Form Of Primary Headache Research Articles

The impact of primary headache in children and adolescents

Headache is one of the most common and disruptive pain manifestations in children and adolescents. This review examines the current evidence for the impact of primary headaches on well-being and quality of life in children with headaches. Several studies support that headaches cause a significant reduction in quality of life, which can be related to the headaches themselves and lead to limitations in family, social, and school activities. There is a need for more studies on well-being among children with headaches as well as a greater focus on other primary headache forms than migraine.

Examining the Impact of Puberty on Primary Headache Disorders in Female Schoolchildren: A Cross-Sectional Study.

Introduction and aim Headaches are one of the most prevalent childhood disorders. Primary and secondary headaches are the two types of headaches affecting kids and teenagers. The three most typical primary headache forms are tension-type headaches (TTH), migraine, and cluster headaches. This study sought to determine the relationship between puberty and types of headaches. Methods This cross-sectional study was conducted from May 18 to July 31, among female schoolchildren aged between eight and 15 years in the Eastern Province of Saudi Arabia. Respondents were recruited through face-to-face interviews. A self-administered questionnaire was utilized, mainly consisting of demographic data and questions related to diagnosing and managing the impact of puberty in girls on the prevalence of primary headache disorder. Results In total, 481 female schoolchildren were interviewed, mostly between 13 and 15 years old (65.9%). Last year prevalence of headaches was 65.5%, with a significant difference among those who lived in Dhahran (p=0.001) and those with a family history of headaches (p<0.001). The most common type of headache was frequent TTH (16.4%) and chronic TTH (16%). Chronic TTH (p<0.001), frequent TTH (p<0.001), and migraine without aura (p=0.005) were significantly more common among the older age groups. Conclusion There was a high prevalence of headaches among female schoolchildren, with frequent TTH and chronicTTH being the most common. Furthermore, increasing age was associated with an increasing risk for chronic TTH, frequent TTH, and migraine headaches without aura. More epidemiological studies are necessary to determine the underlying causes of headaches among schoolchildren.

Differences in musculoskeletal dysfunctions and in postural alterations between chronic migraine and chronic tension type headache: A cross-sectional study

ObjectiveThe aim of present study is to assess postural alterations and musculoskeletal dysfunctions over all spine in patients with chronic migraine and chronic tension type headache, moreover to highlight the differences between these two forms of primary headache. MethodsA Cross sectional study was adopted to evaluate the musculoskeletal profile in patients with chronic migraine and with chronic tension type headache. The Bio photogrammetric evaluation was performed using the postural assessment software PAS/SAPO, while unilateral passive accessory intervertebral motion (PAIMs) were applied for manual examinations of spine segments from C0 to L5 vertebra. The One-way Analysis of Variance (ANOVA) test was used to compare the three groups with the software GraphPad InStat 3.06. ResultsA total of 60 patients were recruited, 20 for chronic tension type group, 20 for chronic migraine group and 20 healthy controls. The most interesting findings was that patients with chronic primary headaches presented postural alterations in all parameters (cranio-vertebral angle and lumbar-pelvic angle) and musculoskeletal dysfunctions in all spine with respect to healthy controls. Finally, the most clinically relevant finding was that no differences were found between chronic migraine and chronic tension type headache concerning the postural alterations nor the musculoskeletal dysfunctions. ConclusionThe sensitization acts as a substrate or consequence of these musculoskeletal dysfunctions in chronic primary headache. Therefore, non-pharmacological treatments targeted in the musculoskeletal system may be a good option in the management of chronic primary headache, especially when these therapies integrate various techniques that involve all spine.

Neurophysiological and Vascular Mechanisms of Action of the Serotoninergic Drugs for Abortive Migraine Treatment

Abstract—Migraine is a form of primary headache that affects at least 10% of the world’s population. In addition to recommendations for modifying the patient’s lifestyle, migraine management involves stopping an attack that’s already occurred and/or preventing its occurrence. In the abortive treatment of this cephalalgia, both non-specific (eg, non-opioid analgesics) and specific pharmacological agents, can be used. The latter include, in particular, serotonergic drugs of the classes of triptans (selective 5-HT1B/1D receptor agonists), ditans (selective 5-HT1F-mimetics), and ergot alkaloids (non-selective modulators of various 5-HT receptor subtypes). The review discusses the currently availably results of numerous basic and applied studies of these drug groups, in which the neuronal and vascular components of their antimigraine pharmacodynamics were identified. A significant part of the information was obtained in vivo on the various experimental models of migraine based on the trigeminovascular theory of its pathogenesis. Other data are the results of ex vivo studies on isolated tissues and cell cultures. When analyzing these experimental results, evidence is provided in favor of similar mechanisms for realizing the antimigraine potential of all representatives belonging to the pharmacological classes listed, the neurotropic activity of which prevails over their direct intervention in vascular tone. At the same time, special attention is paid to the controversial and debatable issues in this area, the successful solution of which is a key to further progress in the pharmacotherapy of migraine.

