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1.
Rev. urug. cardiol ; 39(1): e401, 2024. tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1560457

ABSTRACT

La migraña es una enfermedad que se ha visto asociada a defectos septales auriculares y a su cierre percutáneo, estipulándose en la literatura que sería una rara complicación, pero la evidencia al respecto es escasa. Se realizó una revisión narrativa sobre definiciones, epidemiología, fisiopatología y tratamiento de la migraña y de la entidad migraña poscierre percutáneo de defectos del septum auricular, incluyendo trabajos observacionales (retrospectivos, prospectivos), estudios randomizados, reportes de casos, artículos de revisión y metaanálisis existentes en PubMed y Cochrane, para aportar al conocimiento de esta entidad.


Migraine is a disease that has been associated with atrial septal defects and its percutaneous closure, stipulating in the literature that it would be a rare complication, but evidence is scarce. A narrative review was conducted on definitions, epidemiology, pathophysiology and treatment of migraine and the migraine entity after percutaneous closure of atrial septum defects, including observational studies (retrospective, prospective), randomized studies, case reports, review articles and meta-analyses existing in PubMed and Cochrane, to contribute to the knowledge of this entity.


A enxaqueca é uma doença que tem sido associada a defeitos do septo atrial e seu fechamento percutâneo, estipulando na literatura que seria uma complicação rara, mas as evidências são escassas. Foi realizada uma revisão narrativa sobre definições, epidemiologia, fisiopatologia e tratamento da enxaqueca e da entidade migranosa após fechamento percutâneo de defeitos do septo atrial, incluindo estudos observacionais (retrospectivos, prospectivos), estudos randomizados, relatos de caso, artigos de revisão e metanálises existentes no PubMed e Cochrane, para contribuir com o conhecimento dessa entidade.


Subject(s)
Humans , Fibrinolytic Agents/therapeutic use , Percutaneous Coronary Intervention , Heart Septal Defects, Atrial/surgery , Migraine Disorders/therapy , Treatment Outcome , Heart Septal Defects, Atrial/complications , Migraine Disorders/etiology
2.
Article in Chinese | WPRIM | ID: wpr-980747

ABSTRACT

The basic constituent elements of ancient acupuncture prescriptions and moxibustion prescriptions for migraine and headache are extracted and summarized. The frequency and proportion of each element are counted and its characteristics are analyzed. The basic constituent elements of ancient acupuncture and moxibustion prescriptions includes five aspects: disease symptoms (main symptoms, concurrent symptoms, etiology and pathogenesis), disease type, acupuncture and moxibustion site (acupoint name, site name, meridian name), manipulation method (acupuncture method, reinforcing and reducing method, blood pricking method, moxibustion method) and curative effect. Acupuncture and moxibustion prescriptions are essential for recording the disease symptoms, while the acupuncture and moxibustion site and manipulation methods are the two core elements of ancient acupuncture and moxibustion prescriptions, which are also the premise to ensure that acupuncture and moxibustion prescriptions have good reference value.


Subject(s)
Humans , Moxibustion , Acupuncture Therapy , Meridians , Acupuncture Points , Headache/therapy , Migraine Disorders/therapy
3.
Article in Chinese | WPRIM | ID: wpr-981047

ABSTRACT

Migraine is the most common disabling primary headache with a significant socioeconomic burden. At present, some emerging drugs for migraine preventive treatment are under investigation internationally, which significantly promote the progress of migraine treatment. However, only few of this trial for migraine treatment are explored in China. In order to promote and standardize controlled clinical trials of migraine preventive therapy in China, and to provide methodological guidance for the design, implementation and evaluation of clinical trials, the Headache Collaborators of Chinese Society of Neurology formulated this consensus.


