00167.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Post M, van Gent M, Snijder R, Mager J, Schonewille W, Plokker H, Westermann C. Pulmonary Arteriovenous Malformations and Migraine: A New Vision. Respiration 2008; 76:228-33. [DOI: 10.1159/000134011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2007] [Accepted: 01/28/2008] [Indexed: 01/12/2023] Open
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Ertresvg JM, Stovner LJ, Kvavik LE, Johnsen HJ, Zwart JA, Helde G, Bovim G. Migraine aura or transient ischemic attacks? A five-year follow-up case-control study of women with transient central nervous system disorders in pregnancy. BMC Med 2007; 5:19. [PMID: 17640340 PMCID: PMC1939710 DOI: 10.1186/1741-7015-5-19] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2007] [Accepted: 07/17/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migraine aura may be difficult to differentiate from transient ischemic attacks and other transient neurological disorders in pregnant women. The aims of the present study were to investigate and diagnose all pregnant women with transient neurological disorders of suspected central nervous system origin, and to compare this group with a control group of pregnant women with regard to vascular risk factors and prognosis. METHODS During a 28 month period, 41 patients were detected with transient neurological symptoms during pregnancy. These were studied in detail with thorough clinical and laboratory investigations in order to make a certain diagnosis and to evaluate whether the episodes might be of a vascular nature. For comparison, the same investigations were performed in 41 pregnant controls. To assess the prognosis, both patients and controls were followed with questionnaires every year for five years. RESULTS Migraine with aura was the most common cause of symptoms during pregnancy, occurring in 34 patients, while 2 were diagnosed with stroke, 2 with carpal tunnel syndrome, 1 with partial epilepsy, 1 with multiple sclerosis and 1 with presyncope. Patients had more headache before pregnancy than controls, but the average levels of vascular risk factors were similar. None of the patients or the controls reported cerebrovascular episodes during the five-year follow-up. CONCLUSION The diagnosis of migraine aura was difficult because for many patients it was their first ever attack and headache tended to be absent or of non-migraineous type. The aura features were more complex, with several aura symptoms and a higher prevalence of sensory and dysphasic aura than usual. Gradually developing aura symptoms, or different aura symptoms occurring in succession as described in the International Classification of Headache Disorders, seem to be useful for differentiating aura from other transient disorders. A meticulous history and clinical neurological examination are more useful than routine supplementary investigations for cerebrovascular disease. The five-year follow-up clearly indicates that migraine with aura in pregnancy usually has a good prognosis with regard to cerebrovascular events.
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Affiliation(s)
- Janne Marit Ertresvg
- Norwegian National Headache Centre, Department of Neurology and Clinical Neurophysiology, St Olavs Hospital, and Department of Neuroscience, Norwegian University of Science and Technology, N-7006 Trondheim, Norway
| | - Lars Jacob Stovner
- Norwegian National Headache Centre, Department of Neurology and Clinical Neurophysiology, St Olavs Hospital, and Department of Neuroscience, Norwegian University of Science and Technology, N-7006 Trondheim, Norway
| | - Lene Ekern Kvavik
- Norwegian National Headache Centre, Department of Neurology and Clinical Neurophysiology, St Olavs Hospital, and Department of Neuroscience, Norwegian University of Science and Technology, N-7006 Trondheim, Norway
| | - Hans-Jorgen Johnsen
- Norwegian National Headache Centre, Department of Neurology and Clinical Neurophysiology, St Olavs Hospital, and Department of Neuroscience, Norwegian University of Science and Technology, N-7006 Trondheim, Norway
| | - John-Anker Zwart
- Norwegian National Headache Centre, Department of Neurology and Clinical Neurophysiology, St Olavs Hospital, and Department of Neuroscience, Norwegian University of Science and Technology, N-7006 Trondheim, Norway
| | - Grethe Helde
- Norwegian National Headache Centre, Department of Neurology and Clinical Neurophysiology, St Olavs Hospital, and Department of Neuroscience, Norwegian University of Science and Technology, N-7006 Trondheim, Norway
| | - Gunnar Bovim
- Norwegian National Headache Centre, Department of Neurology and Clinical Neurophysiology, St Olavs Hospital, and Department of Neuroscience, Norwegian University of Science and Technology, N-7006 Trondheim, Norway
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Gaul C, Krummernerl P, Tamke B, Kornhuber M. Chronic Daily Headache in Hereditary Hemochromatosis Treated by Venesection. Headache 2007; 47:926-8. [PMID: 17578548 DOI: 10.1111/j.1526-4610.2007.00638.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Coincidence or causality between iron overload and headaches (e.g., daily headache, migraine, and cluster headache) is still under discussion. Herein we report a patient suffering from hereditary hemochromatosis (homozygous C282Y mutation; OMIM: 235220, Locus 6p21.3) and daily headache fulfilling the IHSD-2 criteria of chronic migraine. Three treatments by venesection improved the headache substantially in frequency, intensity, and duration of attacks. We suggest treatment by venesection for iron depletion in patients suffering from hemochromatois and headache.
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Hermans H, Post MC, Thijs V, Spaepen M, Budts WIHL. Increased prevalence of migraine in adult congenital heart disease. Heart 2007; 93:361-2. [PMID: 17322511 PMCID: PMC1861436 DOI: 10.1136/hrt.2006.100685] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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30
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Gaul C, Krummernerl P, Tamke B, Kornhuber M. Chronic Daily Headache in Hereditary Hemochromatosis Treated by Venesection. Headache 2006. [DOI: 10.1111/j.1526-4610.2006.00638.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
BACKGROUND Headache is a worldwide problem that affects all ages. To date there are no epidemiological data regarding headaches in Qatar. AIM The aim of this study was to use the International Headache Society (IHS) diagnostic criteria to estimate the prevalence of migraine and headache in an adult population. DESIGN This is a cross-sectional population-based study. SETTING The study was carried out at 12 Primary Health Care Centers during the period from October to December 2004 in Qatar. SUBJECTS Of the 1,200 subjects who were approached to participate in this study, 913 gave their consent, representing a response rate of 76.1%. METHODS Subjects were selected by a multistage stratified sampling procedure. We used the IHS criteria for migraine. Face-to-face interviews were based on a questionnaire that included variables such as age, sex, socioeconomic status, lifestyle habits, exacerbating factors, warning symptoms, associated features, family history and associated factors. RESULTS Of the studied subjects, 54.9% were males and 45.1% females. The prevalence of headache and migraine among men was 67.9%, 7.8%, and among women 78.2%, 8.0%, respectively. Subjects aged 25-34 years had higher prevalence of headache comparing to other age groups (27.3%). Prevalence of headache was higher in women. Subjects with less than a high school education had higher frequency of headache (49.1%). The most common warning symptoms prior to headache were abnormal vision (53.0%) and weakness (30.4%). Stress (71.8%) and weather (49.5%) made headache worse in subjects. The majority of the headache sufferers looked for a dark (33.7%) and quiet place (74.5%) to rest. CONCLUSION Headachedisorders constitute a public health problem in a newly developed Qatari society, due to fast urbanization. More women suffered from headache and migraine than men. The study revealed that there was a strong association between hemoglobin level and headache and its severity. Furthermore, the prevalence of headache and migraine in Qatar is higher than in Western and African countries.
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Affiliation(s)
- Abdulbari Bener
- Department of Medical Statistics and Epidemiology, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
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Corrigendum. Cephalalgia 2004. [DOI: 10.1111/j.1468-2982.2004.00885.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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