Chronic migraine is a potentially debilitating condition that can be detrimental to someone’s quality of life. Clinical data has proven OnabotulinumtoxinA (BoNT-A) to be an effective prophylactic treatment for chroni...Chronic migraine is a potentially debilitating condition that can be detrimental to someone’s quality of life. Clinical data has proven OnabotulinumtoxinA (BoNT-A) to be an effective prophylactic treatment for chronic headache types, and it is now regularly employed by headache treatment centers. The PREEMPT injection protocol has become the standard treatment regimen surrounding Botox injections for chronic migraine treatment since it was granted approval by the FDA in 2010. This retrospective chart review of patients treated for chronic migraine at Maine Comprehensive Pain Management in Scarborough, Maine, presents an alteration to the standard PREEMPT injection paradigm that reinforces the efficacy of Botox for chronic migraine treatment. We will discuss our Modified PREEMPT injection paradigm, which yields a positive clinical response rate of 95% of patients achieving at least 50% improvement in their migraine headaches. This appears to be the highest established response rate in the literature to date.展开更多
Objective tinnitus is defined as a type of tinnitus perceived by both the patient and external observer.This paper presents two cases of objective tinnitus related to palatal tremor,along with a literature review.Pala...Objective tinnitus is defined as a type of tinnitus perceived by both the patient and external observer.This paper presents two cases of objective tinnitus related to palatal tremor,along with a literature review.Palatal tremor is a condition characterized by soft palate involuntary contractions.Two types of palatal tremor have been described:symptomatic palatal tremor and essential palatal tremor,with different clinical manifestations.Diagnostic workup is based on medical history and physical examination,including direct oropharynx exploration and cavum visualization through nasopharyngoscopy.Brain MRI is mandatory in all cases.If a secondary origin is suspected,additional lab tests should be performed based on clinical suspicion.First-line treatment is botulinum toxin injection into the levator veli palatini and tensor veli palatini muscles,with velopharyngeal insufficiency being its main adverse effect.Other medications have not been shown to be effective.展开更多
文摘Chronic migraine is a potentially debilitating condition that can be detrimental to someone’s quality of life. Clinical data has proven OnabotulinumtoxinA (BoNT-A) to be an effective prophylactic treatment for chronic headache types, and it is now regularly employed by headache treatment centers. The PREEMPT injection protocol has become the standard treatment regimen surrounding Botox injections for chronic migraine treatment since it was granted approval by the FDA in 2010. This retrospective chart review of patients treated for chronic migraine at Maine Comprehensive Pain Management in Scarborough, Maine, presents an alteration to the standard PREEMPT injection paradigm that reinforces the efficacy of Botox for chronic migraine treatment. We will discuss our Modified PREEMPT injection paradigm, which yields a positive clinical response rate of 95% of patients achieving at least 50% improvement in their migraine headaches. This appears to be the highest established response rate in the literature to date.
文摘Objective tinnitus is defined as a type of tinnitus perceived by both the patient and external observer.This paper presents two cases of objective tinnitus related to palatal tremor,along with a literature review.Palatal tremor is a condition characterized by soft palate involuntary contractions.Two types of palatal tremor have been described:symptomatic palatal tremor and essential palatal tremor,with different clinical manifestations.Diagnostic workup is based on medical history and physical examination,including direct oropharynx exploration and cavum visualization through nasopharyngoscopy.Brain MRI is mandatory in all cases.If a secondary origin is suspected,additional lab tests should be performed based on clinical suspicion.First-line treatment is botulinum toxin injection into the levator veli palatini and tensor veli palatini muscles,with velopharyngeal insufficiency being its main adverse effect.Other medications have not been shown to be effective.
