bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sodium Valproate Prophylaxis in Childhood Migraine
Authors: Serdaroglu Gul , Erhan Elvan , Tekgul Hasan , Oksel Figen , Erermis Serpil , Uyar Meltem , Tutuncuoglu Sarenur 
Published: March 2003

Migraine is a cause of recurrent headache in childhood. The efficacy of sodium valproate is well known in the prophylactic treatment of adult migraine, but there are few studies involving the drug's effect in pediatric migraine.Objective.—To determine the efficacy of sodium valproate in the prophylactic treatment of childhood migraine.Methods.—Fifteen children with migraine according to International Headache Society criteria were included in the study. Headache severity was measured and assessed by Algology unit by a using visual analog scale and a numerical rating scale. All of the subjects were asked to keep a headache diary for 8 weeks. Three subjects who had no headache attacks during the baseline period and two cases who were lost to follow up were excluded. Thus, sodium valproate was initiated in 10 subjects (six boys, four girls), 500 mg/night, and the daily dose was increased up to 1000 mg according to blood levels. Their ages ranged from 9 to 17 (mean age 13.6 ± 3.2 years). Therapy continued for at least 12 weeks.Results.—Headache severity as measured via the mean visual analog score was 6.8 ± 1.8 at baseline and was 0.7 ± 1.2 at the end of the treatment period (P = 0.000). Mean headache attacks per month were 6 ± 4.2 at baseline and were 0.8 ± 1.9 at the end of the treatment period (P = 0.002). The duration of headache was significantly decreased from a mean of 5.5 ± 3.9 hours to 1.1 ± 2.5 hours with treatment (P = 0.001). The observed side effects were dizziness, drowsiness, and increase in appetite; none required drug withdrawal. In two cases, headache attacks recurred after the cessation of valproate, and therapy was restarted. Headache control lasted for six months following cessation of the drug in the remainder of the subjects.Conclusion.—Sodium valproate appears to be effective and safe in selected patients with childhood migraine.
Acupuncture in the Prophylactic Treatment of Migraine Without Aura: A Comparison with Flunarizine
Authors: Allais Gianni , De Lorenzo Cristina , Quirico Piero E. , Airola Gisella , Tolardo Giampiero , Mana Ornella , Benedetto Chiara 
Published: March 2003

Objectives.—In a randomized controlled trial extending over 6 months, we evaluated the effectiveness of acupuncture versus flunarizine in the prophylactic treatment of migraine without aura. Methods.—One hundred sixty women with migraines were randomly assigned to acupuncture treatment (group A, n = 80) or to an oral therapy with flunarizine (group F, n = 80). In group A, acupuncture was carried out in weekly sessions for the first 2 months and then once a month for the next 4 months. The same acupoints were used at each treatment: LR3 Taichong, SP6 Sanyinjiao, ST36 Zusanli, CV12 Zhongwan, LI4 Hegu, PC6 Neiguan, GB20 Fengchi, GB14 Yangbai, EX‐HN5 Taiyang, GV20 Baihui. In group F, 10 mg flunarizine were given daily for the first 2 months and then for 20 days per month for the next 4 months. Results.—The frequency of attacks and use of symptomatic drugs significantly decreased during treatment in both groups. The number of attacks after 2 and 4 months of therapy was significantly lower in group A than in group F, and analgesic consumption was significantly lower in group A at 2 months of treatment. At 6 months no such differences existed between the two treatment groups. Pain intensity was significantly reduced only by acupuncture treatment. Side effects were significantly less frequent in group A. Conclusions.—Acupuncture proved to be adequate for migraine prophylaxis. Relative to flunarizine, acupuncture treatment exhibited greater effectiveness in the first months of therapy and superior tolerability.
Transient Visual Disturbances During Migraine Without Aura Attacks
Authors: Cologno Daniela , Torelli Paola , Manzoni Gian C. 
Published: March 2003

