Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
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The aim of this study was to investigate the clinical characteristics and patterns of diagnosis and treatment of patients with tension-type headache in the neurology outpatient clinic of a university hospital in China. This cross-sectional study was conducted in the neurological clinic of a tertiary care hospital in Chongqing between March 2010 and May 2010. All consecutive patients with the chief complaint of headache were asked to complete a face-to-face interview with physicians. ⋯ In conclusion, many tension-type headache patients did not receive a physician diagnosis of tension-type headache or effective treatment in the neurological clinic. Tension-type headache remains underrecognized in China. Better education among physicians is needed so as to improve the diagnosis and treatment of tension-type headache.
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To date, no studies are available on the effect of pregabalin in dystonia. A patient with subarachnoidal and cerebral hemorrhage was treated with pregabalin for neuropathic pain. ⋯ One possible explanation for these symptoms could be neuronal hyperactivity within still-functioning pathways in connection with the motor cortex. Preponderance of activity in potentially compensatory structures could be suppressed by pregabalin: therefore, its potential benefit in subacute secondary dystonia in cases with orbital brain involvement is suggested.
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Moderate to severe migraine attacks are treated with triptans. However, about 25% of migraineurs fail to respond to triptans. We investigated the involvement of gene polymorphisms, personality traits and characteristics of headache, and made a scoring system for prediction of clinical response to triptans in patients with migraine. ⋯ The score in inconsistent responders (1.6 ± 0.6) was significantly higher than that in consistent responders (0.8 ± 0.7, P < 0.001). Sensibility of low-score (RI = 0) group was 100%, and specificity of high-score (PI ≥ 2) group was 87%. The proposed scoring system should in the future be the object of larger studies to confirm its validity.
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This study aimed to investigate the role of p38 MAPK phosphorylation and opening of the mitoK(ATP) channels in the sevoflurane-induced delayed neuroprotection in the rat brain. Adult male Sprague-Dawley rats (250-300 g) were randomly assigned into four groups: ischemia/reperfusion (Control), sevoflurane (Sevo), 5-hydroxydecanoate (5-HD) + sevoflurane (5-HD + Sevo) and 5-HD groups and were subjected to right middle cerebral artery occlusion (MCAO) for 2 h. Sevoflurane preconditioning was induced 24 h before MCAO in sevoflurane and 5-HD + sevoflurane groups by exposing the animals to 2.4% sevoflurane in oxygen for 60 min. ⋯ Sevoflurane treatment also caused increased phosphorylation of p38 MAPK at 24 and 72 h after reperfusion. These beneficial effects were attenuated by 5-HD. Blockade of cerebral protection with 5-HD concomitant with decrease in p38 phosphorylation suggests that mitoK(ATP) channels opening and p38 phosphorylation participate signal transduction cascade of sevoflurane preconditioning and p38 MAPK activation may be a downstream of opening mitoK(ATP) channels.
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Case Reports
Deep brain stimulation of the globus pallidus internal improves symptoms of chorea-acanthocytosis.
Chorea-acanthocytosis is a rare autosomal recessive disorder. To date, treatment is only symptomatic and supportive. Results from the few reports of chorea-acanthocytosis patients treated with deep brain stimulation (DBS) have been inconsistent. ⋯ One patient, however, did not improve with either low-frequency or high-frequency DBS. Bilateral DBS to the GPi can improve chorea and dystonia in some patients with intractable chorea-acanthocytosis. However, selection criteria for the most promising candidates must be defined, and the long-term benefits evaluated in clinical studies.