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- Stroke-like migraine attacks after radiation therapy (SMART) syndrome
presenting as a migraine copycat: A case report
Authors: Sanaz Shoja Gharehbagh, Nina TTN Nguyen, Dagmar Beier
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Background:Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a possible long term consequence of cranial beam radiation therapy and may present as a perfect mimic of migraine with or without aura.Methods and Results:We present a 57-year-old man suffering from diffuse astrocytoma and presenting with SMART syndrome perfectly mimicking his antecedent migraine with visual aura. He was treated with intravenous steroid therapy inducing rapid response.Conclusion:SMART syndrome is a rare complex delayed complication of brain radiation therapy, which may present as an isolated migraine with or without aura even decades after cranial radiation. Thus, a sudden intensification or relapse of a previous migraine in a patient with remote cranial radiotherapy constitutes a red flag even decades after cranial irradiation and cured or stable tumor disease on a recent brain MRI. Moreover, SMART syndrome adds to the list of secondary headaches not yet listed in the current International Classification of Headache Disorders, 3rd edition (ICHD3).
Citation: Cephalalgia Reports
PubDate: 2022-11-28T08:40:37Z
DOI: 10.1177/25158163221131323
Issue No: Vol. 5 (2022)
- The importance of an early onset of migraine preventive disease control: A
roundtable discussion
Authors: Christopher Gottschalk, Anirban Basu, Andrew Blumenfeld, Bradley Torphy, Michael J Marmura, Jelena M Pavlovic, Paula K Dumas, Nim Lalvani, Dawn C Buse
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Background:Newly approved migraine preventive therapies have allowed for rapid control of migraine activity, offering potential to minimize the burden of migraine. This report summarizes a roundtable discussion convened to analyze evidence for early onset of prevention, ascertain its clinical relevance, and provide guidance for healthcare professionals in crafting goals and treatment expectations for patients with migraine initiating preventive therapy.Methods:A virtual roundtable meeting of migraine clinicians, researchers, and patient advocates convened in October 2020. Participants reviewed and discussed data summarizing patient and healthcare professional perceptions of migraine prevention and evidence from the peer-reviewed and gray literature to develop corresponding recommendations.Summary:Evidence from clinical studies of anti-calcitonin gene-related peptide monoclonal antibodies (erenumab, fremanezumab, galcanezumab, and eptinezumab) and the chemodenervation agent onabotulinumtoxinA indicate that patients may experience reduction of migraine activity within 7 days of drug administration and early attainment of disease control is associated with improvements in clinically important outcomes. The roundtable of experts proposes that early onset be defined as demonstration of preventive benefits within 1 week of treatment initiation. We recommend focusing discussion with patients around “disease control” and potential benefits of early onset of prevention, so patients can set realistic preventive therapy goals and expectations.
Citation: Cephalalgia Reports
PubDate: 2022-10-31T02:35:23Z
DOI: 10.1177/25158163221134593
Issue No: Vol. 5 (2022)
- Eptinezumab administered intravenously, subcutaneously, or intramuscularly
in healthy subjects and/or patients with migraine: Early development
studies
Authors: Brian Baker, Vivienne Shen, Roger Cady, Anders Ettrup, Frank Larsen
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Objective:To report the safety, tolerability, and pharmacokinetics/pharmacodynamics (PK/PD) of eptinezumab using intravenous (IV) infusion compared to other routes of administration from two phase 1 trials.Methods:Study 1 (NCT01579383) and Study 2 (ACTRN12615000531516) were double-blind, placebo-controlled, randomized trials. Study 1 singly administered ascending doses of eptinezumab 1–1000 mg IV infusion or 100 mg subcutaneous (SC) injection to healthy adults on day 1 (n = 60); in a second part, eptinezumab 300 mg IV + sumatriptan 6 mg SC was administered to healthy adults and patients with migraine (n = 18). Study 2 administered eptinezumab 100 or 300 mg intramuscular (IM), 100 mg SC, or 100 mg IV to healthy adults on days 1 and 84 (n = 60).Results:No withdrawals due to treatment-emergent adverse events (TEAEs) were reported due to IV administration, with IV generally reporting TEAEs similar to placebo. The pharmacokinetics of eptinezumab were as expected for a monoclonal antibody, with the 100 mg and 300 mg IV doses exhibiting higher C max and shorter t max compared to identical SC and IM doses.Discussion:These phase 1 safety and tolerability data supported eptinezumab intravenous infusions at 100 and 300 mg; both were approved for migraine prevention, were well tolerated, had low immunogenicity and rapid attainment of high plasma concentrations.