Objective.—To evaluate the prevalence and clinical features of transient visual disturbances (TVDs) during migraine without aura (MO) attacks and to point out any similarities with the disturbances listed among the diagnostic criteria of the International Headache Society (IHS) classification for migraine with aura (MA). Methods.—We studied a sample of 191 patients (145 women and 46 men) with MO and no other associated forms of primary headache who had been referred to the University of Parma Headache Centre between December 1, 1999 and December 1, 2000. Results.—A total of 165 patients reported that they had never experienced TVDs during their MO attacks. In the remaining 26 patients (19 women and 7 men), MO attacks were at times accompanied by TVDs, which were present in over 30% of MO attacks in 65.4% of patients. In about 60% of cases, TVDs lasted less than half a minute. TVDs consisted of phosphenes in most patients, general blurring of vision in about one‐fourth, and scintillating scotomas in 15%. In 73% of cases, TVDs occurred during the headache phase, whereas in the remainder they preceded it. Strict application of the IHS diagnostic criteria would have led to a diagnosis of MA in 12 cases, corresponding to 46% of our MO patients with TVDs and to 6.3% of all patients with an established clinical diagnosis of MO. Conclusion.—The results of our study suggest that current IHS diagnostic criteria for MA may lead to an overestimation of MA cases.
Almotriptan Reduces the Incidence of Migraine‐Associated Symptoms: A Pooled Analysis
Authors: Cady Roger 
Published: March 2003

Objectives.—Evaluate the reduction in migraine‐associated symptoms after administration of a single oral dose of almotriptan.Methods.—This pooled analysis (N=1773) used data from three randomized, placebo‐controlled, phase III trials (studies A, B, and C) to determine the incidence of migraine‐associated symptoms (defined as nausea, vomiting, photophobia, and phonophobia) 2 hours after a single oral dose of study medication (almotriptan, sumatriptan, or placebo). Outcome data was extracted from studies A and B for placebo and the almotriptan 6.25‐mg and 12.5‐mg groups, and from study C for placebo, almotriptan 12.5‐mg, and sumatriptan 100‐mg groups.Results.—The incidence of nausea, photophobia, and phonophobia at 2 hours after dosing with study medication was significantly reduced (all P < .05) with almotriptan 6.25 mg or 12.5 mg compared with placebo. The percentage of patients with vomiting was lower with both doses of almotriptan in studies A and B compared with placebo, although differences were significant only for the 6.25‐mg dose in study A (P < .001). For study C, the incidence of nausea, vomiting, photophobia, and phonophobia was similar for almotriptan and sumatriptan and lower than with placebo at 2 hours after dosing. Significant reductions (all P < .05) versus placebo were observed in the incidence of vomiting and phonophobia with almotriptan 12.5 mg, and photophobia and phonophobia with sumatriptan 100 mg.Conclusion.—Almotriptan provides relief from migraine‐associated symptoms of nausea, vomiting, photophobia, and phonophobia, and thus represents an attractive treatment option for a wide spectrum of migraine symptomatology.
Hormonal Factors in Migraine: A Population‐Based Study of Women Aged 40 to 74 Years
Authors: Mattsson Peter 
Published: March 2003

Objective.—This study investigated some of the relationships between migraine and hormonal factors.Methods.—A neurologist clinically assessed 728 women aged 40 to 74 years attending a population‐based mammography screening program. Headache criteria proposed by the International Headache Society were used. Data on hormonal factors were obtained by interview and questionnaire.Results.—Twenty‐one percent of women with migraine without aura and 4% of women with migraine with aura reported that they experienced ≥75% of their attacks within −2 to +3 days of the menstrual cycle. During pregnancy, women experienced less frequent or less intense attacks of migraine without aura and migraine with aura. A small but significant proportion (12%, P  =  .04) of women with migraine without aura also had premenstrual disorder. Associations between migraine and menarche, pregnancy, pregnancy‐related complications, and menopausal complaints were generally weak and insignificant. Migraine with aura was not related to menopause. A crude odds ratio of 0.47 (95% confidence interval [CI] 0.24‐0.86) indicated a decrease in risk for migraine without aura in postmenopausal women. However, after adjusting for differences in age and the use of hormonal replacement therapy, this association was not statistically significant. Time since menopause was a significant factor for migraine without aura in postmenopausal women.Conclusion.—Although many women with migraine reported a close relationship between their attacks and menses, and relief during pregnancy, the cross‐sectional associations between migraine and menopause and menopausal complaints were insignificant.
The Association Between Migraine and Juvenile Stroke: A Case‐Control Study
Authors: Schwaag Sonja , Nabavi Darius G. , Frese Achim , Husstedt Ingo‐W. , Evers Stefan 
Published: March 2003

