Natural Treatment to Help With Migraine Headaches

The Migraine And Headache Program

This product was created by a Christian Goodman and a woman who has been suffering from migraine problems for over a decade. As she followed the advice in the book along with easy to do stationary movements, she was able to help unlock the path of the oxygen to the brain and make her migraines stop forever. This was done not by treating migraines by the triggers, but by the cause of the migraines which was the lack of the body to send the oxygen and work well. Finally, the creator of the product was able to locate the problem along with easy to do tricks that are not known to the public. Along with that, you will also learn how to sit and walk correctly and loosen the muscles in the body for easier airflow into the brain. You will no longer have to face migraines and let them cripple your ability as a person. These easy tricks will even make you feel better immediately as you start doing them. You won't even need any experience on how to do these exercises because they are all super easy to do. In addition to that, you can get started today in stopping your migraines and headaches by getting the guide. Read more...

The Migraine And Headache Program Summary


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Of all books related to the topic, I love reading this e-book because of its well-planned flow of content. Even a beginner like me can easily gain huge amount of knowledge in a short period.

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Headache following inadvertent dural puncture is a common source of complaint. Dural tap is not, in itself, enough to demonstrate negligence, as long as it is correctly managed. This means that good analgesia should be established for labour and the patient followed up daily while in hospital. Any complaint of headache, neck pain or visual disturbances should be documented and definitive treatment, in the form of epidural blood patch, offered early. Any mother who has suffered a dural tap or postdural puncture headache should be encouraged to contact the hospital if there is a recurrence worsening of symptoms. These patients should be routinely followed up at 6-10 weeks postpartum.

Signs And Symptoms Of Hyponatremia

In evaluating hyponatremic patients, it is important to assess whether or not the patient is symptomatic, because symptoms are a better determinant of therapy than the absolute value itself. Most patients with serum sodium values above 125 mEq L are asymptomatic. The rapidity with which hyponatremia develops is critical in the initial evaluation of such patients. In the range of 125 to 130 mEq L, the predominant symptoms are gastrointestinal ones, including nausea and vomiting. Neuropsychiatric symptoms dominate the picture once the serum sodium level drops below 125 mEq L, mostly because of cerebral edema secondary to hypotonicity. These include headache, lethargy, reversible ataxia, psychosis, seizures, and coma. Severe manifestations of cerebral edema include increased intracerebral pressure, tentorial herniation, respiratory depression and death. Hyponatremia-induced cerebral edema occurs principally with rapid development of hyponatremia,...

Establishing The Diagnosis Of Ischemic Stroke

Insular Ribbon Sign

Unfortunately, there are a variety of other clinical conditions that may mimic the presentation of acute ischemic stroke. These include intracranial hemorrhage, seizure, sepsis, cardiogenic syncope, complicated migraine, dementia, nonischemic spinal cord lesion, peripheral neuropathy, transient global amnesia, and brain tumor, among others. One recent study found that, of patients presenting to a hospital with stroke-like symptoms, the diagnosis of stroke or transient ischemic attack was never established confidently in 31 , and alternative diagnoses were ultimately made in 19 . Modern imaging techniques are capable of establishing the diagnosis with a high degree of certainty, and of doing so in the very rapid time frame required for emergent treatment.

Preoperative abnormalities

Type 1, downward herniation of cerebellar tonsils of at least 3-5 mm below the foramen magnum. A study of posterior cranial fossa and CSF volumes showed them to be reduced compared with normal patients, and hindbrain overcrowding results in direct compression of tissue (Milhorat et al 1999). Clinical symptoms thus relate to CSF disturbances and direct compression of nervous tissue they include headaches, pseudotumour-like episodes, a syndrome resembling Menieres disease, lower cranial nerve signs and spinal cord disturbances without syringomyelia. It is mostly seen in young adults. 7. Sudden unexpected death may occur.A 27 year old presented to the emergency room with headache for which he was given a variety of sedatives and analgesics 4 h later he was drowsy, and at 5 h he developed pulmonary oedema,VF and died. Postmortem showed severe cerebral oedema and herniation of the cerebellar tonsils (Rocker et al 1995).Two fatal cases of unexpected respiratory arrest occurred in two...

