Headache Medicine最新文献

{"title":"Dialysis headache: A literature review in the last 30 years","authors":"M. Souza, Kerly Rocha Lima, Yasmine Maria Leódido Fortes, R. Silva-Néto, M. Filgueiras","doi":"10.48208/headachemed.2022.28","DOIUrl":"https://doi.org/10.48208/headachemed.2022.28","url":null,"abstract":"Introduction\u0000According to the International Classification of Headache Disorders (ICHD-3), dialysis headache has no specific characteristics occurring during and caused by haemodialysis. It resolves spontaneously within 72 hours after the haemodialysis session has ended.\u0000Objective\u0000To describe the prevalence, clinical features, associated symptoms and risk factors of dialysis headache.\u0000Methods\u0000Based on a literature search in the major medical databases and using the descriptors“dialysis headache”, “hemodialysis and headache” and “renal dialysis and headache”we included articles published between 1992 and 2022. Of the 492articles found, only 9 met the inclusion criteria and were analyzed.\u0000Results\u0000We describe 444 patients (53.1% men and 46.9% women) diagnosed with dialysis headache, corresponding to 24.8% of those who underwent hemodialysis.The age ranged from 15 to 75 years. Pain occurred predominantly from the third hour of hemodialysis (65.8%), lasting less than four hours (71.7%), located bilaterally (63.1%), pulsatile (58.5%) and moderate intensity (68.9%).The most frequent associated symptoms were photophobia or phonophobia (71.5%), vertigo (22.3%) and nausea and/or vomiting (16.5%).\u0000Conclusion\u0000This review showed a high prevalence of dialysis headache in patients undergoing hemodialysis and that the clinical characteristics, treatment and prevention are still poorly studied.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89551505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary headache in academics: a cross-sectional study","authors":"Lindair Alves da Silva, A. L. B. Carneiro, Lincoln Basilio Alves, Semírames Cartonilho de Souza Ramos, Iago José Lopes da Silva, A. W. Brasil, F. Sallem","doi":"10.48208/headachemed.2022.30","DOIUrl":"https://doi.org/10.48208/headachemed.2022.30","url":null,"abstract":"Headache is a frequent, long-standing and universal neurological disorder with high prevalence worldwide.\u0000ObjectiveTo verify the prevalence of headache and self-medication among healthcare academics.\u0000MethodsThis was a cross-sectional, descriptive and quantitative study, carried out with 165 healthcare academics. A questionnaire was used as a methodological instrument to collect data.\u0000ResultsThe academics were mostly female, aged between 18 and 54 years, from the State of Paraiba and single. The lifetime prevalence of headaches was 98.2%. Most volunteers (62.4%) have a probable diagnosis of primary headache. Of these, the most prevalent was migraine, especially with aura, and tension-type headache (TTH). Of the group under analysis, the majority have not had consultations because of the pain and therefore have no medical diagnosis and no treatment. Some treated the pain only in a crisis. Of these, most practiced self-medication, mainly with dipyrone and paracetamol.Stress, worry and sleep deprivation were the most cited factors among those that usually cause pain.\u0000ConclusionClarifications, preventive measures, correct diagnosis and appropriate treatment can reduce the emotional, socioeconomic and academic losses of this frequent neurological complaint among students.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77596041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How does pain influence cervical endurance test performance in migraine patients?","authors":"Amanda Rodrigues, M. M. Bragatto, L. Florêncio, Luisa Bigal, M. Bigal, D. Bevilaqua-Grossi","doi":"10.48208/headachemed.2022.supplement.10","DOIUrl":"https://doi.org/10.48208/headachemed.2022.supplement.10","url":null,"abstract":"Introduction\u0000Migraine sufferers frequently complain of cervical pain during and in-between migraine attacks and studies suggest that chronic neck pain is a risk factor for high-frequency migraine, including chronic migraine. Increased headache frequency and chronic neck pain are, in turn, independently associated with cephalic cutaneous allodynia, a known risk factor for increased headache frequency.\u0000Objective\u0000To verify the influence that pain in migraine patients has on muscle performace during the cervical endurance test and whether the change in performance is due to pain during the test, neck muscle dysfunction or both.