Citation: Cephalalgia Reports
PubDate: 2022-10-14T12:25:40Z
DOI: 10.1177/25158163221131326
Issue No: Vol. 5 (2022)
- Predictors of clinical response to erenumab in patients with migraine
Authors: Olga Lekontseva, Meng Wang, Farnaz Amoozegar
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Background:Anti-CGRP monoclonal antibodies have emerged as efficacious preventive therapies for some, but not all patients with migraine. It is not yet fully understood what predicts treatment response.Objective:To identify factors associated with good or poor response to erenumab, the first available CGRP monoclonal antibody.Methods:A chart review of patients with migraine from a large headache center who received at least three 4-weekly doses of erenumab between 2018 and 2020 was conducted. Clinical variables were compared between erenumab responders (defined as ≥30% reduction in monthly headache or migraine days at 3 months) and non-responders via logistic regression analyses.Results:Among 90 enrolled patients, 62.2% were erenumab responders and 37.8% non-responders. A significantly larger proportion of non-responders were unemployed (58.8% vs. 28.6%), had complex diagnosis (chronic migraine overlapping another primary or secondary headache) (47.1% vs. 14.3%), higher monthly headache days (30 vs. 25.5) and migraine days (20 vs. 12), a higher frequency of daily headache (76.5% vs. 48.2%), and failed more preventive therapies (5.5 vs. 3). Based on logistic regressions, erenumab responsiveness did not significantly associate with duration of migraine, presence of aura, medication overuse, number of concurrent preventives, response to onabotulinumtoxinA or triptans, or certain comorbidities and substance use.Conclusions:This work may help improve selection of patients who may benefit from erenumab, but further prospective research studies are needed.
Citation: Cephalalgia Reports
PubDate: 2022-09-27T04:30:46Z
DOI: 10.1177/25158163221128185
Issue No: Vol. 5 (2022)
- History of cluster headache
Authors: Heiko Pohl
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Objective:To summarise the history of cluster headache evolving concepts and growing insights.Background:Excruciating pain, activation of the parasympathetic nervous system, and circadian rhythmicity characterise cluster headache attacks.Results:We find the oldest descriptions of patients suffering from the disorder in case reports of the 17th and 18th centuries. Only in the 19th and early 20th centuries did physicians start hypothesizing its cause. Initially, many researchers suspected the origin of the pain in peripheral nerves or blood vessels. However, eventually, they understood that the cause of the disease lies in the brain. In 1998, Positron emission tomography studies revealed increased activity of the posterior hypothalamus, whose role remains incompletely understood. Only recently have researchers realised that being diseased implies more than dysfunction. Recent studies analysed the consequences of cluster headache for each patient. Many struggle to deal with the disorder even in the absence of pain.Conclusion:Physicians have been aware of this type of pain for at least 300 years. Only when researchers studied pathological anatomy and physiology did knowledge accrue. A more comprehensive picture of the disease severity emerged when they also considered its consequences.
Citation: Cephalalgia Reports
PubDate: 2022-09-21T05:52:19Z
DOI: 10.1177/25158163221128183
Issue No: Vol. 5 (2022)
- Migraine phenotype differentially modulates the attentional network: A
cross sectional observation study
Authors: Angela N Bonsu, Zelie Britton, Zara Asif, Mishaal Sharif, Diego Kaski, Amir Kheradmand, Adolfo M Bronstein, Qadeer Arshad
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Background:Signs of distinct brain dysfunction in patients where migraine intersects with vertigo (i.e. vestibular migraine (VM)), remain elusive. As migraine and vertigo can both independently modulate attentional processes, here we seek the utility of the attentional network to functionally differentiate patients.Methods:We used the Attentional Network Task (ANT) to elucidate three separate functional networks: Alerting, orienting and resolving conflict. 120 participants had to attend to the direction of a target visual stimulus, while other parameters were simultaneously manipulated. Reaction times across the networks were assessed in, (i) 30 healthy controls, (ii) 30 VM patients, (iii) 30 patients with migraine without vertigo, and (iv) 30 patients with benign paroxysmal positional vertigo (BPPV) but no migraine.Results:Patients with VM (mean = 737.1 ms, SEM = 28), migraine (mean = 735.3 ms, SEM = 36.4), and BPPV (mean = 720.3 ms SEM = 24.3) all exhibited significantly delayed ANT reaction times compared to healthy controls (mean = 661.3 ms, SEM = 23.4). Specific attentional network deficits were observed for resolving conflict in VM, alerting in migraine and orienting in BPPV.Conclusion:VM patients displayed deficits in executive function characterized by an inability to focus attentional resources and suppress peripheral distractors, whereas migraineurs without vertigo exhibited changes in the alerting network that reflects hypervigilance.
