The journal of headache and pain
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Randomized Controlled Trial
Botulinum toxin-type A: could it be an effective treatment option in intractable trigeminal neuralgia?
Botulinum toxin type A (BTX-A) has been reported to have analgesic effects independent of its action on muscle tone, mostly by acting on neurogenic inflammatory mediators and controlling the neurotransmitter release of sensory and autonomic nerve terminals that are involved in many chronic painful conditions as chronic intractable trigeminal neuralgia (TN).The aim of our work was evaluating the efficacy, safety, and tolerability of BTX-A for the treatment of intractable idiopathic TN. ⋯ These results indicate that BTX-A has a direct analgesic effect in patients with TN and can represent a therapeutic option for intractable cases.
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Headache disorders cause substantial productivity losses through absenteeism and impaired effectiveness at work (presenteeism). We measured productivity losses from both causes at a heavy-manufacturing company with a largely male workforce in north-western Turkey. ⋯ The high productivity losses in a largely male workforce were surprising. Possible factors were the nature of the work - manual labour for two thirds, often heavy - and the recurring schedule disturbances of shift-work. There was a highly-disabled minority.
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Population-based studies of headache disorders are important. They inform needs assessment and underpin service policy for a set of disorders that are a public-health priority. On the one hand, our knowledge of the global burden of headache is incomplete, with major geographical gaps; on the other, methodological differences and variable quality are notable among published studies of headache prevalence, burden and cost. ⋯ We found wide variations in methodology. The themes within which methodological shortcomings had adverse impact on quality were the following: study design; selection and/or definition of population of interest; sampling and bias avoidance; sample size estimation; access to selected subjects (managing and reporting non-participation); case definition (including diagnosis and timeframe); case ascertainment (including diagnostic validation of questionnaires); burden estimation; reporting (methods and results). These are discussed.
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Red Ear Syndrome (RES) is a very rare disorder, with approximately 100 published cases in the medical literature. Red ear (RE) episodes are characterised by unilateral or bilateral attacks of paroxysmal burning sensations and reddening of the external ear. The duration of these episodes ranges from a few seconds to several hours. ⋯ Secondary forms of RES occur with upper cervical spine disorders or temporo-mandibular joint dysfunction. RES is regarded refractory to medical treatments, although some migraine preventative treatments have shown moderate benefit mainly in patients with migraine-related attacks. The pathophysiology of RES is still unclear but several hypotheses involving peripheral or central nervous system mechanisms have been proposed.
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Socioeconomic status plays an important role in pain coping strategy. Its influence on migraine and tension-type headache may differ by gender. This study aimed to evaluate how socioeconomic status affects the prevalence of migraine and tension-type headache by gender. ⋯ The influence of socioeconomic status on migraine and tension-type headache differs by gender, with women being more susceptible to socioeconomic influence.