Rimegepant for the treatment of migraine.

Migraine is a common form of primary headache, affecting up to 1 in every 6 Americans. The pathophysiology is an intricate interplay of genetic factors and environmental influence and is still being elucidated in ongoing studies. The trigeminovascular system is now known to have a significant role in the initiation of migraines, including the release of pain mediators such as CGRP and substance P. Traditional treatment of migraine is usually divided into acute and preventive treatment. Acute therapy includes non-specific therapy, such as NSAIDs and other analgesics, which may provide relief in mild to moderate migraines. 5-HT1 agonists may provide relief in severe migraine, but are not universally effective and carry a significant side-effect profile with frequent redosing requirement. Prophylactic therapy may reduce the occurrence of acute migraine attacks in selected patients, but does not completely eliminate it. More recently, CGRP antagonism has been studied and shown to be effective in both abortion and prevention of migraine. Novel medications, targeting CGRP, divide into CGRP antibodies and receptor antagonists (gepants). Rimegepant, a second-generation gepant, has shown efficacy in several clinical trials in treating acute migraine. Ongoing trials are also evaluating its role in migraine prophylaxis, and results are promising. It is also generally safer for use than existing options, does not appear to increase the chance of developing chronic migraines, and carries a very tolerable side effects profile. It is a part of a growing arsenal in migraine treatment, and may present the silver bullet for treatment of this disease.

Diagnosis and management of acute out-of-hospital cluster headaches

Cluster headaches are the most painful form of primary headache and the most common of a group of headaches known as trigeminal autonomic cephalalgias (TACs). It is estimated that 25 million days are lost from work or school because of migraine each year, as well as a potential cost of £956 million to health services due to service use, and £4.8 billion due to lost employment each year. Given the burden upon health services and the wider economy, a number of strategic drivers for enhancing general management of headaches have been produced with explicit aims of reducing inappropriate referrals and admissions. This article reviews the current literature and discusses the appropriateness of non-specialist clinicians working in out-of-hospital settings, and in primary, urgent and emergency care, such as paramedics, safely diagnosing and managing cluster headaches in the community, while also considering the balance of possible risks and fiscal benefits. It concludes that community practitioners could safely manage recurrent episodes of cluster headaches within the community, with good referral and consultation pathways in place. However, caution should be paid to discharging those patients presenting with a first bout of cluster headache without specialist clinical assessment.

Migraine with brainstem aura: description of a clinical case

The article focuses on a rare form of primary headache – migraine with brainstem aura (previous term – basilar migraine). The place of this form in the International Classification of Headache Disorders is indicated, diagnostic criteria and clinical features are given. Clinical case of migraine with brainstem aura in a young man is presented. The effectiveness of the acute treatment and preventive therapy are discussed; features of the above case are analyzed.

A Randomized Clinical Trial on the Efficacy of Siravedhana and Kumkumadi Ghrita Nasya along with Chandrakanta Rasa Orally in Ardhavabhedaka w. s. r. to Migraine

Background: Migraine is a form of primary headache, manifested by the recurrent attacks of pulsating headache, mostly associated with nausea, vomiting, photophobia and phonophobia with or without an aura. It is the second most common cause of headache disorder affecting about 12%. In this females are most prone 15% and males are affecting about 6%. On the basis of the symptoms of Ardhavabhedaka, it can be correlated with Migraine. Aim and objectives: To conduct a randomized clinical trial on Kumkumadi Ghrita Nasya and Siravedhana along with Chandrakanta Rasa in the management of Ardhavbhedaka w.s.r. to Migraine. Material and method: Patients attending the O.P.D. and I.P.D. of N.I.A. having the signs and symptoms of Ardhavbhedaka (Migraine) were screened and the diagnosis was achieved on the basis of careful history taking and clinical examination. 30 clinically diagnosed patients of Ardhavbhedaka were registered for trial and they were divided randomly in two groups. Result: Clinical data shows that in Group A effect of therapy on Ardhavbhedhaka is 74.91% and in Group B it is 63.93%; both the results are statistically highly significant at the level of p &lt; 0.001. Conclusion: It can be concluded that clinically Siravedha, Kumkumadi Ghrita Nasya and Chandrakanta Rasa combine work better to manage the Ardhavabhedaka (Migraine)

