1,720,987 research outputs found
Uncommon primary headaches
No full textPURPOSE OF REVIEW:
The new International Classification of Headache Disorders was recently published by the International Headache Society. Several uncommon primary headaches, including some new clinical entities (e.g. hypnic headache), were included in the section on 'Cluster headache and other trigeminal autonomic neuralgias' and 'Other primary headaches'. The recent classification offers an interesting opportunity to evaluate the clinical role and to discuss the mechanisms of some of the more relevant uncommon primary headaches.
RECENT FINDINGS:
Due to the low incidence of these uncommon headache forms, their diagnostic criteria, pathogenetic mechanisms and therapy are still debated. Differential diagnosis versus secondary headaches is also a crucial issue. In this review, some of the most important uncommon primary headaches are discussed in light of the most recent contributions to the literature.
SUMMARY:
The review focuses on the update of the main uncommon primary headaches, intending to clarify some controversial points and to indicate some headlines for further research
Two cases of headache and balance disorders - Possible diagnosis of migraine vertigo
No full textWe still lack definite diagnostic criteria for migraine vertigo, despite its prevalence might be really high. Herein we discuss the diagnosis of migraine vertigo in two dizzy patients, a mother with her daughter, according to very recently proposed diagnostic criteria
Reliability of the nitroglycerin provocative test in the diagnosis of neurovascular headaches
No full textReport of eight new cases of hypnic headache and mini-review of the literature.
No full textHypnic headache is a rare condition first described by Raskin in 1988. This headache is not included in the first edition of the International Headache Society classification (IHC 1st Edition). We describe eight new Italian hypnic headache cases and consider our findings in the light of literature data. Our cases do not completely fulfil the diagnostic criteria for the syndrome proposed in 1997 by Goadsby and Lipton: four of our patients reported an attack duration longer than 60 minutes (ranging from 3 to 10 hours) and five reported unilateral pain. These data are in line with an analysis of all 61 cases published in the literature to date, which reveals a pain duration of over 60 minutes in 45.9\% of the cases and unilateral attacks in 36\%. Hypnic headache will be included in the fourth chapter (Other Primary Headaches) of the revised edition of the above-mentioned classification (IHC 2nd Edition)
The usefulness and applicability of a basic headache diary before first consultation: results of a pilot study conducted in two centres
No full textMedication overuse headache and applicability of the ICHD-II diagnostic criteria: 1-year follow-up study (CARE I protocol)
No full text
Ambulatory 24-h ECG monitoring and cardiovascular autonomic assessment for the screening of silent myocardial ischemia in elderly type 2 diabetic hypertensive patients
No full textThe aim of the study was to evaluate the usefulness of Holter monitoring for the detection of silent myocardial ischemia (SMI) in elderly type 2 diabetic patients with hypertension and the possible relationship between SMI and cardiovascular autonomic neuropathy (CAN). Two hundred and forty-three asymptomatic outpatients, aged 65-75 years, with type 2 diabetes and essential hypertension underwent 24-h ECG monitoring and 5 tests for the evaluation of both parasympathetic (heart rate variability, response to breath deeping, and Valsalva manoeuvre) and sympathetic (cold pressor test and orthostatic hypotension test) autonomic function. A total of 518 asymptomatic episodes of ST depression during Holter monitoring indicative of SMI were detected in 51 of the 243 studied patients (20.9 %). None of the patients with ST depression episodes exhibited a normal response to at least one of the evaluated autonomic function tests, whereas 22 of the 192 patients without ST changes (11.4 %) exhibited a normal response to all tests. Abnormality in both parasympathetic and sympathetic function test responses was found in 94.1 % of patients with ST depression episodes vs 26.1 % of those without ST changes (P < 0.001). Statistical evaluation of the relationship between the abnormal response to single autonomic function test and episodes of ST depression was highly significant for all the 5 tests (P < 0.001). These results indicate that: (a) Holter monitoring enables to detect ST segment changes indicative of SMI in 20.9 % of elderly diabetic patients with hypertension; (b) the presence of autonomic cardiac dysfunction in these patients suggests a role of diabetic neuropathy in the pathogenesis of SMI; an
Effect of Evening Bromazepam Administration on Blood Pressure and Heart Rate in Mild Hypertensive Patients
No full textAim: To assess the effects of chronic evening oral administration
of bromazepam alone or in combination with propranolol
on ambulatory blood pressure (BP) and heart rate (HR) in
mild hypertensive subjects. Methods: Thirty-seven mild hypertensive
patients after a 2-week placebo period were randomized
to bromazepam 3 mg, propranolol 40 mg, bromazepam
3 mg plus propranolol 40 mg or placebo for
2 weeks according to a double-blind, double dummy, crossover
design. After each treatment period, 24-h BP and HR
ambulatory monitoring was performed by using a non-invasive
device. Results: Ambulatory monitoring showed that
during night-time SBP and DBP values were unaffected by
bromazepam as compared to placebo, whereas SBP was significantly
reduced by propranolol both when taken alone
and in combination with bromazepam. HR nocturnal values
were significantly reduced by propranolol, whereas they
were significantly increased by bromazepan both when taken
alone (+11.5%, p < 0.05 vs. placebo) and in combination
with propranolol (+12.8%, p < 0.05 vs. propranolol). No significant
difference in day-time values of SBP, DBP and HR was
observed among the 4 treatment groups. Conclusions: In
mild hypertensive patients, evening consumption of bromazepam
for a 2-week period did not affect BP, while it increased
nocturnal HR. Such an increase was observed both
when bromazepam was taken alone and in combination
with propranolol, which suggests that it depends on a bromazepam
mediated decrease in vagal tone. Whatever the
mechanism, the HR nocturnal increase might be of clinical
relevance, due to the role of high HR as cardiovascular risk
factor, particularly in already at risk hypertensive subjects
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