Abstract:
BACKGROUND:Migraine occurs in 3% to 5% of young children and up to 18% of adolescents. Management requires a tailored regimen of pharmacological and behavioral measures that consider the headache burden and disability. Patients with frequent or disabling attacks (or both) may warrant preventive agents. OBJECTIVE:To investigate the patterns of prophylactic treatment of pediatric migraine within one pediatric neurology practice. METHODS:All charts of patients diagnosed with headache (International Classification of Diseases [ICD] code 784.0) and migraine (codes 346.0, 346.1, and 346.2) during January 2001 July 2001 were retrospectively reviewed to identify diagnosis, demographics, medical decision making, rationale for treatment selections, and outcome assessments. Migraine was diagnosed according to the 1997 proposed pediatric migraine revisions to the International Headache Society. RESULTS:Charts of 250 children and adolescents, aged 3.2 to 18 years (mean, 12), were reviewed. One hundred twenty-six (50%) were prescribed prophylaxis, along with intermittent analgesic agents. Mean age of those provided with daily prophylaxis was 12.4 years (range, 3.9 to 18), and the mean age of those managed with intermittent therapies was 11.5 years. Preventive agents included amitriptyline (n = 73), cyproheptadine (n = 30), propranolol (n = 8), valproic acid (n = 3), naproxen (n = 3), nimodipine (n = 3), imipramine (n = 3), and topiramate (n = 3). Amitriptyline was the most commonly prescribed agent (58%). Ten patients initially treated with other agents were changed to amitriptyline. Fifteen patients required dosing adjustments, 2 stopped treatment, and 7 changed to other agents for lack of efficacy. Mean headache frequency before treatment was 10.9 per month (range, 4 to 15). After treatment, the mean headache frequency decreased to 4.1 per month (range, 0 to 12), a decrease of 62.4% (n = 54). The overall positive response rate was 89%. Cyproheptadine was the second most commonly prescribed agent (mean age, 8.8 years). Thirty patients were initially treated, 5 later changed to cyproheptadine, 6 required dosage changes, 5 changed to other agents for lack of efficacy, and 1 stopped treatment. Mean headache frequency before treatment was 8.4 per month (range, 4 to 15) and following treatment decreased to 3.75 per month (range, 0 to 12), a decrease of 55.3%. The overall positive response rate was 83%. CONCLUSIONS:Fifty percent of patients with migraine were prescribed daily prophylactic medicines, reflecting a referral bias. The most commonly prescribed agents were amitriptyline (preferred for the older patients) and cyproheptadine (preferred for the younger patients). The overall positive response rates were 89% for amitriptyline and 83% for cyproheptadine during a 6-month follow-up. Headache frequencies were reduced with amitriptyline by 62% and with cyproheptadine by 55%. Long-term follow-up of this population is ongoing, and prospective studies are needed.
journal_name
Headachejournal_title
Headacheauthors
Lewis DW,Diamond S,Scott D,Jones Vdoi
10.1111/j.1526-4610.2004.04052.xkeywords:
subject
Has Abstractpub_date
2004-03-01 00:00:00pages
230-7issue
3eissn
0017-8748issn
1526-4610journal_volume
44pub_type
杂志文章相关文献
HEADACHE文献大全abstract:OBJECTIVE:This study aimed to establish whether increased sensitivity to mechanical stimuli is present in neural tissues in chronic tension-type headache (CTTH). BACKGROUND:Muscle hyperalgesia is a common finding in CTTH. No previous studies have investigated the sensitivity of peripheral nerves in patients with CTTH....