A Conceptual Study on Ardhavabhedakw.s.r Migraine

Migraine is a form of primary headache, manifested by the recurrent attacks of pulsating headache, mostly associated with nausea, vomiting, photophobia and phonophobia with or without an aura. It is the second most common cause of headache disorder affecting about 12%. In this females are most prone 15% and males are affecting about 6%. On the basis of the symptoms of Migrainecan be correlated withArdhavabhedak,.Ardhavabhedakis one such disease which is increasing day by day due to lifestyle we are following because of which mental stress is also increasing. It has been described among the Shirorogasby Acharyas, in which there is severe pain in half of the head i.e. Manya, Shankha, Akshi, Karna, Bhru, Lalaata and Arani.Pain is similar to those produced by sharp objects like Shastraand Arani. The occupancy of pain is episodic that may vary from person to person. According to some Acharyasit could lead to deafness and blindness.

Психологические и поведенческие характеристики пациентов с лекарственно-индуцированной головной болью

Study Objective: To evaluate the characteristics of patients with medication-overuse headache (MOH) for their further treatment. Study Design: Prospective study. Materials and Methods. Within 12 months, 120 patients (12 men and 108 women, mean age of men — 46.3 ± 3.54 years, of women — 41.3 ± 9.5 years) with primary headache and MOH were followed up. Participants were divided into two groups depending on the diagnosis: group I (n = 44) — patients with chronic forms of primary headache without MOH, group II (n = 76) — patients with chronic forms of primary headache and MOH. The patients filled out special questionnaires for their characterization. Study Results. The study compared groups according to the frequency of taking various types of analgesic drugs. Patients with MOH took pain medications: non-steroidal anti-inflammatory drugs — 15 (19.7%), triptans — 38 (50%), combined drugs — 23 (30.3%); 46 patients chose analgesic drug/s based on the speed of effect, and the preferred characteristics of the drugs were the availability (n = 25) and complete relieve pain (n = 19). The most of participants chose pain medications based on a doctor's recommendation; 44 (57.9%) of MOH patients tried to cancel them on their own, but failed. In people with MOH, the most common behavioral strategies were: taking painkillers to prevent headaches due to fear of pain (34.2%); refusal to discontinue the drug due to fear of increased pain even in the presence of side effects (22.4%); frequent practice of escalating the amount and dose of symptomatic agents in conditions of catastrophic pain (21.1%). The characteristics of our patients and their emotional and behavioral features showed that a more detailed study of these characteristics and features is necessary to develop a further treatment plan. Conclusion. When treating patients with MOH show that a complex approach to a comprehensive analysis of the state of physical and emotional health is needed. The characteristics of our patients once again prove the importance of a dialogue between a doctor and a patient to improve the effectiveness of treatment. A significant role in preventive methods implemented through educational programs are important for improving the quality of their lives. Keywords: medication-overuse headache, chronic primary headache, migraine, tension type headache, behavioral characteristics of patients with chronic headache, educational programs in management of patients with headache.

Complementary and alternative therapies for tension-type headache: A protocol for systematic review and network meta-analysis.

Background:Tension-type headache (TTH) is the most common form of primary headache with high prevalence, which affects the quantity of life seriously. The pharmacological treatment of TTH is not the most effective. Meanwhile, complementary therapies and alternative therapies play an essential role in the treatment of TTH, and there is an absence of comparison between various interventions. Therefore, we propose the network meta-analysis protocol to compare the efficacy and safety of various complementary therapies and alternative therapies for TTH.Methods:From the beginning to February 2021, we will search the database to collect randomized controlled trials of complementary and alternative therapies for TTH. Two researchers will be responsible for screening retrieve documents, extracting data. The risk of bias will be assessed based on the Cochrane bias risk tool. We will use STATA16.0 and WinBUGS1.4.3 for paired meta-analysis and Bayesian network meta-analysis. The quality of evidence will be assessed using the grading of recommendations assessment development and evaluation.Results:This study will compare and rank the efficacy and safety of various complementary and alternative treatments for TTH.Conclusions:This study will provide more extensive evidence for the complementary and alternative therapies of TTH. We expect to assist clinicians and patients in choosing the optimum treatment.Protocol registration number:INPLASY202130088.

