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- Reversible cerebral vasoconstriction syndrome developed during treatment
of Parkinson's disease with rasagiline mesylate: A case report Authors: Akihiko Nakaya, Kimihiko Kaneko, Arifumi Matsumoto, Yuki Matsumoto, Yasuhiko Matsumori, Isao Nagano Abstract: Cephalalgia Reports, Volume 7, Issue , January-December 2024. BackgroundRasagiline mesylate, a monoamine oxidase-B inhibitor, is used in Parkinson's disease (PD) treatment. We report a case of reversible cerebral vasoconstriction syndrome (RCVS) developed after rasagiline mesylate initiation.Case presentationA 59-year-old woman was diagnosed with PD at the age of 54 years. She experienced frequent episodes of nausea after increasing the dose of levodopa-carbidopa hydrate, and her nausea worsened with the addition of rasagiline mesylate. Three months later, the patient experienced recurrent thunderclap headaches. Brain imaging revealed subarachnoid hemorrhage with segmental vasoconstriction in the main trunks of multiple cerebral arteries. The subsequent clinical course was consistent with RCVS. Her headache and nausea were completely resolved by the discontinuation of rasagiline mesylate and addition of verapamil hydrochloride.DiscussionWorsened nausea was the only sign implicating the elevated monoamine levels, potentially linked to the development of RCVS. RCVS should be considered when a patient taking rasagiline mesylate experiences thunderclap headache. Citation: Cephalalgia Reports PubDate: 2024-07-23T09:22:19Z DOI: 10.1177/25158163241259108 Issue No: Vol. 7 (2024)
- Poor creativity in interictal migraine: A case–control pilot study
Authors: Lara Ruiz-Álvarez, Eva Díez-Rodríguez, Carmelo Pérez Cubillas, Vanesa Soto-León, Yolanda A Pérez Borrego, Fernando Pérez Parra, Antonio Oliviero Abstract: Cephalalgia Reports, Volume 7, Issue , January-December 2024. Background/Hypothesis:Creativity is a cognitive process that affects the performance of many daily life activities. This process, in turn, is influenced not only by various environmental factors but also by numerous individual aspects. Chronic pain is one of the factors that has proven to negatively affect creativity. Our hypothesis is that people with migraine in the interictal phase also have lower levels of creativity than the control group.Methods:We collected data from participants with migraine (n = 31) in the interictal phase and from a non-migraine control group (n = 30). We used the Alternative Uses Task (AUT) test and the Creative Intelligence Test (CREA) to evaluate creativity.Results:Our results revealed lower creativity in participants with migraine. This was confirmed by both the AUT (fluency: controls 7.4 (4.35) vs. participants with migraine 4.4 (2.9); p < 0.001; originality: controls 2.353 (0.457) vs. participants with migraine 2.07 (0.278); p < 0.001; flexibility: controls 3.4 (1.55) vs. participants with migraine 2.0 (1.0); p < 0.001) and CREA (controls 14.0 (9.875) vs. participants with migraine 9.5 (5.0); p = 0.004) tests.Interpretation:The present pilot study provides evidence that migraine, even in the interictal period, reduces creative ideation and this may impact the quality of life of these individuals. Citation: Cephalalgia Reports PubDate: 2024-05-25T11:14:06Z DOI: 10.1177/25158163241255951 Issue No: Vol. 7 (2024)
- Timing of cluster headache preventives in episodic cluster headache:
Protocol for an observational prospective cohort pilot study Authors: Ioana Medrea, Dongliang Wang, Mark J Burish Abstract: Cephalalgia Reports, Volume 7, Issue , January-December 2024. Purpose:In cluster headache, patients often describe a ramp up period with initially milder headache and then build up to a persistent and severe pattern. It is possible that within the early ramp up, patients may be more treatment responsive. We propose to study if response to therapy for prevention of cluster headache is dependent on timing from onset of cluster cycle.Methods:We will conduct a prospective observational cohort study, where we examine the relationship between timing of start of preventive medication and likelihood of response to treatment. We will look at individuals exposed within 10 days of onset of cluster cycle, versus those exposed after 10 days, to preventive medication.Results:We plan to enroll patients into the study and present data on completion.Conclusion:We aim to study the relationship between cluster headache onset and response to therapy. We propose that there is some data to suggest that earlier in cycle cluster headache may be more easily prevented, and we aim to study this relationship systematically. This is an important question that can influence treatment decisions in clinical practice, as well as clinical trial design. Citation: Cephalalgia Reports PubDate: 2024-04-10T03:18:31Z DOI: 10.1177/25158163241236766 Issue No: Vol. 7 (2024)
