Headache
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Multicenter Study Clinical Trial
Clinical significance of brush allodynia in emergency patients with migraine.
Cutaneous brush allodynia may be a practical and readily assessable marker of progression of an acute migraine attack. We determined the relative frequency of this finding in emergency department (ED) patients with acute migraine and tested the hypothesis that the presence of cutaneous brush allodynia prior to initial treatment in the ED could predict poor 2-hour and 24-hour pain intensity outcomes. ⋯ Cutaneous brush allodynia is an uncommon finding in the ED, occurring in fewer than 1 in 5 migraineurs. It does not seem to have prognostic relevance for the ED-based management of the acute migraine attack.
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Multicenter Study
Migraine disability awareness campaign in Asia: migraine assessment for prophylaxis.
This study aimed to survey the headache diagnoses and consequences among outpatients attending neurological services in 8 Asian countries. ⋯ Migraine is the most common headache diagnosis in neurological services in Asia. The prevalence of migraine was higher in countries with higher referral rates of patients to neurological services. Migraine remains underdiagnosed and under-treated in this region even though a high disability was found in patients with migraine. Probable migraine was adopted into the migraine diagnostic spectrum by neurologists in this study.
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Multicenter Study Comparative Study
Behavioral dependence in patients with medication overuse headache: a cross-sectional study in consulting patients using the DSM-IV criteria.
The aim of this study was to assess behavioral dependence on migraine abortive drugs in medication-overuse headache (MOH) patients and identify the predisposing factors. ⋯ In some cases, MOH thus appears to belong to the spectrum of addictive behaviors. In clinical practice, behavioral management of MOH should be undertaken besides pharmacological management.
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Randomized Controlled Trial Multicenter Study
Efficacy and tolerability of coadministration of rizatriptan and acetaminophen vs rizatriptan or acetaminophen alone for acute migraine treatment.
To evaluate the efficacy and tolerability of coadministration of rizatriptan and acetaminophen in the acute treatment of migraine. ⋯ Rizatriptan coadministered with acetaminophen achieved 2 of the 3 primary hypotheses, proving superior to both acetaminophen and placebo for 2-h pain relief, but failing to achieve superiority to rizatriptan alone. RA was as well tolerated as each of the individual agents.
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Randomized Controlled Trial Multicenter Study
Randomized controlled trial of intravenous dexamethasone to prevent relapse in acute migraine headache.
Migraine headache is a common presentation in the emergency department (ED). Inflammation is thought to play a role in the pathophysiology of migraine and there is conflicting evidence regarding the effect of corticosteroids on reducing early recurrences. We conducted a randomized clinical trial to test the hypothesis that dexamethasone (DEX) reduced headaches after discharge and examine the factors associated with relapse. ⋯ The overall relapse rate differed from those previously reported; however, DEX failed to reduce headache relapses after ED discharge. Relapse was closely associated with incomplete pain relief at discharge. Further research is needed to determine the factors associated with migraine relapse.