Top PDF Aspirin and tension-type headache

Aspirin and tension-type headache

Aspirin and tension-type headache

choice. Extensive literature exists regarding both its effi- cacy and safety. Different dosages, formulations and asso- ciations with other drugs have been investigated in vari- ous randomised, double-blind, placebo-controlled studies. Compared to placebo, Aspirin was more effective in reducing headache from severe to mild or in achieving pain relief 1 h after administration [44]. A range of ASA dosages between 650 and 1000 mg proved to be consid- erably more successful for pain reduction than placebo [45]. No statistically significant differences were found between Aspirin and placebo for nausea, vomiting or phonophobia, except in a study conduced by MacGregor et al. [46]. Aspirin’s tablet and effervescent versions dis- played the same efficacy in this study.
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Acute pharmacotherapy of migraine, tension-type headache, and cluster headache

Acute pharmacotherapy of migraine, tension-type headache, and cluster headache

Head-to-head comparisons of triptans with other drugs are shown in Table 2. The 3 oral triptans, sumatriptan, rizatriptan and eletriptan, were superior to oral ergota- mine. In contrast, rectal ergotamine 2 mg (73% relief) was superior to rectal sumatriptan 25 mg [11]. Sumatriptan 100 mg (75%) was superior to tolfenamic acid (58%) for headache relief [17]. Highly buffered aspirin, aspirin plus metoclopramide, and lysine acetylsalicylic acid plus metoclopramide were comparable to sumatriptan 50 mg and 100 mg [11]. Diclofenac potassium was comparable Table 1 Mean TG a for different triptans and forms of administration based on published papers and abstracts (for references and number
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Prevalence of migraine and tension-type headache among adults in Jordan

Prevalence of migraine and tension-type headache among adults in Jordan

Only 17.3% of participants sought medical care for their headaches. This represents 49.7% of migrainers and 15.5% of participants with tension-type headache. Participants who used analgesics on a daily basis accounted for 15.2%. The percentage of participants using analgesics on a weekly basis was 24.5%, less than monthly but more than weekly was 24.8%, monthly usage was 22.5%, and the percentage of participants who never use a analgesics was 14.6%. Participants who used analgesics on the advice of a physician were 15.3%, while those who used analgesics on a pharmacist advice compromised 13.6%. Those who used analgesics based on the experience of a family member or others were 34.8 and 47.4%, respectively (Table 4). In addition, 13.1% of participants complained of increased headache severity or frequency on medication use. Results also revealed that 22.0% of participants had increased their analgesic dose and 78.0% did not change their regimen. The most frequently used analgesic among participants was acetaminophen (78.00%), and to a lesser extent ibuprofen (7.49%) and aspirin (5.58%) (Table 5).
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Greater occipital nerve blockade in migraine, tension-type headache and cervicogenic headache

Greater occipital nerve blockade in migraine, tension-type headache and cervicogenic headache

In the light of these studies, we know that if there is ten- derness and irritation in the GON area it may be relieved by its blockade. On the other hand, the effectiveness of GON blockade is still obscure since previous reports were not placebo-controlled, double-blind and randomised. In this study, we investigated the value and diagnostic importance of GON blockade in the CH, MWOA and TTH groups. However, some authors have used GON blockade during headache and between attacks. Thus, we believe that this study will contribute to the clarification of this problem.
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Self-reported efficacy of complementary and alternative medicine: the Akershus study of chronic headache

Self-reported efficacy of complementary and alternative medicine: the Akershus study of chronic headache

The placebo response in the management of headache is approximately 30% in both pharmacological and non- pharmacological clinical trials [18,19]. The self-reported efficacy of CAM in our study is only slightly higher than the placebo effect. The efficacy of acupuncture was bet- ter in those with chronic tension-type headache (CTTH) and co-occurrence of migraine than in CTTH without co-occurrence of migraine. Otherwise we found no significant differences in the CAM efficacy. A recent Cochrane review of acupuncture for migraine prophy- laxis [20] and a meta-analysis of manual therapies for migraine and cervicogenic headache shows it is likely to be as effective as prophylactic medication for migraine [21,22]. Thus, CAM might have an effect in some types of headaches.
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Tension–type headache in 40–year-olds: a Danish population–based sample of 4000