\u0000Methods\u0000Were evaluate 100 women stratified by diagnosis (migraine, cervical pain, both and none) and self-reported pain during the cervical muscle endurance test in flexion and extension (with or without headache and / or cervical pain during the endurance test). Pain during the test by numerical rate scale (NPRS, 0-10) and pain pressure threshold were collected for all groups. Migraine patients answered 12-item Allodynia Symptom. We used one-way analysis of variance with the Tukey’s HSD post hoc test analysis to contrast pressure pain threshold and endurance across groups. Differences in flexion and extension times were compared using the Welch T-test and the McNemar Test was used to compare differences in headache and neck pain incidence per study group during flexion and extension endurance tests.\u0000Results\u0000There are significantly differences in mean endurance during flexion between migraine and neck pain [34.4s (25)] relative to neck pain alone [45.2 (18)], migraine [40.2s (29)] and controls [57.5.4s (40)] (p = 0.04). On average, those who experienced headache during the flexion test sustained for significantly less time than those without headache during the test (27.80 versus 46.18 seconds, p<0.01); (To see the complete abstract, please, check out the PDF).\u0000 \u0000 ","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75788427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-rater reliability of pressure pain threshold using a digital algometer","authors":"Rosana Tieka Miyazaki Branucci, Vanda de Lelis, Georgia Kleinschmitt Westenhofen, I. Fortini, M. F. Peres","doi":"10.48208/headachemed.2022.supplement.20","DOIUrl":"https://doi.org/10.48208/headachemed.2022.supplement.20","url":null,"abstract":"BackgroundPressure Pain Thresholds (PPT) has been the main sensory modality studied in headache disorders. It is usually repetitive, leading to potential variability between measurements. Since threshold estimation relies on the observer, patient, body site, and the device used, it is important to assess measurement reliability in the specific clinical and methodological scenario to be studied in order to minimize error.\u0000ObjectiveThe aim of this study is to confirm intra-rater reliability of PPT in the head of adults using a digital algometer device.\u0000MethodsPPT was measured with a digital algometer in 3 consecutive assessments conducted 10 min apart. Eight sites were measured in each time at the occipital, temporal and masseter regions bilaterally, frontal and vertex at midline. The reliability using intra-class variability (ICC) and covariance were calculated between times 1, 2, 3, and all times versus the mean. Scores above 0,75 were considered as having excellent reliability.\u0000ResultsTen healthy volunteers aged (21-55) were studied. The sum of all sites measured in the head was 2182 (+-672) KPa for the first measure, 2085 (+- 626) KPa for the second, 2185 (+-685) for the third, and 2150 (+-685) KPa for the mean. All ICC coefficients calculated were 0,975 or higher in all areas.\u0000ConclusionsWe concluded that one PPT measure in the head with a digital algometer is as reliable as 3 repetitive measures The intra-rater reliability for PPT is considered excellent. Future studies assessing pain vulnerability or predicting headache occurrence can be performed without a significant risk of bias.\u0000Keywords: Pressure PainThreshold, Algometry, Reliability, Intra-class.","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77592803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug management for migraine with aura and treatment alternatives: a case report","authors":"Rhayra Alani Villa Deléo, Antônio Carlos Guimarães Pinto, Priscila Cristian do Amaral, Pietra Monique de Souza, Andressa Eliziário Barroso","doi":"10.48208/headachemed.2022.supplement.22","DOIUrl":"https://doi.org/10.48208/headachemed.2022.supplement.22","url":null,"abstract":"Introduction\u0000Migraine is a chronic disease and affects about 15% of the World population. It is the second most disabling disease among young adults. Pathophysiology has not yet been fully clarified, but there is evidence for genetic alterations that cause a state of hyperexcitability and metabolic alterations that make the central nervous system more susceptible to external stimuli.\u0000Objective\u0000To present the evolution of a diagnosis of headache with aura treated with drugs and the results obtained.