Citation: Cephalalgia Reports
PubDate: 2022-09-02T09:46:49Z
DOI: 10.1177/25158163221124264
Issue No: Vol. 5 (2022)
- Placebo response with subcutaneous injections in calcitonin gene-related
peptide receptor monoclonal antibody migraine preventative trials – A
systematic review and meta-analysis
Authors: Sasikanth Gorantla, Murali Mohan Reddy Gopireddy, Archana Bhat, Lavanya Ayyasamy, Sarath Kumar Jaganathan Jaishankar, Bassil Kherallah, Hrachya Nersesyan
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Background:The majority of CGRP monoclonal antibodies for migraine prevention are administered subcutaneously. Therefore, we attempted to calculate the pooled placebo response with subcutaneous placebo injections in this systematic review and meta-analysis.Methods:We identified 16 randomized controlled trials that met our inclusion and exclusion criteria through a comprehensive search in five electronic databases (PubMed Central, EMBASE, MEDLINE, Cochrane library and clinicaltrials.gov). The risk of bias was assessed for all included studies. Random effects model was used to calculate pooled mean monthly migraine days and 50% response rates.Results:A total of 4240 subjects were included from 16 studies in this meta-analysis. The pooled mean monthly migraine day reduction with subcutaneous placebo injections was 2.15 (95% CI: 1.60–2.69). The pooled proportion of patients achieving a 50% reduction in mean monthly headache days was 26% (95% CI: 20%–31%). Placebo response accounted for more than 50% of therapeutic gain in our study.Conclusion:A substantial placebo response was noted with subcutaneous injections in migraine CGRP monoclonal antibody clinical trials. This meta-analysis may serve as a reference point to calculate sample size in clinical trials using subcutaneous interventions for migraine prevention. We registered our study at PROSPERO (CRD42020185300).
Citation: Cephalalgia Reports
PubDate: 2022-08-30T06:03:39Z
DOI: 10.1177/25158163221120103
Issue No: Vol. 5 (2022)
- Corrigendum to “Temporomandibular disorder and headache prevalence: A
systematic review and meta-analysis”
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Citation: Cephalalgia Reports
PubDate: 2022-08-05T11:57:06Z
DOI: 10.1177/25158163221119265
Issue No: Vol. 5 (2022)
- Corrigendum to “Tolosa-Hunt syndrome after COVID-19 infection”
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Citation: Cephalalgia Reports
PubDate: 2022-08-05T11:53:52Z
DOI: 10.1177/25158163221119264
Issue No: Vol. 5 (2022)
- Interrater agreement in headache diagnoses
Authors: Maria Susanne Neumeier, Miranda Stattmann, Susanne Wegener, Andreas R Gantenbein, Heiko Pohl
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Background:Diagnosing headache disorders comprises the collection and interpretation of information. This study estimates agreement and bias in the latter.Methods:Physicians and medical students diagnosed eight patients’ headaches using the International Classification of Headache Disorders. We calculated Cohen’s Kappa for all participants and subgroups (board-certified neurologists, physicians working in a neurology department). Moreover, we asked how sure they felt about their diagnoses. Finally, participants estimated the number of different headache diagnoses a patient receives when consulting many physicians for the same headache and indicated the highest acceptable number.Results:The data of 63 participants entered the analysis, of whom 18 were neurologists (18/63, 28.6%), and 41 were currently working at a neurology clinic (41/63, 66.7%). Cohen’s Kappa decreased (0.706, 0.566, and 0.408) with increasing levels of the classification hierarchy. Interrater agreement was highest among neurologists. Physicians not working in a neurology clinic tended to diagnose secondary headaches more often were less confident about their diagnoses.Conclusions:Physicians with less experience in headache disorders struggle more to diagnose headaches than neurologists do; they suspect secondary headaches, disagree, and feel insecure more often. Thus, interpreting a headache history is prone to error and bias.
