{"title":"Pulsed radiofrequency on the occipital nerve for treatment of short-lasting unilateral neuralgiform headache: A case report","authors":"Fátima López González, I. B. Blasco, C. Ferrí","doi":"10.1177/2515816320908262","DOIUrl":"https://doi.org/10.1177/2515816320908262","url":null,"abstract":"Short-lasting unilateral neuralgiform headache (Short-lasting Unilateral Neuralgiform headache attacks with Conjunctival injection and Tearing (SUNCT)/Short-lasting Unilateral Neuralgiform headache attacks with Autonomic Symptoms) is a trigeminal autonomic cephalalgia with difficult treatment and its management is based on neuromodulator drugs and sometimes ablative procedures on the trigeminal nerve. A positive response to occipital anesthetic blocks and peripheral and deep neurostimulation has also been described. We present the case of a patient with criteria of left SUNCT and transient response to occipital anesthetic blocks, satisfactorily controlled with pulsed radiofrequency (PRF) of the occipital nerve. Upon examination, the patient had tenderness in the left greater occipital nerve (GON). Blockade was performed with anesthetic and corticosteroid, obtaining a highly positive but transient response. After several nerve blocks, the patient was referred to the Pain Unit where pulsed radiofrequency on the left GON was performed. After two sessions, more than 90% of reduction of pain was achieved, maintained for 12 months. There haven’t been found data in the literature on the use of GON PRF for the treatment of SUNCT, while there are descriptions for other types of cranial pain. The intention of our case is to make this procedure to be considered as an alternative for the treatment of this entity in patients who respond to anesthetic blocks.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320908262","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43715968","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":"Managing external cold-stimulus headache with preventive naproxen","authors":"Anthony Khoo, M. Kiley, P. Goadsby","doi":"10.1177/2515816320915696","DOIUrl":"https://doi.org/10.1177/2515816320915696","url":null,"abstract":"The management of external cold-stimulus headache has previously focused on trigger avoidance, which can be an impractical and sometimes impossible solution. We describe the case of a 20-year-old woman who presented with a typical example of external cold-stimulus headache, and in whom a preventive regime of naproxen taken 30 min prior to cold exposure was associated with reliable prevention of cold-induced headache symptoms. This could be an effective strategy for managing patients with cold-stimulus headache for whom cold triggers cannot be avoided.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320915696","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46096031","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}
D. Kudrow, S. Munjal, Leah Bensimon, T. Lokhandwala, B. Yue, Anna D. Coutinho, S. Silberstein
{"title":"Treatment patterns of patients diagnosed with major headache disorders: A retrospective claims analysis","authors":"D. Kudrow, S. Munjal, Leah Bensimon, T. Lokhandwala, B. Yue, Anna D. Coutinho, S. Silberstein","doi":"10.1177/2515816320913992","DOIUrl":"https://doi.org/10.1177/2515816320913992","url":null,"abstract":"Objective: To describe patient characteristics, treatment patterns, and health care costs among patients diagnosed with major headache disorders overall and by type (tension-type headache [TTH], migraine, cluster headache [CH], or >1 primary headache type), and secondarily to evaluate drug treatment patterns among triptan initiators with a major headache diagnosis. Methods: Using US claims data from January 2012 through December 2017, we identified adults with evidence of a major headache disorder: TTH, migraine, or CH; the first diagnosis date was deemed the index date. To evaluate triptan use specifically, patients who initiated triptans were identified; the first triptan claim date was deemed the index date. Patient characteristics, treatment patterns (concomitant treatments, adherence, number of fills), and annual health care costs data were obtained. Results: Of the 418,779 patients diagnosed with major headache disorders, the following 4 cohorts were created: TTH (8%), migraine (87%), CH (1%), and >1 primary headache type (4%). The majority used analgesic (54–73%) and psychotropic (57–81%) drugs, primarily opioids (36–53%). Headache-related costs accounted for one-fifth of all-cause costs. Of the 229,946 patients who initiated triptans, the following 7 study cohorts were analyzed: sumatriptan (68%), rizatriptan (21%), eletriptan (5%), zolmitriptan (3%), naratriptan (2%), frovatriptan (1%), and almotriptan (<1%). The major concomitant analgesic medication classes were opioids (41%) and nonsteroidal anti-inflammatory drugs (34%). Conclusion: The primary headache disorder treatment paradigm is complex, with significant variability. Predominant concomitant use of opioids and switching to opioids is of concern, necessitating solutions to minimize opioid use. Switching to non-oral/fast-acting or targeted preventive therapies should be considered.