\u0000Methods\u0000Data collected through complete anamnesis. \u0000Results/Case report\u0000Woman, 26 years old, student, white, with hypothyroidism, denies smoking and alcohol consumption. Reports practicing physical activity and maintaining a healthy diet. Complains of headache for 9 years, with increased intensity and frequency. At the age of 18, period of onset of pain, frequency was every 10-15 days, with a maximum duration of one day and visual changes. She was using oral contraceptive pill (OCP) and dipyrone, without neurological consultation. At the age of 20, the use of OCP ceased, with worsening of the frequency and intensity of pain, the patient sought specialized medical care. Neurologist diagnosed migraine with aura triggered by stress. As treatment, he prescribed 50 mg/day of topiramate divided into two doses and alprazolam 0.5 mg, with return in 60 days. Reports no improvement and there was an increase in topiramate dosage to 100 mg and alprazolam dosage to 1 mg/day.\u0000There was relative improvement for an approximate period of 4 months. Patient returned to daily pain, with episodes of throbbing pain, with exacerbated photo and phonophobia, need for hospital care twice a month and beginning of concentration problems. In hospital care, reports having received tramal, profenid and dramin. \u0000(To see the complet abstract, please, check out the PDF.)","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79402104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic variants IL1B +3954C>T and -511C>T associated with incapacity and allodynia in migraine","authors":"Aline Vitali da Silva, B. Khouri, Debora Villas Boas Rezende, Ana Paula Gallina Pezzini, Beatriz Rabello Espinosa, Tainah Mendes Ahrens, A. Antonucci, V. A. Bello, Regina Célia Poli Frederico, Carlos Eduardo Coral, E. V. Reiche, A. Simão","doi":"10.48208/headachemed.2022.supplement.13","DOIUrl":"https://doi.org/10.48208/headachemed.2022.supplement.13","url":null,"abstract":"IntroductionThe main mechanisms in the physiopathology of migraine are cortical spreading depression and trigeminal activation with the release of CGRP. Neurogenic inflammation and neuroinflammation can exert an influence over both these mechanisms, but there are still a number of gaps in our understanding. Interleukin (IL)- 1β is a pro-inflammatory cytokine whose levels of plasma increase during the attack phase of migraine. Thus far, its genetic variants have not been well studied.\u0000ObjectiveTo investigate the association between the genetic variants IL1B +3954C>T (rs1143634) and -511C>T (rs16944) and susceptibility to migraine and its clinical characteristics.\u0000Subjects and MethodsCase control study comprising 307 participants, of whom 152 had a diagnosis of migraine and 155 were healthy controls, paired by sex, age, ethnicity and BMI. The clinical and demographic data were evaluated. The patients with migraine were interviewed using a structured form containing information about the type of migraine (with or without aura, episodic or chronic), age at onset of the disease, frequency of attacks, accompanying symptoms that triggered headaches. The patients also answered validated questionnaires to evaluate incapacity (Migraine Disability Assessment - MIDAS) and impact (Headache Impact Test - HIT-6) for migraine, the presence of allodynia (ASC-12), as well as symptoms of anxiety (State Anxiety Inventory - STAI 1 and 2), depression (Beck Depression Inventory) and a hyperacusis scale.The genetic variants IL1B +3954C>T (rs1143634) and -511C>T (rs16944) were identified using polymerase chain reaction (PCR) and the fluorescence levels of PCR products were evaluated using a Step One thermocycler (Applied Biosystems). The analyses were conducted using the dominant, codominant, recessive and over- dominant genetic models. Categorical data were evaluated via the chi-squared test or Fisher’s exact test, and continuous data were evaluated using the Mann-Whitney test.  (To see the complete abstract, please, check out the PDF).","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81853225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of melatonin on degranulation of dura mater mast cells in Wistar rats","authors":"R. Reis, M. Ferreira, R. F. Costa, M. Valença","doi":"10.48208/headachemed.2022.supplement.41","DOIUrl":"https://doi.org/10.48208/headachemed.2022.supplement.41","url":null,"abstract":"Introduction\u0000Migraine is a highly prevalent neurological disorder that affects about 15% of the world's population. Involved in migraine pain, the cranial dura mater is a richly vascularized and innervated membrane, where we also find mast cells, and immune cells that help in the formation of the inflammatory process. As one of the treatments for migraine, we have melatonin, a hormone produced in the pineal gland and with properties such as circadian cycle control and antioxidant action. Capsaicin, a bioactive compound found in peppers and with a pungent and burning effect, also has an action in the painful process and serves as a tool in the study of physiopathogenic processes.