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Familial occurrence of psychiatric disorders in headache, asthmatic, epileptic and healthy children: a controlled study.
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L'APPLICAZIONE DEL CONCETTO DI "DISTURBO DI CONVERSIONE" IN UN BAMBINO DI 11 ANNI: CONSIDERAZIONI CRITICHE SU UN CASO CLINICO
No full textSantuari extraurbani dell'Etruria rupestre tra Barbarano Romano e Blera. I luoghi sacri in località La Noce e La Lega
No full textL'articolo descrive e interpreta alcuni santuari etruschi rurali con i loro riti specifici nella zona di Blera e Barbarano Romano all'interno dell'Etruria meridionale rupestre
Melatonin, 3 mg, is effective for migraine prevention also in school-aged patients
No full textHypothalamic dysfunction may be present in migraine and in circadian periodicity of headache attacks, more specifically, the
suprachiasmatic nucleus and melatonin have been suggested to play a
role in the pathogenesis [1]. Altered melatonin levels have been found
in cluster headache, migraine with and without aura, menstrual
migraine, and chronic migraine. Melatonin may have many metabolic
effects, such as anti-inflammatory effects (melatonin and indomethacin
share similar chemical structure), reducing the up-regulation of proinflammatory
cytokines, and inhibiting nitric oxide synthase activity and
dopamine release. Melatonin administration is thus a possible candidate
for migraine prevention [2].
Objective The aim of this open trial was to test the hypothesis of the
potential effectiveness of melatonin for migraine prophylaxis also in
school-aged children.
Patients and methods We performed an open-label trial of melatonin,
3 mg, for migraine prevention. Twenty-three patients (11 M, 12
F) aged 6–15 years (mean 12.8 years, SD±1.38) with episodic
migraine with or without aura according to ICHD-II 2004 criteria,
were screened for the baseline period. All patients started prophylactic
treatment with melatonin, 3 mg, 10 minutes before bedtime for 3
months. A complete clinical interview and examination as well neurophysiological
recordings (wake and sleep EEG) were performed
for each patient. Study participants experienced between two and six
attacks per month. Exclusion criteria included the presence of sleep
disorders, as confirmed by the mothers of all subjects who filled out
the Sleep Disturbances Scale for Children [SDSC]. The SDSC is a
sleep questionnaire that consists of 26 items subdivided into 6 sleep
disorder subscales according to American Sleep Disorders
Association criteria: DIMS (disorders in initiating and maintaining
sleep), SDB (sleep disordered breathing), DA (disorders of arousal),
SWTD (sleep-wake transition disorders), DES (disorders of excessive
somnolence), SHY (sleep hyperhydrosis).
Results Twenty out of 23 patients completed the study (86.95%). That
patients (85%, 17/20) who completed the study had at least a 50%
reduction in intensity and frequency of headache attacks. Nobody
reported an increase in headache frequency. Complete (100%)
response was achieved in 12 patients (60%) and no adverse effects
were recorded.
Conclusions There is increasing evidence to indicate that the hypothalamus
plays a major role in the pathophysiology of several of the
primary headache disorders, such as migraine, and hypnic headache
[1, 2]. Melatonin, an indole compound derived from serotonin, was
reported safe and effective in adult patients [2], but no data were
available for school-aged children. This is an original study to assess
melatonin, 3 mg, for prophylactic treatment of headache also in
childhood
Utilità della somministrazione di melatonina 3 mg nella prevenzione dell'emicrania in età scolare
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