Background.—Several studies suggest an association between migraine and juvenile stroke. Because of some shortcomings, we designed another case‐control study of a homogenous group of patients with juvenile cerebral ischemia. This study is part of a larger German epidemiological research project on the association of migraine with cerebrovascular disease.Methods.—We enrolled 160 consecutive patients under the age of 46 years with first‐ever ischemic stroke or transient ischemic attack and 160 strictly sex‐ and age‐matched controls. Patients suffering from arterial dissection, brain hemorrhage, cranial sinus thrombosis, lacunar stroke, or from migrainous infarction were excluded. Migraine was diagnosed according to the criteria of the International Headache Society by the same 2 independent interviewers. For analyzing the data, nonparametric statistical methods including odds ratio and 95% confidence interval were used.Results.—Migraine was a significant risk factor for juvenile stroke for the total sample with an odds ratio of 2.11 (confidence interval, 1.16 to 3.82). The odds ratio was even higher in the subgroup under the age of 35 (3.26) and in the female subgroup (2.68). We found migraine to be independent from other vascular risk factors, from etiology, and from the territory of stroke.Conclusions.—We can confirm the findings of previous studies showing a significant association between migraine and juvenile stroke in women. Furthermore, our data suggest migraine to be an even more significant risk factor for patients under the age of 35 and to be independent from other vascular risk factors.
Headache and Hemodialysis: A Prospective Study
Authors: Antoniazzi Ana L. , Bigal Marcelo E. , Bordini Carlos A. , Tepper Stewart J. , Speciali José G. 
Published: March 2003

Objective.—To determine the prevalence and clinical characteristics of headache in patients undergoing hemodialysis and to compare the prevalence of headache prior to and following the beginning of a hemodialysis program.Background.—About 70% of patients receiving hemodialysis complain of headache. Despite this, headaches have not been well studied in this group of patients.Methods.—We evaluated a series of patients with chronic renal failure who attended 3 hemodialysis services in a Brazilian town from January of 1998 to December of 1999. Patients with headache were prospectively followed and classified according to the International Headache Society criteria. The headaches were also categorized according to their temporal profile relative to hemodialysis.Results.—Headache was reported by 87 (70.7%) of the 123 patients studied. Prior to beginning dialysis, 48% had migraine, 19% had episodic tension‐type headache, and 8% had both. Headache related to arterial hypertension was the second most frequent headache diagnosis in these patients (25.4%). Fifty patients (57.5%) experienced headache during the session of hemodialysis. Thirty‐four were classified as dialysis headache, 7 were classified as migraine, 7 as episodic tension‐type headache, and 2 were unclassified. Twenty‐four patients (27.6%) reported dramatic improvement of their headaches after the beginning of the dialysis program.Conclusions.—Headache is common in patients undergoing hemodialysis. Classification of such headaches according to the International Headache society criteria may be difficult.
Dose Range‐Finding Studies With Frovatriptan in the Acute Treatment of Migraine
Authors: Rapoport Alan , Ryan Robert , Goldstein Jerome , Keywood Charlotte 
Published: March 2003

Objective.—To determine the optimum dose of frovatriptan for the acute treatment of migraine.Background.—Frovatriptan is a new triptan developed for the acute treatment of migraine. The dose‐response characteristics and safety of frovatriptan have been investigated across a broad range of doses from 0.5 to 40 mg.Design.—Two randomized, placebo‐controlled, double‐blind, parallel‐group trials, with a total of 1453 patients, were performed to determine the optimal dose of the 5‐HT1B/1D agonist, frovatriptan, for the acute treatment of migraine. The dose ranges studied were 2.5 to 40 mg in the high‐dose study and 0.5 to 5 mg in the low‐dose study.Results.—At 2 hours postdosing for initial moderate or severe headache (International Headache Society grades 2 or 3), there was an approximate two‐fold difference in the proportion of patients taking frovatriptan doses of 2.5 to 40 mg with mild or no headache compared to placebo. Frovatriptan doses of 0.5 mg and 1 mg were not more effective than placebo at 2 hours postdose, and 2.5 mg was identified as the lowest effective dose for the relief of migraine and accompanying symptoms. Above 2.5 mg, no dose‐response relationship was observed for any efficacy parameters. There was an increase in the incidence of adverse events from 10 mg and above, but the vast majority were rated as mild in severity and did not impact upon tolerability in a significant manner.Conclusions.—Frovatriptan was well tolerated throughout the dose range of 0.5 to 40 mg. The 2.5‐mg dose confers the optimal balance of efficacy and tolerability for the acute treatment of migraine.
Cortical Dysplasia: Electroclinical, Imaging, and Neuropathologic Study of 13 Patients
Authors: Tassi Laura , Pasquier Basile , Minotti Lorella , Garbelli Rita , Kahane Philippe , Benabid Alim Louis , Battaglia Giorgio , Munari Claudio , Spreafico Roberto 
Published: March 2003

