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ABSTRACT BACKGROUND AND OBJECTIVES: Temporomandibular disorder-related headache (TMDH) is a very common clinical condition which manifests as pain around the temples. The treatment recommended in dentistry is occlusal splint. However, there is a device generally used in functional jaw orthopedics, called simple Planas indirect tracks (SPIT), which has been shown to be efficient in managing these headaches. This clinical trial aimed to compare SPIT and occlusal splints in the treatment of TMDH patients. METHODS: This randomized clinical trial included thirty-seven women who had TMDH for more than one year into three groups: GPIT treated with SPIT, GSPLINT treated with a Michigan splint, and a control group (CG) submitted to no treatment. The randomization was paired, that is, each new individual was assigned to a group sequentially. The number of headache days per month, average pain intensity, pain response to masseter and temporalis palpation, and days of pain drug use were collected and analyzed. The follow-up lasted for 3 months. RESULTS: Thirty-seven patients were included but 4 dropped out during treatment and 33 underwent intervention. Patients in GPIT exhibited superior results compared to GSPLINT and CG, with significant differences between groups for almost all variables. In GPIT, the number of headache days was reduced by 87.43%, pain intensity by 66.67%, and days of drug use by 88.42%, with significant improvement in all parameters compared to CG. In GSPLINT, the number of headache days decreased by 44.46% and days of drug use by 36.63%, while pain intensity increased by 46.67%; however, there was no significant difference in any of the parameters compared to CG. CONCLUSION: SPIT may be a good treatment option for patients with TMDH since these appliances have shown much more consistent results than occlusal splints. Further studies and with more individuals will be needed to confirm these findings.
RESUMO JUSTIFICATIVA E OBJETIVOS: A cefaleia secundária à disfunção temporomandibular (CDTM), é uma condição clínica muito comum, com dores nas têmporas. O tratamento padrão na odontologia são as placas miorrelaxantes, entretanto um aparelho da ortopedia funcional dos maxilares, chamado de Pistas Indiretas Planas Simples (PIPS), tem se demonstrado eficiente no controle dessas cefaleias. Este estudo clínico visou comparar as PIPS com as placas miorrelaxantes, no quadro álgico de CDTM. MÉTODOS: Este ensaio clínico randomizado incluiu 37 mulheres portadoras de CDTM há mais de um ano, que foram distribuídas aleatoriamente em três grupos: o GPIPS, no qual as pacientes foram tratadas com PIPS, o GPLACA, com uso de placas miorrelaxantes de Michigan e o grupo controle (GC), sem qualquer tratamento. A aleatorização foi pareada, sendo que cada participante era consecutivamente alocada em um grupo diferente. Foram coletados e analisados dias de cefaleia por mês, intensidade de dores, resposta álgica à palpação de masseter e temporal, bem como os dias de uso de fármacos. O acompanhamento foi de três meses. RESULTADOS: Das 37 pacientes iniciais, 4 desistiram do tratamento e apenas 33 foram submetidos a alguma intervenção. As pacientes do GPIPS apresentaram resultados muito superiores às do GPLACA e do GC, com diferenças significativas entre os grupos em quase todas as variáveis. No GPIPS, os dias de dor diminuíram 87,43%, a intensidade 66,67% e os dias de uso de fármacos analgésicos 88,42%, sendo estatisticamente significante a melhora em todos os parâmetros em relação ao GC. Já no GPLACA, os dias de dor diminuíram 44,46% e os dias de uso de fármacos 36,63%, mas a intensidade da dor aumentou 46,67%, porém sem diferença estatisticamente significante em nenhum parâmetro quando comparado ao GC. CONCLUSÃO: O uso do PIPS pode ser uma boa escolha de tratamento da CDTM, tendo apresentado resultados mais consistentes do que as placas miorrelaxantes. Mais estudos e com mais participantes são necessários para confirmar estes achados.