journal_title:Headache
pub_type: 临床试验,杂志文章
doi:10.1111/j.1526-4610.2008.00856.x
更新日期:2008-04-01 00:00:00
abstract::A 33-year-old woman developed persistent postural headache following epidural anesthesia (L2-L3 level). Iohexol myelography (L5-S1 puncture) demonstrated no epidural extravasation of contrast material (Figure A), but subsequent computed tomography (CT) axial images (B, C) revealed leakage of dye through the needle tra...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.2003.03114.x
更新日期:2003-06-01 00:00:00
abstract::A 25-year-old man, subject to bouts of left supraorbital cluster headache on an annual basis over the previous 8 years, volunteered for MRI angiography during an active period. Studies were conducted before and during a typical cluster headache attack induced by alcohol. MRI angiography failed to show dilatation of th...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1994.hed3408463.x
更新日期:1994-09-01 00:00:00
abstract:BACKGROUND:Frequent, excessive use of over-the-counter or prescription analgesics may lead to analgesic rebound headache. Little is known about the magnitude of the health problem posed by analgesic rebound headache, its epidemiology, the characteristics of analgesic rebound headache sufferers, or about physicians' app...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.1996.3601014.x
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:To investigate similarities and differences between patients with cluster headache and patients with migraine. BACKGROUND:Patients with migraine and patients with cluster headache are considered, by many clinical neurologists, to be different psychologically and socially. METHODS:Twenty-five age-matched pai...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.2002.02049.x
更新日期:2002-03-01 00:00:00
abstract::Although severe short-lasting headaches are rare, they can be considered disabling conditions with a major impact on the quality of life of patients. These headaches can divided broadly in to those associated with autonomic symptoms, so called trigeminal autonomic cephalgias (TACs), and those with few or no autonomic ...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/head.12213
更新日期:2013-10-01 00:00:00
abstract::It is to be expected that differences in electrical activity of the brain between migraine patients with aura and those without aura can only be revealed by stimuli that provoke visual spatial processing, i.e. stimuli that trigger so called endogenous Visual Evoked Potential (VEP) activity. This is not the case for th...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1993.hed3308413.x
更新日期:1993-09-01 00:00:00
abstract:OBJECTIVE AND BACKGROUND:Pupillometric investigations into migraine have suggested that an autonomic disturbance is part of the pathogenesis of that condition. This observation is controversial, however, which may reflect that the putative sympathetic hypofunction is either subtle or transient. In this study, we assess...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.12139
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Many children suffering from chronic headache and migraine present with comorbid functional disability, including physical, social, emotional, and academic activities. For children severely impaired by headache, intensive interdisciplinary pain rehabilitation treatment (IIPT) can improve functioning. However...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.13389
更新日期:2018-11-01 00:00:00
abstract::Magnetic resonance (MR) angiography was performed during and between two spontaneous and untreated attacks in a 24-year old male patient with episodic cluster headache. The ipsilateral ophthalmic artery was observed to be markedly dilated during both attacks. No changes were seen in the internal carotid artery or any ...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1993.hed3306291.x
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVE:To assess the acute treatment of pregnant women presenting to a hospital with migraine. BACKGROUND:Migraine is a common problem in pregnancy; however, migraine treatment is challenging in pregnant women for fears of medication teratogenicity and lack of data in this population. To date, no study has directly...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.13434
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:We present a case report of 2 migraine patients engaged in shift work, followed by a narrative review, to assess whether shift work influences headache-related disability and chronification of migraine. BACKGROUND:Numerous modifiable factors can lead to chronification of migraine and to higher headache-relat...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/head.13622
更新日期:2019-10-01 00:00:00
abstract::The majority of research conducted on headache has utilized cross-sectional designs which preclude the examination of dynamic factors and principally rely on group-level effects. The present article describes the application of an individual-oriented process model using time-series analytical techniques. The blending ...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2005.05095.x
更新日期:2005-05-01 00:00:00
abstract::Orthostatic headache is a key symptom of intracranial hypotension; however, not all orthostatic headaches are caused by cerebrospinal fluid leaks leading to intracranial hypotension. We report here the unusual case of a 68-year-old man presenting with orthostatic headache in which compression of the C3 spinal nerve ro...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2007.00982.x
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:A new form of headache, Headache attributed to aeroplane travel (AH), has been recognized within the International Classification of Headache Disorders 3 beta (ICHD-3beta). In 8 out of 85 AH cases we identified the coexistence of a headache with identical features of AH, but appearing during the rapid descen...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.12766
更新日期:2016-02-01 00:00:00
abstract::The usefulness of a headache diary in the diagnosis of migraine and in the clarification of migraine symptoms was studied in 145 children. These children belong to a 1-year age cohort of 5356 children that has been followed since birth. The children were enrolled in the present study according to their headache status...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.1997.3704240.x
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVES:Migraine is a common disabling neurological disorder. Current acute treatments for migraine in adolescents are mostly pharmacological and may have limited effectiveness, can cause side effects, and may lead to medication overuse. There is an unmet need for effective and well-tolerated treatments. Remote elec...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.14042
更新日期:2020-12-21 00:00:00
abstract::A 57-year-old woman presented with an escalation of her headaches which ultimately progressed to multiple strokes and death. MRI/MRA demonstrated diffuse vasospasm and other causes of stroke were excluded on premortem investigation and postmortem examination. Reversible MRI abnormalities, vasospasm on angiogram and fa...
