Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
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The aim of the present study was to investigate the impact of comorbid migraine on quality of life (QoL) of patients with multiple sclerosis (MS). Forty-four MS patients with comorbid migraine and 44 sex/age-matched MS subjects free from primary headache were evaluated. ⋯ Significant correlations between MIDAS score and RL-P (r = -0.43, p = 0.003), BP (r = -0.51; p < 0.001), and HP (r = -0.38; p = 0.01) were also found. In conclusion, we suggest that investigating and treating migraine in MS patients might contribute to improve their QoL.
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Pain has always been considered as part of a defensive strategy, whose specific role is to signal an immediate, active danger. This definition partially fits acute pain, but certainly not chronic pain, that is maintained also in the absence of an active noxa or danger and that nowadays is considered a disease by itself. ⋯ Pain itself can be considered to share the same genesis as emotions and as a specific emotion in contributing to the maintenance of the homeostasis of each unique subject. Interestingly, this role of pain reaches its maximal development in the human; some even argue that it is specific for the human primate.
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On March 15th 2010, Italy adopted the Law no. 38 "Disposizioni per garantire l'accesso alle cure palliative e alla terapia del dolore" (Provisions aimed at ensuring access to palliative care and pain therapy). The aim of pain therapy is to enable patients with chronic diseases to achieve pain control. Palliative care, as defined by the World Health Organization, aims at "improving the quality of life of patients and families, who face the problems associated with incurable diseases, through prevention and relief from suffering, achieved through an early identification and treatment of pain by pharmacological medication and other physical, psychosocial and spiritual techniques". ⋯ Regarding the headaches, it should be noted that the law 38 cited above includes all forms of pain, and headaches should be integrated into the care networks. In this context, several multi-disciplinary professionals within the centers (hub and spoke) or territory (GPs, specialists from neurologists and other professionals involved) should be integrated to offer the best response to the needs of the citizen. The diagnosis and treatment of various forms of headache have to be integrated into the path of pain, both National and Regional, in line with the rest of the organization.
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Case Reports
Widespread urticaria due to intramuscular interferon beta-1a therapy for multiple sclerosis.
We describe two multiple sclerosis patients who displayed widespread urticaria due to intramuscular interferon beta-1a (INF-β-1a). Clinicians should be aware of this adverse event, since it may be severe and it may lead to the definitive interruption of treatment. Widespread urticaria complicating intramuscular INF-β-1a therapy in multiple sclerosis should be therefore added to the list of dermatological lesions associated with interferon therapy.
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Primary headaches are underdiagnosed and undertreated in patients with multiple sclerosis (MS). The aim of our study was to investigate the possibility of using the ID migraine™ (ID-M) questionnaire to make a first-line diagnosis of migraine in subjects affected by MS. We consecutively recruited 144 patients regularly attending the MS Centre of S. ⋯ ID-M showed high sensitivity (91%) and specificity (94%) in identifying patients with migraine. ID-M was also able to discriminate patients affected by headache following interferon beta therapy, having only the 10% out of these patients a positive ID-M. The use of the ID-M as a screening test is warranted not only in the epidemiological research, but also to ensure a better clinical management of patients with MS.