bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genetic and Environmental Factors Associated With Migraine in Schoolchildren
Authors: Bener A. , Uduman S.A. , Qassimi E.M.A. , Khalaily G. , Sztriha L. , Kilpelainen H. , Obineche E. 
Published: March 2003

Objective.–The aim of this study was to find the prevalence of migraine and headache in schoolchildren in the United Arab Emirates and to determine the genetic and environmental factors associated with these conditions.Methods.–A cross‐sectional population study was performed from October 1995 to June 1996. Subjects were selected by a multistage stratified sampling procedure. Data were collected by screening questionnaires followed by clinical interviews. Twelve primary schools and 1400 schoolchildren of United Arab Emirates nationality resident in the Al Ain City, Dubai, and Sharjah emirates were recruited for this study. A total of 1159 (82.7%) schoolchildren gave their consent to the study.Results.–The estimated prevalence rates for headache and migraine were 36.9% and 13.7%, respectively. The prevalence of headache is increased with age, the highest prevalence being in 13‐year‐old children (17.5%). Of the 159 children who fulfilled the diagnostic criteria for migraine, 76 were boys whose mean age (± SD) was 10.3 years ± 2.8 years, and 83 were girls (mean age 9.9 ± 2.5 years). Of the children who had migraine, 20 (12.6%) had migraine without aura, and 13 (8.2%) had migraine with aura. The most common migraine symptoms in schoolchildren had been aggravated by physical activity (47.2%) and a positive family history of migraine (46.5%). The most common illnesses were infectious illnesses (41.5%). There was a strong relationship between migraine and the timing of examinations (46.5%). The most common environmental exposure for migraine was found to be playing on a computer (45.9%), followed by loud noise (41.5%), and a hot climate (37.1%). In familial occurrence of headache among immediate relatives, the most frequently affected relative was the mother (17.6%).Conclusion.–Headache and migraine are common in childhood and may be influenced by social, familial, environmental, and psychological factors.
Solubilized Ibuprofen: Evaluation of Onset, Relief, and Safety of a Novel Formulation in the Treatment of Episodic Tension‐type Headache
Authors: Packman Barry , Packman Elias , Doyle Geraldine , Cooper Stephen , Ashraf Elizabeth , Koronkiewicz Karen , Jayawardena Shyamalie 
Published: March 2003

Objective.—To evaluate the relative efficacy of a new solubilized formulation of ibuprofen compared with acetaminophen caplets. Methods.—This double‐blind, randomized, parallel group study evaluated 154 subjects taking a single dose of solubilized ibuprofen, 400 mg; acetaminophen, 1000 mg; or placebo for the relief of episodic tension‐type headache. Time to relief was measured using a stopwatch, and overall efficacy was measured using traditional categorical pain and relief scales. Results.—Ibuprofen capsules (liquigel), 400 mg, were significantly faster than both acetaminophen, 1000 mg, and placebo for all time‐to‐relief measures. Ibuprofen liquigel had a median time to first perceptible pain relief of 39 minutes compared with 47 minutes for acetaminophen and 113 minutes for placebo. For median time to meaningful relief, ibuprofen liquigel had a time of 39 minutes compared with 53 minutes for acetaminophen and more than 180 minutes for placebo (P.02 for both measures). In addition, ibuprofen liquigels demonstrated significantly superior overall analgesic efficacy compared with acetaminophen, 1000 mg, for the relief of episodic tension‐type headache. Both active treatments had a side effect profile similar to placebo. Conclusions.—Although several other studies have demonstrated the overall analgesic superiority of ibuprofen to acetaminophen, this study demonstrated that the liquigel formulation also provides a clinically relevant advantage for time to analgesic effects.
Venlafaxine Extended Release (XR) for the Prophylaxis of Migraine and Tension‐type Headache: A Retrospective Study in a Clinical Setting
Authors: Adelman Leon C. , Adelman James U. , Von Seggern Randal , Mannix Lisa K. 
Published: March 2003

