Julio Pascual

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..To analyze our experience with the new, 5 mg intranasal formulation of zolmitriptan in the symptomatic treatment of migraine attacks...

..The objective is to analyse our experience with the new intranasal formulation of zolmitriptan 5 mg in the symptomatic treatment of cluster headache in daily clinical practice...

..In conclusion, PS studies augment our knowledge of antimigraine therapy, giving a more complete picture of how such agents work in the general population...

..This experience emphasises that a good clinical interview remains the most important point in the diagnosis and management of headache...

..These clinical characteristics allow its differential diagnosis from other entities, even though a craniocervical magnetic resonance imaging study is mandatory to rule out posterior fossa lesions, especially Chiari type-I malformation...

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..To test treatment combining a beta-blocker plus topiramate in migraine patients previously resistant to the two medications in monotherapy...

..Our aim has been to analyze the specific results from the Spanish participation in phase IIIa and IIIb clinical trials vs placebo and compare them with the results obtained in the global clinical development of eletriptan...

..Preliminary data suggest some beneficial effects of botulinum toxin type A (BT-A) on primary headaches...

..Our data suggest that the current practice recommending periods of preventive treatment of 3-6 months should be reconsidered for many patients...

..To evaluate the efficacy of oral almotriptan 12.5 mg as an acute treatment for migraine with a focus on triptan-experienced versus triptan-naïve patients...

..This suggests that almotriptan is an excellent choice for patients requiring specific acute migraine treatment...

..Data on the reality of chronic migraine in our clinics are scarce. AIM. To know the frequency of consultation and attitude of the neurologist regarding chronic migraine, and the opinion of patients with this condition...

..Migraine is the most common neurological consultation in our country. AIM. To analyse the satisfaction level of the patient with migraine attending our clinics...

..Headache is the most frequent neurological reason for consultation in our country...

..Chronic migraine refractory to preventive treatment is a common clinical situation in general neurology clinics. The aim is to analyse our experience with zonisamide in the preventive treatment of patients with frequent refractory migraine...

..More than one quarter of patients who consult due to migraine need preventive treatment. At least half of these patients do not respond or cannot tolerate classical preventatives: beta-blockers, flunarizine or amitriptyline...

..Clinicians should be aware that these headaches may be symptomatic to structural lesions and therefore usually require careful neuroimaging evaluation...

..About half of the patients with chronic migraine do not respond or do not tolerate the different migraine preventatives...

..These findings indicate that TN patients can expect excellent symptom control when they progress from non-specific analgesia to treatment with almotriptan and support the earlier use of triptans in line with the stratified care paradigm...

..The wafer formulation offers the convenience of being administered without water. As a result of its superior efficacy profile and generally good tolerability, rizatriptan can be considered as a first-line treatment for acute migraine...

..Almotriptan, the most recent drug of the triptan family, has shown good efficacy and tolerability profile in clinical trials...

..Headache in general, and migraine in particular, are the main reasons for general practitioners (GPs) to consult neurology services. Our aim was to analyse the current knowledge of GPs in migraine diagnosis...

..Controlled trials are now necessary to determine the true advantage in efficacy of this combination in difficult to treat migraineurs...

..The efficacy of current preventive migraine treatments is limited. In addition, tolerability problems are not infrequent...

..This autoimmune attack may induce an aseptic leptomeningeal vasculitis, accounting for the headache and the transient symptoms likely through a spreading depression-like mechanism...

..Genetic factors such as the MTHFR C677T polymorphism, and other polymorphisms in folate-related genes associated with high homocysteine levels, may contribute to increasing this vascular risk...

..Research in this field has been controversial, especially in regard to ESR1 gene findings. None of the reports have yet to approach the problem from a multigenic point of view...

..Women carrying the C352C genotype were over 3 times more likely to suffer from migraine than those carrying the G325G genotype. Therefore, we conclude that ESR1 G325C polymorphism is associated with migraine in our population...

..R1441G was not detected in any of our study subjects. The prevalence of G2019S mutation in unselected late-onset PD patients might be higher than previously reported: 3/16 (18.7%) of familial PD and 5/82 (6.1%) of sporadic PD...

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..2-21.1. This locus (named MIGR3) has not been replicated in the only genome-wide association scan study performed to date or in previous genome-wide linkage studies...