Subject(s)
Humans , Adult , Consensus , Migraine Disorders/therapy , Headache , China , Neurology
4.
Chinese Acupuncture & Moxibustion ; (12): 1443-1448, 2023.
Article in English | WPRIM | ID: wpr-1007509

ABSTRACT

To enhance the clinical applicability of guidelines and provide more effective guidance for clinical practice, a clinical value assessment was conducted during the development of the World Federation of Acupuncture-Moxibustion Societies (WFAS) Clinical Practice Guideline of Acupuncture and Moxibustion for Migraine, which involved the evaluation of 59 acupuncture and moxibustion treatment protocols from randomized controlled trials (RCTs). This article introduced the methodology, content and results of the clinical value assessment of RCT-based acupuncture and moxibustion treatment protocols, which involved the integration of historical and contemporary medical evidence and expert consensus. It served as a methodological reference for the future development of acupuncture and moxibustion clinical practice guidelines.


Subject(s)
Humans , Moxibustion , Acupuncture Therapy/methods , Acupuncture , Clinical Protocols , Migraine Disorders/therapy
5.
Journal of Integrative Medicine ; (12): 213-220, 2022.
Article in English | WPRIM | ID: wpr-929225

ABSTRACT

BACKGROUND@#Acupuncture has been widely used to relieve migraine-related symptoms. However, the findings of previous systematic reviews (SRs) and meta-analyses (MAs) are still not completely consistent. Their quality is also unknown, so a comprehensive study is needed.@*OBJECTIVE@#To evaluate the reporting and methodological quality of these MAs concerning acupuncture for migraine, and summarize evidence about the efficacy and safety of acupuncture for migraine.@*SEARCH STRATEGY@#PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Chinese Biomedical Databases, Wanfang Data, and VIP databases were searched from inception to September 2020, with a comprehensive search strategy.@*INCLUSION CRITERIA@#The pairwise MAs of randomized controlled trials (RCTs) concerning migraine treated by acupuncture or acupuncture-based therapies, with a control group that received sham acupuncture, medication, no treatment, or acupuncture at different acupoints were included.@*DATA EXTRACTION AND ANALYSIS@#Two independent investigators screened studies, extracted relevant data, and assessed reporting and methodological quality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2009 and A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2), then all results were cross-checked. Spearman correlation test was used to evaluate the correlation between reporting and methodological quality scores.@*RESULTS@#A total of 20 MAs were included in this study. The included MAs indicated that acupuncture was efficacious and safe in preventing and treating migraine when compared with control intervention. There was a high correlation between reporting and methodological quality scores (rs = 0.87, P < 0.001). The quality of the included SRs needs to be improved mainly with regard to protocol and prospective registration, using a comprehensive search strategy, summarizing the strength of evidence body for key outcomes, a full list of excluded studies with reasons for exclusion, reporting of RCTs' funding sources, and assessing the potential impact of risk of bias in RCTs on MA results.@*CONCLUSION@#Acupuncture is an effective and safe intervention for preventing and treating migraine, and could be considered as a good option for patients with migraine. However, the reporting and methodological quality of MAs included in this overview is suboptimal. In the future, AMSTAR 2 and PRISMA tools should be followed when making and reporting an SR with MA.


Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy/methods , China , Meta-Analysis as Topic , Migraine Disorders/therapy , Research Report
6.
Article in Chinese | WPRIM | ID: wpr-939537

ABSTRACT

Professor WU Zhong-chao's clinical experience of "dredging stagnation and collaterals" acupuncture for migraine is summarized. Professor WU proposes that occiput-nape dysfunction, meridians-tendons dysfunction and stagnation of collaterals due to obstruction of excess-evil could lead to migraine. As such, migraine is treated by comprehensive treatment of adjusting occiput-nape functional zone, relaxing meridians-tendons and blood-letting combined with fire acupuncture.


