A May

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..Intravenous lidocaine may also be helpful as an acute therapy when patients are extremely distressed and disabled by frequent attacks...

..However, modern neuroimaging suggests that the chronification of pain (and headaches) involves functional and structural plasticity of both the central and peripheral nervous system...

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..This uniform pattern was equally present in all examined groups. Chronic pain and depression do not seem to interfere with short-term sensitization and long-term habituation in this model of repetitive phasic heat pain...

..Evidence indicates that the method is pain free, safe and inexpensive...

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..Instead, the data suggest a hitherto unrecognized functional modulation of the pain processing network as the mode of action of hypothalamic deep brain stimulation in cluster headache...

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..This is probably the result of a better understanding of the pathophysiology in combination with efficient treatment strategies, leading to a broader acceptance of the syndrome by doctors...

..These data argue against an unspecific antinociceptive effect or pure inhibition of hypothalamic activity as the mode of action of hypothalamic DBS and suggest functional modulation of the pain-processing network...

..This review covers the clinical picture and therapeutic options. Although studies following the criteria of evidence-based medicine (EBM) are rare, most patients can be treated sufficiently...

..The author suggests that the gray matter change observed in chronic pain patients are the consequence of frequent nociceptive input and should thus be reversible when pain is adequately treated...

..Modern neuroimaging thus clearly suggests that most primary headache syndromes are predominantly driven from the brain, activating the trigeminovascular reflex and needing therapeutics that act on both sides: centrally and peripherally...

..Magnetic resonance morphometry has thereby recently emerged as one of the most promising fields in clinical neuroscience. This review covers the last 3 years, which have witnessed remarkable progress in this alluring new field...

..This article reviews the evidence from the literature and recommendations of European and American task forces regarding the use of instrumental examinations in case of non-acute primary headache...

..This review gives a brief clinical description of the headache disorders and recent pathophysiological findings, as well as an overview of the treatment of cluster headache, paroxysmal hemicranias and SUNCT syndrome...

..Although TACs are, in comparison with migraine, quite rare, it is nevertheless very important to consider the clinical factor that they are easy to diagnose and the treatment is very effective in most patients...

..This review highlights the recent advances made in studying migraine using neuroimaging techniques...

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..One of the major future challenges is to understand the behavioural consequences and cellular mechanisms underlying neuroanatomic changes in pain and headache...

..We need to better understand the behavioral consequences and cellular mechanisms underlying these neuroanatomic changes...

..The in vivo demonstration of a loss of brain gray matter in patients suffering from chronic pain compared to age and sex-matched healthy controls could represent the heavily discussed neuroanatomical substrate for pain memory...

..It is crucial to ensure a competent postoperative follow-up with optimization of stimulation parameters and adjustment of medication...

..The group of symptomatic headaches is heterogeneous. Red flags help to judge the necessity of further diagnostic tests...

..This review highlights new studies and recent advances in studying headache using neuroimaging...

..Functional imaging will undoubtedly provide further opportunities to study and compare metabolic, haemodynamic and structural parameters in headache sufferers' brains...

..This review covers the clinical picture and therapeutic options. Allthough studies following the criteria of evidence based medicine (EBM) are rare, most patients can be treated sufficiently...

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..The current literature was reviewed and a summary is presented. The therapy recommendations do not only include the scientific evidence but also the practical relevance...

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..These data support the hypothesis that ongoing nociception is associated with cortical and subcortical reorganisation on a structural level, which may play an important role in the process of the chronification of pain...

..The finding implies that the alterations are specific to CTTH rather than a response to chronic head pain or chronification per se...

..One explanation for a missing modulatory effect in our study is the relatively short duration of the stimulation...

..This review focusses on DNIC and HNCS including similarities, divergences and their potential clinical relevance...

..Migraine is one of the most frequent disabling neurological conditions with a major impact on the patients' quality of life...

..Cortical hyperexcitability is presumably the result of chronicity and the concomitant central sensitisation process...

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..No gray matter increase was detected. The unilateral thalamic differences may reflect a structural correlate of the loss of afferent input as a secondary change following deafferentation...

..This review provides a synopsis of procedures regarding chronic pain treatments, with particular focus on the most frequent pain disorders. The treatment recommendations follow the current guidelines of the German Society of Neurology...

..The present findings are consistent with the hypothesis that ectopic neurons may be functionally integrated in motor circuits during repetitive voluntary movements...

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..Several studies have suggested clinical efficacy in pain syndromes such as central neuropathic pain or fibromyalgia. However, little is known regarding tDCS effects on nociception in healthy volunteers...

..They should be considered in facial pain before more invasive approaches, such as thermocoagulation or vascular decompression, are performed, given that side effects are mild and the procedure is minimally invasive...

..The stable corneal reflexes after the oral administration of 100 mg sumatriptan suggest that there was no inhibition of the trigeminal system, both in patients during their headache-free period and in healthy controls...

