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1.
The neurobiology of chronic pain, including chronic daily headache (CDH) is not completely understood. “Pain memory” hypothesis
is one of the mechanisms for phantom limb pain. We reviewed the literature to delineate a relation of “pain memory” for the
development of CDH. There is a direct relation of pain to memory. Patients with poor memory have less chance to develop “pain
memory”, hence less possibility to develop chronic pain. Progressive memory impairment may lead to decline in headache prevalence.
A similar relation of pain is also noted with emotional or psychiatric symptoms. Literature review suggests that there is
marked overlap in the neural network of pain to that of memory and emotions. We speculate that pain, memory, and emotions
are interrelated in triangular pattern, and each of these three is related to other two in bidirectional pattern, i.e., stimulation
of one of these will stimulate other symptoms/networks and vice versa (triangular theory for chronic pain). Longstanding or
recurrent noxious stimuli will strengthen this interrelation, and this may be responsible for chronicity of pain. Reduction
of both chronic pain and psychological symptoms by cognitive behavioral therapy or psychological interventions further suggests
a bidirectional interrelation between pain and emotion. Longitudinal studies are warranted on the prevalence of headache and
other painful conditions in patients with progressive memory impairment to delineate the relation of pain to memory. Interrelation
of headache to emotional symptoms should also be explored. 相似文献
2.
Couch JR 《Current pain and headache reports》2004,8(6):479-483
Chronic daily headache (CDH) is an overarching term that includes multiple types of frequent primary headaches that are not
trigeminal-autonomic cephalgias. The components of typical CDH can be divided into a more severe or “big” headache and a less
severe or “little” headache. The big headaches tend to have features of migraine while the little headaches have features
of tension-type headache (TTH). Whether this represents a spectrum or continuum or whether it is the superimposition of two
unique headache entities is open to debate. For subjects with big and little headache, the concept that the TTH component
is part of a spectrum seems likely. Subjects with only TTH and no migrainous component seem to represent a different entity,
pure chronic TTH. These patients have a daily moderate headache that is poorly responsive to current therapies and appears
to be a different TTH than the migraine tension type of CDH. The TTH component of CDH may represent multiple subdivisions
of TTH. 相似文献
3.
Levin M 《Current pain and headache reports》2004,8(1):59-65
Chronic daily headache (CDH) is surprisingly common. It is best defined as a primary headache disorder with head pain on most
days. There are a number of possible secondary causes of persistent headache, including traumatic, vascular, neoplastic, and
infectious processes, all of which must be ruled out when the patient with frequent headache is evaluated. However, most patients
with CDH seem to have a primary neurophysiologic disorder. This category of primary CDH does not seem to be a homogeneous
disorder, but rather one with important subtypes. Several authors have proposed subdivisions of primary CDH such as chronic
migraine, evolved migraine, transformed migraine, chronic tension-type headache, new daily persistent headache, and hemicrania
continua. The International Headache Society (IHS) Classification published in 1988 did not address CDH other than to define
a category “chronic tension-type headache.rd The revised IHS Classification (ICHD II) attempts to characterize CDH more thoroughly
with the addition of chronic migraine and new daily persistent headache diagnoses, but this complex issue continues to defy
easy categorization. This article provides a review of thinking about the nature of primary CDH and how ICHD II attempts to
organize this category for much needed research purposes. 相似文献
4.
Luigi A. Pini 《The journal of headache and pain》2003,4(1):1-6
The role of daily analgesic use (also called abuse) in chronic daily headache (CDH) for the maintenance of chronic headache
is discussed. The comprehension of the underlying mechanisms of actions is lacking mainly because of the absence of animal
models. The abuse should be considered as a compulsive behavior rather than linked to the type of analgesic used and related
both to “how” the drug is taken and to “what” drug is used. Moreover, there is no evidence of addictive personality in these
patients, and also predictive factors for the long-term outcomes are inconsistent. In the literature specific indications
are lacking for the treatment to be performed in these patients. In conclusion, the main problem for these patients is to
manage their headaches, and the aim of the therapy should be to enable patients to feel in control of their migraine rather
than feel that migraine or analgesic drugs control them.
Correspondence to L.A. Pini 相似文献
5.
