217 research outputs found
Brain stimulation in migraine
No full textMigraine is a very prevalent disease with great individual disability and socioeconomic burden. Despite intensive research effort in recent years, the etiopathogenesis of the disease remains to be elucidated. Recently, much importance has been given to mechanisms underlying the cortical excitability that has been suggested to be dysfunctional in migraine. In recent years, noninvasive brain stimulation techniques based on magnetic fields (transcranial magnetic stimulation, TMS) and on direct electrical currents (transcranial direct current stimulation, tDCS) have been shown to be safe and effective tools to explore the issue of cortical excitability, activation, and plasticity in migraine. Moreover, TMS, repetitive TMS (rTMS), and tDCS, thanks to their ability to interfere with and/or modulate cortical activity inducing plastic, persistent effects, have been also explored as potential therapeutic approaches, opening an interesting perspective for noninvasive neurostimulation for both symptomatic and preventive treatment of migraine and other types of headache. In this chapter we critically review evidence regarding the role of noninvasive brain stimulation in the pathophysiology and treatment of migraine, delineating the advantages and limits of these techniques together with potential development and future applicatio
Seizure following the Use of the COX-2 Inhibitor Etoricoxib
No full textWe describe a case of epileptic seizures occurring after the use of a COX-2 inhibitor. A 61-year-old man was admitted to our department because of a generalized tonic-clonic seizure. EEG showed generalized slowdown of the activity. Neuroimaging and blood samples studies did not evidence alterations, but a careful pharmacological history revealed that the patient had taken the COX-2 inhibitor etoricoxib to treat lumbago few days before the onset of clinical symptoms. No seizures were reported after etoricoxib discontinuation and an EEG resulted to be normal two months after this. Conclusion. Knowing the pharmacological history of a patient is important for understanding the clinical presentation and selecting appropriate treatment. This is, to the best of our knowledge, the first reported case of generalized seizures associated with the use of COX-2 inhibitors
Is lack of habituation a biomarker of migraine? A critical perspective
No full textno abstract avalaibl
Brigida Silva’s Story of Etelvina
No full textarranged marriagedeath of childTimor-LesteWorld War II1930’sAsi
A case of atypical sporadic hemiplegic migraine associated with PFO and hypoplasia of vertebro-basilar system
No full textWe describe the case of a patient with atypical hemiplegic migraine and associated basilar symptoms, where a large patent foramen ovale (PFO) and hypoplasia of basilar artery were found. The longer period of 4-year remission of the headache attacks was coincident with the percutaneous PFO closure. When 5 years after, hemiplegic migraine attacks relapsed, with more relevant basilar symptoms, a mild re-opening of PFO was found. The atypical presentation of attacks with basilar symptoms and prolonged hemiplegia does not strictly fit the diagnostic criteria of ICHD-II
Cortical hypoactivity or reduced efficiency of cortical inhibition in migraine?. vol. 27, pp. 187-188.
No full textMultisensorial Perception in Chronic Migraine and the Role of Medication Overuse
No full textMultisensory processing can be assessed by measuring susceptibility to crossmodal illusions such as the Sound-Induced Flash Illusion (SIFI). When a single flash is accompanied by 2 or more beeps, it is perceived as multiple flashes (fission illusion); conversely, a fusion illusion is experienced when more flashes are matched with a single beep, leading to the perception of a single flash. Such illusory perceptions are associated to crossmodal changes in visual cortical excitability. Indeed, increasing occipital cortical excitability, by means of transcranial electrical currents, disrupts the SIFI (ie, fission illusion). Similarly, a reduced fission illusion was shown in patients with episodic migraine, especially during the attack, in agreement with the pathophysiological model of cortical hyperexcitability of this disease. If episodic migraine patients present with reduced SIFI especially during the attack, we hypothesize that chronic migraine (CM) patients should consistently report less illusory effects than healthy controls; drugs intake could also affect SIFI. On such a basis, we studied the proneness to SIFI in CM patients (n = 63), including 52 patients with Medication Overuse Headache (MOH), compared to 24 healthy controls. All migraine patients showed reduced fission phenomena than controls (P < .0001). Triptan MOH patients (n = 23) presented significantly less fission effects than other CM groups (P= .008). This exploratory study suggests that CM - both with and without medication overuse - is associated to a higher visual cortical responsiveness which causes deficit of multisensorial processing, as assessed by the SIFI.Perspective: This observational study shows reduced susceptibility to the SIFI in CM, confirming and extending previous results in episodic migraine. MOH contributes to this phenomenon, especially in case of triptans. (C) 2020 by United States Association for the Study of Pain, Inc
Lack of effects of low frequency repetitive transcranial magnetic stimulation on alpha rhythm phase synchronization in migraine patients
No full textThe study aimed to test the modulation induced by 1Hz repetitive Transcranial Magnetic Stimulation
(rTMS) of the occipital cortex on the alpha phase synchronization under repetitive flash stimuli in 15
migraine without aura patients compared to 10 controls. The EEG was recorded by 7 channels, while
flash stimuli were delivered at 9, 18, 21 and 24 Hz in basal, rTMS (15 min of 1Hz stimulation of the
occipital cortex) and sham conditions. Migraine patients displayed increased alpha-band phase synchronization
under visual stimulation, while an overall desynchronizing effect was evident in controls. The
rTMS resulted in a slight increase of synchronization index in migraine patients, which did not cause
significant differences in respect to the basal and sham conditions. The synchronizing–desynchronizing
changes of alpha rhythm under repetitive flash stimulation, seem independent from the state of occipital
cortex excitability. Other mechanisms beyond cortical excitability may contribute to explain migraine
pathogenesis
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