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1.
Journal of Clinical Neuroscience ; 2022.
Article in English | ScienceDirect | ID: covidwho-1821378

ABSTRACT

We read Shafeeq Ahmed's letter about our recent article with interest. Stress is one of the most well-known migraine triggers. Early studies have already revealed that stress significantly affects migraine clinical course during the COVID-19 pandemic. Therefore, we also took into account the stress factor in our study. We tried to assess the influence of the COVID-19 pandemic on the psychological state of our patients using the Beck Depression Inventory and the Beck Anxiety Inventory. Due to the COVID-19 pandemic, personal protective equipment and disinfectants have been used so widely and intensively for the first time. Thus, we thought that evaluating the effect of the COVID-19 pandemic on migraine only through stress would be an inadequate approach. Our study demonstrated that in addition to stress, mask types, number of masks, duration of mask use, and disinfectant exposure might affect migraine attacks. Taking these factors into account, treatment and preventative methods may improve migraine sufferers' quality of life.

2.
Front Pain Res (Lausanne) ; 3:858709, 2022.
Article in English | PubMed | ID: covidwho-1792989

ABSTRACT

BACKGROUND: After the acute pandemic of coronavirus disease 2019 (COVID-19), a wide variety of symptoms are identified under the term post-COVID syndrome, such as persistent headache. Post-COVID headache can be presented in a broad spectrum like headache attributed to systemic infection, chronification of already existing primary headache, or long-lasting, and also late-onset new daily persistent headache. Still, little is known about the pathophysiology of post-COVID headache, but activation of the trigeminovascular system may be one of the players. CASE REPORT: Here, we present a case with a severe, long-lasting post-COVID headache and its sudden cessation with calcitonin gene-related peptide (CGRP) monoclonal antibody treatment. CONCLUSION: In our previous protein mimicry study, we have pointed at mimicry of virus spike protein and CGRP receptors. This mechanism may enlighten the current, common, and yet unsolved post-COVID headache cases.

3.
Neurological Care and the COVID-19 Pandemic ; : 141-144, 2021.
Article in English | Scopus | ID: covidwho-1783077

ABSTRACT

Headache is a common symptom and the most common neurological manifestation in COVID-19. Its pathophysiology in COVID-19 remains elusive. It is largely managed by usual headache treatments that are dependent on clinical phenotype. When managing headache patients with or without a history of a primary headache disorder, one should take into consideration access to care, particularly in virus hotspots. © 2021 Elsevier Inc. All rights reserved.

4.
Neurol India ; 69(Supplement): S51-S58, 2021.
Article in English | MEDLINE | ID: covidwho-1771349

ABSTRACT

BACKGROUND: Migraine is a common primary headache disorder and Episodic migraine is characterized by the occurrence of up to 14 headache days in a month. The preventive treatment of migraine is useful in patients with frequent migraine attacks, impaired activities of daily living, failure of acute pain management, disabling aura and limitations in the use of acute treatment. It is aimed at reducing headache frequency and intensity, improve response to acute treatment of migraine and improve the quality of life. AIM: To analyze the evidence for the efficacy and tolerability of preventive oral drugs used in the management of episodic migraine. METHODS: A narrative review of the references were reviewed by searching the literature for the articles published in PubMed in English language using all the following MeSH keywords "preventive treatment", "preventive oral treatment", AND "episodic migraine", "migraine". RESULTS: Out of articles identified in the search, 38 articles were reviewed for evidence and summarized. The various oral drugs used in the prevention of episodic migraine are antihypertensives (beta-blockers, calcium channel blockers and Angiotensin-converting enzyme inhibitors/Angiotensin receptor blockers), antidepressants (tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors), antiepileptic drugs (valproic acid, topiramate, lamotrigine) and other miscellaneous agents. HURT questionnaire and HALT 30 index are useful in assessing response to treatment in the follow up of migraine patients. CONCLUSION: An appropriately chosen oral drug is useful in the preventive treatment of episodic migraine. In patients, who fail to respond to the preventive treatment, it is essential to review the diagnosis of migraine, titrate the dosage and duration of preventive treatment and ensure patient compliance. In those patients who fail to respond to monotherapy, polytherapy is a useful option to be considered.