Headache is a common disorder in the general population. Fasting headache is coded to Group 10 of the second edition of the
International Classification of Headache Disorders (“Headache attributed to disorder of homeostasis”). A study conducted in
Denmark’s general population found a lifetime prevalence rate of 4.1% for fasting headache. Fasting headache is usually diffuse
or located in the frontal region, and the pain is nonpulsating and of mild or moderate intensity. In most cases, the headache
occurs after at least 16 h of fasting and resolves within 72 h after resumption of food intake. The likelihood of developing
fasting headache increases directly with the duration of the fast. Headache sufferers have a higher risk of developing headache
during fasting than people who do not usually suffer from headache. Hypoglycemia and caffeine withdrawal have been especially
implicated as causative factors, but much remains to be understood about this topic. 相似文献
6.
Lake AE 《Current pain and headache reports》2005,9(1):4-6
To our patients, their families, and treatment providers who may not be headache specialists, chronic daily headache (CDH)
would appear to refer to headache disorders marked by the presence of daily pain over an extended period of time. To the headache
specialist, in contrast, CDH represents a family of headache disorders in which pain occurs from 15 to 30 days each month
[1], now reflected in the International Headache Society (IHS) criteria for chronic migraine (CM) or chronic tension-type
headache [2]. The IHS classification does not distinguish between daily CM and intermittent CM marked by at least some pain-free
days [3]. Research studies and clinical reports of the diagnostic entities subsumed under CDH often include patients with
pain-free days and those with true daily pain. 相似文献
7.
Cluster headache (CH), also known as “suicide headache,” is characterized by a distinctive behavior during attacks. In 80%
to 90% of cases, patients are restless and constantly moving in a vain attempt to relieve pain. They often perform complex,
stereotyped actions. During attacks, CH sufferers do not want to be touched, stroked, or comforted and frequently moan a great
deal, cry, or even scream. They sometimes indulge in violent, self-hurting behavior. Restlessness is a highly sensitive and
highly specific parameter for CH and has been included among the signs and symptoms accompanying pain of the disorder in the
Second Edition of the International Classification of Headache Disorders. A few hypotheses on pathophysiology of restlessness
are addressed in this paper. 相似文献
8.
B. Petolicchio L. Di Clemente M. Altieri E. Vicenzini G. L. Lenzi Vittorio Di Piero 《The journal of headache and pain》2010,11(2):129-135
In 2003, we conducted a sensitisation campaign on migraine in the Casilino district of Rome, by sending a letter with the
ID Migraine test to all the households and placing posters in the GPs’ waiting room. Out of 195 headache patients recruited,
92% had migraine while 73% had never consulted a physician for headache. The aim of this study was to evaluate the long-term
impact of this campaign. The follow-up was performed by a telephone interview. The questionnaire considered the characteristics
of headache, quality of life, preventive and acute treatments, drug efficacy, comorbidity and subjective usefulness of the
campaign. Of the 179 migraineurs, 90.5% (mean age 40.7 ± 16.5, 139 females) were included in the follow-up. An improvement
was observed in mean pain intensity (−13.9%; p < 0.0001) and mean HIT-6 score (−6.1%; p = 0.0003). The campaign was considered to be useful by 63.6% of cases, while 66.1% reported an improvement in their clinical
status. Improved patients showed a decreased mean number of days with headache per month (−51.7%; p < 0.0001), pain intensity (−21.8%; p < 0.0001), headache duration (−18.1%; p = 0.0008) and HIT-6 score (−11.7%; p < 0.0001). Our data suggest that the effects of a “single shot” campaign are beneficial not only in a short-term perspective,
but even in the long term. Moreover, the lack of benefit in more severe cases suggests that such patients should not be treated
by GPs alone: patients in whom the HIT-6 score, frequency, severity or duration of headache worsen should be promptly referred
to the headache clinic. 相似文献
9.
Annamaria Bini Andrea Evangelista Paola Castellini Giorgio Lambru Tullia Ferrante Gian Camillo Manzoni Paola Torelli 《The journal of headache and pain》2009,10(1):3-9
The purpose of this review was to provide a critical evaluation of medical literature on so-called “cardiac cephalgia” or
“cardiac cephalalgia”. The 2004 International Classification of Headache Disorders codes cardiac cephalgia to 10.6 in the
group of secondary headaches attributed to disorder of homoeostasis. This headache is hardly recognizable and is associated
to an ischaemic cardiovascular event, of which it may be the only manifestation in 27% of cases. It usually occurs after exertion.
