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Prevalence and Perceptions about Migraine among Students and Patients in Khyber Pakhtunkhwa Province, Pakistan  [PDF]
Muhammad Zahid, Aftab Alam Sthanadar, Muhammad Kaleem, Muhammad Latif, Iram Alam Sthanadar, Pir Asmat Ali, Irum Alam Sthanadar, Muhammad Ismail, Noreen Imtiaz, Mudassir Shah
Advances in Bioscience and Biotechnology (ABB) , 2014, DOI: 10.4236/abb.2014.56061

Migraine is a common neurological disorder, prevalent in almost all over the world population and being considered as the 13th major medical disorder among other major disorders across the globe, generally characterized with unilateral or bilateral headache, nausea and vomiting. In developing world, countries like Pakistan, most of the patients are not well aware of migraine headaches, as usually taken for simple headache due to no proper awareness. Usually it is not a contagious condition and most of the time it is recoded as episodic in nature. To assess the migraine, its frequency, symptoms, usual triggers and patients’ perceptions, the present study was conducted. For this purpose a prospective study was carried out based on properly designed questionnaire. The data were collected from 7 educational institutes, including students of Islamia College Peshawar, University of Peshawar, Khyber Medical College, Engineering University Peshawar, Fatima Jinnah College Peshawar, Commerce College Peshawar and Agriculture University Peshawar. Part of data was also collected from patients visiting Khyber Teaching Hospital Peshawar for their headache problems. A total of 270 questionnaires were filled up. About 81 (30.00%) headache cases were recorded, fulfilling the International criteria of Headache. Out of 81 recorded cases, 31 (38.3%) patients were of migraine with aura and 50 (61.7%) were of migraine without aura condition. The prevalence of migraine in the study population was found to be 30.00%. The frequency of female migraine patients was higher i.e. 31 (34.1%) than the male sufferers 50 (27.9%). The present study clearly showed that the higher frequency (65.0%) of migraine exists in the age group of above 30 years age. The most prevalent trigger was found to be tension, which was in parallel followed by the lack of sleep or oversleeping. A family history for migraine was found in migraine patients. Usually the condition was found to limit the routine activities of patients. The present study recorded that most of the migraine patients (40.2%) did not visit doctors at hospital and preferably go for self-medication, which really needs a public awareness in order to properly cope this

Course of migraine during pregnancy among migraine sufferers before pregnancy
Serva, Waldmiro Ant?nio Diégues;Serva, Vilneide Maria Santos Braga Diégues;Caminha, Maria de Fátima Costa;Figueiroa, José Natal;Albuquerque, Emídio Cavalcanti;Serva, Gabriel Braga Diégues;Belo, Marcela Patrícia Macêdo;Batista Filho, Malaquias;Valen?a, Marcelo Moraes;
Arquivos de Neuro-Psiquiatria , 2011, DOI: 10.1590/S0004-282X2011000500008
Abstract: objective: to describe the course of migraine without aura and migraine with aura during pregnancy and factors that could influence its course, among migraine sufferers before pregnancy. method: a cross sectional study undertaken at the imip, brazil. out of 686 consecutively assisted women, at the first postnatal week, 266 were identified as migraine sufferers before pregnancy. results: there was migraine remission in 35.4%, 76.8% and 79.3% among migraine without aura sufferers and 20.7%, 58.6% and 65.5% among those with migraine with aura, respectively in the first, second and third trimesters. statistically significant difference was found when the first trimester was compared with the second and third trimesters. the factors associated with the presence of migraine during pregnancy were: multiparity, menstrually related migraine without aura prior to pregnancy and illness during pregnancy. conclusion: the study contributed to elucidate the course of migraine during pregnancy in migraine sufferers prior to pregnancy.
