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Search on : Trigeminal and Autonomic and Cephalalgias [Words]
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[PMID]: 29516437
[Au] Autor:Wei DY; Jensen RH
[Ad] Address:Headache Group, Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. Diana.wei@kcl.ac.uk.
[Ti] Title:Therapeutic Approaches for the Management of Trigeminal Autonomic Cephalalgias.
[So] Source:Neurotherapeutics;, 2018 Mar 07.
[Is] ISSN:1878-7479
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Trigeminal autonomic cephalalgia (TAC) encompasses 4 unique primary headache types: cluster headache, paroxysmal hemicrania, hemicrania continua, and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms. They are grouped on the basis of their shared clinical features of unilateral headache of varying durations and ipsilateral cranial autonomic symptoms. The shared clinical features reflect the underlying activation of the trigeminal-autonomic reflex. The treatment for TACs has been limited and not specific to the underlying pathogenesis. There is a proportion of patients who are refractory or intolerant to the current standard medical treatment. From instrumental bench work research and neuroimaging studies, there are new therapeutic targets identified in TACs. Treatment has become more targeted and aimed towards the pathogenesis of the conditions. The therapeutic targets range from the macroscopic and structural level down to the molecular and receptor level. The structural targets for surgical and noninvasive neuromodulation include central neuromodulation targets: posterior hypothalamus and, high cervical nerves, and peripheral neuromodulation targets: occipital nerves, sphenopalatine ganglion, and vagus nerve. In this review, we will also discuss the neuropeptide and molecular targets, in particular, calcitonin gene-related peptide, somatostatin, transient receptor potential vanilloid-1 receptor, nitric oxide, melatonin, orexin, pituitary adenylate cyclase-activating polypeptide, and glutamate.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:Publisher
[do] DOI:10.1007/s13311-018-0618-3

  2 / 360 MEDLINE  
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[PMID]: 29450873
[Au] Autor:Yalin OÖ; Uludüz D; Özge A
[Ad] Address:Department of Neurology, Training and Research Hospital, Istanbul, Turkey. osmanozguryalin@yahoo.com.
[Ti] Title:Peripheral nerve blocks for the treatment of short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) during pregnancy.
[So] Source:Agri;30(1):28-30, 2018 Jan.
[Is] ISSN:1300-0012
[Cp] Country of publication:Turkey
[La] Language:eng
[Ab] Abstract:Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a rare, primary headache syndrome, which is classified as a subtype of trigeminal autonomic cephalalgias. Although SUNCT is usually refractory to treatment, several antiepileptic drugs have recently shown promising results for its treatment. However, there is a lack of evidence regarding the course of SUNCT during pregnancy and the available treatment options. Here, we present a 30-week pregnant female with SUNCT who was successfully treated with infra- and supraorbital nerve blocks. Headache attacks completely diminished after the injection, and recurrence was not observed. Although lamotrigine may be relatively safe in pregnant patients with SUNCT attacks, peripheral nerve block may be a feasible technique and can be considered as a safe and effective treatment option. This is the first SUNCT case in the literature that was successfully treated with infra- and supraorbital nerve blocks during pregnancy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180216
[Lr] Last revision date:180216
[St] Status:In-Process
[do] DOI:10.5505/agri.2016.25991

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[PMID]: 29169811
[Au] Autor:Santos-Lasaosa S; Cuadrado ML; Gago-Veiga AB; Guerrero-Peral AL; Irimia P; Láinez JM; Leira R; Pascual J; Porta-Etessam J; Sánchez Del Río M; Viguera Romero J; Pozo-Rosich P
[Ad] Address:Unidad de Cefaleas, Servicio de Neurología, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España. Electronic address: ssantos@salud.aragon.es.
[Ti] Title:Evidencia y experiencia del uso de onabotulinumtoxinA en neuralgia del trigémino y cefaleas primarias distintas de la migraña crónica. Evidence of and experience with the use of onabotulinumtoxinA in trigeminal neuralgia and primary headaches other than chronic migraine.
[So] Source:Neurologia;, 2017 Nov 20.
[Is] ISSN:1578-1968
[Cp] Country of publication:Spain
[La] Language:eng; spa
[Ab] Abstract:INTRODUCTION: In the field of headaches, onabotulinumtoxinA (onabotA) is well established as a treatment for chronic migraine (CM). In recent years, it has been used increasingly to treat other primary headaches (high-frequency episodic migraine, trigeminal-autonomic cephalalgias, nummular headache) and trigeminal neuralgia. As this treatment will progressively be incorporated in the management of these patients, we consider it necessary to reflect, with a fundamentally practical approach, on the possible indications of onabotA, beyond CM, as well as its administration protocol, which will differ according to the type of headache and/or neuralgia. DEVELOPMENT: This consensus document was drafted based on a thorough review and analysis of the existing literature and our own clinical experience. The aim of the document is to serve as guidelines for professionals administering onabotA treatment. The first part will address onabotA's mechanism of action, and reasons for its use in other types of headache, from a physiopathological and clinical perspective. In the second part, we will review the available evidence and studies published in recent years. We will add an "expert recommendation" based on our own clinical experience, showing the best patient profile for this treatment and the most adequate dose and administration protocol. CONCLUSION: Treatment with onabotA should always be individualised and considered in selected patients who have not responded to conventional therapy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171124
[Lr] Last revision date:171124
[St] Status:Publisher