Long-Term Outcome of Indomethacin Treatment in Pediatric Patients with Paroxysmal Hemicrania-A Case Series.

Paroxysmal Hemicrania is a rare form of primary headache in children and adolescents, belonging to the group of trigeminal autonomic cephalalgias. Patients suffer from severe, short-lasting unilateral headaches accompanied by symptoms of the autonomic system on the same side of the head. The short duration of attacks distinguishes Paroxysmal Hemicrania from other trigeminal autonomic cephalalgias. Indomethacin is the treatment of choice, and its effectiveness provides a unique diagnostic criterion. However, the long-term outcomes in children are highly underreported. In this case-series, n = 8 patients diagnosed with Paroxysmal Hemicrania were contacted via telephone 3.1 to 10.7 years after initial presentation. A standardized interview was conducted. n = 6 patients were headache-free and no longer took indomethacin for 5.4 ± 3.4 years. The mean treatment period in these patients was 2.2 ± 1.9 years. Weaning attempts were undertaken after 1.7 ± 1.3 months; in n = 3 patients, more than one weaning attempt was necessary. n = 2 patients were still taking indomethacin (4.5 and 4.9 years, respectively). Both unsuccessfully tried to reduce the indomethacin treatment (two and six times, respectively). Adverse effects appeared in n = 6 (75%) patients and led to a discontinuation of therapy in n = 2 patients. Our long-term follow-up suggests that in a substantial proportion of pediatric patients, discontinuing indomethacin therapy is possible without the recurrence of Paroxysmal Hemicrania.

Effect of habb-e-quqaya in shaqeeqa (migraine without aura) – An open label clinical trial

Backgrounds: Migraine is a form of primary headache, manifested by the recurrent attacks of pulsating headache, mostly associated with nausea, vomiting, photophobia, and phonophobia, with or without an aura. Its onset is unilateral with varying intensity, frequency, and duration. It is the second-most common cause of headache disorder affecting about 12% of general population with 15% females and 6% males. The World Health Organization listed migraine as the 19th disability cause worldwide. In the present scenario of high prevalence and limited treatment options, this study was conducted to assess the safety and efficacy of a unani formulation named Habb-e-Quqaya, as a nervine tonic, brain tonic, stomachic, purgative, and its action in evacuating viscid morbid matter from the body in the management of migraine without aura. Methods: Thirty patients with migraine without aura were selected and administered with Habb-e-Quqaya 3 tablets weighing 500 mg each twice daily for 45 days. Subjective and objective parameters were assessed for each patient every 15 days. Data were analyzed statistically using the Student's t-test and paired proportion test. Results: Highly significant improvement (P < 0.001) was observed in all subjective and objective parameters. Conclusion: It was thus concluded that Habb-e-Quqaya can be a potential treatment for Shaqeeqa (Migraine without aura) with high efficacy and safety and without any side effects or toxicity during or after the trial. Hence, this study validates the use of Habb-e-Quqaya in Shaqeeqa (migraine without aura).

Проблема головной боли напряжения в клинике нервных болезней (обзор)

Tension-type headache (TTH) is the most common form of primary headache. The aim of the review is to analyse research on epidemiology and triggers of TTH. The search for full-text articles in Russian and English languages published within the past decade was performed in E-Library, PubMed, Springer, ClinicalKey and Google Scholar databases. A total of seven Russian and forty-two foreign epidemiological studies have been analysed. Thus, the global prevalence of TTH amounts to 32% (4.4% among these cases are chronic TTH). In Russia, its prevalence is 52.4%. The leading TTH triggers are stress and anxiety-depressive disorders. Insomnia, clinical and meteorological conditions, the ethnos and culture are possible triggers as well. Despite the high occurrence of this primary form of headache in clinical pictures of nervous diseases, it remains insufficiently considered to the date. The issue of TTH requires further investigation.

Chapter 28 - The neurobiology of cluster headache

Cluster headache is a primary headache form occurring in paroxysmal excruciatingly severe unilateral head pain attacks usually grouped in periods lasting 1-2months, the cluster periods. A genetic component is suggested by the familial occurrence of the disease but a genetic linkage is yet to be identified. Contemporary activation of trigeminal and cranial parasympathetic systems-the so-called trigemino-parasympathetic reflex-during the headache attacks seem to cause the pain and accompanying oculo-facial autonomic phenomena respectively. At peripheral level, the increased calcitonin gene related peptide (CGRP) plasma levels suggests trigeminal system activation during cluster headache attacks. The temporal pattern of the disease both in terms of circadian rhythmicity and seasonal recurrence has suggested involvement of the hypothalamic biological clock in the pathophysiology of cluster headache. The posterior hypothalamus was investigate as the cluster generator leading to activation of the trigemino-parasympathetic reflex, but the accumulated experience after 20 years of hypothalamic electrical stimulation to treat the condition indicate that this brain region rather acts as pain modulator. Efficacy of monoclonal antibodies to treat episodic cluster headache points to a key role of CGRP in the pathophysiology of the condition.