Subject(s)
Humans , Acupuncture , Acupuncture Points , Acupuncture Therapy , Meridians , Migraine Disorders/therapy
7.
Article in Chinese | WPRIM | ID: wpr-927340

ABSTRACT

Regarding the development of international standard of Guideline for Clinical Practice of Acupuncture and Moxibustion: Migraine, the existing problems of the design and methodology of randomized controlled trial (RCT) on acupuncture and moxibustion for migraine were summarized in views of participant, intervention, control, outcome and study design. Four directions need to be further explored, (1) research of adolescent migraine, special subtype of migraine and migraine in a special population; (2) research of the immediate analgesic effect of acupuncture and moxibuation at the attack stage of migraine and the therapeutic effect of migraine at each stage; (3) research on safety and health economics; (4) clinical trial registration of acupuncture and moxibustion. In study, the target population should be further determined and specialized, the diagnosis criteria of western medicine and traditional Chinese medicine be generalized and concentrated, the staging and type division of disease be accurate, the intervention procedure be integrated, the control design be rationalized, the outcomes be validated, and the description of randomization and blinding be clarified.


Subject(s)
Adolescent , Humans , Acupuncture , Acupuncture Therapy , Medicine, Chinese Traditional , Migraine Disorders/therapy , Moxibustion
8.
Article in Chinese | WPRIM | ID: wpr-927414

ABSTRACT

OBJECTIVE@#To compare the clinical effect of electroacupuncture at Siguan points and flunarizine hydrochloride capsule on migraine of liver yang hyperactivity.@*METHODS@#A total of 110 patients with migraine of liver yang hyperactivity were randomly divided into an electroacupuncture group (55 cases, 2 cases dropped off) and a western medication group (55 cases, 2 cases dropped off). In the electroacupuncture group, electroacupuncture was applied at Siguan points (Hegu [LI 4] and Taichong [LR 3]), with disperse-dense wave of 2 Hz/100 Hz in frequency and current intensity of 0.1-1 mA, 30 min each time, once a day, 5 times per week for 4 weeks. Flunarizine hydrochloride capsule was given orally in the western medication group, 10 mg a day for 4 weeks. The visual analogue scale (VAS) score and the migraine attack days were observed before and after treatment, during follow-up of 1, 3 and 6 months, and the migraine symptom score was observed before and after treatment in the two groups.@*RESULTS@#After treatment, during follow-up of 1, 3 and 6 months, the VAS scores and the migraine attack days in the two groups were decreased compared with before treatment (P<0.05), and above indexes in the electroacupuncture group were lower than the western medication group (P<0.05). After treatment, the migraine symptom scores in the two groups were decreased (P<0.05), the change in the electroacupuncture group was greater than the western medication group (P<0.05).@*CONCLUSION@#Electroacupuncture at Siguan points could effectively reduce headache intensity and migraine attack days, relieve migraine symptoms in patients with migraine of liver yang hyperactivity, and the efficacy is superior to oral flunarizine hydrochloride capsules.


Subject(s)
Humans , Acupuncture Points , Electroacupuncture , Flunarizine/therapeutic use , Liver , Migraine Disorders/therapy
9.
Chinese Acupuncture & Moxibustion ; (12): 1074-1078, 2021.
Article in Chinese | WPRIM | ID: wpr-921012

ABSTRACT

OBJECTIVE@#To investigate the effect of acupuncture on default mode network (DMN) in migraine patients without aura based on functional Magnetic Resonance Imaging (fMRI).@*METHODS@#Fifteen patients with migraine were included and treated with acupuncture based on "root-knot" theory (Zuqiaoyin [GB 44] for @*RESULTS@#Compared before acupuncture, the functional connections of left parahippocampal cortex (PHC) and anterior medial prefrontal cortex (aMPFC), dorsal medial prefrontal cortex (dMPFC) and lateral temporal cortex (LTC) in DMN after acupuncture were weakened (@*CONCLUSION@#Acupuncture shows good clinical efficacy for migraine without aura, and could adjust the functional connection of DMN.