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320913992","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46246552","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":"A triad of cluster-like headaches with delayed development of a macroscopic prolactinoma: A case report","authors":"Stephanie A Ihezie, M. Chandalia, Mark J. Burish","doi":"10.1177/2515816320911032","DOIUrl":"https://doi.org/10.1177/2515816320911032","url":null,"abstract":"Pituitary hormone testing is recommended in refractory cluster headache (CH), but supporting evidence is limited. We present a patient with cluster-like headaches and a negative brain magnetic resonance imaging (MRI) 1 year after headache onset. He failed multiple medication trials. Three years after headache onset, additional workup showed abnormal pituitary labs including hyperprolactinemia and a brain MRI with a 15 × 15 × 14 mm3 enhancing pituitary lesion. With cabergoline 0.25 mg twice weekly, the patient has been headache-free for over 2 years. This case supports the recommendations for pituitary testing in refractory CH, even if imaging is initially negative for a pituitary tumor.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320911032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45474522","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}
A. Nagai, Daiki Tanaka, K. Kuroshima, S. Ura, Kazuto Yoshida, Yuji Takahashi, I. Yabe
{"title":"Neurovascular changes in magnetic resonance imagining and single-photon emission computed tomography during migraine attack in patients with FHM2 mutations","authors":"A. Nagai, Daiki Tanaka, K. Kuroshima, S. Ura, Kazuto Yoshida, Yuji Takahashi, I. Yabe","doi":"10.1177/2515816320908642","DOIUrl":"https://doi.org/10.1177/2515816320908642","url":null,"abstract":"The aim of this article is to provide neuroimaging data on cases with familial hemiplegic migraine (FHM). A 14-year-old male presented normal diffusion-weighted magnetic resonance imaging (DWI) and fluid-attenuated inversion recovery (FLAIR) findings during his first hemiplegic migraine attack. However, magnetic resonance angiography (MRA) showed diffuse narrowing of the right middle cerebral artery. Cerebral blood flow–single-photon emission computed tomography showed right hypoperfusion. A follow-up study showed no abnormal findings. His mother had normal DWI, FLAIR, and MRA findings during her migraine attack. Both patients were diagnosed with FHM2 (p.R763H mutation in ATP1A2). This study highlights the importance of neurovascular examinations during the FHM2 headache phase. Further cases are required to clarify the pathophysiology of migraine.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320908642","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45145110","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}
J. J. Ong, Devanshi Patnaik, Y. Chan, Oliver Simon, E. Finkelstein
{"title":"Economic burden of migraine in Singapore","authors":"J. J. Ong, Devanshi Patnaik, Y. Chan, Oliver Simon, E. Finkelstein","doi":"10.1177/2515816320908241","DOIUrl":"https://doi.org/10.1177/2515816320908241","url":null,"abstract":"Objective: Despite the high prevalence and disabling nature of migraine, studies evaluating its economic burden in Singapore remain scant. This study aims to quantify the per capita and aggregate economic cost of episodic migraine (EM; ≤14 monthly headache days) without aura among full-time employees in Singapore. Methods: We administered a cross-sectional online survey to full-time employees in Singapore who met the International Classification of Headache Disorders (third edition, 2018) criteria for EM without aura. Eligible participants were classified by the frequency of monthly migraine days (MMDs): lower end episodic migraine (LEM; ≤3 MMDs) and upper end episodic migraine (UEM; 4–14 MMDs). The survey captured per capita healthcare resource utilization and lost work productivity (absenteeism and presenteeism) for each subgroup. Healthcare costs were obtained by multiplying unit costs by healthcare