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[PMID]: 29154684
[Au] Autor:Chong CD; Schwedt TJ; Hougaard A
[Ad] Address:1 Department of Neurology, Mayo Clinic, Arizona, AZ, USA.
[Ti] Title:Brain functional connectivity in headache disorders: A narrative review of MRI investigations.
[So] Source:J Cereb Blood Flow Metab;:271678X17740794, 2017 Jan 01.
[Is] ISSN:1559-7016
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Resting-state functional magnetic resonance imaging (rs-fMRI) is used to interrogate the functional connectivity and network organization amongst brain regions. Functional connectivity is determined by measuring the extent of synchronization in the spontaneous fluctuations of blood oxygenation level dependent (BOLD) signal. Here, we review current rs-fMRI studies in headache disorders including migraine, trigeminal autonomic cephalalgias, and medication overuse headache. We discuss (1) brain network alterations that are shared amongst the different headache disorders and (2) network abnormalities distinct to each headache disorder. In order to focus the section on migraine, the headache disorder that has been most extensively studied, we chose to include articles that interrogated functional connectivity: (i) during the attack phase; (ii) in migraine patients with aura compared to migraine patients without aura; and (iii) of regions within limbic, sensory, motor, executive and default mode networks and those which participate in multisensory integration. The results of this review show that headache disorders are associated with atypical functional connectivity of regions associated with pain processing as well as atypical functional connectivity of multiple core resting state networks such as the salience, sensorimotor, executive, attention, limbic, visual, and default mode networks.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171120
[Lr] Last revision date:171120
[St] Status:Publisher
[do] DOI:10.1177/0271678X17740794

  5 / 360 MEDLINE  
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[PMID]: 29096522
[Au] Autor:Weng HY; Cohen AS; Schankin C; Goadsby PJ
[Ad] Address:1 Department of Neurology, Wan Fang Hospital, Taipei Medical University, and Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
[Ti] Title:Phenotypic and treatment outcome data on SUNCT and SUNA, including a randomised placebo-controlled trial.
[So] Source:Cephalalgia;:333102417739304, 2017 Jan 01.
[Is] ISSN:1468-2982
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Background Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA) are two rare headache syndromes classified broadly as Trigeminal Autonomic Cephalalgias (TACs). Methods Here, 65 SUNCT (37 males) and 37 SUNA (18 males) patients were studied to describe their clinical manifestations and responses to treatment. Results Pain was almost always unilateral and side-locked. There were three types of attack: Single stabs, stab groups, and a saw-tooth pattern, with some patients experiencing a mixture of two types. As to cranial autonomic symptoms, SUNA patients mainly had lacrimation (41%) and ptosis (40%). Most cases of the two syndromes had attack triggers, and the most common triggers were touching, chewing, or eating for SUNCT, and chewing/eating and touching for SUNA. More than half of each group had a personal or family history of migraine that resulted in more likely photophobia, phonophobia and persistent pain between attacks. For short-term prevention, both syndromes were highly responsive to intravenous lidocaine by infusion; for long-term prevention, lamotrigine and topiramate were effective for SUNCT, and lamotrigine and gabapentin were efficacious in preventing SUNA attacks. A randomized placebo-controlled cross-over trial of topiramate in SUNCT using an N-of-1 design demonstrated it to be an effective treatment in line with clinical experience. Conclusions SUNCT and SUNA are rare primary headache disorders that are distinct and very often tractable to medical therapy.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171118
[Lr] Last revision date:171118
[St] Status:Publisher
[do] DOI:10.1177/0333102417739304

