Episodic Headache Research Articles

The effect of P2X7 antagonism on subcortical spread of optogenetically-triggered cortical spreading depression and neuroinflammation

Migraine is a neurological disorder characterized by episodes of severe headache. Cortical spreading depression (CSD), the electrophysiological equivalent of migraine aura, results in opening of pannexin 1 megachannels that release ATP and triggers parenchymal neuroinflammatory signaling cascade in the cortex. Migraine symptoms suggesting subcortical dysfunction bring subcortical spread of CSD under the light. Here, we investigated the role of purinergic P2X7 receptors on the subcortical spread of CSD and its consequent neuroinflammation using a potent and selective P2X7R antagonist, JNJ-47965567. P2X7R antagonism had no effect on the CSD threshold and characteristics but increased the latency to hypothalamic voltage deflection following CSD suggesting that ATP acts as a mediator in the subcortical spread. P2X7R antagonism also prevented cortical and subcortical neuronal activation following CSD, revealed by bilateral decrease in c-fos positive neuron count, and halted CSD-induced neuroinflammation revealed by decreased neuronal HMGB1 release and decreased nuclear translocation of NF-kappa B-p65 in astrocytes. In conclusion, our data suggest that P2X7R plays a role in CSD-induced neuroinflammation, subcortical spread of CSD and CSD-induced neuronal activation hence can be a potential target.

Impact of Migraine on Family Members - A Cross-sectional Study in Southern Part of India.

Migraine is a disabling primary headache disorder characterized by recurrent episodes of headache. Migraine not only imposes a burden on the sufferer but also imposes a burden on their family members too. A holistic approach is more essential in the management of migraine and family members should also be included in the management of migraine. There are no published studies done in India so far to look for the impact of migraine on partners and adolescent children (IMPAC). This pilot study was done to assess the IMPAC. The objective of the study was to study the IMPAC. In this descriptive study, 130 chronic migraine patients were observed in a row during 9 months. The impact of migraine on family members as well as migraine disability and Migraine-specific Quality of Life (MSQoL) was evaluated using validated questionnaires. One hundred and thirty chronic migraine patients were studied as part of this study. The mean age of the study population was 34.43 ± 9.002 years, and two-third of the participants were female. The majority of the participants had a moderate-to-severe disability due to migraine and had negatively impacted their MSQoL. The impact of migraine on family members was moderate-to-severe grade in most of the participants and affected their family life negatively both with children and spouses. The males were more significantly affected than females in terms of MSQoL, anxiety, depression, and also on migraine's impact on family members. Migraine not only affects the sufferers, it also significantly affects their family members.

Integrated Approach to Migraine Management: A narrative review of the Pillars of Lifestyle Medicine

IntroductionMigraine is a debilitating neurological disorder characterized by recurrent episodes of severe headaches, often accompanied by nausea and other autonomic symptoms. It affects a significant portion of the global population, with estimates suggesting a prevalence of approximately 58.2%. Beyond the immediate pain and discomfort, migraine can have a substantial impact on quality of life and productivity. Lifestyle medicine, which emphasizes the power of modifiable lifestyle factors to prevent, manage, and potentially reverse chronic diseases, offers a promising approach to migraine management.ObjectiveThis narrative review aims to map recent findings on the potential of lifestyle medicine pillars as effective strategies for managing migraine.MethodsA comprehensive narrative review was conducted using the PubMed database. Articles published within the past 10 years that investigate the intersection of migraine and lifestyle medicine were included.ResultsInterventions such as diet, physical exercise, stress management, sleep quality, healthy relationships, and cessation of alcohol and smoking can reduce the frequency and severity of attacks.ConclusionThis review highlights the potential of lifestyle medicine strategies to improve the management of migraine. By integrating interventions focused on diet, physical activity, stress management, sleep hygiene, healthy relationships, and substance cessation, migraine sufferers may experience a significant reduction in attack frequency and severity, ultimately leading to an enhanced quality of life.