Citation: Cephalalgia Reports
PubDate: 2022-07-26T04:07:42Z
DOI: 10.1177/25158163221115391
Issue No: Vol. 5 (2022)
- Parenteral NSAIDs for acute treatment of migraine: Adherence to the IHS
guidelines for controlled trials
Authors: John G Curran, John Waters, Hsiangkuo Yuan
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Background:Parenteral non-steroidal anti-inflammatory drugs (NSAIDs) are important alternatives to oral NSAIDs, especially in patients with severe migraine who have emesis or gastroparesis. With increasing research on using parenteral NSAIDs for acute migraine, it is critical to examine the quality of these studies. Our goal was to assess the adherence of these trials to the International Headache Society (IHS) controlled trial guidelines for acute treatment of migraine.Methods:We queried PubMed for clinical trials investigating parenteral NSAIDs for acute treatment of migraine in adult patients. We developed a 14-point scoring system based on the essential components of the IHS guidelines. To date, four versions of the IHS’s Guidelines for controlled trials of acute treatment of migraine attacks have been published. Each trial was evaluated with the appropriate edition of the guidelines.Results:We identified 216 studies and assessed 27 eligible clinical trials. The mean score was 6.7 ± 2.1 (2–11). Most trials followed the IHS migraine diagnosis criteria (85.2%), but only six (22.2%) selected patients based on the recommended headache frequency. Most trials were randomized (88.8%), but fewer were double-blinded (74.1%) or placebo-controlled (11.1%). Almost every trial clearly explained the pain scale (96.3%), and three-quarters (77.8%) assessed headache-associated symptoms. However, no trial utilized the recommended primary endpoint: pain-freedom at 2-hours.Conclusions:Most clinical trials on parenteral NSAIDs for acute migraine did not fully adhere to the IHS recommendations. Future studies should pay special attention to the IHS guideline to improve the quality of clinical trials for the acute treatment of migraine.
Citation: Cephalalgia Reports
PubDate: 2022-07-26T03:48:59Z
DOI: 10.1177/25158163221114465
Issue No: Vol. 5 (2022)
- Corrigendum to “Comprehensive management of adults with chronic
migraine: Clinical practice guidelines in Mexico”
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Citation: Cephalalgia Reports
PubDate: 2022-06-30T04:16:20Z
DOI: 10.1177/25158163221091606
Issue No: Vol. 5 (2022)
- Migraine in the emergency department: A retrospective evaluation of the
characteristics of attendances in a major city hospital in the United
Kingdom
Authors: A-M Logan, I Reid, M Yogarajah, C Wang, N Greenwood, M Edwards, H Jarman, N Nirmalananthan
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Introduction:Detailed Emergency Department attendance data for migraine are needed for service redesign.Methods:A service evaluation was undertaken, classifying adult emergency department headache attendances using the International Classification of Headache Disorders migraine C-E criteria, evaluating attendance characteristics.Results:Migraine/Probable migraine diagnosis was documented in 58% but coded in 24% attendances by ED clinicians. 29% of patients used no analgesia before attending, 43% attended ≥4 days after onset and 19% arrived by ambulance.Conclusion:This evaluation highlights sub-optimal acute management and discrepancy between migraine coding and diagnosis contributing to underreporting. We recommend further evaluation of identified cohorts and headache proforma use.