Subject(s)
Migraine Disorders , Quality of Life , Activities of Daily Living , Anticonvulsants/therapeutic use , Humans , Migraine Disorders/drug therapy , Migraine Disorders/prevention & control , Topiramate/therapeutic use
5.
J Clin Med ; 11(6)2022 Mar 16.
Article in English | MEDLINE | ID: covidwho-1765747

ABSTRACT

Migraine is a debilitating disease whose clinical and social impact is out of debate. Tolerability issues, interactions, contraindications, and inefficacy of the available medications make new options necessary. The calcitonin-gene-related peptide (CGRP) pathway has shown its importance in migraine pathophysiology and specific medications targeting this have become available. The first-generation CGRP receptor antagonists or gepants, have undergone clinical trials but their development was stopped because of hepatotoxicity. The new generation of gepants, however, are efficacious, safe, and well tolerated as per recent clinical trials. This led to the FDA-approval of rimegepant, ubrogepant, and atogepant. The clinical trials of the available gepants and some of the newer CGRP-antagonists are reviewed in this article.

6.
Headache ; 62(3): 284-293, 2022 03.
Article in English | MEDLINE | ID: covidwho-1741387

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic is an ongoing global health crisis that has had a range of impacts on people living with migraine. METHODS: Qualitative interviews performed as part of the Migraine Clinical Outcome Assessment System project, a multi-stage Food and Drug Administration-grant funded program to develop a patient-centered core set of outcome measures for use in migraine clinical trials, offered an opportunity to explore the experience of living with migraine during the pandemic as well as to examine whether migraine treatment priorities, symptoms, and associated disability changed due to the pandemic. Semi-structured interviews were conducted in the United States between the summer and fall of 2020 with 40 individuals with self-reported, medically diagnosed migraine who self-reported that they had not tested positive for or been diagnosed with COVID-19. RESULTS: Seventy percent (n = 28) of the sample reported ≥1 pandemic-related impact on their life with migraine. Fourteen participants reported both positive and negative impacts, twelve reported negative impacts only, and two reported positive impacts only. Among those reporting ≥1 pandemic-related impact, nine participants (32%) reported more frequent and five (17%) reported less frequent migraine attacks. Other negative impacts included interrupted medical care (n = 9; 32%), and greater stress (n = 13; 46%). The most frequent positive impact reported was greater access to health care (n = 8; 29%). Ictal and interictal symptoms were not noted to change due to the pandemic, but some respondents reported less disability due to increased flexibility of schedules and reduced expectations. Treatment priorities did not change due to the pandemic. CONCLUSION: The global COVID-19 pandemic has resulted in both negative and positive impacts for people living with migraine. Lessons to be considered when moving into a post-pandemic world include benefits of and satisfaction with telehealth and the benefits and importance of healthy lifestyle habits and flexibility such as improved sleep, reduced stress, and fewer social expectations.


Subject(s)
COVID-19 , Migraine Disorders , COVID-19/epidemiology , Humans , Migraine Disorders/diagnosis , Migraine Disorders/epidemiology , Migraine Disorders/therapy , Pandemics , Qualitative Research , Quality of Life , United States
7.
Dissertation Abstracts International: Section B: The Sciences and Engineering ; 83(4-B):No Pagination Specified, 2022.
Article in English | APA PsycInfo | ID: covidwho-1716824

ABSTRACT

Migraine is a prevalent but frequently misdiagnosed medical condition involving significant social stigma, leaving many patients feeling devalued and/or misunderstood. Women make up the majority of individuals diagnosed with migraine. This study examined the ways in which a migraine diagnosis shapes an individual's identity. This study's sample consisted of eight female participants, age 31 to 64, who identified as established outpatients at a specialty headache clinic in Chicago, Illinois, which provides services to patients presenting with migraine pain. The interviews were administered in a semi-structured format which provided some structure but also allowed participants the opportunity to elaborate on each topic. All interviews were conducted virtually via a secure video conferencing platform due to the COVID-19 pandemic to ensure the safety of the participants and primary investigator. The interview data collected were qualitatively analyzed using grounded theory to identify key themes related to sense of self and identity and its evolution in response to living with a migraine diagnosis. The results indicated that all participants reported that having a diagnosis of migraine meaningfully impacted their identity in various domains of their life in arenas such as marriage, family, work, friendships, daily life, and sense of self. Some participants expressed feelings of failure regarding their diagnosis whereas others expressed feelings of acceptance. The aim of this study was to contribute meaningfully to existing literature in this area, to assist health care providers in working holistically with this population, and to help validate the experiences of individuals with a diagnosis of migraine. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

