Migraine

IRVINE, Calif.-- Methamphetamine users may develop carotid artery dissections, leading to a severe stroke, an effect also seen in cocaine users, according to researchers here.

We describe a rare case in which chest pain and subcutaneous emphysema developed while the patient was undergoing routine dental extractions under local anesthesia and inhaled nitrous oxide. The patient was found to have extensive pneumomediastinum on a CT scan of the chest. The patient received supportive care and 24-hour high-flow oxygen (100%) and was discharged the next day without any residual symptoms. At a 10-day follow-up visit, neck and chest radiographs revealed no further subcutaneous emphysema.

A 49-year-old man presents with recurring facial pain of 6 months' duration. The pain initially occurred several times per week; it now occurs as often as several times per day. The paroxysmal pain is intense and incapacitating but abates within several minutes. It occurs in the right maxillary region and lower jaw and is sharp and lancinating. Hard chewing and teeth cleaning are the usual precipitating events. Between episodes, the patient is asymptomatic, without numbness or deficit in the affected region.

HYATTSVILLE, Md. -- Persistent pain is remarkably prevalent in America, according to a CDC report. Pain from lower backs, knees, and migraine stood out from the rest.

Although it has been evident since the early days of the HIV epidemic that a dementing illness often accompanies HIV infection and that the virus invades the nervous system soon after systemic infection, the clinical syndrome has evolved with the introduction of antiretroviral therapy.

PALERMO, Italy -- It may take 10 to 20 years, but as children and teenagers reach adulthood, migraine headaches often disappear, alter, or become less severe, researchers here reported.

A 37-year-old woman complains of frequent, severe headaches. She describes the pain as a pressure-like feeling that is usually located at the top of her head and occasionally spreads to one of her temples; she rates its intensity as 9 on a 10-point visual analog scale. The pain becomes throbbing when she tries to engage in any kind of physical activity.

BOSTON -- When a diagnosis of irritable bowel syndrome comes to mind, consider migraine, fibromyalgia, and depression as well.

Hepatomegaly is detected during the routine physical examination of a healthy 40-year-old woman who is employed as a secretary. She has noticed some fullness in the right upper abdomen for many years, but it has not been accompanied by pain or GI symptoms.

The patient is a 47-year-old white woman with frequent, intensely painful unilateral or bilateral headaches that occur behind her left eye or temporal area. These headaches cause throbbing pain that lasts about 40 to 50 minutes: the patient rates the pain severity as a 7 or 8 on a 10-point visual analog scale.

Hepatomegaly is detected during the routine physical examination of a healthy 40-year-old woman. She has noticed some fullness in the right upper abdomen for many years, but it has not been accompanied by pain or GI symptoms.

You have been treating a 28-year-old woman for migraine for the past 4 years. This morning, after reading the headlines about the potential risks of mixing triptans with triptans , she calls your office to ask whether she should stop taking her antidepressant.

ROCKVILLE, Md. -- Mixing common migraine drugs such as Imitrex (sumatriptan) with antidepressants like Prozac (fluoxetine) or Cymbalta (duloxetine) can trigger a life-threatening condition called serotonin-syndrome, the FDA has warned.

Pregnancy, childbirth, and the puerperium are the times when women are at greatest risk for stroke. Women in their childbearing years are at a greater risk for stroke than men of the same age.

LOS ANGELES ? Migraine related to menstruation may be exacerbated by hormonal birth control measures, with more use of analgesics and more recurrences, researchers said here.

LOS ANGELES - Sleeping well, plus behavioral modification techniques, may be a start toward relieving the chronic, daily headaches called transformed migraine, researchers said here.

LOS ANGELES ? Children with headaches are more likely to be overweight or obese, researchers said here.

LOS ANGELES - During the last three months of their tours of duty in Iraq, U.S. soldiers were prone to twice as many migraines as the general population, according to army researchers.

LOS ANGELES - Patients can sense a migraine coming on even before it strikes, and they are almost always on target, even if the diagnostic symptoms they use differ from clinicians' criteria, researchers said here.

LOS ANGELES - If all else fails individually, throw the kitchen sink at some patients with migraine, recommends an Ohio investigator.

LOS ANGELES, June 26 - An anti-seizure agent can reduce the frequency of chronic migraine events, according to a researchers here.

LOS ANGELES ? When applied during the aura phase of migraine, two pulses from an investigational transcranial magnetic stimulator reduced some symptoms in 69% of patients, according to a pilot study reported here.

A 15-year-old boy complains of moderate to severe headaches that occur daily and usually last all day; the pain typically worsens toward the end of the day. How will you help this patient?

Syncope is defined as a sudden, brief loss of consciousness and postural tone followed by spontaneous complete recovery. It accounts for 3% of emergency department visits and 1% of hospital admissions.

Osteoporosis is no longer consideredage- or sex-dependent, although prevalencevaries by sex and race. Postmenopausalwhite women suffer almost75% of all hip fractures and havethe highest age-adjusted rate of fracture.Thanks to progress in our understandingof causes and treatments, thisdisease is largely preventable, and significantimprovements in morbidityand mortality are possible. The beststrategy for prevention and treatmentuses a team approach that involves thepatient, physician, health educators, dietitians,and physical therapists.

The patient presented with left-sided, throbbing headaches that had gradually increased in severity and frequency. These headaches, which occurred once or twice a month, were associated with photophobia, phonophobia, and nausea, and usually lasted 8 to 12 hours. The headaches affected the patient's job performance and attendance, and she complained of fatigue, lack of sleep, and difficulty in concentrating.

A 36-year-old man with a 15-year history of episodic migraine presents to the emergency department (ED) at 5 AM witha right-sided throbbing headache of 4 hours' duration. The headache awakened him, which is typical of his more severemigraine attacks. Unfortunately, the patient forgot to refill his prescription for pain medication and did not "catch" thisheadache in time. He took an over-the-counter combination of aspirin and caffeine, which seemed to help for about 60minutes, but the headache has returned full force. He has vomited twice-another characteristic typical of his migraineattacks

I suspect that my patient has hereditary angioedema (HAE). During her lastpregnancy 2 years earlier, she had severe preeclampsia.

This is a difficult question, because most "sinus headaches" are migraines.1-3 In fact, there is no such thing as a sinus headache. The International Headache Society (IHS) defines a headache attributable to rhinosinusitis according to the criteria listed in Table 1.4 This requires a diagnosis of acute rhinosinusitis and a headache that occurs at the same time.

What are the current recommendations for hormonal contraception (eg, oralcontraceptives, medroxyprogesterone injections) in patients with migraine?