Summary:  Purpose: The aim of this study was to correlate the electroclinical and radiologic data with the neuropathologic findings and surgical outcome in epileptic patients with epilepsy and Taylor's focal cortical dysplasia (TFCD) and to characterize further the abnormal intermediate filaments expression in the balloon cell present in the peculiar dysplasia.Methods: We retrospectively selected 13 TFCD patients who underwent surgery for intractable epilepsy with the aim of removing the magnetic resonance (MR)‐detectable lesion and/or the epileptogenic zone defined by stereoelectroencephalographic recordings. The surgical specimens were analyzed by means of routine neuropathologic and immunocytochemical studies. Antisera against different intermediate filaments also were used in serial adjacent sections to evaluate their coexpression in balloon cells.Results: Histopathologic abnormalities typical of TFCD were found not only within the MR‐visible lesions but also in most of the epileptogenic zones with no MR signal alterations. Furthermore, the MR‐visible lesions contained a high proportion of cells with an abnormal expression of intermediate filament proteins. After a long follow‐up, 10 of the patients are now seizure free.Conclusions: Our findings indicate that highly epileptogenic zones may correspond to tissue alterations not revealed by neuroimaging. Furthermore, the immunocytochemical data show that the dysplastic tissue detected by MR contained high concentrations of cells filled with abnormal intermediate filaments. The detected colocalization of neuronal and glial markers in balloon cells indicates a failure of cellular commitment during development.
Seizure Outcome after Temporal Lobectomy: Current Research Practice and Findings
Authors: McIntosh A. M. , Wilson S. J. , Berkovic S. F. 
Published: March 2003

Summary:  Purpose: The literature regarding seizure outcome and prognostic factors for outcome after temporal lobectomy is often contradictory. This is problematic, as these data are the basis on which surgical decisions and counseling are founded. We sought to clarify inconsistencies in the literature by critically examining the methods and findings of recent research.Methods: A systematic review of the 126 articles concerning temporal lobectomy outcome published from 1991 was conducted.Results: Major methodologic issues in the literature were heterogeneous definitions of seizure outcome, a predominance of cross‐sectional analyses (83% of studies), and relatively short follow‐up in many studies. The range of seizure freedom was wide (33–93%; median, 70%); there was a tendency for better outcome in more recent studies. Of 63 factors analyzed, good outcome appeared to be associated with several factors including preoperative hippocampal sclerosis, anterior temporal localization of interictal epileptiform activity, absence of preoperative generalized seizures, and absence of seizures in the first postoperative week. A number of factors had no association with outcome (e.g., age at onset, preoperative seizure frequency, and extent of lateral resection).Conclusions: Apparently conflicting results in the literature may be explained by the methodologic issues identified here (e.g., sample size, selection criteria and method of analysis). To obtain a better understanding of patterns of long‐term outcome, increased emphasis on longitudinal analytic methods is required. The systematic review of possible risk factors for seizure recurrence provides a basis for planning further research.
Severe Myoclonic Epilepsy of Infancy: Extended Spectrum of GEFS+?
Authors: Singh R. , Andermann E. , Whitehouse W. P. A. , Harvey A. S. , Keene D. L. , Seni M‐H. , Crossland K. M. , Andermann F. , Berkovic S. F. , Scheffer I. E. 
Published: March 2003