ABSTRACT
Zeus is known as the king of the gods and god of the sky. His attributes are lightning and thunder and he is often depicted about to hurl them. According to Greek mythology, Zeus molested the titan Metis and decided to swallow her when she was pregnant, which resulted in an excruciating headache, only relieved after a craniotomy performed using Hephaestus' axe. The result of this procedure was the birth of Athena, Zeus' daughter. We conducted a combined analysis of some writings such as the classical mythological poem Theogony by Hesiod, and some other books that examine and retell myths and legends of ancient Greece, with medical papers on this topic, trying to characterize Zeus' headache. Would it be possible to fit Zeus' headache into the group of thunderclap headaches?
Zeus é conhecido como rei dos deuses e deus dos céus. Tem como atributos os raios e os trovões e é frequentemente representado prestes a lançá-los. De acordo com a mitologia grega, Zeus molestou a titã Métis e resolveu engoli-la grávida, o que resultou em uma cefaleia excruciante, apenas aliviada após uma craniotomia realizada por meio do machado de Hefesto. O fruto deste procedimento foi Atena, filha de Zeus. Realizamos uma análise combinada utilizando escritos mitológicos clássicos como o poema Teogonia de Hesíodo, além de outros livros sobre mitologia e artigos médicos que tratam deste tema, para tentar caracterizar a cefaleia de Zeus. Seria possível enquadrar a cefaleia de Zeus no grupo das cefaleias em trovoada?
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Humans , Craniotomy/history , Headache , Mythology , Headache Disorders , Greece, AncientABSTRACT
Objective To explore the clinical characteristics and prognostic factors of spontaneous intracranial hypotension (SIH) patients. Methods The clinical data of patients with SIH, who admitted to Changhai Hospital of Navy Medical University (Second Military Medical University) from 2010 to 2017 and met the SIH diagnostic criteria of international classification of headache disorders, 3rd edition (ICHD-3), were collected. The effects of the general clinical features, such as gender, age and course of disease, and cerebrospinal fluid pressure and imaging features on prognosis of the SIH patients were analyzed. Results Of 26 SIH patients, 19 patients (73.08%) were cured and 7 patients (26.92%) were relieved. The gender, age, course of disease, severity of headache, headache types and cerebrospinal fluid pressure had no significant effect on the prognosis of the SIH patients. Among the 13 SIH patients with abnormal cranial magnetic resonance imaging findings, such as strenthening signals in cerebral dura, subdural fluid accumulation and brain sagging, 12 patients (63.16%) were cured and 1 (14.28%) was relieved, and the difference was significant (P=0.027). Conclusion SIH patients with headache have a good prognosis; imaging examination contributes to the diagnosis of SIH and may indicate the prognosis.
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The effects of acupuncture and moxibustion on headache in clinical trials were reviewed. First, the effects of Western medicine on headache for patients with primary headache and secondary headache were systematically reviewed based on online data, and possible mechanisms were discussed. Second, the role and potential use of acupuncture and moxibustion on headache were considered based on a review of research literature. Finally, the effectiveness of acupuncture and moxibustion on migraine and tension type headache was systematically examined based on online data. These results suggest that acupuncture and moxibustion may be most effective on recurring headache.
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BACKGROUND AND OBJECTIVES: Sinus headaches are frequently mistaken as primary headaches, and thus, emphasizes the necessity of a specific diagnosis of symptoms to treat patients properly. Therefore, the authors investigated the specific clinical symptoms of patients who visited a rhinologist complaining of headaches or facial pain. SUBJECTS AND METHODS: The present study was performed with retrospective clinical analysis of 990 patients who visited rhinologists from August 2010 to August 2011. The presence and characteristics of headaches or facial pain, physical findings, and the results of treatment were investigated. RESULTS: One hundred sixteen out of 990 rhinologic patients complained of headaches or facial pain. Nineteen out of 69 patients with acute rhinosinusitis (27.5%), 28 out of 317 patients with chronic rhinosinusitis (8.8%), 7 out of 11 patients with fungal sinusitis (63.6%), and 10 out of 222 patients with allergic rhinitis (4.5%) had headaches or facial pain. The symptoms of the majority of cases were ameliorated after an appropriate rhinologic treatment. CONCLUSION: The differential diagnosis of diseases causing headache or facial pain in the rhinologic field should be strongly considered in order to cure patients with headaches more accurately, minimizing erroneous prescriptions.