A Rare Case of Sino-Nasal Teratocarcinosarcoma (Response to Induction Chemotherapy)

We are presenting a rare case of sino-nasal teratocarcinosarcoma. A 43-year-old male patient presented with repeated episodes of epistaxis and headache for 3 months. On examination, the ENT consultant noticed a mass in the right nasal cavity for which biopsy was performed and CT scan advised. Sinonasal teratocarcinosarcoma was diagnosed on biopsy and immunohistochemistry. CT Face followed by PET/CT showed a FDG-avid soft tissue density mass in the right nasal cavity extending locally with a standardised uptake value of 7.4 with no distant metastasis. Surgical debulking is the first line of treatment as per the literature; however, in this case, the multidisciplinary tumour board initiated induction chemotherapy of 02 cycles of CISP/DOC owing to marked local extension of the tumour. Subsequent CT scan of the face shows a good treatment response with shrinkage of the sinonasal mass. After successful chemotherapy, the patient is now scheduled for radiotherapy and subsequently follow-up to assess the response.

The burden of headache and a health-care needs assessment in the adult population of Mali: a cross-sectional population-based study

BackgroundOur recent studies have shown headache disorders to be very common in the central and western sub-Saharan countries of Benin and Cameroon. Here we report headache in nearby Mali, a strife-torn country that differs topographically, culturally, politically and economically. The purposes were to estimate headache-attributed burden and need for headache care.MethodsWe used cluster-random sampling in seven of Mali’s eleven regions to obtain a nationally representative sample. During unannounced household visits by trained interviewers, one randomly selected adult member (18–65 years) from each household was interviewed using the structured HARDSHIP questionnaire, with enquiries into headache in the last year and, additionally, headache yesterday (HY). Headache on ≥ 15 days/month (H15+) was diagnosed as probable medication-overuse headache (pMOH) when associated with acute medication use on ≥ 15 days/month, and as “other H15+” when not. Episodic headache (on < 15 days/month) was recorded as such and not further diagnosed. Burden was assessed as impaired participation (days lost from paid and household work, and from leisure activity). Need for headache care was defined by criteria for expectation of benefit.ResultsData collection coincided with the SARS-CoV-2 pandemic. The participating proportion was nonetheless extremely high (99.4%). The observed 1-year prevalence of any headache was 90.9%. Age- and gender-adjusted estimates were 86.3% for episodic headache, 1.4% for pMOH and 3.1% for other H15+. HY was reported by 16.8% with a mean duration of 8.7 h. Overall mean headache frequency was 3.5 days/month. Participants with pMOH lost more days from paid (8.8 days/3 months) and household work (10.3 days/3 months) than those with other H15+ (3.1 and 2.8 days/3 months) or episodic headache (1.2 and 0.9 days/3 months). At population level, 3.6–5.8% of all time was spent with headache, which led to a 3.6% decrease in all activity (impaired participation). Almost a quarter (23.4%) of Mali’s adult population need headache care.ConclusionHeadache is very common in Mali, as in its near neighbours, Benin and Cameroon, and associated with substantial losses of health and productivity. Need for headache care is high – a challenge for a low-income country – but lost productivity probably translates into lost gross domestic product.