8.
J Clin Neurosci ; 97: 87-92, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1712826

ABSTRACT

Since the onset of the COVID-19 pandemic, the use of personal protective equipment (PPE) and disinfectants has become necessary to prevent transmission of the virus. However, the effects of such pandemic obligations on chronic diseases such as migraine have not been fully elucidated. We aimed to investigate the effects of the COVID-19 pandemic, as well as the use of masks and disinfectants, on migraine patients. A total of 310 migraine patients were included. Demographic data, migraine characteristics, and mask and disinfectant use were obtained through a face-to-face survey. Patients were grouped as worsening, stable, or improving according to pre-pandemic and pandemic migraine characteristics. Migraine worsening was found in 177 (57.1%) patients, stable course in 96 (31%) patients, and improvement in 37 (11.9%) patients. The use of scalp contact masks and double masks and daily mask duration were higher in the worsening group (p:0.005, p:0.005 and p:0.001). In addition, the frequency of personal disinfectant use was higher in this group (p:0.011). In regression analysis, mask type, daily mask duration, presence of allodynia, being a health worker, depression score, and odor were determined as independent risk factors for migraine worsening. We found a worsening of migraines in more than half of patients during the COVID-19 pandemic. We also demonstrated a relationship between migraine worsening and mask type, number of masks, and intensive disinfectant use. Migraine patients should be advised of optimal prevention methods based on individual social and working conditions rather than exaggerated preventative measures.


Subject(s)
COVID-19 , Disinfectants , Migraine Disorders , COVID-19/prevention & control , Humans , Masks/adverse effects , Migraine Disorders/epidemiology , Migraine Disorders/etiology , Migraine Disorders/prevention & control , Pandemics/prevention & control , SARS-CoV-2
9.
Med Hypotheses ; 161: 110812, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1706288

ABSTRACT

Chronic headache is a frequent disorder that can cause a significant deterioration in the quality of life of the affected person. The COVID-19 pandemic is compelling all countries to develop a complete vaccination protocol for the entire population. In this article, we present 8 clinical cases of patients suffering chronic headache which resolved completely or partially after vaccination. Five patients had migraine, 2 had a post-viral headache typical of COVID-19, and one had a headache induced by sexual activity. Resolution was complete in 3 cases, almost complete in 2 others, and a great improvement was observed in the other 3. We hypothesize that the administration of vaccines for COVID-19 can produce an improvement or the disappearance of symptoms in our patients by inhibiting synthesis of pro-inflammatory cytokines.

10.
Neurol Sci ; 43(3): 1583-1585, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1706227

ABSTRACT

BACKGROUND: The study had been initiated because of restrictions put in place to control the spread of coronavirus in Milan in March 2020 that impacted clinical activities at our tertiary headache center in Milan (Foundation IRCSS Carlo Besta Neurological Institute). Treatment efforts were modified to make use of telephonic and internet communication to maintain care of our patients. METHODS: Nineteen patients had undergone our withdrawal protocol for medication overuse headache and were scheduled for follow-up that included pharmacological prophylaxis combined with behavioral therapy and mindfulness, generally performed in small group face-to-face sessions. A behavioral program was organized for them by technology modality (smartphone) due to the pandemic restrictions. RESULTS: The results concern 12-month follow-up. The clinical indexes showed migraine days per month 20.6 (± 6) pre vs 11.2 (± 3.1 at 12 months); medications intake per month 19.4 (± 5.8) pre vs 9.0 (± 4.6) at 12 months; MIDAS 67.7 (± 52.6) pre vs 71.1 (± 60) at 12 months; HIT-6 66.2 (± 5.3) pre vs 62.2 (± 5.9). CONCLUSION: The present study confirmed literature data, supporting the behavioral approach combined to traditional therapies as a novel method to follow patients and guarantee their benefit, also when applied using technology by telemedicine or smartphone.