Tension–type headache in 40–year-olds: a Danish population–based sample of 4000

No tension-type headache was significantly more frequent among those without than those with self-reported migraine. This effect could not be demonstrated in a sub- set of the data based on clinical interviews by a physician including 197 men and 145 women with migraine without aura, 95 men and 68 women with migraine with aura and 68 men and 54 women whom had never had migraine [20]. Although the present study is based on a question- naire, which is less precise than a clinical interview by a physician, the different evaluations showed that the ques- tionnaire is sufficiently precise. The high number of par- ticipants in the present study combined with the validity of the questionnaire makes the data robust. Thus, it seems that migraine makes it more likely for a person to experi- ence tension-type headache. Infrequent episodic tension- type headache was significantly more frequent among those without than those with self-reported migraine,
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The evaluation of sexual dysfunction in male patients with migraine and tension type headache

The evaluation of sexual dysfunction in male patients with migraine and tension type headache

The mean age of the patients was 34.96 ± 1.30 year, 35.54 ± 1.52 year and 32.26 ± 1.38 year for group M, group T and group C, respectively. There was no statis- tical significant difference in age distribution (p = 0,22). The average number of days with headache per month was 4.06 ± 3.35 in Group M and 3.36 ± 2.28 in group T. Mean BMI of group M, group T and group C were 24.68 ± 0.56, 27.06 ± 0.79, 25.85 ± 0.49 respectively. Total testosterone levels were 4.82 ± 0.37 in group M, 4.51 ± 0.34 in group T and 4.59 ± 0.30 in group C and there was no statistical difference between groups (Table 1). Mean IIEF scores was 19.83 ± 2.2, 20.39 ± 1.35 and 27.83 ± 0.34 in groups M,T, C. When M and T groups were compared with group C, there were significant differ- ences between T and M groups and group C, but there was no statistical difference when T and M groups were compared to each other (Table 1). When TSH, T3, T4 and testosterone levels were compared between groups, we identified no significant difference. There was a nega- tive correlation between age and IIEF. We found no cor- relation with headache duration, testosterone level in M and T groups.
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Treatment of migraine and tension-type headache in Croatia

Treatment of migraine and tension-type headache in Croatia

Health care systems must aim to satisfactorily manage the majority of M patients by primary care physicians [21], and more severe cases should have easy access to neurologists, preferably headache specialists. Results of our study regarding treatment patterns of primary headaches in Croatia are similar to other countries worldwide, with certain differences. Current health care laws in Croatia probably influence the treatment of M sufferers. We believe that current health care policies in Croatia regard- ing headache management should be revised to offer an easier approach; patients with headache should be encouraged to visit physicians more regularly, and public information should be more accessible. Such activities are under way, and in near future we expect improvement in headache care in Croatia. We hope that the results of our study will help to improve the management of primary headaches in Croatia.
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Insomnia in tension-type headache: a population-based study

Insomnia in tension-type headache: a population-based study

Insomnia is a relatively common condition, affecting 10–30% of the general population [5]. Individuals with in- somnia tend to exhibit limited functional capacity and de- creased quality of life due to a variety of symptoms, including headaches [6, 7]. Cross-sectional studies have revealed that individuals with headaches exhibit increased odds ratios (ORs) for insomnia relative to those for indi- viduals without headache [8, 9]. Additional research has indicated that the prevalence of insomnia is higher in pa- tients with TTH than in individuals without headache [10]. Longitudinal studies have demonstrated that patients with migraine (OR =1.7) and non-migraineous headache (OR =1.4) are at increased risk for insomnia at the 11-year follow-up. Furthermore, individuals with insomnia exhib- ited an increased risk for TTH (relative risk [RR] = 1.4) and migraine (RR =1.4) at the 11-year follow-up [11, 12]. Several clinical studies have demonstrated an association between insomnia and exacerbation of TTH symptoms [13, 14]. Nevertheless, information regarding the impact of insomnia on the clinical presentation of TTH in a population-based setting is limited. We hypothesised that, among individuals with TTH, those with insomnia experi- ence more severe symptoms than those without insomnia. Therefore, the objectives of the present study were as fol- lows: 1) to evaluate the prevalence of insomnia and TTH in a general population-based sample, 2) to assess clinical characteristics and comorbidities of TTH according to the presence of insomnia, and 3) to investigate the association between TTH and insomnia including covariates such as sociodemographic factors, sleep time, sleep quality, and psychiatric comorbidities.
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Clinical and Radiological Profile of Chronic Headache

