Neurology
-
The authors estimated the prevalence and severity of cutaneous allodynia (CA) in individuals with primary headaches from the general population. ⋯ Cutaneous allodynia (CA) is more common and more severe in transformed migraine and migraine than in other primary headaches. Among migraineurs, CA is associated with female sex, headache frequency, increased body mass index, disability, and depression.
-
Comparative Study
High pulse pressure protects against headache: prospective and cross-sectional data (HUNT study).
Many antihypertensive drugs are also used as migraine prophylactics, but the relationship between blood pressure and headache is not been well understood. The objective of the present study was to explore the association between blood pressure and headache prevalence, and the effect of antihypertensive medication on this relationship, using both cross-sectional and prospective data from a large population. ⋯ Both increased systolic blood pressure and pulse pressure are related to arterial stiffness and may decrease headache prevalence through modulation of the baroreflex arch, which in turn generates hypoalgesia. This is due to a phenomenon called hypertension-associated hypalgesia. Stimulation of the baroreflex arch in response to increased blood pressure is assumed to inhibit pain transmission at both spinal and supraspinal levels, possibly because of an interaction of the centers modulating nociception and cardiovascular reflexes in the brainstem.
-
Comparative Study
Executive dysfunction and memory impairment in idiopathic REM sleep behavior disorder.
Idiopathic REM sleep behavior disorder (iRBD) might be a stage in the development of neurodegenerative disorders, especially Parkinson disease and dementia with Lewy bodies. Recent studies showing a slowing of waking EEG in iRBD suggest that iRBD is associated with cognitive impairment. ⋯ This study shows a co-occurrence of impaired cognitive profile and waking EEG slowing in patients with idiopathic REM sleep behavior disorder similar to that observed in early stages of some synucleinopathies.
-
In our metropolitan area, the Stroke Code (SC) system allows immediate transfer of patients with acute stroke to a stroke center. It may be activated by community hospitals (A), emergency medical services (EMS, B), or the emergency department of the stroke center (C). Our aim was to analyze whether the SC activation source influences the access to thrombolytic therapy and outcome of patients with ischemic stroke. ⋯ Patients arriving directly to the stroke center via emergency medical services or on their own receive neurologic attention sooner, are more frequently treated with tPA, and have better clinical outcome than those patients who are first taken to a community hospital.