Subject(s)
COVID-19 , Headache Disorders, Secondary , Migraine Disorders , Headache Disorders, Secondary/drug therapy , Humans , Internet , Migraine Disorders/drug therapy , Prescription Drug Overuse , SARS-CoV-2
11.
Journal of Investigative Medicine ; 70(2):605-606, 2022.
Article in English | EMBASE | ID: covidwho-1699665

ABSTRACT

Case Report Pediatric Systemic Lupus Erythematous (pSLE) is a multi-system autoimmune disease with varied clinical presentations. Although rare, it can be associated with significant morbidity and mortality. We report a case of a newly diagnosed pSLE patient who's presenting symptoms were concerning for viral pericarditis. Our 17-year-old African American female presented with non-radiating substernal chest pain and shortness of breath for three days. Pain was described as a constant pressure, exacerbated by lying down, and improved with leaning forward. Shortness of breath was most notable with ambulation. Other associated symptoms included subjective fever, chills, fatigue, two-week history of mild cough, intermittent headaches, nausea, emesis, pedal edema, myalgias, arthralgias, and a 10-pound weight loss. Detailed enquiry revealed a long-standing history of lymphadenopathy, neutropenia, microcytic anemia, and migraine headaches. Previous evaluation included normal thyroid studies, Hemoglobin A1c, complete metabolic panel, HIV testing, monospot, and a reassuring peripheral blood smear. Initial evaluation for her chest pain revealed normal EKG and chest x-ray. On physical exam at our facility, she was afebrile with normal vital signs. Soft, mobile, non-tender, <2 cm posterior cervical lymph nodes were palpated. Cardiac exam was unrevealing and no arthritis or rashes were noted. Her lungs were clear, but she had conversational dyspnea. Initial differential diagnoses included systemic processes such as rheumatologic, oncologic, and infectious. Testing revealed elevated troponin, proteinuria, pancytopenia, and elevated inflammatory markers. Coombs test and ACE were negative. D-dimer and creatinine kinase to evaluate for deep vein thrombosis and myositis were normal. EKG was concerning for ST elevation in anterolateral leads, and an echocardiogram revealed a small, globally distributed pericardial effusion. COVID PCR was positive concerning for pericarditis secondary to multisystem inflammatory syndrome in children (MIS-C). Though she met diagnostic criteria for MIS-C with her history of fever, elevated inflammatory markers, and multisystem involvement (cardiac and abdominal), the presence of her symptoms over several months was more concerning for a chronic process. Further evaluation into an underlying etiology revealed low C3/C4, positive ANA, positive ds-DNA, and positive SS-A, SS-B, chromatin, Anti-Smith, and RNP antibodies. The immunologic profile along with her clinical presentation was consistent with pSLE. Treatment with high-dose intravenous steroids resulted in complete resolution of her chest pain and she was discharged on oral hydroxychloroquine. pSLE is a multi-faceted and diagnostically challenging disease. Our case highlights the importance of obtaining a thorough history and a low threshold of suspicion for this complex autoimmune condition.

12.
Acta Neurol Belg ; 122(2): 497-503, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1689444

ABSTRACT

BACKGROUND: The COVID-19 lockdown has influenced people lifestyle, behaviour, physical activity (PA), and working habits as well as, possibly, migraine. The aim of the study was to assess the impact of lockdown on the burden of migraine attacks during COVID-19 lockdown. METHODS: Patients were interviewed, and data about demographics, PA, daily behaviour, working habits, disability (HIT-6) and characteristics of migraine and drugs consumption were compared between the first month of the lockdown in Italy (March 2020), and a reference month prior the lockdown (January 2020). RESULTS: 37 patients were analysed, classified as migraine without aura (MwoA) (n = 26) and migraine with aura (MwA) plus migraine with and without aura (MwA/MwoA) (n = 11). During the lockdown, a greater proportion of patients with insufficient PA (65% vs 31%; p = 0.012) were found. Reduced mean headache duration [3 h, (2-12) vs 2 h (1-8); p = 0.041] and HIT score [59 (51-63) vs 50 (44-57); p = 0.001] were found in MwoA patients during the lockdown, while no changes found in patients with MwA + MwA/MwoA. CONCLUSIONS: Lockdown induced significant changes in PA and working habits of people with migraine and was found to be associated with improved migraine-related symptoms which might depend by different lifestyle habits.