Clinical characteristics of tension headache in occlusive disorders

Relevance. Common physiological human suffering is headache. The prevalence of headache ranks third after back pain and joint pain in the structure of muscle-fascial pain syndromes. However, headaches and facial pains associated with muscle-fascial trigger points are much more common than headaches and facial pains caused by other causes. An extremely irritated area of skeletal muscle associated with an oversensitive palpable node located in a compacted bundle is the muscle–fascial trigger points. In the pathogenesis of headaches, a major role belongs to dysfunction or disease of the temporomandibular joint, age-related changes in the masticatory muscles, jaws and teeth and all elements of the TMJ occuring during a person’s life. In some cases, minor changes in the occlusion of teeth and jaws, as well as a stressful situation, lead to a painful spasm of the masticatory muscles. Goal. To analyze the clinical characteristics of tension headache in patients with occlusive disorders (OD) and physiological occlusion (PO). Material and methods. The study covered 210 patients with occlusion disorders and 92 patients with the signs of physiological occlusion. 141 patients from the first group and 32 patients from the second group complained of a headache. Occlusal relationships of teeth were analyzed in the position of central and dynamic occlusion. The destruction of the hard tissues of the teeth and partial adentia, as well as anomalies and deformities of the dentition were determined as the disorder of occlusion. The study of the muscles of the maxillofacial region and neck was carried out using the techniques described in the book by Travell J.G., Simons D.G. (2005). A visual-analogue pain assessment scale and a Russified McGill’s questionnaire on the nature of pain were used to identify the nature of the pain syndrome, the severity of pain. The assessment was carried out at a consultative appointment, the localization, nature, duration and intensity of pain, as well as the specificities of the pain syndrome being taken into account. When examining muscles, to quantify the data obtained the muscle syndrome index (IMS) was evaluated. The analysis of the research results was carried out using nonparametric criteria. Results. According to the severity of the pain syndrome, the use of a visual analogue scale (VAS) of pain allowed us to divide all patients into 3 groups: with mild pain, with moderate and with severe pain. According to the international classification of headaches, episodic and chronic headaches were distinguished. In patients with OD, the headache becomes chronic more often and is felt more intense than in patients with PO. Among the patients complaining of a headache, in patients with OD the IMS is higher than the IMS of the muscles of the masticatory complex, and in patients with PO the IMS is higher than the IMS of the neck muscles. Conclusions. Female patients with OD and PO suffer from tension headache more often than male patients. In patients with OD, musculo-fascial headaches are twice as common, have a more pronounced character and become chronic more often than in patients with PO. The severity of the IMS of the masticatory muscles in patients with OD is 2.5 times higher than in patients with PO.

IL18 rs360717 and rs187238 genetic variants are associated with migraine diagnosis.

Migraine is a genetically determined disorder that predisposes to recurrent episodes of headache. Interleukin (IL)-18 is a pro-inflammatory cytokine that seems to play a role in migraine pathophysiology, and its genetic variants could potentially impact susceptibility to migraine. To investigate the association between IL18 rs360717 and rs187238 genetic variants with migraine diagnosis and its clinical characteristics. A case-control study was conducted with 152 people with migraine and 155 healthy controls, matched by sex, age, ethnicity, and body mass index. Clinical characteristics of migraine, as well as validated questionnaires regarding disability and impact of migraine, presence of allodynia, anxiety, depression, and hyperacusis were collected. Genotyping for IL18 rs360717 and rs187238 variants was performed using real-time polymerase chain reaction (qPCR) and TaqMan™ method. The IL18 rs360717A and rs187238G alleles were associated with increased chance of being diagnosed with migraine (OR = 1.53, 95%CI 1.05-2.24, p = 0.028 and OR = 1.46, 95%CI 1.00-2.14, p = 0.049, respectively). In the dominant model, the rs360717GA + AA genotypes were also associated with a higher chance of migraine than the GG genotype (OR = 1.69, 95%CI 1.05-2.73, p = 0.030). In women, in addition to the previous associations, there was also an effect of the variants on the chance of migraine in the codominant models and dominant models. Furthermore, among women, there was an influence on the prevalence of postdrome perception with rs360717GA + AA (OR = 3.04, 95%CI 1.10-8.42, p = 0.032) and rs187238CG + GG (OR = 2.97, 95%CI 1.08-8.21, p = 0.035). IL18 rs360717 and rs187238 variants were associated with migraine diagnosis and postdrome symptoms, especially in women. This study has demonstrated that IL18 rs360717 and rs187238 variants play a role in migraine, influencing the chance of being diagnosed with migraine, particularly among women. There are prospects that IL18 variants could be considered potential genetic biomarkers for migraine.

