scholarly journals Visually Evoked Postural Responses (VEPRs) in Children with Vestibular Migraine

Children ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 14
Author(s):  
Riccardo Nocini ◽  
Carlo Baraldi ◽  
Enrico Apa ◽  
Andrea Ciorba ◽  
Daniele Monzani ◽  
...  

Vestibular migraine (VM) is the most common cause of episodic vertigo in children. Vertigo, nausea, dizziness and unsteadiness are often complained of by children with migraine, which can precede, follow or be present simultaneously with headache. The aim of this study was to use posturography to investigate the visually evoked postural responses (VEPRs) of children with VM and compare them to data obtained from children with primary headache (M) and controls (C). Twenty children diagnosed as affected by VM, nineteen children with M without aura and twenty healthy subjects were recruited in this cross-sectional study. Posturography was performed by a standardized stabilometric force-platform (Svep-Politecnica) in the following conditions: open eyes (OE), closed eyes (CE) and during full-field horizontal optokinetic stimulation (OKN-S). Electronystagmography was performed simultaneously to analyze optokinetic reflex parameters. In the OE condition, no difference was found between groups with respect to body sway area. In contrast, this parameter increased in the two pathological groups with respect to controls in the CE condition. The optokinetic stimulations also induced a similar increase of body sway area in the M group relative to controls, but a further increase was elicited in the VM group. Electronystagmographic recording also revealed different optokinetic reflex parameters in the latter groups. This study disclosed an abnormal sensitivity of children with M and VM to full-field moving scenes and a consequent destabilization of posture, as documented by the abnormal VEPRs. Children with VM were particularly exposed to this risk. Possible clinical implications of these findings are discussed.

Author(s):  
Sanjay Prasad ◽  
Abhay Paliwal ◽  
Ram Ghulam Razdan

Background: Primary headache disorders including migraine and tension-type headache (TTH) are of great importance to global public health due to its high prevalence, but very few studies have been conducted to know its prevalence and pain severity of different types of primary headache. Aim of this study was to investigate the subtypes and pain severity of different types of primary headache in hospital setting.Methods: This study is a cross-sectional study with 200 sample size. Includes patients with Primary headache in department of Psychiatry, MGMMC, Indore. Patient aged between 18-65 years, both gender. Diagnosis of headache was done clinically in accordance with International Classification of Headache disorders (ICHD- 3). Semi-structured headache questionnaire, Comparative pain scale were used for assessment of samples.Results: Among 200 patients, Tension type headache was 73.5%, Migraine was 22%, Mixed headache was in 4.5% patients. Majority of migraine and mixed headache cases had severe pain at 93.2% & 55.6% respectively. Majority of TTH cases had moderate pain in 42.2% patients.Conclusions: Study has shown assessments of severity of pain, can be used to assess the impact of Primary headache on patient’s quality of life.


BMC Neurology ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Firas Anaya ◽  
Wala’a Abu Alia ◽  
Feda’a Hamoudeh ◽  
Zaher Nazzal ◽  
Beesan Maraqa

Abstract Background Headache is one of the most disturbing complaints worldwide, negatively impacting social and regular life activities. In the background of stressful life in medical schools, adding to the stressful situation in Palestine, a developing country under occupation, this study investigated the prevalence and clinical characteristics of migraines and tension- type headaches among medical students from the Palestinian Universities in West Bank and Gaza. Methods A questionnaire-based cross-sectional study was conducted on all Palestinian Medical Students. Students were diagnosed based on ICHD-3 criteria. Demographic characteristics were compared by gender for each type of headache. Frequency, percentage, and mean ± SD. Pearson’s chi-squared test, independent t-test, and one-way ANOVA were used where needed. P-value < 0.05 was considered significant. Results The study included 806 medical students; 476 (59.0%) of them were female. TTH and migraine’s prevalence was 59.8 and 22%, respectively, with a higher prevalence among basic year students. The female to male ratio was 1:0.6 for both types of headaches. Sleep deprivation, physical activities, and altered sleep patterns were reported as the top triggering factors. Conclusions The results demonstrate that the prevalence of both subtypes’ primary headache is high among Palestinian medical students, with a higher prevalence among basic year students. The study also showed that these findings are higher than other studies among medical students in other countries.