..We suggest that the grey matter change in migraine patients is the consequence of frequent nociceptive input and should thus be reversible when migraine attacks cease...

..e. they recede after the regular nociceptive input is stopped. This data raises some interesting questions regarding structural plasticity of the brain concerning the experience of both acute and chronic pain...

..5%). The inhalation of oxygen accounted for the lion's share...

..This method will provide an ideal opportunity to study the trigeminal pain system in both health and pathological conditions such as idiopathic headache disorders...

..Recent epidemiological research suggests that these headache disorders are underdiagnosed...

..This was mailed to and completed by 22 experts in Germany. In this article, we discuss the patient preference compared with the expert preference regarding clinic trials and drug therapy...

..Understanding both the phenotypic expression and the biotype will, respectively, enable better acute attack treatments and better preventative management of this horrible form of headache...

..Here, the case of a 17-year-old girl with migraine without aura who developed an 'Alice in Wonderland' syndrome repeatedly on topiramate treatment was presented and potential pathophysiological concepts were discussed...

..The study showed that administration of effervescent ASA leads to remission of the migraine symptoms nausea, photophobia and phonophobia, reduces migraine headache and is comparable to sumatriptan...

..Our results indicate that block of the greater occipital nerve is not effective in the treatment of chronic tension type headache. If at all, rather a 'pro-nociceptive' effect was observed...

..As the individual pharmacokinetics differ substantially, adverse drug effects should be considered if unexplained symptoms occur in the newborn...

..However, all of them failed to demonstrate any antimigraine effects. Current clinical and experimental evidence therefore supports the view that isolated peripheral trigeminal nerve inhibition is insufficient to relieve acute migraine...

..The alteration of pain inhibitory circuits may be the underlying mechanism responsible for the dys-functional neuronal filters of sensory input...

..Current clinical and experimental evidence therefore supports the view that NK(1) receptor antagonists may have no significant antimigraine properties...

..This study confirms that CAM is widely used among primary headache patients, mostly in combination with standard care...

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..These results support the notion that neurostimulation of the posterior hypothalamus is specific for cluster headache and only affects certain aspects of pain sensation...

..Neuronally, this process is mediated by the right opercular region...

..This review covers the past 3 years, which have seen remarkable progress in understanding the pathophysiology of circadian headache syndromes and have brought exciting news...

..Given this area's predominant role in endogenous pain control, this response pattern suggests that habituation to pain is at least in part mediated by increased antinociceptive activity...

..These data challenge the principal concept that patients with ICD have no brain structure abnormalities and that this movement disorder is solely due to abnormal cerebral function...

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..In addition, elderly volunteers who learned to juggle showed transient increases in gray matter in the hippocampus on the left side and in the nucleus accumbens bilaterally...

..The study shows that there is no direct peripheral antinociceptive effect of BoNT/A in humans. The efficacy of BoNT/A in various pain syndromes must be explained by other pathways such as chemodenervation or anti-inflammatory effects...

..No BoNT/A related differences in pain perception were found at any quality. There is neither a direct peripheral antinociceptive effect nor a significant effect against neurogenic inflammation of BoNT/A in humans...

..Further controlled studies are needed to investigate the usefulness of 5-HT1B/1D agonists in painful eye conditions...

..However, imaging data of how the brain processes associate migraine symptoms, such as photophobia, phonophobia, or osmophobia, are rare...

..These results indicate that the acquisition of a great amount of highly abstract information may be related to a particular pattern of structural gray matter changes in particular brain areas...

..On the neural level, painful thermal stimulation was associated with a negative BOLD signal within the pregenual anterior cingulate cortex, and this deactivation was abolished by naloxone...

..A better understanding of the temporal parameters may help to elucidate to what extent this type of cortical plasticity contributes to fast adapting cortical processes that may be relevant to learning...

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..Some types of trigemino-autonomic headaches, such as paroxysmal hemicrania and hemicrania continua have, unlike cluster headaches, a very robust response to indomethacin, leading to a consideration of indomethacin-sensitive headaches...

..Trial Registration controlled-trials.com Identifier ISCRTN27362692...

..Understanding the mechanisms and sites of pathology, such as has been achieved in cluster headaches, facilitates the development of new therapeutic strategies...

..Zolmitriptan nasal spray was well tolerated. CONCLUSIONS: These findings confirm the efficacy demonstrated by zolmitriptan nasal spray in previous clinical trials...

..These studies suggest that the hypothalamus plays a crucial role in the pathophysiology of TACs, thereby supporting the notion that these disorders are primarily due to central rather than peripheral mechanisms...

..The results indicate, that 1000mg intravenous acetaminophen is not superior to placebo in treating severe acute migraine attacks...

..8%). Zolmitriptan nasal spray was well tolerated. Most patients were satisfied with zolmitriptan nasal spray, were willing to continue using it and preferred it to previous therapies...