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Migraine Headaches
Published in Alexander R. Toftness, Incredible Consequences of Brain Injury, 2023
The aura is a phase of the migraine that consists of symptoms other than pain that usually show up just before the headache itself (Russell & Olesen, 1996). The three major types of aura symptoms are visual, sensory, and aphasic, and a person can experience more than one type (Eriksen et al., 2004).
Neurologic disorders in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Robert Burger, Terry Rolan, David Lardizabal, Upinder Dhand, Aarti Sarwal, Pradeep Sahota
Migraine headaches are usually a moderate or severe unilateral or bilateral throbbing or pulsating headache with associated increased sensitivity to light, noise, or physical movement and may be accompanied by nausea and vomiting. Migraine pain also commonly involves the neck and medial shoulders in addition to the head. The usual duration of a migraine headache is 4 to 72 hours. Up to 25% of migraine headaches may be preceded or accompanied by an aura. The aura is due to neuronal dysfunction that is thought to move through the cortex and is accompanied by decreased regional blood flow (1).
Epilepsy and Driving
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
A. James Rowan, Daniel Luciano, H. Richard Beresford
Zielinski (6) reported that many patients did not suspect that the transient symptoms of an aura were epileptic in nature. This is a point to be explored with patients experiencing such phenomena. Auras appear to be fairly stable with time. Of 51 patients with auras followed by Kuhl et al. (7), only one reported disappearance of this phenomenon. The authors point out that the duration of an aura was not always sufficient to bring the patient to safety prior to loss of consciousness. Fountain et al. (8) have proposed that patients with stable prolonged auras be given special consideration in licensing regulations despite the fact that they are not, by definition, seizure-free. In Switzerland, driving regulations are stated not to differ in the case of patients experiencing auras (9). In those patients who experience only auras without subsequent development of further convulsive activity, an argument can be made for limited driving licensure after it has been demonstrated that there is no unsuspected alteration in consciousness (10).
Phonophobia and migraine features in patients with definite meniere’s disease: Pentad or triad/tetrad?
Published in Acta Oto-Laryngologica, 2020
Alia Saberi, Shadman Nemati, Tina Taherzadeh Amlashi, Sepehr Tohidi, Fataneh Bakhshi
Another disease that is relatively common and occurs more often in women is migraine. The main symptom of migraine attacks is headache, which may take a few hours to 2 to 3 days, and often is intense, pulsating and one-sided [3,4]. Other symptoms include nausea, vomiting, intolerance to light, smell and sound (i.e. photophobia, osmophobia and phonophobia), neck pain and muscle tension [4]. Migraine is classified as with or without aura. Aura is a neurological deficit that occurs before migraine headaches and usually lasts 20–30 min, but may continue during or even after headaches. One type of migraine is migraine without headache (migraine variant), and in other types, such as basilar migraine, some clinical symptoms such as dizziness, tinnitus, deafness and occipital headaches may be present [4,5]. Some of the symptoms of migraine are similar with MD, especially in severe migraine associated with aura and vestibular symptoms [5,6]. On the other hand, phonophobia (frequent in migraine [7]) is a common symptom in many types of labirynthitis including MD, but it seems to be neglected in these patients, perhaps for its lower significance compared with other symptoms of MD, such as vertigo or hearing loss. Migraine has different clinical presentations, with typical and atypical features, especially in head and neck region, which mandates otolaryngologists being more familiar with these different features [8].
Targeting CGRP for migraine treatment: mechanisms, antibodies, small molecules, perspectives
Published in Expert Review of Neurotherapeutics, 2020
Eleonora De Matteis, Martina Guglielmetti, Raffaele Ornello, Valerio Spuntarelli, Paolo Martelletti, Simona Sacco
The novel drugs acting on the CGRP pathway will provide new insights in the current understanding of migraine mechanisms and aura genesis. The RCTs, testing the efficacy and safety of MoAbs, enrolled also patients suffering from migraine with aura, thus extending the benefits of the drugs also to this subgroup of patients. At present, there are no clinical studies describing possible modifications of aura in patients treated with drugs targeting the CGRP pathway. Based on the central mechanisms causing the aura, these drugs are expected to be effective on the sole headache. Therefore, it can be theoretically predicted that patients treated with preventive treatments acting on the CGRP pathway may experience episodes of aura without migraine. So far, this possible phenomenon has not been observed and reported, subsequently, we can speculate that these drugs may also prevent aura occurrence. This idea is supported by preclinical studies, which demonstrated the CGRP involvement in the cortical spreading depression, a key pathogenetic step in migraine with aura [98,99]. However, real-life data are needed to demonstrate the action of anti-CGRP treatments on this type of migraine and to provide deeper understanding of connections between central and peripheral systems involved in the disease.
Associations between adherence to dietary approaches to stop hypertension (DASH) diet and migraine headache severity and duration among women
Published in Nutritional Neuroscience, 2020
Atieh Mirzababaei, Faezeh Khorsha, Mansoureh Togha, Mir Saeed Yekaninejad, Ali Asghar Okhovat, Khadijeh Mirzaei
Episodic migraine diagnosis was performed by a neurologist, based on the ICHD3 criteria.22 Criteria for episodic migraine diagnosis include two types of migraine, with aura and without aura. The diagnosis of migraine without aura, according to the IHS, can be made according to the following criteria: five or more attacks, for a duration of 4–72 hours; the headache should have two or more of the following characteristics: unilateral, pulsating, moderate or severe pain intensity, worsened by or causing avoidance of routine PA; and one or more of the following: nausea and/or vomiting; sensitivity to both light (photophobia) and sound (phonophobia). The properties of migraine with aura are typical (with or without headache), migraine with brainstem aura (MBA), hemiplegic, and retinal. MBA is a type of migraine headache with aura that is associated with pain at the back of the head on both sides. An aura is a group of symptoms that generally serve as a warning sign that a bad headache is coming. Auras may consist of dizziness and vertigo, slurred speech, ataxia, tinnitus, visual changes, and/or loss of balance; this diagnosis was performed by a neurologist.23