Diclofenaco intramuscular no tratamento agudo da migranea: um estudo duplo cego placebo controlado
Bigal, Marcelo E.;Bordini, Carlos A.;Speciali, José Geraldo;
Arquivos de Neuro-Psiquiatria , 2002, DOI: 10.1590/S0004-282X2002000300014
Abstract: the aim of this study is to assess, in a double blind fashion, the effect of diclofenac on the pain and associated symptoms in patients with acute migraine. 60 patients with migraine with aura and 60 patients with migraine without aura were assigned at random to receiving intramuscular diclofenac, 75 mg associated to intravenous physiological saline, 10 ml, or physiological saline alone. we used 3 parameters of analgesic evaluation and an analogical scale to asses associated symptoms. we also observed the recurrence and rescue medication percentiles. patients receiving diclofenac showed a statistically significant improvement of pain 60 minutes after the administration in two of the three parameters(migraine without aura) and in all parameters (migraine with aura). they did not present difference, compared to placebo, on the intensity of associated symptoms. we observed a reduction on the recurrence and rescue medication utilization. despite being an option to treat migraines attacks in the emergency room settings, diclofenac has a slow onset action and no effects on the associated symptoms.
Características clínicas da enxaqueca sem aura
Arquivos de Neuro-Psiquiatria , 1998, DOI: 10.1590/S0004-282X1998000100012
Abstract: a detailed study of the clinical characteristics of migraine without aura (moa) reveals some interesting data. a questionnaire was returned by 200 patients who met the international headache society criteria for moa. the peak of onset of migraine was between 10 and 19 years of age. the headache was side-locked in 19%. it was exclusively bilateral in 9%. the majority (86.2%) of the patients who described headaches in only one site located them in the fronto-temporal area. neck pain was associated with migraine attacks in 70.5% and face pain in 73.5%. a pounding quality was noted by 81%. every patient described the headache as moderate to severe. only 55% stated that it was aggravated by routine physical activity. nausea occurred in 91%, photo and phonophobia in 77%, and vomiting in 50%. this close look at moa uncovers a great complexity of symptoms.
H. Pourmahmoodian,M. Kahani,M. Ghaffarpour,M. H. Harrirchian
Acta Medica Iranica , 2007,
Abstract: There are several conflicting reports about the EEG of the migraineurs. In this study we report the ictal and interictal EEGs of 100 migraineurs, in comparison with control group. The range age for patient and control groups were 9-48 (mean: 26 ± 1.8) and 10-46 (mean: 23 ± 2.1) years respectively. 32% of the patients were less than 14 years old and the remaining 68% were more than 14 years. In the patient group, 68% of cases had migraine without aura and 32% suffered from migraine with aura. Hemiplegic and basilar migraines were observed in one and two of our patients respectively. Gender and age had no effect on the type of migraine. Family history for first degree relatives was found in 64% of patients, without being influenced by gender or type of migraine. Male to female ratio was 1/1.6 (38/62). Abnormal EEG was found to be much more frequent in migraineurs than the control group (47% vs. 7%). Children had an overall somewhat more abnormal EEGs, compared with adult group (53% vs. 44% or 17/32 vs. 30/68), though slow discharges were detected more in adult group. The most common abnormality was slow high voltage waves, which was observed in 33/47 (70%) of abnormal recordings. The less common findings, in decreasing order of frequency were: focal (slow, sharps or mixed) discharges in 14/47 (29%), epileptiform (alone or associated with slow waves) in 4/47 (8.5%), diffuse beta and frontal intermittent delta, activity each being in 1/47 (2.1%) of abnormal recordings.
Sudden Loss of Vision During Pregnancy: Migraine with Visual Aura Presenting with Quadranopsia
Nurettin ?zgür DO?AN
Turkish Journal of Emergency Medicine , 2012,
Abstract: Migraine aura without headache can be easily diagnosed from an appropriate migraine history. However, diagnosis is more difficult with a different migraine pattern, especially during pregnancy. A 32-year-old woman in her 37th week of pregnancy presented with quadranopsia in the upper outer quadrant of the left eye. There were no signs of meningismus, sensory or motor deficits. Visual field examination revealed quadranopsia, which lasted 40 minutes and spontaneously resolved. Subsequently, a typical migraine headache began. Several studies have reported that migraine improves in most women during pregnancy. Migraine headaches start de novo during pregnancy in approximately 10% of cases, and the new-onset migraine is often accompanied by migraine aura. Migraine with aura is one of the most common disorders underlying transient focal neurological symptoms among pregnant women. Emergency physicians should take care about pregnant woman presenting with visual disturbance, and consider migraine as differential diagnosis.