Subject(s)
COVID-19 , Migraine with Aura , Migraine without Aura , Communicable Disease Control , Humans , Life Style , Migraine with Aura/complications , Migraine without Aura/complications
13.
Cephalalgia ; : 3331024211068074, 2022 Feb 15.
Article in English | MEDLINE | ID: covidwho-1685877

ABSTRACT

BACKGROUND: Headache is a frequent symptoms of coronavirus disease 2019 (COVID-19). Its long-term evolution remains unknown. We aim to evaluate the long-term duration of headache in patients that presented headache during the acute phase of COVID-19. METHODS: This is a post-hoc multicenter ambisective study including patients from six different third-level hospitals between 1 March and 27 April 2020. Patients completed 9 months of neurological follow-up. RESULTS: We included 905 patients. Their median age was 51 (IQR 45-65), 66.5% were female, and 52.7% had a prior history of primary headache. The median duration of headache was 14 (6-39) days; however, the headache persisted after 3 months in 19.0% (95% CI: 16.5-21.8%) and after 9 months in 16.0% (95% confidence interval: 13.7-18.7%). Headache intensity during the acute phase was associated with a more prolonged duration of headache (Hazard ratio 0.655; 95% confidence interval: 0.582-0.737). CONCLUSION: The median duration of headache was 2 weeks, but in approximately a fifth of patients it became persistent and followed a chronic daily pattern.

14.
Cephalalgia ; : 3331024211067787, 2022 Feb 15.
Article in English | MEDLINE | ID: covidwho-1685876

ABSTRACT

INTRODUCTION: Headaches associated with personal protective equipment were reported in health-care workers in previous epidemiological studies. METHODS: National web-based survey advertised by the Portuguese Headache Society and National Headache and Migraine patient´s organization between September-December 2020 screening for personal protective equipment usage pattern, pre-existing and de novo headaches after the onset of the COVID-19 pandemic, and its relation to personal protective equipment use. RESULTS: Of 5064 participants, 90.6% (4562/5034) were women, mean age was 37.2 ± 11 years. Most questions had a completion rate above 87% (non-completion rate ranging from 0-12.7%). Twenty percent were health-care professionals (993/5046). Surgical and cloth masks were the most common personal protective equipment type, whereas protective eyewear and FFP2/FFP3 masks were mostly used by health-care professionals. About 97% (1814/1870) of migraine and headache participants reported aggravation of pre-existing headaches with personal protective equipment use, and 56% (2476/4420) had de novo headaches. Participants with de novo headaches had a higher frequency of pre-existing migraine (1118/1226, 91.2% vs 1408/1600, 88%, P = .042), and wore personal protective equipment for longer periods of time (7 ± 2 h 42 vs 6 ± 2 h 54 min per day, P < .001). In multivariate analysis longer mean duration of personal protective equipment use (OR of 1.1, 95% CI 1-1.2) and previous migraine (OR of 1.2, 95% CI 1-1.4) were predictors of developing de novo headaches. CONCLUSIONS: Almost all participants with pre-existing headache reported worsening of their headaches, and more than half of the study population developed de novo headaches following personal protective equipment use. Duration of personal protective equipment usage and pre-existing migraine were the strongest predictors of de novo headaches.