Primaries non-migraine headaches treatment: a review.

In the "headache world," great attention has always been paid to migraine patients, especially for the research and development of new therapies. For the other forms of primary headaches, especially those of Chapters 2 and 3 of the classification, there are however therapies that, even if not specific, can give significant results. Tension-type headache recognizes in NSAIDs the most effective drugs to treat acute attack, while prevention is based on the use of tricyclic antidepressants and muscle relaxants. For TACs, the discussion is more complex: first of all, there are two forms of primary headache that respond absolutely to indomethacin. For these, the main problem is how to manage the possible side effects arising from prolonged treatments and possibly what to use as an alternative. For cluster headaches and short-lasting unilateral neuralgiform headache attacks, we have drugs with good efficacy as regards medical therapy, such as verapamil or lamotrigine, but in recent years, neuromodulation techniques, both surgical and non-invasive, have also been affirming themselves, which represent a more possibility for forms of headache that are often very disabling and resistant to common analgesics.

The Relationship between Infant Colic and Migraine as well as Tension-Type Headache: A Meta-Analysis.

Background Infant colic is a common benign disease during early infancy. Migraine and tension-type headache (TTH) are the most common primary headache forms among pediatric population. Several studies have investigated the incidence of infant colic in patients with migraine and TTH. The meta-analysis was to assess the relationship between infant colic and migraine as well as TTH. Methods PubMed, Web of Science, and Cochrane Library were searched until August 16, 2018, for potential studies. Data were extracted by two independent authors and analyzed using RevMan 5.2 software. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to determine the association between infant colic and migraine as well as TTH, respectively. Results A total of 148 studies were found, and 7 studies were finally included. A higher incidence of colic during infancy was revealed in migraine patients than controls (P=0.05, OR: 2.51, 95% CI: 1.32–4.77) and TTH subjects (P=0.02, OR: 0.33, 95% CI: 0.13–0.86), respectively. And no significances were found between TTHs with controls (P=0.51, OR: 1.17, 95% CI: 0.73–1.89). Conclusion This meta-analysis indicated that migraine was associated with increased incidence of infantile colic history, but TTH incidence was not relevant with the incidence of infantile colic history.

Management of migraine

Migraine is the most common severe form of primary headache, with a global prevalence of around one in seven people. Migraine occurs in 15% of the UK adult population, and is three times more commo...

Chronobiological features of primary headaches and the role of melatonin in the regulation of biological rhythms

Frequency is considered as a key sign of the course of some forms of primary headaches (PH). One of the most prominent representatives is the hypnical and cluster headache, which predetermined their name. Clinical observations demonstrate a clear circadian rhythm and seasonal pattern of cluster headache (CH) and migraine (M) attacks. In accordance with modern concepts, the phenomenon of the periodicity of painful episodes of a number of forms of primary headaches is associated with dysfunction of the suprachiasmatic nucleus of the hypothalamus, the main pacemaker of biological rhythms. The connection of PH with chronopathology is confirmed by revealing the disturbances of melatonin secretion in CH and M. Melatonin has proven to be effective in treatment of these PH.

Peripheral neurostimulation in headache treatment

According to rough estimates, at least one third of the population in developed countries suffers, to varying degrees, from certain forms of primary headache, the modern pharmacotherapy of which is not always effective and has a number of limitations. The non-pharmacological treatment of headache can be an alternative to the prescription of pharmacological agents and the only possible assistance option for patients developing drug-resistant cephalalgias. This review describes various methods of electrical neuromodulation that are used for the management of primary headaches. The authors provide information on current stages in implementation of implantable and non-invasive equipment into clinical practice, which makes possible electrical stimulations of peripheral nerves and of the sphenopalatine ganglion, as well as allows transcranial magnetic stimulation. Also the appearance and usage of portable electrical devices available on the world market are described, and mechanisms that can underlie anticephalgic action of neuromodulation therapy are discussed. Special attention is paid to the methods that are applied for electrostimulation of the vagus nerve and occipital nerves.