- Paranoid psychosis after a single parenteral dose of indomethacin
administered for headache diagnosis: A case and review of the literature Authors: Nazia Karsan, Ray Pyari Bose, Peter J Goadsby Abstract: Cephalalgia Reports, Volume 7, Issue , January-December 2024. Background:Indomethacin is a non-steroidal anti-inflammatory used to diagnose and treat hemicrania continua and paroxysmal hemicrania. Treatment can be complicated by gastrointestinal adverse effects; less commonly reported are idiosyncratic neuropsychiatric adverse effects with indomethacin.Methods:A 50-year-old male with lateralized brief attacks of headache associated with cranial autonomic symptoms was administered a single 200 mg dose of intramuscular indomethacin. Within an hour, he developed acute psychosis, with paranoid delusions and verbal and physical aggression lasting 5 h, followed by recovery to baseline. We used search terms “indomethacin psychosis,” “indomethacin psychiatric,” “indomethacin side effects,” “non-steroidal anti-inflammatory psychosis,” and “non-steroidal anti-inflammatory psychiatric” within PubMed to identify previous reports and literature in this area.Results:Neuropsychiatric adverse effects of indomethacin have been reported since 1965 in a dose-dependent manner, usually with oral courses. They may be more common in the elderly, postpartum women and postoperative patients.Conclusion:Neuropsychiatric adverse effects should be considered in headache medicine, particularly in at-risk groups when indomethacin is administered. Patients, particularly those at highest risk, should be counseled about the risk of neuropsychiatric side effects on indomethacin which may be dose-dependent and are generally reversible on stopping the drug. Citation: Cephalalgia Reports PubDate: 2024-03-29T07:37:00Z DOI: 10.1177/25158163241230685 Issue No: Vol. 7 (2024)
- Real-world effectiveness of add-on fremanezumab in patients receiving
onabotulinumtoxinA for the prevention of chronic migraine in a US tertiary headache center: A retrospective chart review study Authors: Hsiangkuo Yuan, Fred Cohen, Maurice T Driessen, Lynda J Krasenbaum, Mario Ortega, Mary Hopkins, Michael J Marmura Abstract: Cephalalgia Reports, Volume 7, Issue , January-December 2024. Background:Concomitant fremanezumab, a calcitonin gene-related peptide (CGRP) pathway monoclonal antibody (mAb), and onabotulinumtoxinA (onabotA) improve treatment response compared with onabotA alone in patients with chronic migraine (CM).Methods:This was a single-center, retrospective, observational study that assessed treatment response (change over time in monthly headache days [MHD] and pain intensity [PI]) in adult patients with CM receiving fremanezumab as add-on therapy to onabotA for CM prevention.Results:In the study population (N = 116, age 50.0 ± 13.1, female 85.3%, pre-index onabotA use 46.5 ± 34.2 months) receiving concurrent onabotA and fremanezumab for 17.5 ± 11.6 months, MHD decreased by 3.60 days (95% confidence interval [CI]: −5.26, −1.94, p < 0.001) and PI was reduced by 0.43 (95% CI: −0.77, −0.09, p = 0.012) at the final visit. Statistically significant reductions were seen in both MHD (−4.61, 95% CI: −6.84, −2.39; p < 0.001) and PI (−0.52, 95% CI: −0.84. −0.09; p = 0.017) among patients naïve to mAbs against CGRP or its receptor. No unexpected adverse events were observed.Conclusion:Concomitant fremanezumab and onabotA for CM prevention were effective at reducing the number of MHD and lessening PI, particularly in patients with difficult-to-treat CM who are naïve to mAbs against CGRP or its receptor. Citation: Cephalalgia Reports PubDate: 2024-03-29T07:31:57Z DOI: 10.1177/25158163241238448 Issue No: Vol. 7 (2024)
- Corrigendum to “Eptinezumab administered intravenously, subcutaneously,
or intramuscularly in healthy subjects and/or patients with migraine: Early development studies” Abstract: Cephalalgia Reports, Volume 7, Issue , January-December 2024.