Objective.—To assess the efficacy of extended‐release venlafaxine in the prophylaxis of migraine and chronic tension‐type headache. Background.—Venlafaxine, a structurally novel antidepressant, is a selective serotonin‐norepinephrine reuptake inhibitor. This study is the first to test the effects of extended‐release venlafaxine on headaches. Methods.—Patients were evaluated on a retrospective basis. Fifty‐six patients with chronic tension‐type headache and 114 patients with migraine were prescribed extended‐release venlafaxine. Nearly all the study subjects had been resistant to several previous preventive medications. Patients took venlafaxine for an average of 6 months with a median dose of 150 mg (range, 37.5 to 300 mg). Results.—The mean frequency of headaches in the group with chronic tension‐type headache fell from 24.0 to 15.2 per month (P < .0001). The group with migraine showed a reduction from 16.1 to 11.1 headaches per month (P < .0001). The medicine was well tolerated. Conclusions.—This trial indicates that extended‐release venlafaxine has potential in headache prophylaxis based on its efficacy and safety profile. We recommend a double‐blind, placebo‐controlled study to further assess the role of extended‐release venlafaxine in headache prevention.
Postpartum Cerebral Angiopathy in a Patient With Chronic Migraine With Aura
Authors: Modi Mala , Modi Girish 
Published: March 2003

A 25‐year‐old woman with a history of chronic severe migraine with aura presented in an apoplectic state 1 week after the delivery of her third child. She developed a severe headache and within hours lapsed into a coma. A CT scan of the brain showed cerebral edema and an occipital hemorrhage. A four‐vessel angiogram showed diffuse arterial narrowing of all the intracranial vessels with segmental narrowing of the suprasellar portion of the internal carotid arteries bilaterally. She had no risk factors for stroke or vasculitis. Her pregnancy and delivery were uneventful with no preeclampsia or eclampsia. Apart from ergometrine at the time of the delivery, no vasoconstrictor drugs were used.She recovered spontaneously. Serial CT scans of the brain demonstrated resolution of the edema and hemorrhage with the development of cortical and watershed infarcts. A repeat cerebral angiogram was normal. She was, therefore, diagnosed as having suffered from postpartum cerebral angiopathy, a form of reversible cerebral vasoconstriction, called the Call or Call‐Fleming syndrome.The relationship between migraine and postpartum angiopathy in the development of reversible cerebral vasoconstriction is discussed.
Botulinum Toxin Type A and EMG: A Key to the Understanding of Chronic Tension‐type Headaches?
Authors: Rollnik Jens D. , Karst Matthias , Fink Matthias , Dengler Reinhard 
Published: March 2003

Background.—The pathogenesis of chronic tension‐type headache remains unclear, and the role of muscle tension is especially controversial. Botulinum toxin type A, a potent inhibitor of muscle tone, has been used to treat chronic tension‐type headache.Objective.—To determine whether clinical response to treatment of chronic tension‐type headache with Botox A parallels changes in resting muscle activity recorded through serial electromyography (EMG).Methods.—We randomly assigned eight patients with chronic tension‐type headache to pericranial injection of 500 MU Botox A versus placebo (isotonic saline).Results.—At 6 and 12 weeks following treatment, there were no significant differences in clinical outcome between the placebo and the Botox A groups. This occurred despite EMG evidence of a reduction in resting muscle activity in the Botox A‐treated patients.Conclusion.—These results support the hypothesis that peripheral mechanisms such as increased muscle tone play, at most, a minor role in the pathophysiology of chronic tension‐type headache.
Chronic Daily Headache: Identification of Factors Associated With Induction and Transformation
Authors: Bigal Marcelo E. , Sheftell Fred D. , Rapoport Alan M. , Tepper Stewart J. , Lipton Richard B. 
Published: March 2003