Effect of Helicobacter Pylori Treatment on the Number and Intensity of Migraine Attacks
Alireza Bakhshipour,Mahsa Momeni,Nourollah Ramroodi
Zahedan Journal of Research in Medical Sciences , 2012,
Abstract: Background: Migraine is a common headache with an unknown cause. Migraine is about three times more common in women (18.2%) than in men (6.2%). The recent studies have posed the possible relationship between the Helicobacter pylori infection and migraine headache. This study tries to analyze the effect of treating H. pylori infection on number and severity of migraine attacks.Materials and Methods: In this clinical pilot study, a number of 60 patients with migraine were examined in terms of infecting with H. pylori. Patients with the infections were treated by H. pylori eradication treatment standard triple regimen and the frequency and severity of their migraine attacks were measured for three months and finally the average of frequency and severity of attacks before and after treatment were compared. Results: The average frequency of the migraine attacks in patients with the H.pylori infection who have been treated was 7.1 before treatment and 2.7 after treatment (p=0.001). Likewise, the severity rate of such attacks in such patients was 9 which decreased to 4.5 after treatment (p=0.002). Conclusion: According to our study, patients with migraine attacks are preferred to be examined tested in terms of infecting with H. pylori. Thus, and eradication of this infection can be effective in decreasing of the migraine attacks.
The Effect of Fatigue and Instability on Postural Control Parameters in Standing Posture in Healthy Adults and Patients with Chronic Low Back Pain
Amir Hosein Kahlaee,Farid Bahrpeyma,Ali Esteki
Zahedan Journal of Research in Medical Sciences , 2012,
Abstract: Background: This study aims at analyzing the effect of fatigue and instability on postural control parameters in both healthy people and patients with the chronic nonspecific low-back pain.Materials and Methods: In this non-experimental case-control study, oscillations of center of pressure were statistically analyzed in 16 healthy people and 15 patients with the chronic nonspecific low back pain. The analysis was conducted through two stages: before and after fatigue and under both stable and unstable surfaces. Results: Under the pre-fatigue, stable condition, there was not any difference between the two groups. Both fatigue and unstable surface changed our variables (sway area, range, velocity, frequency and total power of the signal). All the changes in variables were significant in the low-back pain group; while changes in the healthy group only covered the time-domain variables. The effect of instability was higher than that of fatigue. Conclusion: The postural control system for patients with low-back pain before fatigue and under stable condition, revealed sufficient competence to provide postural stability and its function cannot be differentiated from that in healthy people. Meanwhile, different mechanisms were used by these patients to confront stability challenging factors and further neural activity was required to counteract such factors.
A Case of New Onset Migraine with Prolonged Aura Mimicking Cerebrovascular Accident in an Adolescent
Ahmet Demircan,Ayfer Kele?,Betül Akbu?a ?zel,Nurettin ?zgür Do?an
Journal of Academic Emergency Medicine , 2011,
Abstract: Acute migraine attacks are less common in children and adolescents than adults. In children and adolescents, migraine with aura is much less common than migraine without an aura. A 16 year old male patient presented to our emergency department with a worsening headache, accompanied by nausea and difficulty in speaking. On physical examination, the patient described a bouncing type headache in the left temporal area. The patient also had diplopia, dysarthric speech, difficult understanding and sensory deficit in the right face, right arm and hand. Blood biochemistry, imaging studies and lumbar puncture showed no acute pathology. He responded positively i.v. medication. He was diagnosed with migraine with prolonged aura.
The Occurrence of Migraine Auras and Possible Triggers  [PDF]
William Burke, John Robinson
Health (Health) , 2014, DOI: 10.4236/health.2014.619307
Abstract: Our aim is to determine the cause(s) of migraine auras. Our understanding of how migraines and migraine auras originate is very imperfect. An important observation is that migraines occur more frequently in women at reproductive age than in men at a similar age. This suggests that gonadal hormones may be relevant triggers. The occurrence of classical (typical auras without headache) auras in one author (WB) has been recorded. Every aura in six years (85) has been noted, studied and analysed statistically. The auras occur predominantly in Spring and Autumn, especially in the longer reproductive season of Spring. This association is supported statistically. The results support the idea of gonadal hormones as relevant triggers, the strongest candidate being estrogen. Basic mechanisms underlying the auras are discussed, especially the phenomenon of cortical spreading depression. We also propose that both auras and migraines depend upon previous injury to the head or to the brain, giving rise to a condition of “deafferentation hypersensitivity”.
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