journal_title:Headache
pub_type: 信件
doi:10.1111/j.1526-4610.2007.00695.x
更新日期:2007-02-01 00:00:00
abstract::The combination of lysine acetylsalicylate and metoclopramide is effective in the treatment of migraine attacks. It was unknown whether repeated doses could improve efficacy. The aim of this open trial was to evaluate the effects of a second, and eventually a third dose of lysine acetylsalicylate and metoclopramide wh...
journal_title:Headache
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1046/j.1526-4610.1997.3707452.x
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVE:We aimed to investigate (1) to which extent headache diary variables correlate among each other; (2) to which extent they correlate with generic measures of quality of life and disability; (3) and whether correlations vary over time. METHODS:We performed a secondary analysis of data from 301 patients sufferi...
journal_title:Headache
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1526-4610.2009.01434.x
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVES:In a randomized controlled trial extending over 6 months, we evaluated the effectiveness of acupuncture versus flunarizine in the prophylactic treatment of migraine without aura. METHODS:One hundred sixty women with migraines were randomly assigned to acupuncture treatment (group A, n = 80) or to an oral th...
journal_title:Headache
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1526-4610.2002.02203.x
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Primary headaches (migraine, tension headache, cluster headache, and other trigeminal autonomic cephalgias) are common in pregnancy and postpartum. It is unclear how to best and most safely manage them. OBJECTIVE:We conducted a systematic review (SR) of interventions to prevent or treat primary headaches in...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/head.14041
更新日期:2021-01-12 00:00:00
abstract::The recent publication of drug formularies by third-party payers has serious implications for the practice of medicine. These formularies list the medications for which the consumer can be reimbursed by the third-party payer. The most restrictive of the five formularies I have received lists only two agents for the tr...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1995.hed3504225.x
更新日期:1995-04-01 00:00:00
abstract:OBJECTIVE:To describe a standardized methodology for the performance of peripheral nerve blocks (PNBs) in the treatment of headache disorders. BACKGROUND:PNBs have long been employed in the management of headache disorders, but a wide variety of techniques are utilized in literature reports and clinical practice. MET...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/head.12053
更新日期:2013-03-01 00:00:00
abstract:OBJECTIVE/BACKGROUND:This study aims to determine the prevalence of primary headache disorders using the second edition of international classification of headache disorders among urban slum dwellers. Headache is a common neurological disorder and one of the most common reasons for visiting the neurology clinics in Nig...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.12465
更新日期:2014-11-01 00:00:00
abstract::Following tooth pulp extirpation, some subjects suffer from persistent pain which affects edentate sites in absence of any local pathology. As regards this peculiar pain, called phantom tooth pain (PTP), what is puzzling is the fact there is a low prevalence of PTP in a very large population showing identical conditio...
journal_title:Headache
pub_type: 临床试验,杂志文章
doi:10.1111/j.1526-4610.1991.hed3109577.x
更新日期:1991-10-01 00:00:00
abstract:OBJECTIVES:To describe patterns of perceived stress across stages of the migraine cycle, within and between individuals and migraine episodes as defined for this study. METHODS:Individuals with migraine aged ≥18 years, who were registered to use the digital health platform N1-HeadacheTM , and completed 90 days of dail...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.13943
更新日期:2020-09-12 00:00:00
abstract:BACKGROUND:Research imaging of brain structure and function has helped to elucidate the pathophysiology of medication overuse headache (MOH). METHODS:This is a narrative review of imaging research studies that have investigated brain structural and functional alterations associated with MOH. Studies included in this r...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/head.13037
更新日期:2017-07-01 00:00:00
abstract::We report the case of a man with episodic cluster headache who suffered from severe obstructive sleep apnea (OSA) as well as periodic limb movements during sleep (PLMS). His attacks of headache occurred primarily during sleep being timely to REM sleep as 90 to 120 minutes interval. OSAs were more frequent and prolonge...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2005.t01-3-05013.x
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Migraine is a common primary headache disorder occurring predominantly in a young, relatively healthy population. RESULTS:There is a growing literature on associations between migraine, especially migraine with aura, and ischemic stroke as well as other vascular events. Migraine as a risk factor for vascula...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/head.12304
更新日期:2014-03-01 00:00:00