Subject(s)
Humans , Acupuncture Therapy , Brain Mapping , Default Mode Network , Magnetic Resonance Spectroscopy , Migraine Disorders/therapy , Quality of Life
10.
Article in Chinese | WPRIM | ID: wpr-887486

ABSTRACT

The survey is conducted prior to the development of international standard,


Subject(s)
Humans , Acupuncture , Acupuncture Therapy , Migraine Disorders/therapy , Moxibustion , Surveys and Questionnaires
11.
Acta Physiologica Sinica ; (6): 433-445, 2021.
Article in Chinese | WPRIM | ID: wpr-887679

ABSTRACT

Migraine is a neurological disorder characterized by attacks of moderate or severe headache and various neurological symptoms. Acupuncture, as a commonly used non-pharmacological therapy, has the advantage of obvious therapeutic effect and few side effects in the prevention and treatment of migraine. But the underlying mechanism of acupuncture on migraine remains unclear. Recently, advances in neuroimaging technology have helped to objectively assess the effect of acupuncture on treating migraine and offered new opportunities to explore the central mechanism of acupuncture on treating migraine. In order to better understand the current status of neuroimaging studies on the therapeutic mechanism of acupuncture on migraine and shed light on future research, this review aims to overview the neuroimaging studies in recent 10 years from two aspects: (1) Central mechanism of acupuncture on treating acute migraine attack; (2) Central mechanism of acupuncture on preventing migraine attack.


Subject(s)
Humans , Acupuncture Therapy , Migraine Disorders/therapy , Neuroimaging
12.
Article in Chinese | WPRIM | ID: wpr-877558

ABSTRACT

OBJECTIVE@#To observe the therapeutic effect between acupuncture combined with medication and simple medication on migraine and cerebral hemodynamics.@*METHODS@#A total of 120 patients with migraine were randomized into an acupuncture plus medication group (60 cases, 3 cases dropped off) and a medication group (60 cases, 6 cases dropped off). In the medication group, flunarizine hydrochloride capsule was given orally before sleep, 10 mg a day. On the basis of the treatment in the medication group, acupuncture was applied at Sizhukong (TE 23), Shuaigu (GB 8), Taiyang (EX-HN 5), Fengchi (GB 20) and etc. in the acupuncture plus medication group, 30 min each time, once a day. Treatment for 4 weeks was required in both groups. Before and after treatment, the visual analogue scale (VAS) score, indexes of cerebral hemodynamic [blood flow velocity of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), vertebral artery (VA) and basilar artery (BA)] and total TCM syndrome score were observed, and the clinical therapeutic effect and the incidence of the adverse events were evaluated in both groups.@*RESULTS@#Compared before treatment, the VAS scores, the blood flow velocity of ACA, MCA, PCA, VA, BA and the total TCM syndrome scores were decreased in both groups (@*CONCLUSION@#Acupuncture combined with flunarizine hydrochloride capsule can effectively relieve the pain in patients with migraine, reduce the cerebral blood flow velocity, the efficacy is superior to simple flunarizine hydrochloride capsule.


Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Hemodynamics , Migraine Disorders/therapy , Pain , Treatment Outcome
13.
Article in Chinese | WPRIM | ID: wpr-877668

ABSTRACT

OBJECTIVE@#To observe the effect of five-element acupuncture on the cognitive function repair of migraine patients with depression/anxiety disorder.@*METHODS@#The migraine patients with depression/anxiety disorder (19 cases, 5 cases dropped off) were taken as the observation group, and received five-element acupuncture twice a week for 8 weeks. Healthy subjects (19 cases) were selected by demographic data matching as the control group. The cognitive function was evaluated with the event related potential (ERP) technique, and the latency and amplitude of visual evoked potential P300 were adopted as the observation indexes. The headache days (every 4 weeks), headache intensity [visual analogue scale(VAS) score], and headache impact test-6 (HIT-6) score, Hamilton depression scale (HAMD) score and Hamilton anxiety scale (HAMA) score were used as the observation indexes for curative effect.@*RESULTS@#Before the treatment, latency of target stimulus at Fz [ (417.5±34.3) ms] in the observation group was extended compared with the healthy subjects of the control group [(388.6±42.1) ms, @*CONCLUSION@#There are some cognitive impairments in migraine patients with depression/anxiety disorder. Five-element acupuncture not only relieves headache, anxiety and depression effectively, but also improves the activation level of the frontal lobe. It significantly repairs the impaired cognitive function.


Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Anxiety Disorders , Cognition , Depression/therapy , Evoked Potentials, Visual , Migraine Disorders/therapy , Treatment Outcome
14.
Artemisa; I Jornada Científica de Farmacología y Salud. Fármaco Salud Artemisa 2021; 2021. [1-13] p. tab.
Non-conventional in Spanish | LILACS, MTYCI | ID: biblio-1284607

ABSTRACT

Introducción: La cefalea migrañosa ocupa la séptima causa de incapacidad a nivel mundial, constituyendo un problema de salud que requiere un adecuado diagnóstico y tratamiento. Objetivo: valorar la efectividad de la acupuntura en pacientes con cefalea migrañosa atendidos en la consulta de neurología en el policlínico Aracelio Rodríguez Castellón del municipio Cumanayagua. Material y método: se realizó una investigación experimental, de tipo cuasiexperimental. El universo estuvo constituido por 40 pacientes atendidos en consulta de neurología en el policlínico Aracelio Rodríguez Castellón de Cumanayagua. La muestra la conformaron 16 pacientes, por muestreo probabilístico aleatorio simple. Las variables utilizadas fueron: edad, sexo, intensidad, frecuencia, trastornos del sueño, efectos adversos del tratamiento con acupuntura, efectividad del tratamiento. Procedimientos. Aplicación de acupuntura en intervalos de 1,5-2 meses, 10 sesiones dos veces por semana. Resultados: el 75% de los pacientes con cefalea migrañosa son mujeres, el 62.5% presento dolor de moderada intensidad, el 50% de los casos estudiados respondieron de forma excelente al tratamiento acupuntural. Conclusiones: la terapia acupuntural evidencia efectividad, seguridad en el tratamiento complementario de la cefalea migrañosa. Su empleo racional es una opción terapéutica que refuerza el arsenal terapéutico en las comunidades.


Subject(s)
Acupuncture Therapy , Migraine Disorders/therapy , Patients , Sleep Wake Disorders , Complementary Therapies , Cuba
15.
West Indian med. j ; 69(2): 121-128, 2021. tab, graf
Article in English | LILACS | ID: biblio-1341877

ABSTRACT

ABSTRACT Objective: To examine the effect of body awareness therapy on pain, fatigue and quality of life in women with tension-type headaches (TTH) and migraine. Methods: Socio-demographic features of patients who are included in the study were recorded. Visual analogue scale was used for pain and fatigue severity scale was used for fatigue, Nottingham health profile (NHP) was used for life quality related to health. Following the first evaluation, body awareness therapy (BAT) was applied to patients for six weeks per 60 minutes in three sessions. Results: Among patients with TTH, there was statistical difference between visual analogue scale, fatigue severity scale and total NHP score before and after BAT (p < 0.05). Among patients with migraine, there was statistical difference between total NHP score before and after BAT (p < 0.05). Conclusion: Body awareness therapy is an effective method that can be used in order to increase life quality related to health among female patients with TTH and migraine.


Subject(s)
Humans , Female , Adult , Middle Aged , Quality of Life , Tension-Type Headache/therapy , Fatigue/etiology , Pain Management/methods , Migraine Disorders/therapy , Pain Measurement , Tension-Type Headache/complications , Migraine Disorders/complications
16.
Rev. chil. pediatr ; 91(1): 46-50, feb. 2020. tab
Article in Spanish | LILACS | ID: biblio-1092786

