169,941 research outputs found
Idiopathic stabbing headache: Clinical characteristics of children and adolescents
No full textVery few cases of short-lasting headaches have been reported in children and adolescents. The aim of this study is to describe a group of patients in the pediatric age group with short attacks of head pain and to demonstrate that they are not easily classified according to existing criteria for adults. We describe 23 subjects in retrospect, 12 males and 11 females, with brief attacks of headache, stabbing in nature, self-limited, lasting from a few seconds to 15 min. This sample was taken from a total population of 548 children and adolescents referred to our Pediatric Headache Unit during the years 1995-1999. Mean age at onset of symptomatology was 9 years. The localization of the headache was bilateral in 60% of the patients and unilateral in 40%. The pain was either unifocal at the orbit or temple (60%) or multifocal (40%). In 24% of the children, the interictal awake EEG showed infrequent posterior slow-waves. In 12 patients we used paracetamol with a good response. Although these painful episodes shared some aspects with the adult form of idiopathic stabbing headache, they had different durations of attack, and other primary headache syndromes did not accompany them either at the time of presentation or during the following 2 years. Short attacks of headache are present in the pediatric age group and are not easily classified according to the International Headache Society criteria. Their nature and correlation with migraine remains unclear. We propose follow-up of these subjects to obtain a better description of the natural history of these forms of headache in the pediatric age group. © 2003 Elsevier Science B.V. All rights reserved
Idiopathic stabbing headache: clinical characteristics of children and adolescents
No full textVery few cases of short-lasting headaches have been reported in children and adolescents. The aim of this study is to describe a group of patients in the pediatric age group with short attacks of head pain and to demonstrate that they are not easily classified according to existing criteria for adults. We describe 23 subjects in retrospect, 12 males and 11 females, with brief attacks of headache, stabbing in nature, self-limited, lasting from a few seconds to 15 min. This sample was taken from a total population of 548 children and adolescents referred to our Pediatric Headache Unit during the years 1995-1999. Mean age at onset of symptomatology was 9 years. The localization of the headache was bilateral in 60% of the patients and unilateral in 40%. The pain was either unifocal at the orbit or temple (60%) or multifocal (40%). In 24% of the children, the interictal awake EEG showed infrequent posterior slow-waves. In 12 patients we used paracetamol with a good response. Although these painful episodes shared some aspects with the adult form of idiopathic stabbing headache, they had different durations of attack, and other primary headache syndromes did not accompany them either at the time of presentation or during the following 2 years. Short attacks of headache are present in the pediatric age group and are not easily classified according to the International Headache Society criteria. Their nature and correlation with migraine remains unclear. We propose follow-up of these subjects to obtain a better description of the natural history of these forms of headache in the pediatric age group
Gianluca Cinelli e Robert S. C. Gordon (a cura di), Innesti. Primo Levi e i libri altrui
No full textValproic acid in migraine prophylaxis of young patients. Three new reports
No full textSeveral clinical studies report the efficacy of valproic acid in migraine prophylaxis of adult patients and its well tolerability. In childhood and adolescent patients its use is usually restricted to epilepsy and very few cases have been reported in literature on the use of valproic acid for "juvenile migraine". We describe three pediatric patients fulfilling the International Headache Society (IHS) criteria for migraine with and without aura treated with low dose of sodium valproate (10 mg/Kg/die) for six months. They had previously undergone other migraine preventive treatment unsuccessfully. We obtained a good response in all cases: in only one subject, prophylactic treatment was stopped because of weight gain, as adverse effect. In conclusion, in accord with other authors, we suggest that valproic acid may be helpful in the prophylaxis migraine in pediatric age
Sulfonylurea treatment in a girl with neonatal diabetes (KCNJ11 R201H) and celiac disease: Impact of low compliance to the gluten free diet
No full textA girl with celiac disease and KCNJ11 mutation was transferred to glibenclamide when 19.8 years old. When her compliance to the gluten free diet worsened, her metabolic control deteriorated. Since glibenclamide is absorbed in the intestine, its absorption seems to be impaired by chronic malabsorption, increasing the risk of hyperglycaemia. (C) 2009 Elsevier Ireland Ltd. All rights reserved
Analysis of endothelial protein c receptor gene and metabolic profile in Prader-Willi syndrome and obese subjects.
No full textThe endothelial protein C receptor (EPCR) has a critical role in the regulation of anticoagulant and anti-inflammatory functions of activated protein C (APC). Abnormalities in EPCR might be associated with an increased risk of thrombosis. In this respect, a 23 bp insertion in the exon 3 of the EPCR gene predicts a truncated protein which cannot bind APC. High levels of C-reactive protein (CRP), a strong predictor of cardiovascular events, are found both in the obese and in subjects with Prader-Willi syndrome (PWS). Several cardiovascular risk factors are already present in prepubertal PWS children, but it is uncertain which mechanism contributes to the increased risk of cardiovascular disease in PWS. We analyzed the distribution of 23 bp insertion in the EPCR gene in 81 overweight and obese PWS subjects, 52 adults and 29 children, and in 58 overweight and obese children and adolescents (controls). We found that 1/58 (1.7%) of the controls was heterozygous for the 23 bp insertion, while this mutation was never found in PWS subjects. Furthermore, we evaluated CRP levels, glucose, insulin, and lipid profile, and we found higher CRP values in PWS adults with respect to children with PWS and controls, and a better insulin sensitivity in all PWS subjects than in the controls. This study suggests that in PWS subjects there is no predisposition to develop thrombotic events in association with EPCR gene alteration and demonstrates substantial differences regarding metabolic and inflammatory profile between PWS and non-PWS obese children, with further impairment in adults with PWS
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