Clinical and Radiological Profile of Chronic Headache

The most common cause of generalized persistent headache, both in adolescents and adults, is depression or anxiety in one of its several forms. The authors have also noted that many seriously ill psychiatric patients complain of frequent headaches that are not typically of the tension type. These patients report unilateral or generalized throbbing cephalic pain lasting for hours every day or two. The nature of these headaches, which in some instances resemble common migraine, is unsettled. Others have delusional symptoms involving physical distortion of cranial structures. As the psychiatric symptoms subside, the headaches usually disappear.
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Tension-type headache and sleep apnea in the general population

Tension-type headache and sleep apnea in the general population

The relatively low participation rate may introduce a selection bias. However, participants and non-participants were not significantly different regarding self reported headache, depression, gender or age. Regarding the dif- ference between the participants and the study population, we found that self reported simple snoring was somewhat overrepresented in the low risk group in the study sample as compared to the low risk respondents of the question- naire. If there is a relationship between snoring and head- ache, this may have introduced a misclassification bias resulting in a slight overestimation of headache in partic- ipants without obstructive sleep apnea in our study [29, 35]. This will not, however, influence our finding that tension-type headache and the AHI was not significantly related. As with most studies, a larger sample may have demonstrated greater precision of the results. Since this was an epidemiologic study of the general population, the amount of participants with chronic tension-type headache was small. This requires a more cautious interpretation of the statistical findings regarding chronic tension-type headache, since we cannot exclude a type-2 error due to the small numbers. Finally, it cannot be completely ruled out that the use of single in-patient PSG may be a potential limitation to our study [36]. Although the mean total sleep time in this sample was 409.6 min, which may represent a first night effect, we believe the latter is more important in measuring of the sleep quality than in diagnosing of obstructive sleep apnea.
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Functional Assessment in Greek Tension-Type Headache Sufferers: Validity, Reliability, Responsiveness and Psychometrics of the Migraine Disability Assessment Questionnaire (MIDAS)

Functional Assessment in Greek Tension-Type Headache Sufferers: Validity, Reliability, Responsiveness and Psychometrics of the Migraine Disability Assessment Questionnaire (MIDAS)

Short-term test–retest reliability was estimated on a subgroup of 39 headache patients randomly selected from the initial sample. The questionnaire was administered to the patients for the first time (t1) during their initial visit to the clinic. A repeat administration (t2) after 7 days and before first treatment session (without any active treatment in-between) was chosen in order to minimise clinical or cognitive changes but also to reduce any chance recall of previous answers. Responsiveness was examined for the MIDAS- GR after the implementation of a behaviourally oriented physical therapy/acupuncture program, in a subgroup of 22 subjects (t3). The physiotherapy approach was not structured and included any approach selected by the therapists (e.g. electrotherapy, deep friction massage, acupuncture, myofascial release techniques, etc.). Construct validity was assessed in the form
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Genetic factors in migraine and chronic tension-type headache

Genetic factors in migraine and chronic tension-type headache

demiological surveys [9, 14, 15, 29]. All the studies except the American [15] showed an increased risk of MA among first-degree relatives. The family members of the American study were only asked about their most severe type of headache by a lay interviewer [15]. The diagnosis of MA does not require specific headache characteristics [19]. However, the American study changed the diagnostic crite- ria, so that the headache characteristics were similar to those of MO. This may have causes an underestimation of MA since the headache in that type is often less severe than it is in MO [8, 10]. Furthermore, for an unerring diagnosis inter- views by physicians are preferred. Thus, the American sur- vey seems inconclusive. The Greek [29] and Italian [14] studies were based on clinic populations, which may have caused bias [12]. The Danish genetic epidemiological sur- vey [9] found that, compared with the general population, first-degree relatives of probands with MA had a 3.8-fold increased risk of MO, while spouses of probands had no increased risk of MA [9].
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Myofascial trigger points in migraine and tension-type headache