ABSTRACT

Resumen: Introducción: La migraña abdominal (MA) es infrecuente y poco estudiada. Nuestro objetivo fue investigar el diagnóstico y tratamiento de niños y adolescentes con MA y compararlos entre gastroen terólogos y neurólogos pediatras. Pacientes y Método: Todos los cuadros de MA (1-18 años) de un hospital de EE. UU, con diagnóstico de MA o sus variantes (ICD-9 346.2 o IC-10 G43.D, G43.D0, G43.D1) entre 2011-2017 fueron revisados. La información sobre diagnóstico, intervalo desde inicio de síntomas, criterios diagnósticos, pruebas diagnósticas, tratamiento y resultado se analizaron. Re sultados: Sesenta y nueve historias médicas fueron identificadas. La edad media al diagnóstico fue 9,7 años. El 48% de los pacientes fueron del sexo femenino. Cincuenta (72,4%) pacientes fueron tratados solo por gastroenterólogos pediatras, y 10/69 (14,5%) por neurológos pediatras exclusivamente. 6/69 (8,7%) fueron inicialmente evaluados por gastroenterología y posteriormente referidos a neurología, y 2/69 (2,9%) fueron inicialmente evaluados por neurología y luego referidos a gastroenterología. 3/10 (30%) de las MA diagnosticadas por neurólogos no mencionaban que el paciente tuviera dolor abdominal, sin embargo, todos los diagnósticos realizados por gastroenterólogos presentaron dicho síntoma (p=0,0035). 5/50 (10%) de las historias médicas de gastroenterología y ninguna de las histo rias de neurología mencionaban los criterios de Roma. Conclusiones: La mayoría de los niños fueron diagnosticados por pediatras gastroenterólogos. Los gastroenterólogos rara vez utilizaron los criterios de Roma. Pacientes evaluados por neurología son frecuentemente diagnosticados con MA, incluso sin presentar dolor abdominal (criterio necesario para el diagnóstico). Se recomienda educación para el correcto y oportuno diagnóstico de la migraña abdominal.


Abstract: Introduction: Abdominal migraine (AM) is uncommon and understudied. Our objective was to investigate the diagnosis and treatment of children and adolescents with AM and compare with that of pediatric gastroenterologists and neurologists. Patients and Method: All AM cases (1-18 years) from a USA hospital with diagnosis of abdominal migraine or its variants (ICD-9 346.2 or IC-10 G43.D, G43.D0, G43.D1) between 2011 and 2017 were reviewed. Information on diagnosis, interval from onset of symptoms, diagnostic criteria, diagnostic tests, treatment, and outcome were analyzed. Results: 69 medical records were identified. The mean age at diagnosis was 9.7 years, and 48% of patients were female. 50/69 (72.4%) patients were exclusively treated by a pediatric gastroenterologist and 10/69 (14.5%) exclusively by a pediatric neurologist. 6/69 (8.7%) were initially evaluated by gas troenterology and referred to neurology, and 2/69 (2.9%) were initially evaluated by neurology and then referred to gastroenterology. 3/10 (30%) of the AM diagnosed by neurologists did no report ab dominal pain (AP), however, all diagnoses made by gastroenterologists did (p = 0.0035). 5/50 (10%) of the gastroenterology medical records and no neurology medical records mentioned Rome criteria. Conclusions: Most of the children were diagnosed by pediatric gastroenterologists. Gastroenterolo gists rarely use the Rome criteria. Patients evaluated by neurologists are frequently diagnosed with AM even without AP (a criterion that is required for its diagnosis). Education is recommended for the correct and timely diagnosis of AM.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Pediatrics , Practice Patterns, Physicians'/statistics & numerical data , Healthcare Disparities/statistics & numerical data , Gastroenterology , Migraine Disorders/diagnosis , Migraine Disorders/therapy , Neurology , Referral and Consultation , United States , Abdominal Pain/etiology , Follow-Up Studies , Practice Guidelines as Topic , Guideline Adherence/statistics & numerical data , Diagnosis, Differential , Diagnostic Errors , Migraine Disorders/complications
17.
Chinese Acupuncture & Moxibustion ; (12): 1245-1249, 2020.
Article in Chinese | WPRIM | ID: wpr-877593

ABSTRACT

Through analyzing the differences in the clinical questions of


Subject(s)
Humans , Acupuncture , Acupuncture Therapy , Migraine Disorders/therapy , Moxibustion , Reference Standards
18.
Article in Chinese | WPRIM | ID: wpr-878796