Summary:  Purpose: Severe myoclonic epilepsy of infancy (SMEI) is an intractable epilepsy of early childhood of unknown etiology. It is often associated with a family history of seizure disorders, but epilepsy phenotypes have not been well described. We sought to characterize the seizure phenotypes of relatives to better understand to the genetic basis of SMEI.Methods: Probands with SMEI were identified, and systematic family studies were performed. Epilepsy syndromes were characterized in affected family members.Results: Twelve probands with SMEI were identified. Eleven of the 12 probands with SMEI had a family history of seizures, and the twelfth was the result of a consanguineous marriage. We found that 16.7% of full siblings and 8.3% of parents had definite seizures. A total of 39 affected family members was identified. The most common phenotype was febrile seizures in 14, febrile seizures plus in seven, partial epilepsy in two, and there were single individuals with SMEI, myoclonic–astatic epilepsy, Lennox–Gastaut syndrome, and 13 cases with unclassified or unconfirmed seizures.Conclusions: The family history of seizures in SMEI is in keeping with the spectrum of seizure phenotypes seen in generalized epilepsy with febrile seizures plus (GEFS+). Our findings suggest that SMEI is the most severe phenotype in the GEFS+ spectrum.
Neuroimaging Findings of Cortical Dyslamination with Cytomegaly
Authors: Lee Sung Kun , Choe Gheeyoung , Hong Keun‐Sik , Nam Hyun‐Woo , Kim Joo‐Yong , Chung Chun‐Kee , Lee Dong‐Soo , Chang Kee‐Hyun 
Published: March 2003

Summary:  Purpose: Our aims were to identify (a) the characteristic magnetic resonance imaging (MRI) findings of cortical dyslamination with cytomegaly, including dysplastic and destructive lesions; (b) the relationship between MRI findings and pathologic characteristics; (c) the diagnostic role of functional neuroimaging studies in patients with these pathologies.Methods: The series consisted of 23 adult patients who had proven cortical dyslamination with cytomegaly. The abnormalities found on MRI were subdivided according to the patterns of involvement. They also were compared with the patients' pathologic characteristics. With visual qualitative analysis, [18F]fluorodeoxyglucose with positron emission tomography (FDG‐PET), and ictal single‐photon emission computed tomography (SPECT), observations were classified as localizing, lateralizing, nonlateralizing, false‐localizing, and false‐lateralizing. The standard for correct localization of neuroimages was defined to be the resected lobe.Results: Focal abnormalities were found in 14 cases by MRI. Six cases showed typical MRI findings of focal cortical dysplasia, with focal areas of cortical thickening with or without poor grey–white matter differentiation. Focal subcortical high signal intensities on T2‐weighted images occurred in two cases. Six patients had the focal destructive pattern. Three of eight cases with normal MRI and four of eight cases with the nondestructive cortical dysplasia pattern had balloon cells. However, these were not found in six patients with the destructive MRI pattern. FDG‐PET localized the pathologic lobe in 13 (65%) of 20 cases, and ictal SPECT achieved this in 11 (61.1%) of 18 cases. FDG‐PET and ictal SPECT also correctly localized the pathologic lobe in four and two cases with normal MRI, respectively.Conclusions: Two distinct patterns of abnormal MRI were found in the pathology of cortical dyslamination with cytomegaly. These dysplastic and destructive patterns might reflect different pathogeneses, such as the time of insult. FDG‐PET and ictal SPECT have confirmatory and independent diagnostic roles in localizing epileptogenic foci.
Comparison of Hippocampal Volumetry at 1.5 Tesla and at 3 Tesla
Authors: Briellmann Regula S. , Syngeniotis Ari , Jackson Graeme D. 
Published: March 2003

Summary:  Purpose: Hippocampal volumetry using magnetic resonance imaging (MRI) is a common clinical study in epilepsy patients. Most clinical MR scans operate at 1.5 tesla (T); however, there is increasing use of scanners of a higher field strength. We analyzed whether control data of hippocampal volumes can be used across different field‐strength scanners.Methods: We studied eight adult healthy controls twice at both 1.5 and 3 T. Bilateral hippocampal volumes were measured by manual outlining. Measurement error was analyzed based on the variability between two measurements at the same field strength, and intrascanner variability was analyzed based on the difference between measurements obtained at 1.5 and at 3 T.Results: The measurement error was 4.0% (±3.1) at 1.5 T, and 3.4% (±2.5) at 3 T. The intrascanner variability between measurements at 1.5 and at 3 T was 6% (±3.9). The intrascanner variability was not different from the measurement error.Conclusions: Control hippocampal volume measurements obtained at 1.5 and at 3 T were not different.