Myofascial trigger points in migraine and tension-type headache

Interventions targeted at MTrPs show promising re- sults [50–52, 56, 57], but the quality of studies varies greatly and lack placebo-control. Giambierardino et al. demonstrated that local anesthetic infiltration of MTrPs resulted in a reduction of migraine symptomatology in terms of frequency and intensity [52]. Furthermore, there was a reduction of hyperalgesia, not only at the in- jection site but also in referred areas overlapping with migraine pain sites. Similar, Ranoux et al. injected botu- linum toxin in MTrPs with similar results in terms of re- duction in headache days [56]. Gandolfi et al. improved the outcome of prophylactic botulinum toxin treatment in chronic migraine patients with manipulative treat- ment of MTrPs [50]. The outcome was a lower con- sumption of analgesics, improvement in pressure pain threshold and increased cervical range of motion. Like- wise, Ghanbari et al. reported that combined positional release therapy targeted at MTrPs with medical therapy is more effective than the sole pharmacological treat- ment [51]. Interestingly, sessions of magnetic stimulation
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The best from East and West? Acupuncture and medical training therapy as monotherapies or in combination for adult patients with episodic and chronic tension type headache: study protocol for a randomized controlled trial

The best from East and West? Acupuncture and medical training therapy as monotherapies or in combination for adult patients with episodic and chronic tension type headache: study protocol for a randomized controlled trial

Using a video recording of a patient’s pain body language (their pain gestures), their pain will be assessed before (T0) and 6 weeks after the intervention (T3). In addition to the location, which can be determined precisely by the pain gesture, the way the gesture is made will be discussed as a potential clinical sign in combination with the loca- tion. First, by analyzing the observed pain gestures, categories and pain clusters that may help in the diagnosis of tension-type headaches will be created according to the fascial distortion model described by Typaldos [29], be- cause of the lack of previous studies. A fundamental as- pect of how the cause of pain is identified in the fascial distortion model is through observing body language, which helps to give a precise differentiation of the symp- toms. Then, these categories and pain clusters will be assessed for correlations with the TCM diagnoses.
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Pain and tension-type headache: a
review of the possible pathophysiological
mechanisms

Pain and tension-type headache: a review of the possible pathophysiological mechanisms

It is likely that an impaired supraspinal modulation of the repeated peripheral stimulation may play a part in these chronic pain disorders, but a precise molecular identifica- tion is lacking and the cause-effect relationship to pain continuous for decades is yet unclear. Biochemical defects either in the opioid system or in the production of neuro- transmitters have been suspected [19], but no recent stud- ies have confirmed these findings. Normal plasma levels of substance P, neuropeptide Y, vasoactive intestinal polypeptide [62] and calcitonin gene-related peptide [63] in patients with chronic tension-type headache, unrelated to headache state, have been demonstrated. Among the studies of neuropeptides and endorphins only one study [64] indicated activation of the enkephalinergic antinoci- ceptive system at the spinal-trigeminal level, whereas the beta-endorphinergic system appears normal. This enkephalinergic activation may be caused by increased activity in the primary nociceptive afferents, or may be compensatory to decreased activity in endogenous antinociceptive systems other than the opioid one [64]. Various abnormalities may result in or be a function of the disturbed balance between peripheral input and central modulation, but the primary eliciting cause and the evolu- tion of pain are, however, still unknown [1].
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Nutraceuticals for the treatment of migraine prophylaxis

Nutraceuticals for the treatment of migraine prophylaxis

Headache is one of the most common disorders of the nervous system. Headache is further classified into migraine, tension-type headache, and cluster headache. Migraine occurs in about 12% of people age 12 and older in the United States (17% of women and 6% of men). It is about three times more common in women than men. It is estimated that every 10 seconds someone in the United States goes to the emergency room with a migraine or headache due to the excruciating pain, severe nausea or dehydration, drug interactions, or side effects from headache medications. In recent years there has been a growing interest and demand from the public for ‘natural’ treatments such as vitamins and supplements in trying to control migraine headaches. A variety of natural supplements, vitamins and herbal preparations have been promoted as having efficacy in migraine prophylaxis. This mini-review analyzes the various natural and herbal therapies for the prophylaxis and treatment of migraine.
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Chronic daily headache in developmental ages: diagnostic issues