Citation: Cephalalgia Reports
PubDate: 2022-05-23T04:12:01Z
DOI: 10.1177/25158163221084325
Issue No: Vol. 5 (2022)
- Temporomandibular disorder and headache prevalence: A systematic review
and meta-analysis
Authors: Pankaew Yakkaphan, Jared G Smith, Pav Chana, Tara Renton, Giorgio Lambru
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Background:Temporomandibular disorders (TMD) and headaches are prevalent among the global population. Patients often suffer from both conditions, and they are likely to be associated in a bidirectional way. However, the nature of the association remains unclear. Understanding the epidemiological aspects of the relationship between these conditions could have important clinical implications.Objective:To evaluate the prevalence of headaches in TMD patients as well as the prevalence of TMD in patients who suffer from headaches.Method:A systematic literature search was conducted using electronic databases. Studies published in English and those that used an acknowledged diagnostic criteria for TMD and headaches were included. Study quality was assessed using the Newcastle-Ottawa scale and meta-analyses were performed to generate pooled prevalence estimates.Result:Thirty-one studies met the selection criteria for the review; 16 studies evaluated the prevalence of headache in TMD patients and 15 studies evaluated the prevalence of TMD in headache patients. The included studies were of moderate-to-high quality. Meta-analyses revealed moderate-to-large heterogeneities across included studies. Pooled prevalence estimates from meta-analyses indicated similar rates of headaches in TMD patients and of TMD in headache patients (61.58%, 95% CI 45.26–76.66 and 59.42%, 95% CI 51.93–66.60, respectively). Migraines were more commonly observed in TMD patients (40.25%, 95% CI 35.37–45.23) compared to tension-type headaches (18.89%, 95% CI 12.36–26.44). The prevalence of headaches was particularly high in painful-TMD (82.80%, 95% CI 75.41–89.10).Conclusion:Despite large variance in prevalence rates across included studies, this review suggests headache and TMD frequently co-occur, particularly in the case of migraines and muscle related TMD. This association has important clinical, pathophysiological and therapeutic implications.
Citation: Cephalalgia Reports
PubDate: 2022-05-18T07:57:46Z
DOI: 10.1177/25158163221097352
Issue No: Vol. 5 (2022)
- Patient-identified burden and unmet needs in patients with cluster
headache: An evidence-based qualitative literature review
Authors: Emily Freeman, Michael Adair, Dori Beeler, Rozanne Casper, Melissa P Herman, David Reeves, Stefan Reinsch
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Objectives:To qualitatively identify evidence-based literature related to the daily burden and unmet treatment and psychosocial needs of patients with cluster headache (CH).Methods:A literature search was conducted through October 20, 2020 across MEDLINE, EMBASE, CINAHL, and PsychInfo databases exploring quality of life (QoL) and disease burden in adults with CH. The search was restricted to full-text reports in peer-reviewed journals. Methodologic quality was assessed using the Critical Skills Appraisal Program.Results:From 11 identified publications, QoL was reduced in persons living with CH, with significant psychological, social, and socio-economic burdens, and work-related disability. The CH disease trajectory is complex, with patients experiencing the impact of their disease across multiple domains beyond the biological manifestation of the disease including stigma, employment limitations, and suicidal ideation, and with a lack of effective treatment from the patient perspective.Discussion:These findings strengthen comprehension of the CH patient experience, enabling a deeper understanding of the patients’ perspective and experience of their disease andunmet needs, providing a basis for future research into this debilitating condition. Minor limitations of this study include data extraction and study selection biases.
Citation: Cephalalgia Reports
PubDate: 2022-04-30T12:29:35Z
DOI: 10.1177/25158163221096866
Issue No: Vol. 5 (2022)
- Orofacial pain disorders: An overview and diagnostic approach
Authors: Kuan-Po Peng, Thalea Oppermann
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Background:Non-dental orofacial pain disorders are not uncommon, but idiopathic or primary facial pain syndromes are rare. Inadequate recognition of these disorders usually leads to unsatisfactory and unmet treatment needs.Methods:We conducted a narrative review with a literature search in PubMed until December 2021, focusing on current guidelines and the recently published International Classification of Orofacial Pain (ICOP).Results:In this paper, we provide an updated overview of the common orofacial pain disorders following the ICOP, covering the classification, epidemiology, pathophysiology, clinical approaches, and treatment options. Additionally, we propose a pragmatic approach focusing on the attack duration to improve distinguishing orofacial disorders.Conclusion:The introduction of ICOP offers the opportunity to better coordinate and concentrate scientific efforts, which lays the foundation for the identification of the disease mechanism of facial pain disorders and the optimization of the currently still insufficient therapeutic strategies.