Sometimes routine examinations, cardiac enzymes, ECG and even exercise stress test prove negative. In such cases, only a coronary
angiogram can provide sufficient evidence for diagnosis. Cardiac cephalgia manifests itself without a specific pattern of
clinical features: indeed, in this headache subtype there is a high variability of clinical manifestations between different
patients and also within the same patient. It “mimics” sometimes a form of migraine either accompanied or not by autonomic
symptoms, sometimes a form of tension-type headache; on other occasions, it exhibits characteristics that can hardly be interpreted
as typical of primary headache. Pain location is highly variable. When the headache occurs as the only manifestation of an
acute coronary event, the clues for suspicion are a) older age at onset, b) no past medical history of headache, c) presence
of risk factors for vascular disorders and d) onset of headache under stress. Knowledge of cardiac cephalgia is scarce, due
to its rare clinical occurrence and to the scant importance given to headache as a symptom concomitantly with an ischaemic
cardiac event. 相似文献
10.
J. Hampton Atkinson Shetal M. Patel Jonathan M. Meyer Mark A. Slater Sidney Zisook Edmund Capparelli 《Current pain and headache reports》2009,13(2):93-99
Most antidepressants and anticonvulsants used in chronic pain syndromes have dose- and concentration-response curves developed
for their application to treat psychiatric disorders. Because these are important clinical tools in medication management
of psychiatric syndromes, it is reasonable to expect that utilizing concentration-effect relationships and known sources of
pharmacokinetic variability for determining doses for analgesia may also improve treatment tolerability and outcomes. Efforts
to identify dosing “therapeutic windows” or minimum “thresholds” for analgesic efficacy have provided useful guidance for
initiating treatment, reducing toxicity, and assisting with decision making in the face of limited therapeutic response. This
article reviews the strengths, limitations, and potential of therapeutic drug monitoring of antidepressants and anticonvulsants
as analgesics for selected chronic pain syndromes. 相似文献
11.
Paolo Rossi Cristina Tassorelli Marta Allena Enrico Ferrante Carlo Lisotto Giuseppe Nappi 《The journal of headache and pain》2010,11(3):259-265
Hemicrania continua (HC) and new daily-persistent headache (NDPH) represent the only two forms of chronic daily headache in
Chap. IV “Other Primary Headaches” of the second edition of the International Classification of Headache Disorders. HC and
NDPH are rare and poorly defined from a pathophysiological point of view; as a consequence, their management is largely empirical.
Indeed, there is a lack of prospective, controlled trials in this field, and treatment effectiveness is basically inferred
from the results of sparse open-label trials, retrospective case series, clinical experience and expert opinions. In this
narrative review we have summarised the information collected from an extensive analysis of the literature on the treatment
of HC and NDPH in order to provide the best available and up-to-date evidence for the management of these two rare forms of
primary headache. Indomethacin is the mainstay of HC management. The reported effective dose of indomethacin ranges from 50
to 300 mg/day. Gabapentin 600–3,600 mg tid, topiramate 100 mg bid, and celecoxib 200–400 mg represent the most interesting
alternative choices in the patients who do not tolerate indomethacin or who have contraindications to its use. NDPH is very
difficult to treat and it responds poorly only to first-line options used for migraine or tension-type headache. 相似文献
12.
Primary cough headache, primary exertional headache, primary sexual headache, and idiopathic stabbing headache are included
in “Other Primary Headaches” (Group 4) in the International Classification of Headache Disorders, 2nd edition (ICHD-II). Headaches
provoked by cough, exertion, and sex have different age distributions, but they do share some clinical and pathogenic characteristics.
The triggering activities frequently involve Valsalva-like maneuvers, which may explain part of the pathogenesis. Primary
stabbing headache is common and characterized by ultra-short stabbing headaches. All these headache disorders respond well
to indomethacin, and they are commonly comorbid with migraine except for primary cough headache. Of note, some patients with
sexual headache had reversible cerebral vasoconstriction syndromes. Recent large-scaled studies have revealed that the ICHD-II
criteria of these four headache disorders cannot be completely fulfilled. Further revisions for the ICHD-II criteria are required
based on these results of the evidence-based studies. 相似文献
13.
Tension-type headache (TTH) is a relatively featureless headache. Many primary and secondary headache disorders can mimic
TTH, particularly in its chronic form, chronic tension-type headache. This review will address both primary and secondary
disorders that can present with headaches phenotypically similar to TTH, and will focus on clinical pearls that help distinguish
these “mimics” from TTH. 相似文献
14.