Background.—Chronic daily headache (CDH) is one of the more frequently encountered headache syndromes at major tertiary care centers. The analysis of factors related to the transformation from episodic to chronic migraine (CM) and to the de novo development of new daily persistent headache (NDPH) remain poorly understood. Objectives.—To identify somatic factors and lifestyle factors associated with the development of CM and NDPH. Methods.—We used a randomized case‐control design to study the following groups: 1) CM with analgesic overuse (ARH), n = 399; 2) CM without analgesic overuse, n = 158; and 3) NDPH, n = 69. These groups were compared with two control groups: 1) episodic migraine, n = 100; and 2) chronic posttraumatic headache (CPTH); n = 65. Associated medical conditions were assessed. We investigated the case groups for any association with somatic or behavioral factors. Data were analyzed by the two‐sided Fischer's exact test, with the odds ratio being calculated considering a 95% confidence interval using the approximation of Woolf. Results.—When the active groups were compared with the episodic migraine group, the following associations were found: 1) ARH: hypertension and daily consumption of caffeine; 2) CM: allergies, asthma, hypothyroidism, hypertension, and daily consumption of caffeine; and 3) NDPH: allergies, asthma, hypothyroidism, and consumption of alcohol more than three times per week. The following associations were found when comparing the active groups with CPTH: 1) ARH: asthma and hypertension; 2) CM: allergies, asthma, hypothyroidism, hypertension, and daily consumption of caffeine; and 3) NDPH: allergies, asthma, hypothyroidism, and consumption of alcohol more than three times per week. Conclusions.—Several strong correlations were obtained between patients with specific types of CDH and certain somatic conditions or behaviors; some have not been previously described. Transformation of previously episodic headache or development of a NDPH thus may be related to certain medical conditions and behaviors beyond the frequently incriminated precipitant analgesic overuse. As similar results were obtained when CPTH was used as a control, the correlation is more complex than simple comorbidity.
Results of Surgery in Patients with Refractory Extratemporal Epilepsy with Normal or Nonlocalizing Magnetic Resonance Findings Investigated with Subdural Grids
Authors: Cukiert Arthur , Buratini Jose A. , Machado Elcio , Sousa Alcione , Vieira Joaquim O. , Argentoni Meire , Forster Cassio , Baldauf Cristine 
Published: March 2003

Summary:  Purpose: To study the efficacy of extensive coverage of the brain surface with subdural grids in defining extratemporal cortical areas amenable for resection in patients with refractory extratemporal epilepy (R‐ExTE) and normal or nonlocalizing magnetic resonance imaging (MRI) scans.Methods: Sixteen patients with R‐ExTE were studied. Eleven patients had simple partial, eight had complex partial, and three had supplementary motor area seizures. Seizure frequency ranged from three per month to daily episodes. Interictal EEG showed large focal spiking areas in 11 patients, secondary bilateral synchrony in four, and was normal in one patient. Surface ictal recordings were nonlocalizing in six patients, and in 10, they disclosed large ictal focal spiking areas. MRI was normal in 10 patients, and in six patients, focal nonlocalizing potentially epileptogenic lesions were found. All patients were given an extensive coverage of the cortical convexity with subdural electrodes through large unilateral (n = 13) or bilateral (n = 3) craniotomies. Bipolar cortical stimulation was carried out through the implanted electrodes.Results: Interictal invasive recording findings showed widespread spiking areas in 13 patients and secondary bilateral synchrony in three. Ictal invasive recordings showed focal seizure onset in all patients. There were six frontal, two parietal, one temporooccipital, four rolandic, and three posterior quadrant resections. Thirteen patients had been rendered seizure free after surgery, and three had 90% of seizure‐frequency reduction. Pathologic findings included gliosis (n = 10), cortical dysplasia (n = 5), or no abnormalities (n = 1). Six patients had transient postoperative neurologic morbidity.Conclusions: Extensive subdural electrodes coverage seems to be an effective way to investigate patients with R‐ExTE and normal or nonlocalizing MRI findings.
Anticonvulsant Profile of Valrocemide (TV1901): A New Antiepileptic Drug
Authors: Isoherranen Nina , Woodhead José H. , White H. Steve , Bialer Meir 
Published: March 2003

Summary:  Purpose: We sought to investigate the anticonvulsant activity of the new antiepileptic drug (AED), valrocemide or TV1901 (VGD) in various animal (rodent) models of human epilepsy to determine its anticonvulsant profile and safety margin.Methods: VGD was administered intraperitoneally to CF no. 1 mice and orally or intraperitoneally to Sprague–Dawley rats. The anticonvulsant activity of VGD was examined in nine different animal models of epilepsy for its ability to block electrically, chemically, or sensorily induced seizures.Results: In mice VGD afforded complete protection against maximal electroshock (MES)‐, pentylenetetrazole‐, picrotoxin‐, and bicuculline‐induced seizures and 6‐Hz “psychomotor” seizures with median effective dose (ED50) values of 151, 132, 275, 248, and 237 mg/kg, respectively. VGD was also effective in preventing sound‐induced seizures in Frings audiogenic‐seizure susceptible mice (ED50, 52 mg/kg). The median neurotoxic dose in mice was 332 mg/kg. After oral administration to rats, VGD was active in the MES test, with an ED50 of 73 mg/kg, and the median neurotoxic dose was 1,000 mg/kg. Intraperitoneal administration of 300 mg/kg of VGD to hippocampal kindled Sprague–Dawley rats blocked generalized seizures and shortened the afterdischarge duration significantly. VGD also provided complete protection from focal seizures in the corneally kindled rats (ED50,161 mg/kg).Conclusions: The results obtained in this study suggest that VGD has a broad spectrum of anticonvulsant activity and promising potential as a new AED.
The Ontogeny of Partial Seizures in Infants and Young Children
Authors: Nordli Douglas R. , Kuroda Maxine M. , Hirsch Lawrence J. 
Published: March 2003