Citation: Cephalalgia Reports
PubDate: 2022-04-28T10:02:58Z
DOI: 10.1177/25158163221097349
Issue No: Vol. 5 (2022)
- The impact of topiramate, botulinum toxin type A, and CGRP-antibodies on
medication overuse headache in patients with chronic migraine: A protocol
for systematic review and meta-analysis
Authors: Samita Giri, Erling Tronvik, Mattias Linde, Knut Hagen
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Medication overuse headache (MOH) is defined as headache occurring ≥15 days/month developing as a consequence of regular overuse of acute or symptomatic headache medication for more than 3 months. MOH is present in more than 50% of patients with chronic migraine (CM). Although, studies have shown a positive impact for MOH patients of early introduction of preventive treatment and withdrawal of overused medication, uncertainties remain. The main purpose of this systematic review and meta-analysis is to assess the relative impact of topiramate, botulinum toxin type A, and human monoclonal antibodies (mAbs) targeting calcitonin gene-related peptide (CGRP) or its receptor (CGRPr) among MOH patients with CM. The PRISMA guideline for conducting systematic review will be followed. CENTRAL, MEDLINE, Embase and Web of Science databases will be searched. RCTs reporting outcomes such as change in migraine/headache frequency, change from MOH to no MOH, and ≥50% response rate will be included. The effect will be measured as mean difference (MD) for continuous data and odds ratio (OR) for dichotomous data. Heterogeneity across studies will be assessed using the Cochrane I2 statistics. The Cochrane RoB2 tool will be used to assess risk of bias, and the quality of evidence for outcomes will be rated according to five factors defined in Cochrane GRADE approach. The revision of the included articles, data extraction, risk of bias assessment, and quality rating of evidence will be independently done by two reviewers. Any discrepancies will be resolved through consensus with the third reviewer.
Citation: Cephalalgia Reports
PubDate: 2022-04-28T10:00:30Z
DOI: 10.1177/25158163221096867
Issue No: Vol. 5 (2022)
- Nummular headache in children: A case series and systematic literature
review
Authors: Daniel N Lax, Andrew D Hershey, Marielle A Kabbouche, Joanne Kacperski
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Background:Nummular headache is a rare primary headache disorder potentially disabling and refractory to treatment. Of over 300 reported cases, only 9 are children.Design/Methods:We searched our institutional database and PubMed for “nummular headache” and synonyms and evaluated select articles from reference lists of substantial reviews.Results:Seven children were identified from our institution and nine from 107 unique publications. Mean age at onset was 9.7 and 11.9 years in our cohort and the literature, respectively, with a female:male ratio of 2:1. Location and quality varied, and allodynia was reported in five. Frequency ranged from every other week to continuous. Imaging was normal except in four cases. Migraine was often comorbid. Published cases were frequently refractory to treatment whereas four of our cohort improved with therapy for comorbid migraine.Conclusions:Nummular headache is rarely reported in children. We describe characteristics of seven new and nine previously published pediatric cases.
Citation: Cephalalgia Reports
PubDate: 2022-04-04T03:15:48Z
DOI: 10.1177/25158163221091782
Issue No: Vol. 5 (2022)
- Case series of HaNDL syndrome responding to valproic acid
Authors: Elif Ilgaz Aydinlar, Mustafa Ertas
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Objective:We report a case series of patients diagnosed with the syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL) responding to high dose Valproic acid.Background:HaNDL syndrome is an infrequent entity, presenting with neurological impairment episodes and severe headache. A treatment to prevent the attacks has not been proposed yet.Results:We describe 6 patients with a definite diagnosis of HaNDL, responding to Valproic acid 1000–1500 mg/day.Conclusion:Although HaNDL’s self-limiting nature, episodes may cause important disability and can last up to 3 months. Valproic acid may be a good choice to prevent attacks due to its effect on cortical depression and fast titration.
