Sanjay Prakash

..We conclude that NDPH-like headache may occur as a post infectious process following a recent infection. We also speculate on the possible mechanisms of headache in our patients...

..Response to indomethacin is an essential feature for the diagnosis of both paroxysmal hemicrania (PH) and hemicrania continua (HC). Cluster headache (CH) is widely considered to be a disease unresponsive to indomethacin...

..Episodes of severe MV of more than 1-day duration were successfully terminated by intravenous methylprednisolone (IV MPS) in 2 patients. Two other patients who had attacks of MV almost daily also showed complete response to IV MPS...

..The findings suggest that initial treatment with drugs specific for primary headache disorders should be instituted before subjecting patients to invasive procedures...

..The presence of vitamin D receptor, 1alpha-hydroxylase and vitamin D-binding protein in the hypothalamus further suggest a role of vitamin D deficiency in the generation of head pain...

..However, these all features may not be present in all cases and a few cases may remain unclassified according to the 2nd Edition of The International classification of Headache Disorders (ICHD-II) criteria for PH...

..It is diagnosed according to the criteria of the International Headache Society (IHS), but in clinical practice, these criteria seem too restrictive and many hemicrania continua-like headaches remain unclassified...

..Response was better in patients who received intravenous therapy of methyl prednisolone and sodium valproate. We suggest prospective and controlled studies to confirm our observations...

..We discuss a possibility of RLS in these patients and suggest to take a trial of l-dopa in patients with isolated insomnia who has a positive family history of RLS or in a patient who do not show response to usual therapies for RLS...

..Overtime symptoms occurred with minimal exercise. Secondary dyskinesia was ruled out by investigations. Patient responded well to Carbamazepine, relapsed when stopped taking it...

..Both headache disorders responded to indomethacin. The patient had also in addition persistent elevation of fasting serum insulin...

..Interrelation of headache to emotional symptoms should also be explored...

..Large prospective studies are required to confirm these observations...

..Here we report a 16-year-old girl with RLS secondary to vitamin D deficiency (VDD) caused by chronic administration of carbamazepine. We also speculate on the possible mechanisms for the development of RLS in patient with VDD...

..We suggest that headache and vertigo of migraine may be inversely related to each other and suppression of one may induce or aggravate the other...

..The patient showed complete response to indomethacin (75 mg at bedtime). Frequent tapering of indomethacin was required to look for the remission phase...

..We also discuss the side effects of indomethacin in the various headache disorders and other painful conditions, and suggest the need for trial of other drugs for the patients of HC...

..We also review the literature especially for the presence of indomethacin response and ipsilateral cranial autonomic features...

..Angiography and CT chest are two other investigations that may be supplemented in patients with high risk for head/neck vessel pathology and carcinoma lung...

..We also review the clinical profiles of the patients in whom RLP and migraine were related to each other, and speculate on the possible mechanisms for RLP in the patients with migraine...

..The improvement in the headache was much earlier than the improvements in the symptom complex of osteomalacia. We also speculate on the possible mechanisms for headache in the patients with vitamin D deficiency...

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..Exquisite and persistent effect of indomethacin is a fundamental property of HC. We report 2 patients of HC in which attacks were successfully eliminated by repeated infusion of methyl prednisolone...

..Both types of headache responded to indomethacin. Review of the literature suggests that simultaneous occurrence of CH and CPH in a patient may be both over and under reported...

..Indomethacin was successfully weaned off after completion of antileprotic therapy...