Headache Characteristics of Pediatric Sport-Related Concussion.

Headache is among the most common symptoms following concussion, yet headache after concussion (HAC) remains poorly characterized. This study describes headache characteristics over the first four weeks following pediatric sport-related concussion. This is a retrospective case series of 87 athletes (mean: 14.9 years; range: 8.4-18.8 years; 38% female) treated in a specialty sports concussion clinic within 28 days of injury. Primary outcomes of headache consistency, frequency, duration, and associated migrainous symptoms were assessed at immediate (0 to 48 h) and weekly time points over the first 28 days post-injury. Generalized mixed linear models compared headache characteristics across time points. Secondary analyses compared each outcome by as-needed analgesic use. During the immediate post-injury period, headache was more often constant (p = 0.002) and associated with migrainous symptoms (p < 0.001). By the third week post-injury, episodic headache was more prevalent (p < 0.001). Most patients (54%) transitioned from constant, migrainous headache to episodic, non-migrainous headache. This finding was uninfluenced by as-needed analgesic medication use. These findings document the trajectory of HAC. Future studies should assess relationships between initial headache characteristics and recovery.

Intravenous methylprednisolone in patients with episodic cluster headache non-responders to oral steroids: results from an observational, interventional, single-center study

Background: Verapamil is the drug of choice in the prophylaxis of episodic cluster headache (ECH), and oral corticosteroids are frequently prescribed as concurrent bridging therapy. Approximately 25% of the patients do not respond to oral treatment. The aim of this study was to assess safety and efficacy of high dose intravenous methylprednisolone (MPD) in ECH patients who had not responded to combined oral therapy with prednisone and verapamil. Methods: Forty-four ECH patients – non responders to oral therapy – were treated with intravenous MPD (500 mg/day for 5 days) and verapamil during cluster headache active periods. No serious adverse event was reported. Results: After 5 days of intravenous therapy, the 24-hour frequency of cluster headache attacks significantly decreased. Sixty-eight percent of patients became headache-free, and 25% experienced a reduction of more than 50% in daily attacks. No clinical benefit was reported in the remaining three patients. Conclusions: Our study shows that intravenous MPD is a safe, effective, and reproducible treatment for ECH patients not responding to oral therapy.

(055) A RETROSPECTIVE ANALYSIS ON THE BENEFITS OF AN OVER-THE-COUNTER COMBINATION OF ASPIRIN, ACETAMINOPHEN, AND CAFFEINE (AAC) IN MENSTRUAL MIGRAINE