Citation: Cephalalgia Reports
PubDate: 2022-03-07T08:31:23Z
DOI: 10.1177/25158163221084274
Issue No: Vol. 5 (2022)
- Tolosa-Hunt syndrome after COVID-19 infection
Authors: Tyler Etheridge, Jordan Jones, Eric L Caskey, Kathleen B Digre, Judith EA Warner, Meagan D Seay
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Tolosa-Hunt syndrome (THS) is a rare, idiopathic, non-specific inflammation within the cavernous sinus and/or superior orbital fissure leading to painful ophthalmoplegia. The authors describe the first case of a 12-year-old otherwise healthy girl who presented with painful ophthalmoplegia after a documented COVID-19 infection. Neuroimaging revealed inflammation within the ipsilateral cavernous sinus, Meckel’s cave, and orbital apex. After a comprehensive work-up was negative, the patient experienced prompt clinical and radiographic improvement with high-dose corticosteroids, and a diagnosis of THS was made.
Citation: Cephalalgia Reports
PubDate: 2022-02-25T03:45:12Z
DOI: 10.1177/25158163221078977
Issue No: Vol. 5 (2022)
- Epidemiology of diagnosed cluster headache in Norway
Authors: Joan Crespi, Sasha Gulati, Øyvind Salvesen, Daniel Fossum Bratbak, David W Dodick, Manjit Singh Matharu, Erling Tronvik
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Background:Cluster headache (CH) is one of the most painful conditions in humans and there is limited epidemiological data on this debilitating condition.Objectives:To describe the epidemiology of CH in NorwayMethods:We conducted a nationwide study to investigate the prevalence, incidence, and comorbidity of CH in Norway between January 1 2008 and December 31 2016. Treatment and outcome data from the Norwegian patient registry and the Norwegian prescription database were linked on an individual basis.Results:Among 3,892,260 individuals ≥18 years old of age, we identified a total of 1891 patients with CH. The prevalence of CH was 48.6 per 100,000, and the male-to-female ratio was 1.47. The estimated incidence of CH was 3.0 per 100,000/year. Among patients with CH, increased age and sex adjusted odds ratios ([OR], all with p-values
Citation: Cephalalgia Reports
PubDate: 2022-02-09T04:29:12Z
DOI: 10.1177/25158163221075569
Issue No: Vol. 5 (2022)
- Rimegepant 75 mg for acute treatment of migraine is associated with
significant reduction in monthly migraine days: Results from a long-term,
open-label study
Authors: Gilbert L’Italien, Evan Popoff, Karissa Johnston, Donnie McGrath, Charles M Conway, Lauren Powell, Linda Harris, Nicole Kowalczyk, Robert Croop, Vladimir Coric
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Background:Rimegepant, a small molecule oral calcitonin gene-related peptide (CGRP) receptor antagonist, is approved for the acute and preventive treatment of migraine. We hypothesized that intermittent CGRP receptor blockade with rimegepant 75 mg acute treatment as needed (PRN) might result in reductions in monthly migraine days (MMD) over time, and was evaluated as the study objective.Methods:This was a post-hoc analysis of adults with ≥6 MMD at baseline who self-administered rimegepant 75 mg orally PRN for acute treatment of migraine up to 52-weeks in an open-label safety study (BHV3000-201; NCT03266588). Outcome measures (defined as median time to) and response rates (defined as proportion of patients reporting) were captured for ≥30% and ≥50% reduction of baseline MMD.Results:1044 participants with ≥6 MMD at baseline were analyzed. Median time to ≥30% reduction in MMD was 12 weeks (IQR; 4–40 weeks); median time to ≥50% reduction was 32 weeks (IQR; 12-NR weeks). Reduction in MMD was observed over time regardless of baseline migraine frequency, however higher baseline MMD were associated with a longer time to achieving ≥30% or ≥50% MMD reduction.Conclusion:In participants presenting with ≥6 MMD, PRN acute treatment of migraine attacks over 52-weeks with oral rimegepant 75 mg was observed to confer reductions in migraine frequency.Trial registration:NCT03266588
Citation: Cephalalgia Reports
PubDate: 2022-02-01T08:12:55Z
DOI: 10.1177/25158163221075596
Issue No: Vol. 5 (2022)
- Migrainous headaches, calcified cysticercosis and breakthrough seizures
Authors: Oscar H Del Brutto, Ana M Robles, José M Láinez
Abstract: Cephalalgia Reports, Volume 5, Issue , January-December 2022.
Citation: Cephalalgia Reports
PubDate: 2022-02-01T08:12:54Z
DOI: 10.1177/25158163221076464
Issue No: Vol. 5 (2022)
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