\u0000Objectives\u0000To evaluate the degranulation of dura mater mast cells from Wistar rats stimulated in situ with capsaicin and synthetic interstitial fluid (SIF) and previously treated with melatonin.\u0000Methods\u0000Twenty-five male Wistar rats were used, obtained from the Department of Antibiotics - Danti of the Federal University of Pernambuco - UFPE and with use authorized by the Ethics Committee in the Use of Animals - CEUA of UFPE, according to protocol nº 0084/2019. During the adaptation period, the animals were acclimatized under standard laboratory conditions, with water and food ad libitum. After this period, they were separated into two groups: a control group (CG) (n = 12) and a melatonin group (GM) (n = 13), and underwent a daily treatment for 10 days with the intraperitoneal application. The GM received a dosage of 10 mg/kg of the animal weight of melatonin diluted in a saline solution at 0.9% and the GC was treated only with the vehicle. After the treatment, the animals were anesthetized and submitted to an experimental surgery...\u0000(To see the complet abstract, please, check out the PDF.)","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"147 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86110774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the influence of migraine on stroke ischemic penumbra","authors":"F. A. A. Oliveira, Mario Genuíno Dourado Filho, P. A. Rocha-Filho","doi":"10.48208/headachemed.2022.supplement.23","DOIUrl":"https://doi.org/10.48208/headachemed.2022.supplement.23","url":null,"abstract":"Abstract\u0000Introduction\u0000There is controversy as to whether migraine affects the behavior of ischemic penumbra during the acute phase of an ischemic stroke, thereby accelerating the formation of cerebral infarction. \u0000Objectives\u0000To assess whether migraine modifies the existence and volume of the divergence between the areas of diffusion and perfusion in the stroke (the penumbra).\u0000Methods\u0000This was a prospective cohort study carried out in a hospital in the city of Recife, Pernambuco, Brazil. We included consecutively hospitalized patients with ischemic stroke within 72 hours of symptom onset. A diagnosis of ischemic stroke was made by the presence of a diffusion restriction pattern on the MRI within a compatible clinical context. Patients were assessed by a neurologist who conducted an interview using a semi-structured questionnaire containing questions regarding sociodemographic data, the presence and characteristics of headaches in their lives, the presence and characteristics of headaches related to ischemic stroke and the related clinical condition to ischemic stroke. The headaches presented were classified according to the diagnostic criteria of the third edition of the International Classification of Headache Disorders. The National Institute of Health Stroke Scale and the modified Rankin scale were used. Patients underwent MRI of the brain with diffusion and with perfusion. \u0000Results: A total of 221 patients were included, 59.3% of whom were male, and a mean age of 68.2 ± 13.8 years. Ischemic penumbra analysis was performed in 118 patients. There was no association between migraine and the absence of ischemic penumbra (OR: 1.22; CI95%: 0.52 – 2.87; p=0.649; Chi-Square Test). There was no difference in the volume of ischemic penumbra between those with and without migraine. There was no difference in stroke volume between those with and without migraine (1.0; 0.38 – 7.9 cm3...\u0000(To see the complet abstract, please, check out the PDF.)","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90198469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ambiguity and limit of caffeine in migraine: a literature review","authors":"Rhayra Alani Villa Deléo, Andressa Eliziário Barroso, Pietra Monique de Souza, Priscila Cristian do Amaral, Andreia Silva de Oliveira","doi":"10.48208/headachemed.2022.supplement.14","DOIUrl":"https://doi.org/10.48208/headachemed.2022.supplement.14","url":null,"abstract":"Introduction\u0000Migraine is a chronic disease that affects about 15% of world's population. It is the most disabling disease among men and women under 50 years. Studies indicate that the caffeine, which is the most consumed stimulating in the world and present on the daily diet, can be related to the migraine in an ambiguous way.