Summary:  Purpose: To describe the clinical manifestations of partial seizures in the pediatric population as a function of age.Methods: Using the database of the pediatric epilepsy monitoring unit (Children's Hospital of New York), clinical and EEG characteristics of partial seizures were distributed by age groups 0–2, 2–6, and 6+ years for 123 patients who had at least one such seizure with a clear EEG correlate during their admission. χ2 tests for trend were used to examine clinical and EEG features as a function of age.Results: The frequency of aura, limb automatisms, dystonic posturing, secondary generalization, and unresponsiveness increased with age, whereas asymmetric clonus and symmetric tonic posturing decreased with age. There were no clear changes in the types of EEG ictal patterns observed with age; however, partial seizures emanating from the anterior regions of the brain tended to increase with age, whereas those from the posterior regions tended to decrease with age.Conclusions: Important differences exist in the clinical expression of seizures between young children and adults. These findings will contribute to a better understanding of ictal ontogeny that will promote more accurate classification of seizures and of the epilepsies in young patients. Such efforts can be used to identify young patients for focal epilepsy surgery and to select appropriate anticonvulsive medications.
Destruction of Peripheral C‐Fibers Does Not Alter Subsequent Vagus Nerve Stimulation‐Induced Seizure Suppression in Rats
Authors: Krahl Scott E. , Senanayake Shayani S. , Handforth Adrian 
Published: March 2003

Summary:  Purpose: Early animal studies of the therapeutic mechanisms of vagus nerve stimulation (VNS) suggested that seizure suppression requires maximal activation of small, unmyelinated vagal C fibers. However, effective therapeutic stimulation parameters appear to be subthreshold for these fibers in humans, and there are no clinical reports of the autonomic side effects that would be expected if these fibers were maximally activated. We report here that selective destruction of C fibers with capsaicin does not affect VNS‐induced seizure suppression in rats.Methods: Rats were pretreated with capsaicin or vehicle in three injections over a 2‐day period. A cuff electrode was later implanted on the left cervical vagus nerve. Two days after surgery, VNS was given to half of the capsaicin‐ and vehicle‐treated rats. The remaining rats were connected to the stimulator but did not receive VNS. Thirty seconds after VNS onset, seizures were induced by pentylenetetrazol (PTZ), and seizure severity was measured. Two days later, the reciprocal VNS treatment was given, and PTZ‐induced seizure severity was again measured.Results: VNS effectively reduced seizure severity in both capsaicin‐ and vehicle‐treated rats as compared with their non‐VNS baselines.Conclusions: These results indicate that activation of vagal C fibers is not necessary for VNS‐induced seizure suppression.
Estimating the Costs of Epilepsy: An International Comparison of Epilepsy Cost Studies
Authors: Kotsopoulos Irene A. W. , Evers Silvia M. A. A. , Ament André J. H. A. , De Krom Marc C. T. F. M. 
Published: March 2003