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[PMID]: 28942483
[Au] Autor:Barloese MCJ
[Ad] Address:Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark. mads.christian.johannes.barloese@barloese.net.
[Ti] Title:The pathophysiology of the trigeminal autonomic cephalalgias, with clinical implications.
[So] Source:Clin Auton Res;, 2017 Sep 23.
[Is] ISSN:1619-1560
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:The hallmark of primary headaches belonging to the group known as the trigeminal autonomic cephalalgias is unilateral headache accompanied by cranial autonomic symptoms. Being relatively rare and poorly understood, they represent a clinical challenge, leading to underdiagnosis and undertreatment. While the headache is the most obvious and disabling symptom, it is only part of a complex symptomatology which hints at the involved pathophysiological mechanisms. Activation of the trigeminal-autonomic reflex results in the aforementioned cranial autonomic symptoms, which are well understood; however, it is obvious that this brainstem reflex is regulated by higher centers that seemingly play a pivotal role in the attacks and the wide range of other symptoms indicating a homeostatic disturbance. These symptoms, as well as a number of well-validated findings, implicate the hypothalamus in the pathophysiology. over the course of the past 2-3 decades, novel therapies and technological advances have helped increase our knowledge of these clinical syndromes, and will likely continue to do so in the coming years as we witness the arrival of new drugs and neurostimulation options. In this review, the clinical presentation for cluster headache, paroxysmal hemicrania, short-lasting unilateral neuralgiform headache with conjunctival injection and tearing, and hemicrania continua is covered, along with our current understanding of the common pathophysiology and clinical manifestations.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1709
[Cu] Class update date: 170924
[Lr] Last revision date:170924
[St] Status:Publisher
[do] DOI:10.1007/s10286-017-0468-9

  7 / 360 MEDLINE  
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[PMID]: 28886860
[Au] Autor:Jay GW; Barkin RL
[Ad] Address:Clinical Professor, Department of Neurology, University of North Carolina, United States.
[Ti] Title:Primary Headache Disorders Part I- Migraine and the Trigeminal Autonomic Cephalalgias.
[So] Source:Dis Mon;63(11):308-338, 2017 Nov.
[Is] ISSN:1557-8194
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:In Primary Headache Disorders, Part 1, we discuss three of the primary headache disorders using the headache definitions from ICHD-III (Beta): Migraine, with and without aura; its pathophysiology and treatment are discussed. We then discuss the Trigeminal Autonomic Cephalalgias (TACs), including Cluster Headache and Hemicrania Continua, two more primary headache disorders, as well as the other TAC Headaches. We discuss pathophysiology as well as diagnosis, treatment, and pharmacotherapeutic management of these headache diatheses.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 171110
[Lr] Last revision date:171110
[St] Status:In-Process

  8 / 360 MEDLINE  
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[PMID]: 28721092
[Au] Autor:Prakash S; Patel P
[Ad] Address:Department of Neurology, Smt. B. K. Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth University, Vadodara, Gujarat, India.
[Ti] Title:Hemicrania continua: clinical review, diagnosis and management.
[So] Source:J Pain Res;10:1493-1509, 2017.
[Is] ISSN:1178-7090
[Cp] Country of publication:New Zealand
[La] Language:eng
[Ab] Abstract:Hemicrania continua (HC) is an indomethacin-responsive primary headache disorder which is currently classified under the heading of trigeminal autonomic cephalalgias (TACs). It is a highly misdiagnosed and underreported primary headache. The pooled mean delay of diagnosis of HC is 8.0 ± 7.2 years. It is not rare. We noted more than 1000 cases in the literature. It represents 1.7% of total headache patients attending headache or neurology clinic. Just like other TACs, it is characterized by strictly unilateral pain in the trigeminal distribution, cranial autonomic features in the same area and agitation during exacerbations/attacks. It is different from other TACs in one aspect. While all other TACs are episodic, HC patients have continuous headaches with superimposed severe exacerbations. The central feature of HC is continuous background headache. However, the patients may be worried only for superimposed exacerbations. Focusing only on exacerbations and ignoring continuous background headache are the most important factors for the misdiagnosis of HC. A large number of patients may have migrainous features during exacerbation phase. Up to 70% patients may fulfill the diagnostic criteria for migraine during exacerbations. Besides migraine, its exacerbations can mimic a large number of other primary and secondary headaches. The other specific feature of HC is a remarkable response to indomethacin. However, a large number of patients develop side effects because of the long-term use of indomethacin. A few other medications may also be effective in a subset of patients with HC. Various surgical interventions have been suggested for patients who are intolerant to indomethacin. Several aspects of HC are still not defined. There is a great heterogeneity in types of patients or articles on the HC in the literature. Diagnostic criteria have been modified several times over the years. The current diagnostic criteria are too restrictive in some aspects. We suggest a more accommodating type of criteria for the appendix of International Classification of Headache Disorder (ICHD).
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1707
[Cu] Class update date: 170723
[Lr] Last revision date:170723
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.2147/JPR.S128472

