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96 Q&A related to Headache Migraine

Nighttime hallucinations | Neurology | 06-2012
Without more details, it s hard to know the diagnosis of your patient. As you mention, hypnagogic hallucinations occur during the transition from wakefulness to sleep and are often seen ...

Brain imaging | Imaging | 06-2012
White matter WM hyperintense foci are very common on MRI scans of the brain and have been associated with a large variety of neuropsychiatric conditions. Their importance in each individual ...

Auras, seizures and stroke signs | Neurology | 04-2011
Often, a patient presents to the physician complaining of transient neurological symptoms, but the examination is now normal and one must interpret the history to make a judgement on what ...

Transcranial magnetic stimulation | Neurology | 04-2011
Transcranial magnetic stimulation uses electromagnetic induction to non-invasively cause depolarization of cortical neurons. If applied to the motor cortex, it can cause contralateral muscle contraction, which can be recorded with ...

Worst headache ever | Neurology | 02-2011
A thunderclap headache is a headache of very sudden onset. This should always be a red flag in the history of any patient with acute headache. It s important to ...

Listen to your heart | Cardiology | 02-2011
People do sometimes hear their pulse quite loudly in their ear when lying in certain positions. For most people this happens only occasionally. It s normal, of course, to hear ...

Can giving blood cure headaches? | Hematology | 12-2010
Cluster headache is a neurological disorder of unknown cause, characterized by unilateral excruciating headaches appearing periodically in clusters for days and months followed by spontaneous pain-free periods of one month ...

Recognize temporal arteritis | Rheumatology | 09-2010
According to the American College of Rheumatology criteria for classification of temporal arteritis, at least 3 of the following 5 items must be present sensitivity 93.5 , specificity 91.2 Age ...

Cool patient | Infectious Disease | 12-2009
Normal body temperature varies during the course of the day, of course, and also between individuals. Definitions for fever vary but generally speaking it may be defined to be present ...

Why are migraines one-sided? | Neurology | 11-2009
This question reminds me of that story about the elderly man who goes to his physician complaining of a sore knee. The doctor tells him, It s just old age. ...

Magnesium in migraine | Neurology | 11-2009
The roles of magnesium in cortical spreading depression, neurotransmitter release, and platelet aggregation suggest an involvement in the pathogenesis of migraine. Some studies have found that patients with migraine may ...

What pulls the migraine trigger? | Neurology | 10-2009
Many environmental factors have been reported to trigger headaches in some migraineurs. These include foods rich in nitrites hot dogs, other prepared meats , monosodium glutamate, octopamine, phenylethylamine, or tyramine ...

Pineal gland cysts: common and mostly harmless | Endocrinology | 08-2009
Pineal gland cysts are a common finding with a reported prevalence of 25 to 40 in autopsy series. The majority are benign and asymptomatic. Rarely they can enlarge and compress ...

Celiac link to migraine? | Gastroenterology | 08-2009
As with irritable bowel syndrome, a small number of migraine sufferers maybe about 5 may have celiac disease. The many ways in which this disease presents itself never ceases to ...

Migraine in pregnancy: safe choices | Ob/Gyn | 08-2008
Both physicians and women feel that avoidance of any medication during the first trimester of pregnancy is the best choice, but disabling migraines often require more than acetaminophen. As such, ...

Post-concussion treatment | Neurology | 07-2008
Headache after a concussion is a common problem and is often associated with other features such as dizziness, fatigue, insomnia, irritability, trouble with concentration and memory, and intolerance of stress, ...

Antidepressants for pain -- why do they work? | Clinical Pharmacology | 06-2008
While the precise mechanism of action remains unclear, amitriptyline, which was originally developed as an antidepressant, has been shown to work as a pain reduction agent. The effect appears to ...

How to prevent headaches after exercise | Neurology | 04-2008
Primary exertional headache usually occurs during strenuous exercise that involves a Valsalva manoeuvre. Most of the patients I see with this type of headache are young men who've recently started ...

Make the right OC choices | Ob/Gyn, Neurology | 03-2008
The response of migraine to initiation of OCs varies between patients. Many show no change in headache pattern, a few improve and some worsen. Epidemiologic studies suggest that migraine and ...

Preventing hyponatremia in nursing homes | Nephrology | 02-2008
Hyponatremia -- defined as serum sodium 135 mmol L -- is often due to the body's inability to appropriately excrete dilute urine. Though any level of plasma osmolality may be ...

Preventing hyponatremia in nursing homes | Geriatrics | 02-2008
Although hyponatremia is usually defined as a plasma sodium 135 mm L, the frail elderly, particularly those with cognitive vulnerability, may show increased confusion when sodium levels fall under 130. ...