Citation: Cephalalgia Reports PubDate: 2024-03-12T10:05:09Z DOI: 10.1177/25158163241233831 Issue No: Vol. 7 (2024)
- A century of bruxism research in top-ranking medical journals
Authors: Frank Lobbezoo, Merel C Verhoeff, Jari Ahlberg, Daniele Manfredini, Ghizlane Aarab, Michail Koutris, Peter Svensson, Magdalini Thymi, Corine M Visscher, Gilles J Lavigne Abstract: Cephalalgia Reports, Volume 7, Issue , January-December 2024. Background:Bruxism is a jaw-muscle activity characterized by teeth grinding and clenching. While many of its negative consequences (e.g., jaw-muscle pain, tooth fractures) are of particular interest to dentists, new insights underline the need for physicians to be knowledgeable about bruxism. In order to facilitate transfer of knowledge across disciplines, our objective was to assess what top-ranking medical journals have published on bruxism. Besides, we tested the insights described there against current science regarding the definition, assessment, epidemiology, etiology, consequences, comorbidities, and management of bruxism.Results:In the past century, the four top-ranking medical journals have provided their readership with various bits and pieces of information on bruxism. While some of these insights have withstood the test of time, others are somewhat outdated. Further, the identified publications provide an incomplete picture of what physicians should know. The present article helps reduce this knowledge gap.Conclusion:The role of the physician with regard to bruxism focuses mainly on its assessment and management, while insight into risk factors and comorbid conditions of bruxism is essential to high-level patient care. It is hoped that this article will contribute to improve the long-needed interdisciplinary collaboration between physicians and dentists regarding the assessment and management of bruxing patients. Citation: Cephalalgia Reports PubDate: 2024-03-07T07:21:37Z DOI: 10.1177/25158163241235574 Issue No: Vol. 7 (2024)
- Extended regular use of kinetic oscillation stimulation (KOS) in
refractory chronic migraine: case report of a first, single-subject experience Authors: Giorgio Liaci, Claudia Altamura, Nicoletta Brunelli, Luisa Fofi, Maria Pia Prudenzano, Fabrizio Vernieri Abstract: Cephalalgia Reports, Volume 7, Issue , January-December 2024. Background:Kinetic Oscillation Stimulation (KOS) is a novel and non-invasive neuromodulation method for migraine therapy. Emerging evidence suggests that applying low-frequency intranasal vibrations to the sphenopalatine ganglion (SPG) could be a safe and effective option for migraine treatment.Case report:We present a case of a 60-year-old man affected by refractory chronic migraine with a history of failure or progressive ineffectiveness of multiple approved therapies. Given the limited available options, we proposed the patient a 6-week treatment cycle with KOS. After 1 month, monthly migraine days (MMD) dropped from 18 to 7, with significant pain reduction by week 6. However, the benefits were not sustained after discontinuation, requiring a second stimulation cycle after 3 months, which yielded an even faster and more significant response.Conclusions:This experience reveals KOS safety and effectiveness for long-term SPG neuromodulation, highlighting the potential of focusing treatment on the trigeminal-autonomic reflex (TAR) as a promising direction to pursue. Citation: Cephalalgia Reports PubDate: 2024-03-07T07:15:37Z DOI: 10.1177/25158163241234054 Issue No: Vol. 7 (2024)
- Rimegepant as an acute treatment in a refractory migraine patient
non-responder to two anti-CGRP monoclonal antibodies and triptans: Case report and pharmacological considerations Authors: Andrea Burgalassi, Giulia Vigani, Alberto Boccalini, Francesco De Cesaris, Guido Mannaioni, Alberto Chiarugi, Pierangelo Geppetti, Luigi Francesco Iannone Abstract: Cephalalgia Reports, Volume 7, Issue , January-December 2024. Background:Small molecule receptor antagonists (gepants), or monoclonal antibodies (mAbs) against calcitonin gene-related peptide (CGRP) have recently become available for migraine prophylaxis and/or acute treatment. Considering their shared mechanisms of action, if the failure to an anti-CGRP(R) mAbs preclude the effectiveness of gepants or vice versa is still unknown. Herein, we report the first case of a patient with refractory migraine responsive to the acute use of rimegepant that previously failed two different anti-CGRP(R) mAbs and with no response to other acute treatments. Finally, we performed a literature review on the use of gepants in patients that failed other anti-CGRP and/or triptans.Case:A 56-year-old female with a long history of chronic migraine without aura, fulfilling the EHF definition for a diagnosis of refractory migraine. Overall, the