ABSTRACT

To systematically evaluate the efficacy and safety of acupuncture versus Flunarizine hydrochloride in the treatment of migraine. Four Chinese databases(CNKI, VIP, WanFang, CBM), three English databases(Cochrane Library, EMbase, Medline) and ClinicalTrail.gov were systematically and comprehensively retrieved. The retrieval time was from the establishment of each database to January 8, 2020. Randomized controlled trial(RCT) for acupuncture versus Flunarizine in the treatment of migraine were screened out according to inclusion criteria and exclusion criteria. The included studies were evaluated with the Cochrane bias risk assessment tool. The included studies was conducted by RevMan 5.3, and the outcome indicators were evaluated for evidence quality and strength of recommendation by the GRADE system. A total of 1 033 literatures were retrieved, and 23 studies were finally included. Except for 4 multiarm tests, the total sample size was 1 548, including 785 in acupuncture group and 763 in Flunarizine group. The overall quality of the included studies was not high. Meta-analysis results showed that the acupuncture group was superior to the Flunarizine group in reduction of headache frequency(SMD=-1.00, 95%CI[-1.45,-0.54], P<0.000 1). In reduction of headache intensity, acupuncture group was superior to Flunarizine group(SMD=-1.05, 95%CI[-1.41,-0.68], P<0.000 01). In reduction of headache duration, acupuncture group was superior to Flunarizine group(SMD=-1.42, 95%CI[-1.83,-1.02], P<0.000 1). The acupuncture group was superior to Flunarizine group(MD=-0.17, 95%CI[-0.21,-0.13], P<0.000 01) in reduction of the painkillers taking frequency. The acupuncture group was superior to Flunarizine group(SMD=-0.94, 95%CI[-1.35,-0.52], P<0.000 1) in allevia-tion of paroxysmal symptoms, such as nausea and vomiting. The GRADE system showed that the evidence level of the above indicators was extremely low, and the strength of recommendation was low. As for the occurrence of adverse reactions, the adverse reactions reported in the acupuncture group included in the study were all mild adverse reactions, like drowsiness, subcutaneous bleeding, local pain, subcutaneous hematoma and dizziness needle. The available evidence showed that acupuncture has a better efficacy than Flunarizine hydrochloride in the treatment of migraine in adult patients. However, due to the high bias risk in the included studies, the conclusions of this study shall be adopted with caution, and more high-quality studies shall be carried out for verification in the future.


Subject(s)
Humans , Acupuncture Therapy , Flunarizine/therapeutic use , Migraine Disorders/therapy , Treatment Outcome
19.
Arq. neuropsiquiatr ; 77(7): 509-520, July 2019. tab
Article in English | LILACS | ID: biblio-1011369

ABSTRACT

ABSTRACT Chronic migraine poses a significant personal, social and economic burden and is characterized by headache present on 15 or more days per month for at least three months, with at least eight days of migrainous headache per month. It is frequently associated with analgesic or acute migraine medication overuse and this should not be overlooked. The present consensus was elaborated upon by a group of members of the Brazilian Headache Society in order to describe current evidence and to provide recommendations related to chronic migraine pharmacological and nonpharmacological treatment. Withdrawal strategies in medication overuse headache are also described, as well as treatment risks during pregnancy and breastfeeding. Oral topiramate and onabotulinum toxin A injections are the only treatments granted Class A recommendation, while valproate, gabapentin, and tizanidine received Class B recommendation, along with acupuncture, biofeedback, and mindfulness. The anti-CGRP or anti-CGRPr monoclonal antibodies, still unavailable in Brazil, are promising new drugs already approved elsewhere for migraine prophylactic treatment, the efficacy of which in chronic migraine is still to be definitively proven.