15.
Cardiopulmonary Physical Therapy Journal ; 33(1):e13-e14, 2022.
Article in English | EMBASE | ID: covidwho-1677330

ABSTRACT

BACKGROUND AND PURPOSE: Post-Covid Syndrome is the chronic phase after COVID-19 when a person no longer has a positive polymerase chain reaction (PCR) test, however continues to display symptoms. Symptoms include fatigue, post-exertional malaise, cognitive dysfunction, shortness of breath and transient or long-term orthostatic intolerances such as Postural Orthostatic Tachycardia Syndrome (POTS). There is limited evidence on exercise guidelines for Post-Covid Syndrome. The purpose of this case study is to describe the physical therapy (PT) plan of care for patient with Post-Covid Syndrome. CASE DESCRIPTION: A 51-year-old female with diagnosed COVID-19 with a nonremarkable recovery at home. Her past medical history was significant for depression, anxiety and migraines. She was active, engaging in hiking and recreational sports. She developed Post-Covid Syndrome and POTS five months later, with medical testing negative for brain MRI, echocardiogram, EKG, pulmonary function test, and bloodwork. Positive tests indicative of POTS, included the cardiac stress test and active stand test. PT started four months later to address fatigue and muscle weakness. She presented with mild cognitive impairment, impaired cardiovascular endurance and standing balance, left upper and lower extremity weakness. She was unable to walk more than 0.5 miles, required rest breaks during activity of daily living, and was unable to return to work. Based on exercise guidelines by De Wandele et al. for POTS, an exercise program was developed. Vitals (BP, HR, oxygen saturation and BORG Rating of Perceived Exertion) were monitored each session. The program was implemented at a frequency of 2 times/week for 10 visits and 1 time/week at home. The mode of exercise was endurance training using recumbent ergometer at 75% of max HR or Borg RPE of 13-15. Total intervention time was 30 minutes including 10 minutes for warm-up and cool-down. Patient was assessed at evaluation and progress report, 10 visits later with the 6- minute walk test (6MWT) to assess endurance, the Modified Fatigue Impact Scale (MFIS) to assess perceived fatigue severity and its impact on function, subjective activity diary of post-exertional malaise, and the EURO-Quality of Life (EUROQOL-5) to determine overall health. OUTCOMES: The patient completed supervised sessions without adverse reactions. She maintained the target HR and demonstrated improved 6MWT by 87 m, MFIS by 18 points and EUROQOL-5 by 8 points after 10 visits. She also had reduced post-exertional malaise episodes from twice a day to twice a week. DISCUSSION: This cardiovascular endurance training program is correlated with positive improvements in endurance, fatigue severity, and quality of life in a person with PostCovid Syndrome. Post-Covid Syndrome is a developing diagnosis and there is limited data on its clinical course of recovery. Further research is needed to develop specific exercise guidelines for Post-Covid Syndrome.

16.
Prescriber ; 33(1):4-4, 2022.
Article in English | EMBASE | ID: covidwho-1664441
17.
Value in Health ; 25(1):S8, 2022.
Article in English | EMBASE | ID: covidwho-1650141

ABSTRACT

Objective: To identify the perceived causes for chronic ocular pain (COP) (≥3 months pain duration), its impact on quality of life (QoL) and understand the patient journey from social media posts. Methods: In this retrospective study, publicly available social media conversations were identified from searches triaged by a combination of automated relevancy keyword algorithm and manual review, and subsequently analyzed post anonymizing for COP content. Twitter, forums, and other (Facebook, Blogs, etc.) platforms were leveraged for the time period February 2020 to February 2021. Results: A total of 464 (UK=208, US=175, Canada=65 and Australia=16) patient/caregiver conversations on COP were identified. Top discussion points were symptoms (62%) and causes of COP (58%). Ocular factors (including dry eye disease, thyroid/Graves’ disease, and ocular surgeries) contributed to ∼46% of causes identified, while non-ocular factors (including migraine, COVID, and side-effects/withdrawal of medications) contributed to ∼54%. The most commonly mentioned symptoms (555) were headache/head pressures (96), dry/gritty eyes (67), light sensitivity (34), insomnia (29), and redness/pink eyes (28). Symptoms impacted all aspects of patients’ QoL: physical day-to-day activities such as reading, driving, and sleeping;emotional wellbeing such as depression/hopelessness, frustration/anger, fear, and suicidal thoughts;functional wellbeing such as difficulty at work/study place, reduced productivity or having to quit their job;social impacts such as being irritated around people, and having a less active social life. Eye drops (58/140 mentions) are the most commonly mentioned treatment option. Common coping strategies mentioned were blue-light filter glasses/eyeglasses (17), and hot compresses (11). Key unmet needs mentioned by patients were failed, improper, delayed diagnosis (62), and lack of effective treatments or appropriate management (30). Conclusion: Insights from this study reported patients’ experiences, concerns, and the adverse impact on overall QoL. The results can help in better understanding the patients’ perspective, which can be considered during drug development.

