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Bob_Johnson
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Research summaries--several Cluster topics
« on: Jul 4th, 2004, 4:41pm » |
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: Headache. 2004 Jun;44(6):633.
CLUSTER.
[No authors listed]
Weintraub JR. Cluster headaches and sleep disorders. Curr Pain Headache Rep. 2003;7:150-156.Cluster headaches are characterized by unilateral paroxysmal attacks of severe pain with associated symptoms. The headaches occur during particular sleep stages and are associated with other chronobiologic factors. Several sleep disorders have been associated with the occurrence of cluster headache; multiple hormonal influences affect the relationship between sleep and headache. Melatonin and other treatments that affect circadian rhythm have been suggested for the treatment of cluster headache. Obstructive sleep apnea can occur in patients with cluster headache; attempts to treat one disorder may influence the other. Sleep disorders such as insomnia and narcolepsy also may be associated with and influence cluster headaches. This article examines the relationship between the various sleep disorders and cluster headache, and reviews current research. Normal and abnormal sleep and details of treatments for specific sleep disorders that may decrease the frequency and severity of cluster headaches also are discussed. The relationship between obstructive sleep apnea, which is the most common sleep disorder, and cluster headache is discussed in detail. Comment: A fascinating review on complicated relationships between sleep and the classic circadian and circannual headache disorder. Stewart J. Tepper Finkel AG. Epidemiology of cluster headache. Curr Pain Headache Rep. 2003;7:144-149.Cluster headache is rare, occurring in less than 1% of the population. Studies suggest that, in addition to the pain and associated autonomic disturbances recognized to be characteristic of the syndrome, patients also may experience nausea, photophobia, behavioral agitation, or restlessness. A decreasing male:female ratio also has been noted, perhaps attributable to lifestyle trends adopted by more women that were previously associated with men, such as tobacco use, alcohol consumption, and working outside of the home. The relationship between cluster headache and hormonal events does not appear to be strong. Hormonal influences on the chronic form of cluster headache in women are a subject of investigation. The emerging understanding of the genetics of cluster headache increasingly suggests a genetic component, with familial transmission now recognized to be more common than previously appreciated. Head trauma, coronary artery disease, and migraine appear to be present in more patients with cluster headache than can be explained by chance alone. Ethnic and racial differences in prevalence are less well understood. Comment: I have always wanted a first rate review of cluster epidemiology, and finally Professor Alan Finkel of North Carolina has provided one for use in teaching residents and colleagues. Stewart J. Tepper Markley HG. Topical agents in the treatment of cluster headache. Curr Pain Headache Rep. 2003;7:139-143.This article discusses topical intranasal medications in the treatment of cluster headache. Comment: Professor Alan Rapoport of Columbia University School of Physicians and Surgeons and The New England Center for Headache has long had an interest in intranasal delivery systems for cluster, including capsaicin (Marks DR, Rapoport A, Padla D, Weeks R, Rosum R, Sheftell F, Arrowsmith F. A double-blind placebo-controlled trial of intranasal capsaicin for cluster headache. Cephalalgia. 1993;13:114-116) and civamide (Phillips SB, Bernstein JE and the Intranasal Civamide Study Group. Intranasal civamide: a novel neuropeptide active agent in development for the treatment of migraine and cluster headache. Cephalalgia. 2000; 20:333 (abs). There is also placebo controlled evidence for the effectiveness of sumatriptan nasal spray in cluster (van Vliet JA, Bahra A, Martin V, Aurora SK, Mathew NT, Goadsby PJ. Intranasal sumatriptan is effective in the treatment of acute cluster headache- a double-blind placebo-controlled crossover study. Cephalalgia. 2001;21:270-271). Here, Dr Herb Markely gives us an overview of all of the intranasal approaches. SJT
PMID: 15186316 [PubMed - as supplied by publisher]
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Bob Johnson
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Prense
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Re: Research summaries--several Cluster topics
« Reply #1 on: Jul 4th, 2004, 4:46pm » |
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on Jul 4th, 2004, 4:41pm, Bob_Johnson wrote:: Headache. 2004 Jun;44(6):633.
A decreasing male:female ratio also has been noted, perhaps attributable to lifestyle trends adopted by more women that were previously associated with men, such as tobacco use, alcohol consumption, and working outside of the home.
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How about more educated docs and proper diagnosis regardless of stigma???
Some people...
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Where does the white go in a snowman when the snow melts?
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