Abstract Introduction • Migraine affects approximately 15% of the general population globally. It is an episodic headache disorder that produces a wide spectrum of pain and associated disability. • Women are 3 times more likely than men to experience migraine headache. More than 60% of women with migraine experience attacks that occur in association with the menstrual periods. • Although some women experience migraine exclusively during the perimenstrual period others have attacks both during the perimenstrual period and at other times of the month. Menstrual migraine is thought to be more severe and disabling and less responsive to non-drug treatments than is non-menstrual migraine Objective Since menstrual migraine is an important health issue for women, we wanted to examine whether AAC is more effective than placebo in relieving menstruation associated migraine and improving the quality of life (QoL) of patients. Methods The study population selected for this analysis were adapted from a pooled analysis of women associated with menstrual migraine [Clin Therapeutics 21(3) 475, 1999]. A total of 185 women with menstrual associated migraine, of which 85 took one dose of AAC (aspirin/acetaminophen/caffeine – 250 mg/250 mg/65 mg) and 100 took placebo were included in this study. The data was analyzed using SAS Windows version 9.4. All post-rescue medication severity scores were assigned either the baseline value or the last recorded value whichever was most severe. Post-rescue medication pain relief scores were classified as “no relief”. Results It was observed that the intensity of the headache pain was reduced to mild or none (1) within 30 min in 20% (AAC treated) vs (10% in placebo). Within 1 hour in 40% (AAC treated) vs (14% placebo) (p&amp;lt;=0.001) treated patients and the pain relief lasted for at least six hours. The quality of life (able to perform all or usual activities with minimal or no additional effort) also improved within 1 hour in 48.2% (AAC treated patients) vs 28% (placebo) (p&amp;lt;=0.005) and within 3 hour in 68.2% AAC treated patients vs 40% (placebo) (p&amp;lt;=0.001). In addition, in terms of relative change (%) difference, there was a 19% improvement in QoL with a 24.6% reduction in pain intensity within 1 hour. At 3 hours the QoL scores improved to 38.1% with a reduction in pain intensity of 41.1% that lasted till 6 hours in AAC treated patients vs placebo. Conclusions This post- hoc pooled analysis provides evidence that a single dose of AAC provides significant benefits in relieving menstrual migraine associated pain relief and improves quality of life of patients in their ability to perform usual activities with minimal or no additional effort. Disclosure Yes, this is sponsored by industry/sponsor: Haleon Clarification: Industry initiated, executed and funded study. Any of the authors act as a consultant, employee or shareholder of an industry for: Haleon.

EE302 Cost-Utility Analysis of Eptinezumab Versus Erenumab for Episodic Migraine Headaches Patients in the United States

EE302 Cost-Utility Analysis of Eptinezumab Versus Erenumab for Episodic Migraine Headaches Patients in the United States

Evaluation of patients presenting with headache to the emergency outpatient clinic

Aims: This study aimed to explore the factors contributing to headache presentation in patients by recognizing headache as a symptom of various potential ailments. It is crucial to understand these factors for appropriate assessment and treatment planning in patients with headaches. Additionally, this study investigated patients' preferences for headache management, which is an understudied aspect in the field. Methods: In 2012, a two-month study was conducted at an emergency department outpatient clinic to assess the general characteristics, severity, frequency, duration, and location of headache episodes among patients presenting with headache complaints. The study analyzed various parameters, including the different types of pain, such as throbbing, stabbing, and burning, as well as the impact of headaches on daily performance, medication use, specific medications taken, and alternative treatment methods via a headache questionnaire. Results: The survey results revealed that 21.7% of the patients described their pain as extremely severe, 52.2% as severe, and 26.1% as distressing. Pain descriptions were predominantly throbbing (79.4%) and pain (62.2%), with sensations of pressure (20%), stabbing (18.3%), pulsating (13.3%), burning (10.6%), and constriction-like a band (2.8%). The localization of pain was bilateral in 15.0% of patients, unilateral in 18.3%, around or behind the eyes in 28.3%, and in the neck or back of the head in 38.3%. Headaches were found to affect the work life of 40.6% of patients, 20% reported no impact, and 39.4% experienced occasional interference. No significant statistical difference was observed regarding the intensity, frequency, and duration of pain, and its impact on work life with respect to sex. The usage of non-prescription medication was high (92.8 %), whereas prescription medication usage was 57.8%. Regarding alternative treatment methods, massage therapy was used by 53.6% of the patients and herbal treatments by 17.8%. Conclusion: This study examined the frequency and handling of headaches among patients visiting an emergency department. The results indicate that headaches affect both sexes equally, with a marginal prevalence in females. To provide better care, addressing patients’ preferences and experiences is important. As patients rely on non-prescription medications and alternative therapies, concerns regarding healthcare accessibility arise. A combination of medication management, patient education, and non-pharmacological therapies is necessary to achieve better outcomes and decrease the burden on healthcare systems.