\u0000ObjectiveConsidering the epidemiologic and economic point of view, the disease phisiopatology and the accessibility to caffeine, this study aims to understand if there would be a safe minimum dosage of caffeine for patients with migraine.\u0000MethodsThe words \"migraine\" and \"caffeine\" were searched in July 2022 at PUBMED and BVS with predetermined filters and selection of publication in qualis journals A1 and A2. 13 articles were found for this revision.\u0000ResultsCaffeine's effects on the nervous system and its relation with headaches have been target of several studies, mainly for producing symptoms similars to the prodromic phase of migraine e for the existence of the Caffeine Abstinence Syndrome, known as a diagnostic entity by the International Migraine Classification. The sensory hypersensitivity (migraine's characteristic) does not appear at the abstinence syndrome. The lack of information about pre-existing headache at studies shows a gap in the parameter ''caffeine withdrawal as a trigger per se''. It is possible that premonitory symptoms such as yawns, low energy and sleepiness can lead to caffeine intake, bringing forth the wrong idea that it has initiated the migraine.Caffeine, however, induces urinary magnesium loss, reducing its reabsorption. As magnesium affects neuromuscular conduction, nerve transmission and is beneficial in chronic pain conditions and migraines, caffeine, by decreasing magnesium level, can induce headache. Additionally, caffeine contains thiaminases, enzymes that degrade thiamine, which may have protective potential in migraine.  (To see the complete abstract, please, check out the PDF). ","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"186 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80659428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trigeminal autonomic cephalalgias and intranasal lidocaine: a symptomatic management option","authors":"R. Londero","doi":"10.48208/headachemed.2022.supplement.51","DOIUrl":"https://doi.org/10.48208/headachemed.2022.supplement.51","url":null,"abstract":"Introduction\u0000Trigeminal Autonomic Cephalalgias (TAC) are excruciating headaches with limited treatment options. In addition to drug therapy, there are some studies regarding nerve blocking and nerve stimulation with acceptable results. We had a sequence of three difficult to treat patients because of the disease or some associated condition that made us try something not so usual. Lidocaine, by blocking voltage-gated Na+ channels can reduce the excitability of neurons and thus prevent or reduce the sensation of pain, which can relieve neuropathic pain, hyperalgesia, and complex regional pain syndrome.\u0000Objective\u0000Observe if intranasal lidocaine could be effective and safe for patients with TAC.\u0000Methods and Results\u0000The three patients signed a consent permission form. (1) 29-year-old pregnant woman with a history of headaches for about 3 years. Pain was localized in the right periorbital region with the severity of about 7 out of 10. Attacks of excruciating pain associated with ipsilateral tearing 5–8 times a day - Paroxistic Hemicrania. She was diagnosed with prolactinoma two years ago. The management of the tumor had resolved the pain. With the pregnancy, Bromocriptine has been stopped. So, 1 month later, the pain returned. As indomethacin could not be used in this situation, we opted to prescribe intranasal lidocaine. After the first dose, the patient had control of the pain. It was prescribed lidocaine 2%, 2mL intranasal (IN) until four times a day. (2) 56-year-old man with a history of headaches for about 4 months. Pain was localized in the right periorbital region with the severity of about 10 out of 10. Attacks of excruciating pain associated with ipsilateral tearing and conjunctival injection lasting for 30-90 seconds and occurring as single stabs 30-50 times a day - Short-lasting unilateral neuralgiform headache attacks with conjunctival...\u0000(Too see the complet abstract, please, check out the PDF,)","PeriodicalId":12925,"journal":{"name":"Headache Medicine","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89964400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}