..1; 99% CI=0.8-1.5, p=0.499). Our study did not confirm the HTR2C Cys23Ser polymorphism as a risk factor for migraine and MA...

..CONCLUSIONS: According to this analysis, a higher lipophilicity does not seem crucial to improve triptan efficacy. This physico-chemical property, however, correlates with higher CNS AE and, possibly, lower recurrence rates...

..The aim of this study was to evaluate if 2 functional endothelial nitric oxide synthase (eNOS) gene polymorphisms might be risk factors for migraine...

..In the current literature, there is neither a reported systematic review comparing the efficacy of triptans at 30 minutes and 1 hour after the migraine treatment, nor data related to efficacy of new marketed triptans...

..The results of this study, using patient-oriented, clinically relevant endpoints such as functional disability and preference, will help to guide practitioners in making recommendations for acute migraine treatment...

..CONCLUSIONS: Rizatriptan was associated with significantly lower triptan tablet use and additional medication use per attack than the other triptans. Additional randomized studies are needed to confirm the conclusions of this study...

..When used for mild intensity head pain, almotriptan 12.5 mg produced a significantly higher incidence of pain-free status at 1 and 2 hours and lower incidences of early headache recurrence or need for rescue medication...

..Conclusion: We observed higher number of activated EPCs in migraine patients than in controls. CD62E+ EPCs might be considered a marker for vascular damage in migraine patients...

..In sum, early intervention with triptans can improve outcomes, avoiding much of the pain and disability associated with treating moderate or severe attacks...

..To investigate long-term efficiency of an intervention protocol for chronic daily headache with medication overuse (CDHwMO) in the general population...

..Almotriptan's high efficacy together with its excellent tolerability and safety profile confirm this new 5-HT(1B/1D) agonist as a drug of choice for the symptomatic treatment of migraine attacks...

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..Sarcoidosis should be considered in the differential diagnosis of stroke of unknown origin in any young patient, even in the absence of other clinical or laboratory features of sarcoidosis...

..There is only one reported case of recurrent coital headache related to an unruptured saccular aneurysm of the carotid artery...

..CSF hypovolemia can be spontaneous or secondary to CSF removal. Treatment of acquired tonsillar herniation depends on the responsible etiology...

..Status epilepticus is a medical emergency associated with significant morbidity and mortality...

..Further studies are necessary, however, to confirm the significance of topiramate in this indication...

..08; 95% CI = 1.3-7.4). We conclude that the pathogenetic role of the MTHFR T677 allele in migraine is modulated by functional polymorphisms of TS and MTHFD1...

..Cough headache is a different condition when compared to headache due to physical exercise and sexual activity, which are clinical variants of the same entity...

..5 mg were equivalent, which suggests that most migraine patients differentiate between triptans. A faster onset of action (speed of onset) was the most important reason for preference...

..In summary, almotriptan's promising basic profile together with its excellent tolerability/safety profile and good efficacy confirm this new 5-HT(1B/D) agonist as a drug of choice for the symptomatic treatment of migraine attacks...

..Hydrocephalus and low intracranial pressure syndrome should be ruled out in patients showing tonsillar herniation in an MRI study and consulting due to daily headache...

..CONCLUSIONS: Lamotrigine should be considered in clinical practice for the preventive treatment of selected patients with disturbing migraine auras. Lamotrigine seems worthy of a controlled trial as prophylaxis of migraine aura...

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..CONCLUSIONS: In the general population, CDH reduced all QoL aspects studied with the SF-36. This reduction in QoL was most marked in subjects with analgesic overuse. QoL was affected more by the chronicity than by the intensity of pain...

..Migraine is frequently under-treated. The 4-item Migraine Assessment of Current Therapy (Migraine-ACT) questionnaire is a simple, patient-friendly tool to identify patients requiring change in acute migraine treatment...

..We conclude that motor neuron symptoms and signs may be a striking manifestation in SCA2, masking pre-existing cerebellar and extrapyramidal semeiology...

..Our case illustrates that permanent language dysfunction may occur after recurrent complex partial and secondarily generalized seizures...

..Purpose: To assess the long-term tolerability and efficacy of oral almotriptan 12.5 mg administered for every migraine attack over a 1-year period...