Chronic daily headache in developmental ages: diagnostic issues

The aim of our study was to analyze the clinical features of CDH with childhood or adolescence onset on the basis of the current status of knowledge. The symptoms of CDH in children and adolescents present age-related features [24] and do not overlap with adult characteristics. De- velopmental factors, onset age, comorbidities and several other factors influence the clinical phenomenology, the time trend and the outcome of CDH, even if little is known about them. Two points seem to differentiate the child or adoles- cent clinical expression of CDH compared to the adult form. On one hand, in the developmental age, frequent and severe migraine attacks overlap daily crises of tension-type headache. The onset clinical features are similar to the sub- sequent (chronic) trend. On the other hand, in adults, the tendency of migraine to change over time is more typical, taking tension features with almost daily crises. About 30% of adult CDH sufferers are “unclassifiable” according to IHS criteria [11, 25]. Either the symptomatological features of the crises are incompatible with IHS criteria for chronic tension-type headache, because specific migraine symptoms occur, or the length of the attacks exceeds 72 hours (over the border term accepted for migraine).
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Anger and emotional distress in patients with migraine and tension–type headache

Anger and emotional distress in patients with migraine and tension–type headache

recent studies suggested that patients with chronic daily headache have a significant impairment of serotonin metabolism [32, 33]. So the dysfunction of cerebral sero- tonergic system seems to be one of the key features in the mechanism of transformation of an episodic to a chronic form of headache and it may play a role in the abnormali- ties in anger experience and control observed in our patients. The results obtained by the administration of the CBA 2.0 and the BDI evidence a lack of psychopathologi- cal impairment in the migraine group compared to con- trols. On the contrary, the chronic tension-type headache and migraine associated with tension-type headache patients experienced higher levels of depressive symp- toms, state and trait anxiety, phobias (especially social refusal and departures), emotion liability, psychophysio- logical disorders and obsessive-compulsive symptoms in comparison with controls. Episodic headaches differed from controls only on trait anxiety, emotion liability and obsessive-compulsive symptoms. Our results provided evi- dence that patients with chronic tension-type headache and migraine associated with tension-type headache experi- ence more emotional distress in comparison to both migraine and tension-type headache with an episodic occurrence. However, it is important to highlight the self- report nature of the tests used and the consequent method- ological limitations of the interpretation of the data.
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Genetics of tension-type headache

Genetics of tension-type headache

Co-occurrence of tension-type headache and migraine Tension-type headache and migraine are clinically distinct headache syndromes and defined so by the ICHD [1,2]. Tension-type headache is usually characterised by a mild pain intensity, normal or slightly reduced activities and no accompanying symptoms, while migraine is a more severe pain, causing reduced activity/bed rest and is accompanied by photo- and phonophobia, nausea and sometimes vomit- ing. Osmophobia, a symptom not included in the ICHD, is not experienced by those with tension-type headache, while it is experienced by 43% of those with migraine without aura and 39% of those with migraine with aura [15]. Patients often mentioned stress and mental tension as pre- cipitating factors in both tension-type headache and migraine, while smoking and weather changes are men- tioned more often as a precipitating factor in tension-type headache than in migraine [16]. Previous Danish epidemi- ological surveys of the general population based on inter- view by a physician do not show diagnostic overlap between tension-type headache and migraine, but a number of patients have co-occurrence of tension-type headache and migraine [5–7, 15, 17]. Table 2 shows that the preva- lence of frequent episodic and chronic tension-type headache increases significantly in those with co-occur- rence of tension-type headache and migraine as compared to those with exclusively tension-type headache [6]. This result was replicated in a large population-based twin study [7], while earlier population-based studies based on the 1st edition of the ICHD showed a similar tendency [18, 19].
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