Characteristic and overlapping features of migraine and tension-type headache.

OBJECTIVE: This epidemiological survey was conducted to investigate comprehensive characteristic and overlapping features of migraine and tension-type headache (TTH) disorders classified based on International Classification of Headache Disorders-II. METHODS: The stratified cohort of this study was composed of 2504 schoolchildren aged 10 to 17 years. A 38-item questionnaire inquiring all characteristic features of primary headache syndromes mandatory for classification was applied to selected 483 children with recurrent headache in the last 6 months. RESULTS: Migraine was diagnosed in 227 (47.0%) of 483 children and TTH in 154 (31.9%). Out of 125 children with definite migraine, 73 (58.4%) reported tension-type symptoms and 94 (68.1%) of 138 children with definite TTH reported migraine-type symptoms. Pressing pain (21%) and lack of aggravation of pain by physical activity (34%) were the major tension-type features in patients with migraine. Throbbing quality (43%) and aggravation by physical activity (30%) determined the main migraine-type features in patients with TTH. CONCLUSION: The frequent co-occurrence of migraine and TTH symptoms suggests the presence of a common pathogenesis.

The efficacy of steroids in idiopathic facial nerve paralysis: an open, randomized, prospective controlled study.

OBJECTIVES: Although corticosteroid therapy is widely used in idiopathic facial nerve paralysis, its efficacy has not been clearly demonstrated. This study was designed to evaluate the role of steroids in idiopathic facial nerve paralysis. PATIENTS AND METHODS: The study included 56 patients (29 males, 27 females; mean age, in men 44.1, in women 40.3 years) with a diagnosis of idiopathic facial nerve paralysis. Within the first three days after the onset of symptoms, the patients were randomly assigned to two groups to receive either steroids or other medications for the prevention of ocular complications or to provide pain relief. The severity of facial paralysis was evaluated using the House-Brackmann classification before and after three and six weeks of the treatment. Regression to stage 1 or 2 disease was regarded as a successful response. RESULTS: Although the initial response to steroid therapy seemed to be better, the results at the end of three and six weeks of the treatment were not statistically different from those of patients receiving other supportive treatments (p>0.05). CONCLUSION: Further studies with large patient series are needed to clarify the use of steroids in the treatment of idiopathic facial nerve paralysis.

The related causes in very early morning onset of stroke.

We investigated the influence of early awakening and related factors on onset of cerebrovascular disease (CVD). Totally 1199 stroke patients, in whom the onset time was known, at 3 reference hospitals were included in this study. The effects of demographic, medical, and pathophysiological factors on the circadian pattern of an unselected series of patients with ischemic stroke were analyzed. Nine-hundred seventeen CVD patients with cerebral infarction (CI), 240 patients with intracerebral hemorrhage (CH), and 42 patients with subarachnoid hemorrhage (SAH) were identified. The greatest portion of strokes (32.5%) occurred between 03:00 and 06:00 a.m. Nearly one half of the strokes in this series occurred in the very early- to mid-morning hours. This analysis of strokes provides strong evidence with a higher risk in the early morning hours (03:00 a.m. to 06:00 a.m.), and lower risk during the night time period (21:00 p.m. to midnight). Approximately 1 of every 3 strokes (1 of 3 ischemic strokes, 1 of 6 hemorrhagic strokes, and 1 of 8 subarachnoid hemorrhages) is attributable to the early morning excess. This difference tried to be explained by three ways: cold weather, religious factors, and physiological mechanisms.