RESUMO A migrânea (enxaqueca) crônica determina uma carga pessoal, social e econômica significativa e é caracterizada por dor de cabeça presente em quinze ou mais dias por mês por ao menos três meses, com no mínimo oito dias de cefaleia migranosa a cada mês. É frequentemente associada ao uso excessivo de medicação analgésica ou antimigranosa aguda e isso não deve ser negligenciado. Este consenso foi elaborado por um grupo de membros da Sociedade Brasileira de Cefaleia, para descrever as evidências atualmente disponíveis e fornecer recomendações relacionadas ao tratamento farmacológico e não farmacológico da migrânea crônica. Estratégias de retirada na cefaleia por uso excessivo de medicamentos também são descritas, assim como os riscos dos tratamentos durante a gravidez e a amamentação. O topiramato oral e as injeções de toxina onabotulínica A são os únicos tratamentos que receberam a recomendação classe A, enquanto que o valproato, a gabapentina e a tizanidina receberam recomendação classe B, juntamente com acupuntura, biofeedback e mindfulness. Os anticorpos monoclonais anti-CGRP ou anti-CGRPr, ainda não disponíveis no Brasil, são novos fármacos promissores, já aprovados em outros países para o tratamento profilático da migrânea, cuja eficácia na migrânea crônica ainda está por ser definitivamente comprovada.


Subject(s)
Humans , Societies, Medical , Consensus , Migraine Disorders/therapy , Brazil , Chronic Disease , Migraine Disorders/classification , Migraine Disorders/diagnosis
20.
Medicina (B.Aires) ; 78(6): 410-416, Dec. 2018. tab
Article in Spanish | LILACS | ID: biblio-976139

ABSTRACT

El vértigo es definido como la sensación de movimiento ilusorio del cuerpo o de los objetos que le rodean. Es una de las causas más comunes de consulta en los departamentos de emergencia, y 2 a 3% de la población mundial consulta anualmente por este síntoma. De acuerdo al compromiso vestibular en el oído interno o en el sistema nervioso central o ambos, puede clasificarse en vértigo periférico, central o de origen mixto, siendo la principal causa del periférico el vértigo posicional paroxístico benigno. La valoración semiológica y anamnesis es fundamental para el diagnóstico. En el examen físico inicial, la diferenciación de un vértigo de origen central de otro de origen periférico, puede realizarse mediante el análisis del nistagmo, la valoración del impulso cefálico y la desviación ocular, que se integran en un sistema denominado HINTS, por sus siglas en inglés (Head Impulse, Nystamus type, Test of Skew), y por la realización de pruebas que evalúen también la vía vestíbulo-cerebelosa. Además, la realización de una audiometría tonal, aumentaría la sensibilidad diagnóstica de 71 a 89% en la evaluación inicial. El diagnóstico apropiado es la base para el tratamiento y control de esta condición clínica en el mediano y largo plazo.


Vertigo is defined as an abnormal sensation of body motion or of its surrounding objects. It is a common chief complaint in emergency departments comprising 2 to 3% of these consultations worldwide. Vertigo is classified as peripheral or central, according to its origin, and can also be occasionally mixed, the most common cause of peripheral involvement being benign paroxysmal positional vertigo. The initial findings on clinical evaluation of patients are the clues for making a correct diagnosis. The differentiation between central and peripheral vertigo can be optimized by analysing nystagmus, by using the skew test and the head impulse test (HINTS), as also by performing the appropriate tests to evaluate the integrity of the vestibular-cerebellar pathway. In addition, tonal threshold audiometry could raise the diagnostic sensibility from 71 to 89% on initial approach. Appropriate diagnosis is the principal key for managing this clinical condition.


Subject(s)
Humans , Vertigo/diagnosis , Vertigo/physiopathology , Vestibular Neuronitis/diagnosis , Vestibular Neuronitis/therapy , Dizziness/diagnosis , Dizziness/physiopathology , Dizziness/therapy , Benign Paroxysmal Positional Vertigo/diagnosis , Benign Paroxysmal Positional Vertigo/physiopathology , Benign Paroxysmal Positional Vertigo/therapy , Meniere Disease/diagnosis , Meniere Disease/physiopathology , Meniere Disease/therapy , Migraine Disorders/therapy
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