patient treated five not-consecutive migraine attacks. All of them were treated according to the predefined criteria. The mean (±SD) NRS before rimegepant assumption was 7.8 ± 0.9, all attacks cause at least severe impairment at onset, and no rescue medications were used. Pain free at 2 hours was achieved in three out of five attacks (60.0%), with no recurrence of migraine in the following 24 hours. The patient reported also a sustained benefit the day after the drug assumption. The response pain free was achieved after a mean time of 13.3 ± 4.5 minutes considering only attacks successfully treated (three out of five attacks). No adverse events were reported.Conclusions:In conclusion, rimegepant for acute treatment may be a viable option in patients with partial or no response to triptans that failed preventive treatments targeting the CGRP pathway, regardless to ligand or receptor. The failure of anti-CGRP(R) mAbs does not necessarily preclude the use of gepants (acute and/or preventive), but further studies are urgently needed to provide evidence on the efficacy of these treatments in managing drug-resistant migraine and to identify novel treatments for patients. Citation: Cephalalgia Reports PubDate: 2024-03-07T07:09:13Z DOI: 10.1177/25158163241235130 Issue No: Vol. 7 (2024)
- Protocol of a cross-sectional, multicentre and multidisciplinary study
describing phenotype and burden of a midfacial segment pain Authors: Marcin Straburzyński, Adrian M Agius, Magdalena Boczarska-Jedynak, Eliza Brożek-Mądry, Karolina Dżaman, Elżbieta Gradek Kwinta, Anna Gryglas-Dworak, Magdalena Nowaczewska, Anshul Sama, Joanna Smardz, Hoo Kee Tsang, Mieszko Więckiewicz, Marta Waliszewska-Prosół Abstract: Cephalalgia Reports, Volume 7, Issue , January-December 2024. Background:Midfacial segment pain is a term used in the past in the diagnosis of patients mainly from ear, nose and throat clinics. This type of pain cannot be attributed to other primary or secondary facial pain, but is to a large extent similar to tension-type headache with midfacial location. The purpose of this study is to describe midfacial segment pain phenotype, burden and comorbidities in a multicentre and multidisciplinary setting. The ultimate goal is a comprehensive description of this type of pain allowing for its implementation in future classifications.Methods:This cross-sectional study is designed to describe midfacial segment pain in a clinical setting. Patients from rhinologic, headache and facial pain or oral medicine/dentistry secondary care centres will be recruited during a 1 year period. Individuals with other facial pain according to current classification such as sinonasal disorders, neoplasms, local infections, history of significant trauma associated with pain onset will be excluded. Data will be collected through a structured questionnaire covering pain characteristics, coexisting diagnoses, pain-related burden and consequences, physical examination and paranasal sinuses imaging. Citation: Cephalalgia Reports PubDate: 2024-03-07T06:56:57Z DOI: 10.1177/25158163241235642 Issue No: Vol. 7 (2024)
- Tolerability of calcitonin gene-related peptide monoclonal antibodies and
other monoclonal antibodies in adults with concurrent migraine and other medical conditions Authors: Kevin Weber, Tanner Ferderer, Meghan Hubert, Ann Pakalnis Abstract: Cephalalgia Reports, Volume 7, Issue , January-December 2024. Background/Hypothesis:Calcitonin gene-related peptide monoclonal antibodies (CGRP mabs) are relatively new preventive treatments in adult migraine. Co-morbid medical conditions such as autoimmune or other neurologic/oncologic disorders are not uncommon in migraine patients and some exhibit notable co-morbidity such as asthma. These clinical conditions may necessitate concomitant treatment with another monoclonal antibody with a different mechanism of action other than the CGRP pathway in some individuals with migraine.Methods:We report a retrospective case series in 23 patients identified from our headache clinic treated concurrently with a CGRP monoclonal antibody and other monoclonal antibody for another medical condition. These other medical conditions were neurologic, oncologic, or autoimmune conditions. These patients were evaluated for tolerability, safety, and stability of disease processes including their migraine response.Results/Conclusion:We did not find evidence of new adverse or serious adverse side effects with coadministration of CGRP and non-CGRP monoclonal antibodies during our study time period of 13 months, for the duration of overlap between treatments (between 3 and 12 months). Citation: Cephalalgia Reports PubDate: 2024-02-17T05:54:14Z DOI: 10.1177/25158163241230681 Issue No: Vol. 7 (2024)
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