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[PMID]: 28681219
[Au] Autor:Kingston W; Halker R
[Ad] Address:Mayo Clinic Arizona, Phoenix, AZ, USA. willkingston@gmail.com.
[Ti] Title:LASH: A Review of the Current Literature.
[So] Source:Curr Pain Headache Rep;21(8):36, 2017 Aug.
[Is] ISSN:1534-3081
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:PURPOSE OF REVIEW: The purpose of this review is to evaluate and explain our current understanding of a very rare disorder, long-lasting autonomic symptoms with associated hemicranias (LASH). RECENT FINDINGS: At present, there are four known cases in the literature of LASH. Its characteristics and reported response to indomethacin link it most closely to the trigeminal autonomic cephalalgias (TACs). Its pathophysiology and epidemiology remain unclear. Variance in the pain and autonomic symptom relationship in the existing TAC literature along with the reports of TAC sine headache suggests that LASH may represent a far end of the spectrum of TACs, with most similarities to paroxysmal hemicrania (PH) and hemicrania continua (HC).
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1707
[Cu] Class update date: 170811
[Lr] Last revision date:170811
[St] Status:In-Process
[do] DOI:10.1007/s11916-017-0636-6

  10 / 360 MEDLINE  
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[PMID]: 28615434
[Au] Autor:Müller KI; Alstadhaug KB; Bekkelund SI
[Ad] Address:From the Department of Clinical Medicine (K.I.M., K.B.A., S.I.B.), UiT-The Arctic University of Norway; Department of Neurology (K.I.M., S.I.B.), University Hospital of North Norway, Tromsø; and Department of Neurology (K.B.A.), Nordland Hospital Trust, Bodø, Norway. kai.ivar.muller@unn.no.
[Ti] Title:A randomized trial of telemedicine efficacy and safety for nonacute headaches.
[So] Source:Neurology;89(2):153-162, 2017 Jul 11.
[Is] ISSN:1526-632X
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To evaluate long-term treatment efficacy and safety of one-time telemedicine consultations for nonacute headaches. METHODS: We randomized, allocated, and consulted nonacute headache patients via telemedicine (n = 200) or in a traditional manner (n = 202) in a noninferiority trial. Efficacy endpoints, assessed by questionnaires at 3 and 12 months, included change from baseline in Headache Impact Test-6 (HIT-6) (primary endpoint) and pain intensity (visual analogue scale [VAS]) (secondary endpoint). The primary safety endpoint, assessed via patient records, was presence of secondary headache within 12 months after consultation. RESULTS: We found no differences between telemedicine and traditional consultations in HIT-6 ( = 0.84) or VAS ( = 0.64) over 3 periods. The absolute difference in HIT-6 from baseline was 0.3 (95% confidence interval [CI] -1.26 to 1.82, = 0.72) at 3 months and 0.2 (95% CI -1.98 to 1.58, = 0.83) at 12 months. The absolute change in VAS was 0.4 (95% CI -0.93 to 0.22, = 0.23) after 3 months and 0.3 (95% CI -0.94 to 0.29, = 0.30) at 12 months. We found one secondary headache in each group at 12 months. The estimated number of consultations needed to miss one secondary headache with the use of telemedicine was 20,200. CONCLUSION: Telemedicine consultation for nonacute headache is as efficient and safe as a traditional consultation. CLINICALTRIALSGOV IDENTIFIER: NCT02270177. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that a one-time telemedicine consultation for nonacute headache is noninferior to a one-time traditional consultation regarding long-term treatment outcome and safety.
[Mh] MeSH terms primary: Headache Disorders, Secondary/therapy
Migraine Disorders/therapy
Outcome and Process Assessment (Health Care)
Pain Management/methods
Telemedicine/methods
Tension-Type Headache/therapy
Trigeminal Autonomic Cephalalgias/therapy
[Mh] MeSH terms secundary: Adult
Female
Humans
Male
Middle Aged
Pain Management/adverse effects
Pain Management/standards
Pain Measurement
Telemedicine/standards
[Pt] Publication type:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Em] Entry month:1707
[Cu] Class update date: 170719
[Lr] Last revision date:170719
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:170616
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004085


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