Manzoni GC Bonavita V Bussone G Cortelli P Narbone MC Cevoli S D'Amico D De Simone R Torelli P;ANIRCEF 《The journal of headache and pain》2011,12(6):585-592
In the field of so-called chronic daily headache, it is not easy for migraine that worsens progressively until it becomes
daily or almost daily to find a precise and universally recognized place within the current international headache classification
systems. In line with the 2006 revision of the second edition of the International Classification of Headache Disorders (ICHD-2R),
the current prevailing opinion is that this headache type should be named chronic migraine (CM) and be characterized by the
presence of at least 15 days of headache per month for at least 3 consecutive months, with headache having the same clinical
features of migraine without aura for at least 8 of those 15 days. Based on much evidence, though, a CM with the above characteristics
appears to be a heterogeneous entity and the obvious risk is that its definition may be extended to include a variety of different
clinical entities. A proposal is advanced to consider CM a subtype of migraine without aura that is characterized by a high
frequency of attacks (10–20 days of headache per month for at least 3 months) and is distinct from transformed migraine (TM),
which in turn should be included in the classification as a complication of migraine. Therefore, CM should be removed from
its current coding position in the ICHD-2 and be replaced by TM, which has more restrictive diagnostic criteria (at least
20 days of headache per month for at least 1 year, with no more than 5 consecutive days free of symptoms; same clinical features
of migraine without aura for at least 10 of those 20 days). 相似文献
15.
Pasquale Parisi Alberto Verrotti Maria Chiara Paolino Antonella Urbano Mariangela Bernabucci Rosa Castaldo Maria Pia Villa 《The journal of headache and pain》2010,11(1):45-51
We investigated whether children affected by tension-type headache and migraine without aura, compared with a healthy control
group that was matched by age, culturally and socioeconomically display a diverse intellectual functioning and have a separate
“cognitive profile”. A cross-sectional study was conducted from January 2006 to November 2008 at “Sapienza University” in
Rome. A total of 134 children were diagnosed as being affected by either migraine without aura (93) or tension-type headache
(41). On the basis of our exclusion/inclusion criteria, we enrolled 82 of these 134 children, 63 of whom were affected by
migraine without aura and 19 by tension-type headache. On entry, cognitive functions were assessed in both the affected subjects
and the control group by the Wechsler Intelligence Scale for Children-revised. Significant differences were found between
the headache and control groups in the mean total intelligence quotient and verbal intelligence quotient scores (p < 0.001). Significant negative correlations were found between the total intelligence quotient, verbal intelligence quotient,
performance intelligence quotient and the frequency of attacks (r = −0.55 and p < 0.001, r = −0.61 and p < 0.001, r = −0.29 and p < 0.01, respectively), as well as between the total intelligence quotient score and the age at headache onset (r = 0.234, p < 0.05). Our results suggest that the cognitive profile of children affected by headache should be assessed at the first
child neurology outpatient observation. From a therapeutic point of view, although within a normal range, the abilities most
likely to be less brilliant in such children are verbal skills. 相似文献
16.
Summary
In the last decades back pain has reached dramatic proportions in industrialized countries. Disorders of the back are nowadays
the leading cause of direct and indirect health care costs. Accurate prevalence estimates are needed to serve as a basis for
health care evaluations. A review of epidemiologic studies in the general population reveals that back pain has reached a
prevalence of 40 % for current pain. 7 to 18 % are “frequently”, “often”, “daily” or “constantly” affected. 75 % of the adult
population suffers from back pain during the last year. 80 to 90 % of the adult population in industrialized countries experience
back pain ever. Gender specific differences are only present in severe, chronic forms which are more often experienced by
women. Back pain has a prevalence maximum at 50 to 64 years. Older persons display lower prevalence estimates. The prevalence
maximum in men is one decade earlier than in women. There are several potential explanations for this prevalence pattern that
are discussed in the article. Back pain can be classified by location, temporal characteristics, pain intensity and pain history.
Currently, for none of these dimensions generally accepted, uniformly employed and validated definitions are available. In
most of the industrialized countries back pain is one of the most expensive symptoms. 75–90 % of the direct and indirect health
care costs were caused by those 5–10 % of patients who are disabled. As predictors of back pain a history of back pain and
job satisfaction play by far a more important role than the extensively studied mechanical factors. For a first episode of
back pain the prognosis is favorable. If the pain persist for more than three months the prognosis is unfavorable. After six
months of absenteeism because of back pain more than half of the afflicted never return to work. Rarely back pain is present
as a single symptom. In more than 80 % back pain is associated with pain in at least one joint. It remains to be studied if
back pain may be viewed as an entity or as part of a more complex pain syndrome.
相似文献
17.