Do lamotrigine or pregabalin prevent migraine? | Neurology | 09-2007
Neither of these drugs carries an official indication for migraine prophylaxis. Even off-label, neither is anywhere close to a first-line treatment for migraine. Since you're asking, though, let's take a ...

La lamotrigine ou la prégabaline préviennent-elles la migraine ? | Neurology | 09-2007
Ni la lamotrigine ni la pr amp eacute gabaline n'ont d'indication officielle pour la prophylaxie de la migraine. M amp ecirc me hors indication, ces agents ne conviennent pas au ...

Can statins speed mental deterioration in the elderly? | Geriatrics | 07-2007
Headache is a well recognized side effect of statins, occurring in about 10 of patients. Personally, I'm not aware of research showing any important association with confused states or delirium. ...

Don't forget about transient global amnesia | Neurology | 06-2007
TGA is a fascinating condition. Once seen, it's never forgotten by the examining physician and never remembered by the patient. A previously well person, usually over 50, suddenly develops a ...

Can kids have true sinusitis? | Pediatrics | 06-2007
Sinusitis in kids is an extremely controversial subject. The sinuses aren't fully formed for many years. The frontal ones aren't developed until the child is at least 10 years old. ...

Investigating headache in kids: pineal cyst finding | Neurology | 05-2007
A pineal cyst is not an uncommon incidental finding on neuroimaging. In one study, 1 of 49 neurologically normal children presenting with headache had a pineal cyst on MRI. In ...

Are riboflavin and CoQ10 effective against migraines? | Clinical Pharmacology | 11-2006
Migraine is a common and bothersome problem that's seen in older children, adolescents and adults. It shows interesting variations in presentation and therapy, depending on age. In general, these headaches ...

When sleep depends on zopiclone | Psychiatry | 09-2006
Zopiclone is a cyclopyrrolone, a drug chemically unrelated to the benzodiazepines, although they share the same receptor. Systematic studies have all shown that it has very few withdrawal effects. From ...

SSRIs: exacerbation of migraines | Pharmacology | 07-2006
Worsening of migraines isn't a common adverse effect associated with SSRI therapy. Having said that, there are case reports with sertraline -- treated in one patient by prescribing the anticonvulsant ...

Serotonin syndrome: what's the risk? | Psychiatry | 07-2006
The usual cause of serotonin syndrome is excess serotonergic agonism, both centrally and peripherally. There are three principal causes. One is the therapeutic use of drugs, another is intentional self-poisoning ...

Peaceful Z-Z-Zs without nocturia | Urology | 05-2006
An oral form of antidiuretic hormone has been put on the market for just this purpose. It's not effective in all patients, but it's worth a try in stubborn cases. ...

Shedding light on winter blues | Psychiatry | 03-2006
There's a review of research on light therapy in a recent journal of psychiatry Golden RN et al. amp lt i amp gt Am J Psychiatry amp lt i amp ...

Why is the neck neglected in headache Tx? | Rheumatology | 03-2006
The global approach to neck pain and referred headache involves efforts to improve posture and muscle tone and strength in the shoulder girdle and the abdominals, which are often very ...

Does celiac disease spur migraines? | Gastroenterology | 01-2006
Like in irritable bowel syndrome, a small number of migraine sufferers amp amp 151 maybe about 5 amp amp 151 may have celiac disease. The many ways in which this ...

Kids stuffed up with sinusitis | Pediatircs | 11-2005
Sinusitis is a controversial subject in pediatrics, as the diagnosis is made on clinical grounds, and so it tends to be subjective. I try to avoid antibiotics if not necessary. ...

Which anticonvulsants best stabilize mood? | Psychiatry | 05-2005
A number of second- and third-generation anticonvulsants are currently used in psychiatry. Carbamazepine and valproate appear to be effective in the treatment of acute mania while carbamazepine and lamotrigine are ...

Can botulinum toxin freeze head tremor? | Rheumatology | 03-2005
The anaerobic bacterium amp lt i amp gt Clostridium botulinum amp lt i amp gt produces a variety of toxins, which in their natural state cause botulism. Minute amounts of ...

Update on atypical facial neuralgia | Neurology | 12-2004
Patients presenting with facial pain may be displaying one of several conditions including atypical facial pain, atypical odontalgia, trigeminal neuralgia, trigeminal neuropathy, glossopharyngeal neuralgia, geniculate neuralgia, burning mouth syndrome, temporomandibular ...

Does botulinum toxin prevent headaches? | Neurology | 11-2004
There's emerging evidence that botulinum toxin A may offer options for the treatment of various types of headache, including tension and migraine. Its transient paralytic effects could potentially influence increased ...

Progressive upper body numbness: stop OCP? | Neurology | 10-2004
Investigation of a patient presenting with a transient hemisensory disturbance begins with a good case history. amp quot Sensory march amp quot occurring over a few seconds may suggest an ...