Genetic evidence for the causal relationships between migraine, dementia, and longitudinal brain atrophy

BackgroundMigraine is a neurological disease with a significant genetic component and is characterized by recurrent and prolonged episodes of headache. Previous epidemiological studies have reported a higher risk of dementia in migraine patients. Neuroimaging studies have also shown structural brain atrophy in regions that are common to migraine and dementia. However, these studies are observational and cannot establish causality. The present study aims to explore the genetic causal relationship between migraine and dementia, as well as the mediation roles of brain structural changes in this association using Mendelian randomization (MR).MethodsWe collected the genome-wide association study (GWAS) summary statistics of migraine and its two subtypes, as well as four common types of dementia, including Alzheimer’s disease (AD), vascular dementia, frontotemporal dementia, and Lewy body dementia. In addition, we collected the GWAS summary statistics of seven longitudinal brain measures that characterize brain structural alterations with age. Using these GWAS, we performed Two-sample MR analyses to investigate the causal effects of migraine and its two subtypes on dementia and brain structural changes. To explore the possible mediation of brain structural changes between migraine and dementia, we conducted a two-step MR mediation analysis.ResultsThe MR analysis demonstrated a significant association between genetically predicted migraine and an increased risk of AD (OR = 1.097, 95% CI = [1.040, 1.158], p = 7.03 × 10− 4). Moreover, migraine significantly accelerated annual atrophy of the total cortical surface area (-65.588 cm2 per year, 95% CI = [-103.112, -28.064], p = 6.13 × 10− 4) and thalamic volume (-9.507 cm3 per year, 95% CI = [-15.512, -3.502], p = 1.91 × 10− 3). The migraine without aura (MO) subtype increased the risk of AD (OR = 1.091, 95% CI = [1.059, 1.123], p = 6.95 × 10− 9) and accelerated annual atrophy of the total cortical surface area (-31.401 cm2 per year, 95% CI = [-43.990, -18.811], p = 1.02 × 10− 6). The two-step MR mediation analysis revealed that thalamic atrophy partly mediated the causal effect of migraine on AD, accounting for 28.2% of the total effect.DiscussionThis comprehensive MR study provided genetic evidence for the causal effect of migraine on AD and identified longitudinal thalamic atrophy as a potential mediator in this association. These findings may inform brain intervention targets to prevent AD risk in migraine patients.

Non-Invasive Neuromodulation for Episodic and Chronic Migraine Headache: Preliminary Findings on Feasibility of At-Home Transcranial Direct Current Stimulation With Remote Supervision

Non-Invasive Neuromodulation for Episodic and Chronic Migraine Headache: Preliminary Findings on Feasibility of At-Home Transcranial Direct Current Stimulation With Remote Supervision

A prospective exploration of the urban exposome in relation to headache in the Dutch population-based Occupational and environmental health cohort study (AMIGO)

ObjectiveHeadache is one of the most prevalent and disabling health conditions globally. We prospectively explored the urban exposome in relation to weekly occurrence of headache episodes using data from the Dutch population-based Occupational and Environmental Health Cohort Study (AMIGO). Material and MethodsParticipants (N = 7,339) completed baseline and follow-up questionnaires in 2011 and 2015, reporting headache frequency. Information on the urban exposome covered 80 exposures across 10 domains, such as air pollution, electromagnetic fields, and lifestyle and socio-demographic characteristics. We first identified all relevant exposures using the Boruta algorithm and then, for each exposure separately, we estimated the average treatment effect (ATE) and related standard error (SE) by training causal forests adjusted for age, depression diagnosis, painkiller use, general health indicator, sleep disturbance index and weekly occurrence of headache episodes at baseline. ResultsOccurrence of weekly headache was 12.5 % at baseline and 11.1 % at follow-up. Boruta selected five air pollutants (NO2, NOX, PM10, silicon in PM10, iron in PM2.5) and one urban temperature measure (heat island effect) as factors contributing to the occurrence of weekly headache episodes at follow-up. The estimated causal effect of each exposure on weekly headache indicated positive associations. NO2 showed the largest effect (ATE = 0.007 per interquartile range (IQR) increase; SE = 0.004), followed by PM10 (ATE = 0.006 per IQR increase; SE = 0.004), heat island effect (ATE = 0.006 per one-degree Celsius increase; SE = 0.007), NOx (ATE = 0.004 per IQR increase; SE = 0.004), iron in PM2.5 (ATE = 0.003 per IQR increase; SE = 0.004), and silicon in PM10 (ATE = 0.003 per IQR increase; SE = 0.004). ConclusionOur results suggested that exposure to air pollution and heat island effects contributed to the reporting of weekly headache episodes in the study population.

