RESUMEN
To evaluate brainstem excitability in menstrual migraine (MM) patients and compare the electrophysiological parameters of the trigeminocervical reflex (TCR) during the perimenstrual (headache period) and follicular (headache-free) periods with those in healthy controls. Thirty-one patients with MM and 22 volunteer age- and sex-matched healthy women were included in the study. The TCR was studied bilaterally with stimulation of the supraorbital branch of the trigeminal nerve during the perimenstrual period and follicular phase. The electrophysiological parameters of the TCR were compared between MM patients and controls. In controls, there was no statistically significant difference in the mean reflex latencies recorded during the perimenstrual and follicular phases (P > 0.05). In MM patients, the mean reflex latencies recorded during the perimenstrual (headache period) and follicular phase (headache-free) periods were significantly different from each other and from those in controls. The latencies of MM patients during the follicular (headache-free) period were significantly longer than those of controls. Brainstem excitability differed significantly between the perimenstrual (headache period) and follicular phase (headache-free) periods in MM. Furthermore, trigeminal excitability in MM patients was significantly different from that in healthy controls in both phases of the menstrual period.
Asunto(s)
Ciclo Menstrual/fisiología , Trastornos de la Menstruación/fisiopatología , Trastornos Migrañosos/fisiopatología , Umbral del Dolor/fisiología , Nervio Trigémino/fisiopatología , Adulto , Vías Aferentes/fisiopatología , Tronco Encefálico/fisiopatología , Estimulación Eléctrica , Electrodiagnóstico/métodos , Femenino , Humanos , Trastornos de la Menstruación/complicaciones , Persona de Mediana Edad , Trastornos Migrañosos/etiología , Músculos del Cuello/inervación , Músculos del Cuello/fisiopatología , Conducción Nerviosa/fisiología , Neuralgia/diagnóstico , Neuralgia/etiología , Neuralgia/fisiopatología , Nervio Oftálmico/anatomía & histología , Nervio Oftálmico/fisiología , Dimensión del Dolor/métodos , Tiempo de Reacción/fisiología , Reflejo/fisiología , Núcleos del Trigémino/fisiopatología , Adulto JovenRESUMEN
The objective of this study was to investigate the long-term efficacy and safety of botulinum toxin type-A (BoNT-A) for refractory chronic tension-type headache (CTTH). An open-label, prospective study was carried out in the Department of Neurology of Kirikkale University on 28 patients (8 males, 20 females), mean age 35.6 years, diagnosed with moderate/severe CTTH refractory to preventive medications. Each patient received BoNT-A injections once in pericranial muscles. Efficacy and safety data were analysed for 28 refractory CTTH patients who were receiving concomitant headache prophylactic medications at baseline and during the study. The main outcome parameters were reduction of headache frequency and intensity over 1 year. Both parameters were significantly decreased (p<0.05) by the end of the study. Sixty-four percent of patients reported complete headache relief at the final visit, compared to 7% CTTH persisted. BoNT-A also resulted in significant reductions in analgesic consumption (p<0.05). Adverse effects were transient and local. BoNT-A was found to be an effective and safe treatment for refractory CTTH patients with concomitant headache prophylactic medications, resulting in significant reductions in headache frequency, intensity and analgesic consumption which persisted up to 1 year.
Asunto(s)
Toxinas Botulínicas Tipo A/administración & dosificación , Toxinas Botulínicas Tipo A/efectos adversos , Músculo Esquelético/efectos de los fármacos , Cefalea de Tipo Tensional/tratamiento farmacológico , Adulto , Analgésicos/uso terapéutico , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Músculo Esquelético/fisiopatología , Músculos del Cuello/efectos de los fármacos , Músculos del Cuello/fisiopatología , Fármacos Neuromusculares/administración & dosificación , Fármacos Neuromusculares/efectos adversos , Satisfacción del Paciente , Estudios Prospectivos , Recurrencia , Cefalea de Tipo Tensional/fisiopatología , Tiempo , Factores de Tiempo , Resultado del TratamientoRESUMEN
BACKGROUND: Both basic and clinical research has demonstrated that antiepileptic drugs can be effective in alleviating neuropathic pain. It was hypothesized that oxcarbazepine might be effective in reducing the symptoms of painful diabetic neuropathy. AIMS: To investigate the long-term efficacy and safety of oxcarbazepine in symptoms of painful diabetic neuropathy. MATERIALS AND METHODS: This study included thirty-eight painful diabetic neuropathy patients, which were screened with clinical assessment and electrophysiological studies. The efficacy and safety of oxcarbazepine were evaluated according to the changes in pain intensity and social interference subitems scores of Short-form Brief Pain Inventory besides electrophysiological studies at the end of six months of the treatment. STATISTICAL ANALYSIS: The Students t, Mann-Whitney U and Rank Sum test and Chi-square tests were applied to examine variables differences. The level of statistical significance was chosen to be P<0.05. RESULTS: A significant difference was found in all of subitems of pain intensity and social interference at the end of the study according to the baseline scores. Improvement was observed in 52.7%, 63.1%, 55.3% and 63.2% of patients for worst, least, average and pain right now at the end of six months, respectively. Improvement was observed as 60.6%, 63.2%, 52.6%, 60.5%, 68.4% and 63.2% for general activity, mood, walk, work, people relations, sleep and life enjoyment subitems, respectively. None of these patients had any prominent side effect leading to discontinue the treatment. CONCLUSION: Long-term oxcarbazepine treatment was found to be effective and safe in the symptoms of painful diabetic neuropathy.