2021 ◽  
Author(s):  
Firas M. Anaya ◽  
Wala’a Abu Alia ◽  
Feda’a Hamoudeh ◽  
Zaher A. Nazzal ◽  
Beesan Maraqa

Abstract Background Headache is one of the most disturbing complaints worldwide, negatively impacting social and regular life activities.In the background of stressful life in medical schools, adding to the stressful situation in Palestine, a developing country under occupation, this study investigated the prevalence and clinical characteristics of migraines and tension headaches among medical students from the Palestinian Universities in West Bank and GazaMethods:A questionnaire-based cross-sectional study was conducted on all Palestinian Medical Students. Students were diagnosed based on ICHD-3 criteria. Demographic characteristics were compared by gender for each type of headache. Frequency, percentage, and mean ± SD. Pearson's chi-squared test, independent t-test, and one-way ANOVA were used where needed. P-value < 0.05 was considered significant.Results:The study included 806 medical students; 476 (59.0%) of them were female. TTH and migraine's prevalence was 59.8% and 22%, respectively, with a higher prevalence among basic year students. The female to male ratio was 1:0.6 for both types of headaches. Sleep deprivation, physical activities, and altered sleep patterns were reported as the top triggering factors.ConclusionsThe results demonstrate that the prevalence of both subtypes' primary headache is high among Palestinian medical students, with a higher prevalence among basic year students. The study also showed that these findings are higher than other studies among medical students in other countries.


2021 ◽  
Author(s):  
Toshihide Toriyama ◽  
Yoshiki Hanaoka ◽  
Tetsuyoshi Horiuchi

Abstract Background: The demographic and clinical characteristics of vestibular migraine (VM) based on the International Classification of Headache Disorders (ICHD)-III beta are not well documented, and the underlying pathophysiology remains largely unknown. Based on evidence that central sensitization is involved in VM pathogenesis, we hypothesized that cutaneous allodynia (CA), which is a clinical manifestation of central sensitization, and interictal widespread pressure hyperalgesia (IWPH), which may be an accelerator for central sensitization, are more frequently associated with VM patients compared with non-VM patients. The aim of this study was as follows: 1) to assess differences in demographic and clinical characteristics among VM patients, patients with migraine with vestibular symptoms not meeting VM criteria (MwVS), and patients with migraine without vestibular symptoms (MwoVS); and 2) to evaluate whether VM patients were more frequently associated with CA/IWPH compared with the other two groups.Methods: This cross-sectional study enrolled consecutive migraine patients, aged 18–65. The comprehensive interview form included diagnostic questions of migraine and VM, demographic characteristics, migraine-specific variables, migraine-associated symptoms, and CA. IWPH occurrence was investigated using a manual tender point survey and clinical parameters were compared.Results: A total of 245 episodic migraineurs (mean age = 39.5 ± 11.3 years, 81.2% women) were enrolled. Based on ICHD-III beta criteria, 65 (26.5%), 74 (30.2%), and 106 (43.3%) patients were assigned to the VM group, MwVS group, or MwoVS group, respectively. Pairwise comparisons demonstrated no significant differences between the VM and MwVS groups, except for higher occurrence of headache disability in the VM group. Compared with the MwoVS group, the VM group was significantly associated with aura, severe disability, depression, tinnitus, sleep disorders, multimodal CA, and IWPH.Conclusions: There were no significant differences in clinical features between VM and MwVS groups, except for disability, which was possibly caused by criteria selection bias. VM and MwVS may be on the same disease process spectrum. Widespread multimodal CA, including clinical manifestations of thalamic sensitization, was significantly associated with VM patients compared with MwoVS patients, which indicates that thalamic sensitization may play a key role VM pathogenesis. Furthermore, IWPH may enhance susceptibility to thalamic sensitization.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jasem Youssef Al-Hashel ◽  
Fathi Abokalawa ◽  
Maram Alenzi ◽  
Raed Alroughani ◽  
Samar Farouk Ahmed

