effect of methylprednisolone acetate injection at cervical trigger points in both chronic and drug resistant headache

Most adults have surely once experienced a headache. A high percentage of these headaches are the referred pain from cervical structures, such as neck muscles, known as cervicogenic headaches. This study aimed to assess the efficacy of injection of methylprednisolone acetate at the Gallbladder-20 acupuncture points in muscle originated chronic and drug resistant headaches. In this randomized clinical trial study conducted at Shiraz University of Medical Sciences in 2009-2010, 25 patients with both chronic and drug resistant cervicogenic headaches, who had cervical muscle tender points, underwent methylprednisolone acetate injection. To evaluate the severity of these patients' headache, VAS [Visual Analogue Scale] was used. The collected data was analyzed using the SPSS software and Wilcoxon test. The Mean headache intensity on the visual scale of these people before the injection was 3 .2 +/- 76.7. This value was 2.60 +/- 2.9, 3 days after injection. The values at 1 and 3 months post procedure were 3.52 +/- 3.3, and 3.48 +/- 3.5, respectively. In other words, a statistically significant loss of pain score [P<0.001] was observed. The frequency of headache attacks 1 and 3 months after injection decreased 72% and 76% among patients, respectively. Average duration of headache attacks, one month and three months after injection, was decreased in 72 percent of patients. Injection of methylprednisolone acetate at the GB-20acu points in muscle originated cervicogenic headache could be used as an appropriate therapy that has significant therapeutic efficacies only when injected once

[Hemiplegia and facial palsy due to brucellosis [a case report]]

Manifestations involving the nervous system [neurobrucellosis], is a treatable infection, however it is not well documented. Direct invasion of the central nervous system occurs in fewer than 5% of cases. Acute or chronic meningitis is the most frequent nervous system complication. However, hemiplegia and cranial nerve involvement are rarely encountered. In this report we present a patient with "seventh cranial nerve palsy" and "hemiplegia, " as the manifestations of probable neurobrucellosis. Thus, in endemic area, brucellosis should be ruled out in patients who develop unexplained neurological symptoms such as hemiplegia