18.
Neurol Sci ; 2022 Jan 19.
Article in English | MEDLINE | ID: covidwho-1633886

ABSTRACT

OBJECTIVE: The medication-overuse headache (MOH) prevalence has not been investigated in a general Japanese population. We performed questionnaire-based survey and revealed MOH prevalence and its characteristics. We also performed clustering to obtain insight for MOH subgrouping. METHODS: In this cross-sectional study, the 15-64-year-old population was investigated in Itoigawa during their COVID-19 vaccination under the national policy. MOH was defined as ≥ 15 days/month plus self-report of use of pain medications ≥ 10 or 15 days/month in the last 3 months. Ward method and k-means + + were used to perform clustering MOH patients. RESULTS: Among 5865 valid responses, MOH prevalence was 2.32%. MOH was common among females and the middle-aged. Combination-analgesic is the most overused as 50%. MOH had aggravation by routine physical activity, moderate or severe pain, and migraine-like, compared to non-MOH. The 136 MOH patients could be grouped into 3 clusters. Age and frequency of acute medication use were essential factors for clustering. CONCLUSIONS: This is the first study of MOH prevalence in Japan. Most MOH characteristics were similar to previous reports worldwide. Public awareness of proper headache treatment knowledge is still needed. Clustering results may be important for subtype grouping from a social perspective apart from existing clinical subtypes.

19.
Vaccines (Basel) ; 10(1)2022 Jan 13.
Article in English | MEDLINE | ID: covidwho-1625705

ABSTRACT

The BNT162b2 (Pfizer BioNTech) mRNA vaccine is an effective vaccine against COVID-19 infection. Here, we report an adverse event following immunization (AEFI) in a 48-year-old female patient who presented with fasciculations, migraine auras without headaches and in an increased discomfort of previously present palpitations, as well as excitation and insomnia. Her fasciculations were intermittently present until the time this paper was written, starting from the 6th day post-vaccination; they changed localization and frequency, but most commonly they were generalized, affecting almost all muscle groups. The patient also suffered from two incidents of migraine auras with visual kaleidoscope-like phenomena without headaches a few months after the vaccination. These symptoms were considered to be AEFI and no causal relation with the vaccine could be proven.

20.
Journal of Experimental and Clinical Medicine (Turkey) ; 38(4):645-648, 2021.
Article in English | EMBASE | ID: covidwho-1614657

ABSTRACT

Headache is one of the most prevalent disorders of the nervous system. Headache is also the most common symptom of a variety of diseases, including migraine, COVID-19. International Classification of Headache Disorders (ICHD) lists over a thousand different types of headaches. Migraine is a widely known type of primary headache. Much research supports that the enhancement in migraine intensity related to chronic migraine such as neurogenic neuroinflammation, possibly leading to increased cytokine expression via activation of protein kinases in neurons and glial cells of the trigeminovascular system like some of the other headache diseases. No currently drug class available, either specific (triptans, ergots) or non-specific (opioids, paracetamol, NSAIDs), is effective in all types of headaches, in all patients and all attacks of the same patient. However, non-steroidal anti-inflammatory drugs (NSAIDs) minimize prostaglandin synthesis by blocking cyclooxygenase, which is included in the pathophysiology of migraine headaches. We searched the employed source was The Journal of Headache and Pain database by using NSAIDs with Headache, Migraine, and COVID-19 keywords. The search was performed from April 2021 and included 2017-2018-2019-2020-2021 (last five years) the studies and reviews from the Journal of Headache and Face Pain Sites. Additionally, we noted the published or on-going studies, eight of these, about NSAIDs information contain searches that exist in the 12th European Headache Federation Congress (jointly with 32nd National Congress of the Italian Society) Study of Headaches’ book. Also, we included relationship migraine with COVID-19 studies to highlight the connection between the headache, which is one of the most common symptoms of both migraine and COVID-19, and the importance of managing migraine pain with NSAIDs during corona processing.

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