Summary:  Purpose: To compare systematically the national and per capita estimates of the cost of epilepsy in different countries.Methods: Studies for this literature review were selected by conducting a Medline literature search from January 1966 to March 2000. Key methodologic, country‐related, and monetary issues of the selected epilepsy cost studies were evaluated to compare their direct cost estimates and to explore their distribution. The results of the selected studies were made comparable by converting them with different types of conversion factors and expressing them as a proportion of the national expenditure on health care.Results: Ten epilepsy cost studies were reviewed. The proportion of national health care expenditure on epilepsy shows a range of 0.12–1.12% or 0.12–1.05% depending on the type of conversion factor. The list of cost components included in the estimation of the direct costs of epilepsy differs from study to study. A comprehensive list is associated with a decrease in the contribution of drug and hospital costs to the total direct costs of epilepsy.Conclusions: This study highlights the importance of studying the economic consequences of epilepsy and of interpreting the results on the international level. The results of epilepsy cost studies can provide insight into the distribution of the costs of epilepsy and the impact of epilepsy on the national expenditure on health care.
The Costs of Childhood Epilepsy in Italy: Comparative Findings from Three Health Care Settings
Authors: Guerrini R. , Battini R. , Ferrari A. R. , Veggiotti P. , Besana D. , Gobbi G. , Pezzani M. , Berta E. , Tetto A. , Beghi E. , Monticelli M. L. , Tediosi F. , Garattini L. ,   theEpilepsy Collaborative Study Group, Russo S. , Rasmini P. , Amadi A. , Quarti P. , Fabrizzi R. 
Published: March 2003

Summary:  Purpose: To determine the direct costs of epilepsy in a child neurology referral population, stratified by disease, duration, and severity, comparing three different health care settings [i.e., teaching or clinical research (CR) hospitals, general hospitals, and outpatient services].Methods: Patients were accepted if they had confirmed epilepsy and were resident in the center catchment area. Eligible subjects were grouped in the following categories: (a) newly diagnosed patients; (b) patients with epilepsy in remission; (c) patients with active non–drug‐resistant epilepsy; and (d) those with drug‐resistant epilepsy. Over a 12‐month period, data regarding the consuming of all resources (i.e., consultations, tests, hospital admissions, drugs), were collected for each patient. Using the Italian National Health Service tariffs, the unit cost of each resource was calculated and indicated in Euros, the European currency.Results: A total of 189 patients was enrolled by two teaching‐CR hospitals, two general hospitals, and two outpatient services. The patients were evenly distributed across the four categories of epilepsy. The mean annual cost per person with epilepsy was 1,767 Euros. Drug‐resistant epilepsy was the most expensive category (3,268 Euros) followed by newly diagnosed epilepsy (1,907 Euros), active non–drug‐resistant epilepsy (1,112 Euros), and epilepsy in remission (844 Euros). Costs were generally highest in teaching‐CR hospitals and lowest in outpatient services. Hospital services were the major cost in all epilepsy groups, followed by drugs.Conclusions: The cost of epilepsy in children and adolescents in Italy tends to vary significantly depending on the severity and duration of the disease Hospitals services and drugs are the major sources of costs. The setting of health care plays a significant role in the variation of the costs, even for patients in the same category of epilepsy.
Vigabatrin Visual Toxicity: Evolution and Dose Dependence
Authors: Malmgren Kristina , Ben‐Menachem Elinor , Frisén Lars 
Published: March 2003

Summary:  Purpose: To investigate the prevalence and prognosis of visual field defects (VFDs) in epilepsy patients with and without vigabatrin (VGB) treatment; to investigate the possible relationship between VFDs and cumulative VGB dose, and to characterise the evolution of VFDs.Methods: A cohort of 155 presurgical candidates who had undergone full‐field Goldmann perimetry (GP) was studied, 99 (64%) of whom had been treated with VGB. All GPs were reevaluated in 1998 by one experienced examiner, blinded to medication. Duration of treatment and total VGB dose were related to perimetric results.Results: Twenty‐five (16%) of the 155 patients had VFDs: Nineteen (19%) of the 99 VGB‐treated patients, and six (11%) of the 56 patients unexposed to VGB. VGB‐treated patients with VFDs had been treated significantly longer than those without VFDs. Cumulative VGB dose could be calculated for 84 patients. The prevalence of VFDs increased significantly with increasing total VGB‐dose, from 4% in the 51 patients who had been exposed to ≤1 kg VGB, to 75% in the eight patients with a total dose of 3–5 kg of VGB. Sixteen VGB‐treated patients were reexamined 2–10 years later. In the 12 where evaluation was possible, all still had VFDs, which had worsened in five cases (42%) and improved in none.Conclusions: This study indicates a strong relationship between VFDs and duration and total dose of VGB. VFDs were irreversible and in a substantial percentage progressive. Similar VFDs may, however, also be found in patients unexposed to VGB. A model of the evolution of the VFDs in VGB toxicity is introduced, and a new simple visual field test is proposed.