Headache
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The Convergence Hypothesis postulates a single pathophysiological mechanism to explain the clinical spectrum of primary headaches seen in patients with migraine. The history and the scientific underpinnings of the Convergence Hypothesis are presented. Extrapolations from the Convergence Hypothesis are used to explore the evolution of episodic to chronic migraine and the development of common migraine co-morbidities as a consequence of frequent migraine. A patient staging system is presented to illustrate this transformation process in migraine patients.
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To develop a German language questionnaire for screening for migraine, tension-type headache, and trigeminal autonomic cephalgias. ⋯ We present the first questionnaire in German language including 3 most common primary headaches for use in epidemiological research.
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There is growing evidence that central sensitization plays a role in migraine pathogenesis, and that cutaneous allodynia is its clinical correlate. In headache research, allodynia has largely been studied in episodic migraine. The purpose of this investigation was to determine whether cutaneous allodynia occurs in transformed migraine, using individuals without headaches as controls. ⋯ This study is the first to demonstrate allodynia in transformed migraine patients using a headache-free control population and supports the hypothesis that central sensitization plays a role in the evolution of transformed migraine.