The aim of this study was to determine whether subcutaneous octreotide is effective for the treatment of acute migraine. Patients with migraine with and without aura as classified by the International Headache Society...The aim of this study was to determine whether subcutaneous octreotide is effective for the treatment of acute migraine. Patients with migraine with and without aura as classified by the International Headache Society were recruited to a double- blind placebo- controlled crossover study. Patients were instructed to treat two attacks of at least moderate pain severity, with at least a 7 day interval, using subcutaneous 100 μ g octreotide or matching placebo. The primary endpoint was the headache response defined as: severe or moderate pain becomes mild or nil, at 2 h. The primary endpoint was analysed using a Multilevel Analysis approach. Secondary end- points included associated symptoms and a four- point functional disability score. The study was powered to detect a 30% difference at an α of 0.05 and a β of 0.8. A total of 51 patients were recruited, of whom 42 provided efficacy data on an attack treated with octreotide and 41 with placebo. Modelling the headache response as a binomial determined by treatment, using the patient as the level 2 variable, and considering a possible period effect, and sex and migraine type as other variables of interest, subcutaneous octreotide was not significantly superior to placebo. The two hour headache response rates were 20% for placebo and 14% for octreotide, whilst the two hour pain free rates were 7% and 2% , respectively. Subcutaneous octreotide 100 μ g is not effective in the acute treatment of migraine when compared to placebo.展开更多
Short-lasting unilateral neuralgiform headache attacks with conjunctival inje ction and tearing (SUNCT) is a rare type of primary headache. In this report we describe the occurrence of SUNCT in a family. Unfortunately...Short-lasting unilateral neuralgiform headache attacks with conjunctival inje ction and tearing (SUNCT) is a rare type of primary headache. In this report we describe the occurrence of SUNCT in a family. Unfortunately, one of the siblings was already dead. However, clear and detailed information from close relatives and her general practitioner confirmed the diagnosis of SUNCT. It is likely that genetic factors contribute to all types of trigeminal autonomic cephalalgias.展开更多
A case of migraine is presented with visual aura triggered on two separate occasions by glyceryl trinitrate (GTN). Positron emission tomography was carried out during the second triggering session. Activation in the p...A case of migraine is presented with visual aura triggered on two separate occasions by glyceryl trinitrate (GTN). Positron emission tomography was carried out during the second triggering session. Activation in the primary visual area of the occipital cortex was demonstrated during the aura. This is the first published case of migraine aura triggered reproducibly by GTN.展开更多
偏头痛是最常见的功能障碍性神经疾病之一,会对患者的生活质量造成严重影响。为了在文献检索和专家组共识基础上对不同类型偏头痛综合征的各种药物治疗方案提供循证或专家推荐,我们从现有的所有医学参考文献系统中筛选出关于有先兆型或...偏头痛是最常见的功能障碍性神经疾病之一,会对患者的生活质量造成严重影响。为了在文献检索和专家组共识基础上对不同类型偏头痛综合征的各种药物治疗方案提供循证或专家推荐,我们从现有的所有医学参考文献系统中筛选出关于有先兆型或无先兆型偏头痛以及偏头痛样综合征等各种类型临床资料进行分析。根据欧洲神经病学学会联盟(European Federation of Neurological Societies.EFNS)制定的推荐意见分级方案对这些研究结果进行评价从而确定A级、B级或C级推荐和良好的临床实践要点。对于偏头痛急性发作期的治疗,推荐口服非甾体消炎药(NSAID)和曲坦类药物。用药方案应遵循分层治疗的观念。在服用NSAID和曲坦类药物之前,推荐口服甲氧氯普胺或多潘立酮。极重度发作的首选药物为静脉注射乙酰水杨酸或皮下注射舒马曲坦。偏头痛持续状态或许可用类固醇治疗。对于偏头痛的预防性治疗,β-受体阻断药(普萘洛尔和美托洛尔)、氟桂利嗪、丙戊酸和托吡酯可作为首选用药,其次可选择阿米替林、萘普生、蜂斗菜烯碱和比索洛尔。展开更多
文摘The aim of this study was to determine whether subcutaneous octreotide is effective for the treatment of acute migraine. Patients with migraine with and without aura as classified by the International Headache Society were recruited to a double- blind placebo- controlled crossover study. Patients were instructed to treat two attacks of at least moderate pain severity, with at least a 7 day interval, using subcutaneous 100 μ g octreotide or matching placebo. The primary endpoint was the headache response defined as: severe or moderate pain becomes mild or nil, at 2 h. The primary endpoint was analysed using a Multilevel Analysis approach. Secondary end- points included associated symptoms and a four- point functional disability score. The study was powered to detect a 30% difference at an α of 0.05 and a β of 0.8. A total of 51 patients were recruited, of whom 42 provided efficacy data on an attack treated with octreotide and 41 with placebo. Modelling the headache response as a binomial determined by treatment, using the patient as the level 2 variable, and considering a possible period effect, and sex and migraine type as other variables of interest, subcutaneous octreotide was not significantly superior to placebo. The two hour headache response rates were 20% for placebo and 14% for octreotide, whilst the two hour pain free rates were 7% and 2% , respectively. Subcutaneous octreotide 100 μ g is not effective in the acute treatment of migraine when compared to placebo.
文摘Short-lasting unilateral neuralgiform headache attacks with conjunctival inje ction and tearing (SUNCT) is a rare type of primary headache. In this report we describe the occurrence of SUNCT in a family. Unfortunately, one of the siblings was already dead. However, clear and detailed information from close relatives and her general practitioner confirmed the diagnosis of SUNCT. It is likely that genetic factors contribute to all types of trigeminal autonomic cephalalgias.
文摘A case of migraine is presented with visual aura triggered on two separate occasions by glyceryl trinitrate (GTN). Positron emission tomography was carried out during the second triggering session. Activation in the primary visual area of the occipital cortex was demonstrated during the aura. This is the first published case of migraine aura triggered reproducibly by GTN.
文摘偏头痛是最常见的功能障碍性神经疾病之一,会对患者的生活质量造成严重影响。为了在文献检索和专家组共识基础上对不同类型偏头痛综合征的各种药物治疗方案提供循证或专家推荐,我们从现有的所有医学参考文献系统中筛选出关于有先兆型或无先兆型偏头痛以及偏头痛样综合征等各种类型临床资料进行分析。根据欧洲神经病学学会联盟(European Federation of Neurological Societies.EFNS)制定的推荐意见分级方案对这些研究结果进行评价从而确定A级、B级或C级推荐和良好的临床实践要点。对于偏头痛急性发作期的治疗,推荐口服非甾体消炎药(NSAID)和曲坦类药物。用药方案应遵循分层治疗的观念。在服用NSAID和曲坦类药物之前,推荐口服甲氧氯普胺或多潘立酮。极重度发作的首选药物为静脉注射乙酰水杨酸或皮下注射舒马曲坦。偏头痛持续状态或许可用类固醇治疗。对于偏头痛的预防性治疗,β-受体阻断药(普萘洛尔和美托洛尔)、氟桂利嗪、丙戊酸和托吡酯可作为首选用药,其次可选择阿米替林、萘普生、蜂斗菜烯碱和比索洛尔。