..001). Both active treatments were well tolerated. The most common side effects with rizatriptan and sumatriptan were nausea (6.6 and 6.9% of patients, respectively), dizziness (6.1 and 5.8%) and somnolence (7.4 and 6.7%)...

..Overall, the 12.5-mg dose was associated with the most favourable efficacy/tolerability ratio and is, therefore, the recommended dose...

..Migraine interferes with the quality of life of patients. Prophylactic medication is an option to be considered in cases showing inefficiency of symptomatic medication or an increase in the number of attacks...

..We report on a new case and review the body of knowledge currently available on this recently identified condition...

..Putaminal preservation accounts for good response to both levodopa therapy and subthalamic nucleus stimulation...

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..Even though, in terms of frequency, headache is a very common reason for neurology consultation, the present results show that the majority of preadolescents consulting because of headache suffer from benign conditions...

..Case 3 only improved in frequency, while the remaining patient showed no benefit. These findings suggest that daily hyperbaric oxygen treatment can be used as a transient preventive treatment for desperate cluster headache sufferers...

..The prevalence of chronic daily headache subtypes shown here differs from data obtained from headache clinics, emphasizing that caution is needed in extrapolating data from specialized units to the general population...

..The possible pathophysiological significance of this concurrence of both types of indomethacin-responsive pain is discussed...

..This personality profile is still found more frequently in patients presenting symptomatic medication abuse...

..To analyze the prevalence and demography of chronic daily headache (CDH) with analgesic overuse...

..Our results may help in planning the public health aspect of migraine and add some light to the natural history of this common condition...

..From this review we conclude that while there have been relevant advances in the symptomatic treatment of migraine, there is a need for the development of better preventive compounds...

..The occipital condyle syndrome may be the first manifestation of cancer or of chronic inflammatory lesions; recognition of this distinctive headache enables the clinical diagnosis to be made...

..In conclusion, around 80% of unselected migraineurs experience RS and PS. Migraine with aura and severe pain are risk factors for experiencing PS and RS, while preventatives were protective, especially for PS...

..20; 95% CI 1.14-4.40; P=0.019) higher than TT/TC genotypes. In conclusion, the GNAS1 T393C variant is associated with migraine, which suggests a genetic basis for its higher SNS sensitivity...

..001) at 2 h. Adverse events were generally mild or moderate and transient. This randomised trial shows that oral eletriptan is more efficacious in the acute treatment of migraine than oral Cafergot and is well tolerated...

..In conclusion, everolimus may permit reduced exposure to CNIs in renal transplant recipients, with the potential to improve tolerability and renal function...

..In conclusion, almotriptan's consistent pharmacokinetics and good efficacy, in combination with excellent tolerability, make it an attractive choice in the acute treatment of migraine attacks...

..A new examination of this topic including only randomized, controlled trials based on currently used, new, potent therapy with calcineurin inhibitors and mycophenolate mofetil (MMF), avoiding early trials with azathioprine, is justified...

..The role of topiramate in the prophylactic treatment of cluster headache is still unclear. The aim of this study was to evaluate the effectiveness of topiramate in a group of patients with refractory episodic or chronic cluster headache...

..This suggests that concentration-controlled everolimus can be successfully combined with optimized administration of CsA and that this regimen may maximize immunosuppression, whilst preserving renal function...

..As a result of its mode of action, this class of agent (i.e., everolimus and sirolimus) is associated with certain adverse events (e.g., lymphocele, arthralgia, edema and hyperlipidemia)...

..Maintaining everolimus troughs in the range 3 to 8 ng/mL in the first posttransplant year with reduced-exposure cyclosporine is associated with good efficacy and safety profiles...

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..The results of the first 30 patients showed a significant improvement in different headache parameters and a high degree of satisfaction with the treatment received...

..Therefore, conversion to everolimus from CsA in a renal transplant recipient led to improvements in blood pressure and resolution of recurrent cutaneous neoplasia, with no evidence of rejection or changes in renal function...

..The challenge in renal transplantation is to improve long-term patient and graft survival without increasing early acute rejection by minimizing immunosuppression...

..A longer follow-up will be needed to confirm the expected advantages for the long-term outcome and to assess the long-term safety of this minimization of immunosuppressive therapy...

..Emphasis should be placed on the need to stop smoking and to control hypertension and pre- and posttransplantation levels of serum cholesterol...