Abstract Background Coronavirus disease-19 is caused by the severe acute respiratory syndrome coronavirus 2 Headache is a common symptom during and after Coronavirus disease-19. We aimed to study headache character in relation to COVID-19. Methods This was a cross-sectional study. Patients who had Coronavirus disease-19, confirmed by reverse transcription polymerase chain reaction technique and presented to the headache clinic within 3 months after the onset of infections were identified to the study. Study included patients diagnosed as primary headache disorders according to The International Classification of Headache Disorders, 3rd edition. Participants were grouped into categories according to having previous or de novo headache. Descriptive data, paired sample t-test and the chi-squared test (X2) were used for statistical analyses of the data. Results A total of 121 patients were included in this study. Their mean age was 35.29 + 9.54 and most of them were females (83.5%). Prior to Coronavirus disease-19 infections, 78 (64.5%) had migraine and 11(9.1%) experienced a tension-type headache while 32 (26.4) reported de novo headache post Coronavirus disease-19. Patient had significant increase in headache days 11.09 ± 8.45 post Coronavirus disease-19 compared with 8.66 ± 7.49 headache days before Coronavirus disease-19 infection (p < 0.006). Post Coronavirus disease-19, the usage of analgesic increased significantly by the patient with migraine (2.31 ± 1.65 vs 3.05 ± 2.09, p = 0.002) while the patient with tension type headache had statistically significant increase in severity (5.556 ± 1.86 vs 7 ± 2.25, p = 0.033) and frequency (7 ± 6.29 vs 12.72 ± 7.96, p = 0.006) of headache attacks. Bi-frontal and temporal headache are the most reported (40.6% each) headache site among de novo headache group. Patients younger than 40 years had longer duration of the headache attack (18.50 ± 16.44 vs 5.5 ± 9.07, p = 0.045) post COVID-19. Male patients compared to females (8.66 ± 1.15 versus 5.93 ± 2.01 p = 0.04) had more severe headache post Coronavirus disease-19. De novo headache resolved within 1 month in most of patients (65.3%). Conclusion Primary headache get worse after Coronavirus disease-19. De novo primary headache is frequent post Coronavirus disease-19 and resolve within 1 month. Headaches related to Coronavirus disease-19 are severe, present as migraine phenotype. Young male patients with Coronavirus disease-19 tend to have worse headache.


Cephalalgia ◽  
2020 ◽  
Vol 40 (13) ◽  
pp. 1422-1431 ◽  
Author(s):  
Rehab Magdy ◽  
Mona Hussein ◽  
Christine Ragaie ◽  
Hoda M Abdel-Hamid ◽  
Ahmed Khallaf ◽  
...  

Objective To study the characteristics of headache attributed to COVID-19 infection and predictors of its severity. Methods A cross-sectional study involved 172 individuals who had headache due to COVID-19 infection. A detailed analysis of such headache was done through a face-to-face interview. Patients with any other form of secondary headache were excluded. Labs, including lymphocytic count, C-reactive protein, D-dimer and ferritin and chest imaging, were made available. Results: The majority of our patients had a diffuse headache (52.9%). It was pressing in 40.7%, with median intensity of 7 (assessed by visual analogue scale) and median frequency of 7 days/week. Patients with preexisting primary headache (52.9%) had significantly more frequent COVID-19 related headache than those without (47.1%) ( p = 0.001). Dehydrated patients (64.5%) had more frequent COVID-19 related headache than those who were not dehydrated (35.5%) ( p = 0.029). Patients with fever (69.8%) had significantly higher frequency and intensity of COVID-19 related headache compared to those without fever (30.2%) ( p = 0.003, 0.012). Patients with comorbidities (19.8%) had significantly higher frequency and intensity of headache than those without comorbidities (80.2%) ( p = 0.006, 0.003). After multiple linear regression, primary headache disorders, dehydration and comorbidities were considered predictors of frequency of COVID-19 related headache. Meanwhile, fever and dehydration were predictors of pain intensity. Conclusion Healthcare providers of COVID-19 patients need to be aware of frequency and intensity predictors of COVID-19 related headache: Primary headache disorders, fever, dehydration, and comorbidities.


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