Case Report: Surgical management of petrous face meningioma

Petrous face meningioma presents a significant difficulty in neurosurgery because of its complex anatomical position near cranial nerves, brainstem, and important blood vessels. This case report describes the clinical course and successful surgical treatment of a 50-year-old female patient who had a two-month history of ataxia, along with a one-week episode of severe headache and vomiting. An MRI verified the existence of a petrous face meningioma after a thorough diagnostic assessment. Following that, the patient had a left retro-sigmoid craniotomy, which led to the complete excision of the tumour and relief of symptoms. A thorough one-month follow-up examination showed no recurring symptoms, suggesting a positive result and successful clearance of the meningioma. This case highlights the need of timely diagnosis and surgical treatment in dealing with petrous face meningioma, focusing on attaining complete tumour excision. This case demonstrates the success of complete removal of a tumour and the possibility of full return of neurological function in individuals with similar symptoms. This article enhances the current literature by offering insights into the management of petrous face meningioma and recommending a thorough surgical strategy to improve patient outcomes.

Investigating the Role of Oxidant-Antioxidant Balance in the Etiology of Migraine

Aim: Migraine, a prevalent neurovascular disorder, is marked by repetitive headache episodes. Its complex etiology encompasses biochemical, genetic, and environmental influences, but its exact pathophysiology remains elusive. Recent studies have hinted at a link between migraine and oxidative stress. Hence, this study sought to delve into the correlation between migraine, oxidative stress markers, and lipid profiles. Material and Method: This case-control study involved 60 adult migraine patients from Dicle University's Neurology Department in Diyarbakır, Türkiye, observed between 2009 and 2010. The control group was age- and gender-matched healthy individuals. Parameters like malondialdehyde (MDA), paraoxonase-1 (PON-1), total antioxidant capacity (TAC), and lipid constituents such as total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides (TG) were measured in both groups. Results: Migraine sufferers, particularly those with aura, had significantly elevated MDA levels compared to controls (p

Headache in systemic lupus erythematosus: The LUNA registry cross-sectional study.

This study investigated the clinically relevant factors for headaches in patients with systemic lupus erythematosus (SLE) using a registry from a Japanese multicenter cohort. This cross-sectional study analysed the clinical information of patients with SLE who experienced headache episodes using the Migraine Disability Assessment (MIDAS) questionnaire. Significant findings in the comparisons between patients with headache (HA patients) and those without headache (non-HA patients) and in the comparisons depending on the grades of headache-induced disability in daily life based on the MIDAS scores were evaluated. Multivariate logistic regression analyses were performed to identify the relevant factors for headache. We analyzed 369 patients (median age, 45 years; female, 90.8%), including 113 HA patients who were significantly younger than non-HA patients (p < .005). HA patients had significantly higher frequencies of photosensitivity, rashes, and mucosal ulcers than non-HA patients (p < .05). Age and photosensitivity were significantly associated with headache (odds ratio (OR) 0.93, 95% confidence interval (CI) 0.95-0.99; OR 2.11, 95% CI 1.29-3.49, respectively). In the HA patients, hypocomplementemia was significantly associated with a disability of more than mild grade (OR 2.89, 95% CI 1.14-7.74), while rash was significantly observed in those presenting with moderate and severe disability. This study suggests that photosensitivity is a relevant manifestation of headache in patients with SLE. Persistent hypocomplementemia can contribute to headache-induced disability in daily life, whereas a rash may be a dominant manifestation in patients presenting with moderate/severe headache-induced disability.