Aynur Özge 《Current pain and headache reports》2013,17(12):1-8
Disabling headache disorders are ubiquitous in all age groups, including the elderly, yet they are under-recognized, underdiagnosed and undertreated worldwide. Surveys and clinic-based research reports on headache disorders in elderly populations are extremely limited in number. Chronic daily headache (CDH) is an important and growing subtype of primary headache disorders, associated with increased burden and disruption to quality of life. CDH can be divided into two forms, based on headache duration. Common forms of primary headache disorders of long duration (>4 hours) were comprehensively defined in the third edition of the International Classification of Headache Disorders (ICHD-3 beta). These include chronic migraine, chronic tension-type headache, new daily persistent headache, and hemicrania continua. Rarer short-duration (<4 hours) forms of CDH are chronic cluster headache, chronic paroxysmal hemicrania, SUNCT, and hypnic headache. Accurate diagnosis, management, and relief of the burden of CDH in the elderly population present numerous unique challenges as the “aging world” continues to grow. In order to implement appropriate coping strategies for the elderly, it is essential to establish the correct diagnosis at each step and to exercise caution in differentiating from secondary causes, while always taking into consideration the unique needs and limitations of the aged body. 相似文献
18.
Belcastro V Striano P Kasteleijn-Nolst Trenité DG Villa MP Parisi P 《The journal of headache and pain》2011,12(3):289-294
Despite the fact that migraine and epilepsy are among the commoner brain diseases and that comorbidity of these conditions
is well known, only few reports of migralepsy and hemicrania epileptica (HE) have been published according to the current
ICHD-II criteria. Particularly, ICHD-II describes “migraine-triggered seizure” (i.e., migralepsy) among complications of migraine
at “1.5.5” (as a rare event in which a seizure happens during migrainous aura), while hemicrania epileptica (coded at “7.6.1”)
and post-ictal headache (coded at “7.6.2”) are described among headaches attributed to epileptic seizure. However, to date
neither the International Headache Society nor the International League against Epilepsy mention that headache/migraine may
be the sole ictal epileptic manifestation. Based on the current knowledge, migralepsy is highly unlikely to exist as such.
We, therefore, propose to delete this term until clear evidence its existence is provided. Moreover, we herein propose a revision
of terminology and classification criteria to properly represent the migraine/headache relationships. We suggest the term
“ictal epileptic headache” in cases in which headache/migraine is the sole ictal epileptic manifestation. 相似文献
19.
Nour T. Baghdady Suman Banik Shari A. Swartz Roger S. McIntyre 《Advances in therapy》2009,26(4):404-424
Introduction The kidney is a primary route of drug elimination; abnormal kidney function is predicted to alter the pharmacokinetics of
agents metabolized and/or excreted predominantly through this route. The high prevalence of mental disorders associated with
psychotropic drug use in individuals with deteriorating renal function suggests there is a need to investigate the effects
of renal failure on psychotropic pharmacokinetics. The aim of this review is to provide a clinically accessible overview of
the effect of chronic renal failure on the pharmacokinetics for each of the major classes of prescribed psychotropic agents.
Methods All English language articles published between 1977 and 2008 were searched through PubMed, using the following keywords:
“renal,” “kidney,” “pharmacokinetics,” “renal impairment,” “renal insufficiency,” and “renal failure.” Each of these search
words was cross-referenced with the non-proprietary name of each psychotropic agent. The manufacturer’s product insert was
also reviewed for some agents for updated dosing. Owing to the lack of adequately powered studies, an inclusive manner was
used.
Results Chronic renal failure variably affects the pharmacokinetic parameters of psychotropic drugs. A review of each psychotropic
drug is provided, with an emphasis on the individual pharmacokinetic parameters and recommended dosing. Conclusions: The adjudication
of safe and effective doses for any psychotropic agent needs to be individualized. Tactics including dosage adjustment, slow
titration, and careful monitoring for serious adverse events should be incorporated into practice. 相似文献
20.
Rothrock JF 《Current pain and headache reports》2001,5(5):463-466
For years clinicians and researchers have debated the nosology of headache generally and of “migraine” versus “tension-type
headache” in particular, an exhaustive process that arguably has done little to improve patient management and clinical outcome.
New research data now indicate that the migraine versus tension-type distinction indeed may possess some clinical use, because
patients with migraine or “mixed” headache syndromes may respond differently to a specific therapeutic intervention than patients
with “pure” tension-type headache. This variable response to treatment intervention would seem to imply that similarly distinctive
biologies are generating the respective headache syndromes, but to date we have insufficient evidence to support that conclusion. 相似文献