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Humans , Diagnosis, Differential , Facial Pain , Headache , Prescriptions , Retrospective Studies , Rhinitis , Rhinitis, Allergic, Perennial , SinusitisABSTRACT
We report a 6 year old female child, who presented with history of right sided recurrent headache for four months. On diagnostic nasal endoscopy, a metallic foreign body was seen impacted between superior turbinate, middle turbinate and nasal septum which was removed using pediatric nasal endoscope. Following removal, the symptom of unilateral headache subsided. Possibility of a foreign body should always be ruled out while evaluating a child with recurrent, unilateral headache.
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La Clasificación de la Sociedad Internacional de Cefaleas es una herramienta fundamental para la práctica médica y la investigación, ya que es una fuente de referencia y consulta necesaria para un mejor entendimiento de la fisiopatología, para el establecimiento de diagnósticos diferenciales y para el desarrollo de opciones terapéuticas. La primera edición se fundamentó principalmente en los síntomas de las cefaleas; en la segunda edición, más actualizada y basada en la evidencia, se le dio más importancia a la etiología y se clasificaron las cefaleas en dos grandes grupos: primarias y secundarias, que se subdividen en tipos, subtipos y en subformas. En este artículo se hace una breve descripción de esta clasificación y se destaca su importancia clínica y epidemiológica.
The Classification of the International Headache Society is an essential tool for medical practice and research, since it is a source of reference and consultation which is necessary for a better understanding of the pathophysiology, for the establishment of differential diagnosis, and for the developement of therapeutic options. The first edition was based mainly on tbe symptoms of headaches, and in the second edition, updated and based on evidence, more importance was given to the ethiology of headaches and they were classified into two major groups; primary and secondary, which were subdivided into types, subtypes and subforms. This article gives a brief description of the classification and it highlights its clinical and epidemiologyc importance.
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Humans , Headache Disorders, Primary , Diagnosis , NeurologyABSTRACT
SUNCT is one of the rarest and least known primary headache disorders. Although its pathogenesis has been partially understood by functional neuroimaging and reports of secondary cases, there is limited understanding of its cause. We report a case of SUNCT in a 54-years-old man, that could not be strictly classified as secondary SUNCT; however, the time lag of pain onset suggests a new theory in which neuroplasticity could be involved in the origin and duration of the pain in SUNCT syndrome.
SUNCT é uma das mais raras e menos conhecidas cefaléias primárias. Embora sua patogênese esteja parcialmente compreendida por neuroimagem funcional e relatos de casos secundários, há insuficiente conhecimento a respeito de sua causa. Nós relatamos um caso de SUNCT em um homem de 54 anos, que não poderia ser estritamente classificado como SUNCT secundário; entretanto, o lapso de tempo para o início da dor sugere uma nova hipótese na qual a neuroplasticidade possa esta envolvida na origem e duração da dor na síndrome SUNCT.
Subject(s)
Humans , Male , Middle Aged , Neuronal Plasticity , SUNCT Syndrome/diagnosis , Magnetic Resonance Imaging , Neuronal Plasticity/physiology , SUNCT Syndrome/physiopathologyABSTRACT
Headache is a common clinical symptom.Some headache disorders belong to secondary category.Many intracranial disorders,such as head trauma,cerebral vascular diseases,intracranial tumors and inflammation,can lead to headache due to mass effect,inflammation reaction,stimulation of vasoactive substances and decreased intracranial pressure.Furthermore,many drugs and other substances,disorders of eyes,nose,ear,mouth,neck and other systemic disorders can also cause headache.Many headache disorders can be determined by detailed case history and physical examination.Blood test,lumber puncture,CT,MRI and other imaging examinations are necessary methods for finding the causes and the treatment of diseases.