ABSTRACT
We assessed interobserver reliability of the International Headache Society (IHS) classification for diagnosis of primary headaches. The study was performed on 103 patients consecutively seen at two Headache Centres. Each patient was given a structured interview recorded on videotape. Four experienced clinicians then reviewed the interviews separately and made a diagnosis of headache according to IHS criteria at the one- and two-digit levels. At both the one- and the two-digit level the agreement was substantial (Kappa = 0.74 and 0.65, respectively). The analysis of reliability for each of nine items necessary for diagnosis showed an agreement ranging from substantial (Kappa = 0.69) to almost perfect (Kappa = 0.89). Our results indicate that the IHS classification has a good reliability for the diagnosis of primary headaches at the one- and two-digit levels.
Subject(s)
Headache/classification , Observer Variation , Adolescent , Adult , Aged , Diagnosis, Differential , Female , Headache/diagnosis , Humans , Male , Middle Aged , Migraine Disorders/classification , Migraine Disorders/diagnosis , Neurologic Examination , Prospective Studies , Societies, Medical , Surveys and QuestionnairesABSTRACT
Before describing the state of knowledge on headache and epilepsy at the Salerno Medical School (SMS), we will briefly summarize in the first part its history through the centuries until the "golden period" of the 12th century when it reached its peak by outshining all others in teaching, studies and research. In the second part we will refer to Saint Donato, healer of epileptics in the south of Italy, whose worship is still alive today. The finding of common symbols in conceptions of headache and epilepsy, both in the scientific tradition of the School and in popular medicine, represents a link which is explicable by the wide dissemination of the school's doctrines.
Subject(s)
Education, Medical/history , Epilepsy/history , Headache/history , Medicine, Traditional/history , Religion and Medicine , Schools, Medical/history , Symbolism , History, Medieval , History, Modern 1601- , Humans , Italy , Saints/historyABSTRACT
The aim of our study was to evaluate the efficacy of long-term migraine prophylaxis with flunarizine. The efficacy of the drug was evaluated on the basis of the frequency, pain severity and duration of migraine attacks. Frequency, the most modified parameter, was reduced to about half of the pre-treatment level in one to three months time. The condition remained more or less stable from the third treatment month onwards. The results showed remarkable efficacy of long-term prophylaxis with flunarizine, and the response was better in younger patients with a short history of migraine.