Energy Alterations in Patients with Chronic Headaches and How Can We Treat This Condition Without Using Pain Killers?

Introduction: A chronic headache condition occurs when a person has fifteen or more headaches per month. The purpose of this study is to demonstrate that patients with chronic headaches have an energy deficiency inside the five internal massive organs (Liver, Heart, Spleen, Lungs and Kidneys) according to the Five Elements theory of traditional Chinese medicine, and the procedure for this condition involves treating the cause of the chronic headache formation and not just treating the symptoms. Methods: A study was done through the examination of two case reports of patients with frequent daily episodes of headaches who had been seen by neurologists and had been using medication to reduce their pain without any improvement. These two patients were submitted to the measurement of their energy within their five internal massive organs using the radiesthesia procedure. Results: All organs were found to be at their lowest level of energy with a rating of one out of a scale of eight. The treatment of this condition where it was necessary to replenish and rebalance the internal energy consisted of using Chinese dietary counseling, auricular acupuncture with apex ear bloodletting, systemic acupuncture, crystal-based medication and, also highly diluted medication following the theory of Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine. All of these were important in the treatment of their headache condition without the use of painkillers. Both patients saw an improvement in their headache symptoms without the need for painkillers.The Conclusion of this study hopes to show that patients with headaches have energy deficiencies inside their five internal massive organs as pertaining to the Five Elements theory (Liver, Heart, Spleen, Lungs and Kidneys), and the treatment of this condition of rebalancing the internal energy using Chinese dietary counseling, auricular acupuncture with apex ear bloodletting, systemic acupuncture and replenishing the internal energy using highly diluted medications according to the theory of Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine as well as crystal-based medication can all reduce or even cure headache symptoms without the use of painkiller medication.

АКТУАЛЬНОСТЬ И ЭФФЕКТИВНОСТЬ ПРИМЕНЕНИЯ СПЛИНТ-ТЕРАПИИ ПРИ ДИСФУНКЦИИ ВИСОЧНО-НИЖНЕЧЕЛЮСТНОГО КОМПЛЕКСА И СОПУТСТВУЮЩЕЙ ГОЛОВНОЙ БОЛИ (ОБЗОР ЛИТЕРАТУРЫ)

Introduction. Currently, there is an increased incidence of episodic headache, which patients often attribute to emotional overstrain and stress. However, headaches can be a complication of a more complex condition such as temporomandibular disorder (TMD), which patients may not even be aware of. The use of splint therapy can relieve the patient of pain and discomfort, thereby improving quality of life. The aim of study was to identify the effectiveness of splint therapy in the treatment of dysfunction of the temporomandibular complex, complicated by headache, followed by its relief. Materials and methods. When writing this review, articles published in foreign and domestic scientific publications over the past 19 years have been studied. The articles had certain requirements: compliance with the topic, relevance, the number of participants in the study is greater than or equal to 20, the article does not violate anyone's rights and does not pursue commercial interests. Analysis of the structure and content of the articles allowed selecting 22 articles, which best reveal the topic. Of the selected articles, 7 met the requirements. Results and Discussion. The use of splint therapy as the main method of rehabilitation of patients with dysfunction of the temporomandibular complex raises many questions and doubts, however, this attitude is caused more by the relative novelty of the presented method than by its objective results. There are a large number of studies that describe the high effectiveness of this type of rehabilitation. Splint therapy can be used as an additional method in the complex treatment of headaches, as well as as a main tool in the treatment of joint and muscle pathologies and bruxism. Conclusions. Treatment of patients with TMD and concomitant headache requires a comprehensive approach. Splint therapy appears to be an effective method for eliminating myalgia and headache, as well as pain in the TMJ.