utilization. Finally, per capita (patient) costs of each subgroup were then imputed and multiplied by prevalence data to quantify the aggregate burden of migraine in Singapore. Results: Of the 606 participants who completed the survey, 81% experienced ≤3 MMDs. Total annual per capita costs were SGD4925 (USD 3620; 95% confidence interval (CI): SGD 4438–5411) and SGD14,476 (USD 10,639; 95% CI: SGD 11,908–17,045) for the LEM and UEM subgroup, respectively. Healthcare costs on average accounted for 17.6% of per capita costs, of which was driven primarily by diagnostic tests (33.6%), followed by consultations (17.1%), medications (16.7%), alternative medications (16.6%) and hospitalizations (14.8%). Lost productivity accounted for 82.4% of costs, chiefly attributable to absenteeism in the LEM group (38.2%), followed by presenteeism in the UEM group (26.0%), absenteeism in the UEM group (18.8%) and presenteeism in the LEM group (17.1%). The total cost to Singapore for EM in 2018 was approximately SGD 1 billion (USD 0.75 billion; SGD 1.00 = USD 0.74). Conclusion: Overall, EM imposes a substantial economic burden on society in Singapore. Total migraine cost per capita is greater in the UEM (4–14 MMDs) as compared to the LEM subgroup. Majority of the overall costs result from missed workdays and lost work productivity. Future research should determine the extent to which optimized migraine treatments could improve productivity, and by extension, mitigate the staggering costs of this disorder.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320908241","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45826463","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}
Chi-Chung Li, J. Palcza, Jialin Xu, B. Thornton, Wendy Ankrom, Abhijeet S. Jakate, E. Marcantonio
{"title":"The effect of multiple doses of ubrogepant on the pharmacokinetics of an oral contraceptive in healthy women: Results of an open-label, single-center, two-period, fixed-sequence study","authors":"Chi-Chung Li, J. Palcza, Jialin Xu, B. Thornton, Wendy Ankrom, Abhijeet S. Jakate, E. Marcantonio","doi":"10.1177/2515816320905082","DOIUrl":"https://doi.org/10.1177/2515816320905082","url":null,"abstract":"Background: Ubrogepant is a novel, oral calcitonin gene–related peptide receptor antagonist for acute treatment of migraine. This study evaluated potential drug–drug interactions between ubrogepant and an oral contraceptive containing ethinyl estradiol (EE) and norgestimate (NGM). Methods: This open-label, single-center, two-period, fixed-sequence study enrolled healthy, postmenopausal or oophorectomized, adult women. In period 1, participants received a single oral dose of EE 0.035 mg/NGM 0.25 mg (EE-NGM) followed by a 7-day washout. In period 2, participants received oral ubrogepant 50 mg daily on days 1–14; single-dose EE-NGM was coadministered with ubrogepant on day 10. Pharmacokinetic parameters for plasma EE and norelgestromin (NGMN) were compared with and without ubrogepant. Results: Twenty-two participants aged 46–66 years were enrolled; 21 completed the study. Geometric mean ratios and 90% confidence intervals for the comparison of EE-NGM + ubrogepant to EE-NGM alone were contained within 0.80 and 1.25 for area under the plasma drug concentration–time curve (AUC) from time zero to infinity (AUC0–∞; 0.96 [0.91, 1.01]) and C max (0.91 [0.82, 1.004]) of NGMN and AUC0–∞ (0.97 [0.93, 1.01]) of EE, but not C max of EE (0.74 [0.69, 0.79]). Median t max of EE was delayed following EE-NGM + ubrogepant (3.0 h) versus EE-NGM alone (median of 1.5 h), whereas median t max of NGMN was unchanged (1.5 h). Geometric mean apparent terminal half-life (t ½) was similar with and without ubrogepant for EE (23 vs. 21 h) and NGMN (36 h both conditions). All ubrogepant-related adverse events were mild or moderate. Conclusion: Ubrogepant did not demonstrate potential for clinically meaningful drug–drug interactions with an EE-NGM oral contraceptive. Trial registration: Not applicable (phase 1 trial)","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320905082","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49032726","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":"Headache highlights 2019: Junior editors’ choice","authors":"K. Peng, Shih-Pin Chen, L. S. Gudmundsson","doi":"10.1177/2515816320903292","DOIUrl":"https://doi.org/10.1177/2515816320903292","url":null,"abstract":"In the year 2019 in research on headache disorders, migraine remains the focus of attention as the antibodies against calcitonin gene-related peptide (CGRP) and its receptor have become available in several countries