Headache
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Although diagnostic rates for migraine have increased over the past 5 years, the proportion of migraine sufferers using triptans has remained essentially stable. ⋯ New use of triptans is low in the population. Because adequacy of care was not assessed, future studies should focus on investigating whether this low rate of triptan start is proper or if it reflects an unmet treatment need.
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Individual differences in pain sensitivity have long remained a perplexing and challenging clinical problem. How can one individual have a sensory experience that is vastly different than that of another, even when they have received similar sensory input? Developing an understanding of such differences and the mechanisms that support them has progressed substantially as psychophysical findings are integrated with measures of brain activation provided by functional brain imaging techniques. Continued delineation of these mechanisms will contribute substantially to the development of combined psychophysical/psychological models that can be used to optimize pain treatment on an individual-by-individual basis.
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To determine whether controlled changes in barometric pressure activate rat spinal trigeminal neurons as a possible animal correlate of headaches. ⋯ We conclude that distinct neurons in the trigeminal nucleus caudalis, particularly with preferential afferent input from the eye, respond to lowering of atmospheric pressure. Similar mechanisms may contribute to the generation of headaches during changes in weather.
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Further questions need to be addressed in the evaluation of locus of control (LOC) in headaches, such as reducing scale length and adapting them to diverse cultural environments, as in the case of Spain. ⋯ The so-called Headache-Specific Locus of Control Scale-Short Form 9 has turned out to be a parsimonious (9 items), valid, and reliable measure of headache LOC.
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Burning mouth syndrome is a chronic pain condition characterized by burning, painful sensations within the oral cavity. A patient developed symptoms of burning mouth syndrome after initiating topiramate treatment for headache prevention. The symptoms resolved when the medication was discontinued, and the association was replicated upon re-challenge of the drug.