Migraine prevention with an antipsychotic? | Neurology | 03-2004
To date, I'm not aware of any studies suggesting that quetiapine helps prevent migraine attacks. LW

Telling tick-borne diseases apart | Infection | 01-2004
Lyme disease is characterized by an initial expanding skin lesion erythema migrans with subsequent spread to other sites, such as the nervous system, heart and joints, and may become chronic. ...

Can lung ailments cause headache? | Neurology | 01-2004
Traditionally, the interaction between the respiratory and nervous systems is split into two basic categories. The first is the effect of neurologic disease on the respiratory system. For example, neurologic ...

Can lung ailments cause headache? | Respirology | 01-2004
Lung conditions are often accompanied by headaches as a manifestation of systemic disease. As you've observed, two common associations are with lung cancer and atypical pneumonia. Metastatic lung carcinoma can ...

Is it safe to take triptans several times a week? | Rheumatology | 01-2004
General migraine management principles suggest that patients with one or more headaches per week may benefit from using a headache prophylaxis agent. These medications can lessen not only the frequency ...

Approaches for migraine with Raynaud's disease | Neurology | 12-2003
Managing migraine should begin with the basic principles of educating the patient and looking for migraine triggers. Once she's been educated as to what she should avoid or how to ...

Severe exertional headache: sign of something serious? | Neurology | 11-2003
Sudden and severe headache during exertion should always raise concern over the possibility of increased intracranial pressure or subarachnoid hemorrhage. With a history of a single episode of sudden, severe ...

Are migraine, antiphospholipid antibodies and stroke linked?" | Neurology | 10-2003
The precise relationship between migraine, antiphospholipid antibodies and stroke isn't clear, though a number of small studies have looked at this issue over the years. Other factors that may ultimately ...

Headache: sildenafil or sex to blame? | Neurology | 10-2003
Approaching any patient with a history of headaches should begin with the basics, including where in the head they've been occurring, their frequency and any recognized triggers. Medications can contribute ...

Nefazodone for chronic daily headache and migraine | Neurology | 09-2003
Nefazodone is an antidepressant medication in which mechanism of action appears to be partly as a 5-hydroxytriptamine superscript 2 5-HT superscript 2 antagonist. This means it shares some properties with ...

Can magnesium mitigate menstrual migraine? | Neurology | 08-2003
Managing menstrual migraine has often been difficult. Fortunately, the introduction of the triptan medications naratriptan, rizatriptan, sumatriptan, zolmitriptan has improved acute treatment. Some women, however, who may be intolerant of ...

Sizing up side effects of conjugate meningococcal C vaccine | Infection | 07-2003
Conjugate meningococcal C vaccine has a well-established safety profile. Typical reactions include pain, tenderness, swelling and redness at the injection site, which occur in about 25-50 of cases. Fever, headache ...

Can progesterone help women with epilepsy? | Neurology | 07-2003
The influence of ovarian hormones on neurologic conditions is an area of ongoing research and investigation. We've long recognized that fluctuating hormone levels probably play a role in triggering migraine ...

Using feverfew for migraine prophylaxis | Neurology | 04-2003
Feverfew is a relatively common herbal medication derived from Tanacetum parthenium. The leaf and aerial parts of the plant are used in preparing the herbal medication. It's thought the pharmacologic ...

Why is migraine more common in women? | Neurology | 03-2003
We don't fully understand the basis for the relationship between migraine headaches and menstruation. There's evidence to suggest that fluctuating hormonal levels, in particular falling estrogen levels, may play an ...

TIA: start antiplatelet agent or wait for CT? | Neurology | 02-2003
Investigation and treatment of TIAs follow some general principles, but also must be individualized with each patient. TIAs may be mimicked by other conditions, such as intracranial mass lesions, migraines, ...

When sex is a big headache | Neurology | 02-2003
Some severe headaches, such as exertional, cough-associated and coital headaches, share common clinical features and may also have the same causes. These headaches tend to occur acutely, last seconds to ...

Shedding light on seeing flashing lights | Ophthalmology | 02-2003
When patients complain of flashing lights in their vision, it's important to try to find out whether it's affecting one eye or both. Seeing peripheral flashing lights in a binocular ...

Options for migraine in kids | Pediatrics | 02-2003
In my opinion, the first line of drug therapy for treating pediatric migraines is ibuprofen. Well-designed studies show that ibuprofen is more efficacious than acetaminophen. The newer triptan agents can, ...

Helping headache after head injury | Neurology | 12-2002
Following head injury, it's not uncommon for patients to complain of headache and potentially a myriad of other symptoms, including difficulty concentrating, poor memory, dizziness and altered mood. The majority ...