along with the publication of phase 3 clinical trials of the newer generation oral CGRP receptor antagonists. Aside from the overshadowing CGRP research, several other interesting studies have been published. Herewith, we provide an overview of the publications that, in our opinion, contribute greatly to the understanding and treatment of headache disorders. Of note, the selection for the list is subjective and does not include all research works in the year of 2019 worthy of mention. We hope that our selection serves as a short summary and a catalyst to increase the interests of headache researchers. In the current editorial, we will discuss preclinical and clinical studies, which provide a better understanding of the disease mechanisms or a potential to future treatment targets.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816320903292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41933708","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}
H. Deng, Qiushi Wang, D. P. Turner, Katherine E Sexton, S. Burns, M. Eikermann, Dianbo Liu, Dan Cheng, T. Houle
{"title":"Sentiment analysis of real-world migraine tweets for population research","authors":"H. Deng, Qiushi Wang, D. P. Turner, Katherine E Sexton, S. Burns, M. Eikermann, Dianbo Liu, Dan Cheng, T. Houle","doi":"10.1177/2515816319898867","DOIUrl":"https://doi.org/10.1177/2515816319898867","url":null,"abstract":"Background: Migraine is a highly prevalent disorder that is typically episodic in nature. Social network data reflecting personal commentary on everyday life patterns, including those interrupted by migraine, represent a unique window into the real-life experience of those willing to share them. The experience of a migraine attack might be captured by twitter text data, and this information might be used to complement our current knowledge of activity in the general population and even lead to enhanced prediction. Objective: To characterize tweets reporting migraine activity and to explore their social-behavior features as foundation for further investigations. Methods: A longitudinal cohort study utilizing 1 month of Twitter data from November to December 2014 was conducted. Tweets containing the word “migraine” were extracted, preprocessed, and managed using natural language processing (NLP) techniques. User behavior profiles including tweeting frequencies, high-frequency words, and sentimental presentations were reported and analyzed. Results: During the observation period, 98,622 tweets were captured from 77,335 different users. The overall sentiment of tweets was slightly negative for expressive tweets but neutral for informative tweets. Among posted negative expressive tweets, we found a strong tendency that high-frequent expressions were those with the extreme sentiment, and profanity was common. Conclusions: Twitter users with migraine showed distinct sentimental patterns while suffering from disease onsets exemplified by posting tweets with extreme negative sentiments.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816319898867","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44803534","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":"An unsuspected and unrecognized cause of medication overuse headache in a chronic migraineur—essential oil-related medication overuse headache: A case report","authors":"T. Mathew, S. John","doi":"10.1177/2515816319897054","DOIUrl":"https://doi.org/10.1177/2515816319897054","url":null,"abstract":"Essential oils are widely used by people for common ailments like headache and backache. We report a case of chronic daily headache in an adolescent migraineur refractory to most antimigraine drugs secondary to topical application of essential oils containing camphor and eucalyptus. A 14-year-old boy presented with chronic daily headache of 1-year duration, refractory to four antimigraine drugs including valproate and topiramate. He was daily applying a balm called Amruthanjan (10% camphor and 14.5% eucalyptus) on his forehead to relieve headache. Patient had complete relief of headache in 2 weeks after stopping the balm application. All his antimigraine drugs were tapered and stopped over a period of 3 months. At 1-year follow-up, he is headache free. Brain-stimulant essential oils of camphor and eucalyptus may be an important unrecognized cause of medication overuse headache.","PeriodicalId":9702,"journal":{"name":"Cephalalgia Reports","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2515816319897054","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43212801","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}