HEADACHE AFTER HEAD INJURY: WHAT'S NEXT? | Neurology | 09-2002
Headache arising after head injury is a well-recognized phenomenon. The degree of trauma can vary significantly, from severe cranial trauma to minor injury without loss of consciousness. Headaches triggered by ...

MIGRAINE: CAN PROPHYLAXIS PREVENT STROKE? | Neurology | 08-2002
It's been recognized that migraine with prolonged aura is a risk factor for stroke. In the past, it was thought that this might be the result of prolonged vasoconstriction, leading ...

HOW DOES BOTULINUM TOXIN ZAP MIGRAINE? | Neurology | 07-2002
At this stage, it's best to view the use of Botox in the management of migraine and other headache types as experimental. We still don't know its precise mechanism of ...

BASILAR MIGRAINE: A TREATMENT CHALLENGE | Neurology | 07-2002
Treating basilar and hemiplegic migraine is a special challenge. Many authorities feel the use of triptans is contraindicated in such cases, out of concern over the potential for cerebral vasoconstriction ...

OCs, migraine and stroke risk | Neurology | 06-2002
To answer the question accurately, it's important to have an accurate diagnosis. While there's some literature on the risk of OC use in migraineurs, little if any is available on ...

Is valproate an option for actue migraine? | Neurology | 05-2002
Divalproex has been used for a number of years as a migraine prophylaxis agent. Recently, with the availability of an IV form, it's been tried as an acute treatment agent. ...

Does OC + migraine raise stroke risk? | Neurology | 05-2002
For patients with migraine, the relationship between the use of OCs and the potential for stroke is complex. It's probably safe to use a low-dose OC less than 50 mcg ...

TRIPTAN USE DURING AURA PHASE | Neurology | 03-2002
Using triptans isn't absolutely contraindicated during the aura phase of a migraine, though it's been suggested they be avoided in patients with basilar or hemiplegic migraine. There's also emerging evidence ...

WHAT'S BEHIND BENIGN INTRACRANIAL HYPERTENSION? | Neurology | 03-2002
Benign intracranial hypertension, also known as pseudotumour cerebri or idiopathic intracranial hypertension, likely represents a somewhat underdiagnosed condition. Patients with this condition present with increased intracranial pressure, headache and papilledema. ...

ARE TRICYCLICS ACCEPTED FOR IBS? | Gastroenterology | 02-2002
I often use a small dose of a tricyclic antidepressant for IBS. Rather like its use in migraine headaches, fibromyalgia and chronic pain, it's a pretty good amp quot visceral ...

TRYING TOPIRAMATE FOR MIGRAINE PROPHYLAXIS | Neurology | 02-2002
Migraine prophylaxis hasn't seen the exciting breakthroughs that acute migraine management has in recent years. Among the various prophylaxis agents, anticonvulsants such as valproic acid and, more recently, topiramate have ...

THE LATEST ON MALARIA PROPHYLAXIS | Infection | 09-2001
The epidemiology of malarial resistance continues to change. Not only are the areas of the world with chloroquine-resistant strains expanding, but resistance to newer drugs has appeared. As well, Plasmodium ...

INVESTIGATING SEVERE HEADACHE | Neurology | 09-2001
To answer the question, I'd need to know if you're referring to a single headache associated with photophobia, phonophobia and nausea, or a patient with a history of multiple episodes ...

KIDS WITH HEADACHE: IS IT GLAUCOMA? | Ophthalmology | 08-2001
Headaches in children can't be attributed to primary glaucoma, although elevated intraocular pressure, which can develop following ocular injury, can produce pain that's usually associated with decreased vision. In a ...

MIGRAINE OPTIONS IN KIDS: A REAL HEADACHE! | Neurology | 06-2001
Compared to the adult population, treating migraine in the pediatric age group is complicated by apparent age and gender differences. It's also hampered by the limited scientific data available on ...

TIPS ON TRIPTANS | Neurology | 02-2001
With respect to oral tablets sumatriptan, rizatriptan, zolmitriptan these medications are more similar than different. The risk benefit ratio is very similar for all triptans and so is the cost. ...

TAILORING TRIPTANS | Neurology | 01-2001
Using triptans for migraine has revolutionized its management in many ways. They're not, of course, without their inherent risks. Frequently, we focus on nonneurologic contraindications such as ischemic heart disease, ...

INVESTIGATING REALLY BAD "ICE CREAM HEADACHES" | Neurology | 11-2000
The best way to diagnose your patient's headache is to first analyze the symptoms she experiences during episodes to decide what type it is, such as migraine. There's often a ...

POST-RUN MIGRAINE AURA: ANY SOLUTIONS? | Neurology | 10-2000
It's true that treating migraine aura can be problematic. First, it's important to be certain that these are true migraine symptoms, and not part of a new disorder such as ...



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