Historical Survey of Biofeedback Development

Psychophysiology is the scientific study of the interrelationships between cognitive, emotional, behavioral, and physiological processes. Biofeedback techniques and applications grew out of the research in psycho-physiology. Biofeedback research became widespread in the 1960s, when studies reported that a variety of presumable nonvoluntary responses could be brought under operant control. Many studies using electroen-cephalographic feedback were reported which indicated that alpha brain activity could be brought under voluntary control. As these studies gained the attention of clinicians, soon biofeedback was applied to treating various disorders such as migraine headache and hypertension. The growing body of research on stress also provided support for the use of biofeedback as a research tool as well as a treatment approach. Research on the effects of relaxation, meditation, and hypnosis in producing the relaxation response to counteract the effects of stress provided further...

Penicillium Chrysogenum On

Stachybotrys Chartarum Pictures

Reports in the literature about building structures with poor indoor air quality (IAQ) increasingly appeared soon after the mid-1970s (Hodgson, 1992 Spangler and Sexton, 1983). SBS, a term that is sometimes used for symptoms commonly associated with poor IAQ, was first described in 1982. The first study examining more than one building with SBS was published in 1984 (Finnigan et al.). Although SBS has been difficult to define, evidence is now coming to the fore that seems to indicate the importance of indoor fungal growth in this phenomenon (Straus, 2001). SBS literally means that there is something inside of said building that is actually making people sick. These symptoms most commonly are fatigue, runny nose, itchy eyes, sore throat, and headaches (Cooley et al., 1998). Although no single cause for the above symptoms is likely to be found, the presence of certain molds is becoming increasingly associated with this phenomenon (Burrell, 1991 Cooley et al., 1998 Dales et al., 1991...

Management options

Migraine can usually be easily distinguished from PDPH. In migraine, the headache is usually unilateral and frontal whereas in PDPH the headache is usually bilateral, occipital and frontal. The dramatic improvement in PDPH on lying down is not present with migraine. New onset severe headache should always alert medical staff to the possibility of other underlying conditions (see Chapter 44, Postdural puncture headache, p. 114).

Periinfarct Depolarizations

Brain tissue depolarizations after ischemic stroke are believed to play a vital role in recruiting adjacent penumbral regions of reversible injury into the core area of infarction. Cortical spreading depression (CSD) is a self-propagating wave of electrochemical activity that advances through neural tissues at a rate of 2-5 mm min, causing prolonged (1-5 min) cellular depolarization, depressed neuro-electrical activity, potassium and glutamate release into adjacent tissue and reversible loss of membrane ionic gradients. CSD is associated with a change in the levels of numerous factors including immediate early genes, growth factors, and inflammatory mediators such as inter-leukin-1b and TNF-a 70 . CSD is a reversible phe-nomenon,and,while implicated in conditions such as migraine, reportedly does not cause permanent tissue injury in humans. In severely ischemic regions, energy failure is so profound that ionic disturbances and simultaneous depolarizations become permanent, a process...

Cryptococcus neoformans

C. neoformans is a ubiquitous organism acquired by inhalation. Patients with meningitis may present acutely or insidiously over days or weeks with a headache, general malaise, confusion or seizures. The classical signs of meningism neck stiffness, photophobia and Kernig's sign are frequently absent. Brain imaging is usually normal but MRI may reveal small abcesses cryptococomas. The CSF cell count and protein may be normal and the diagnosis is confirmed by the presence of cryptococcal antigen in the CSF in 95 of cases. India ink staining is positive in 75 . 85 of cases are culture positive the gold standard. Measurement of the serum cryptococccal antigen is a useful screening tool in patients presenting with headache or fever but should not be considered definitive.

Neurological manifestations

In patients infected with HIV, the whole neuraxis is vulnerable to damage. Up to 10 of patients may present with a neurological disorder at seroconversion (Box 8.1). The aseptic meningoencephalitis, which is usually self limiting, presents with headache, meningism, cranial nerve palsies and seizures. An acute demyelinating polyradiculoneuropathy (Guillain Barre syndrome) is identical to that found in non-HIV-infected individuals, clinically and in the response to treatment with intravenous immunoglobulin or plasmapharesis. However, the cerebrospinal fluid shows a pleocytosis of over 20 cells mm3 which is unusual in non HIV cases. A high index of suspicion is required and HIV should be considered in all such cases.

Patient And Clinical Course

Since the age of three the Turkish girl suffered from recurrent oral ulcers. In these situations she refused to eat. A viral infections were diagnosed. Six years later she developed genital ulcerations. With 12 years she fell ill with severe headache and double vision. We diagnosed idiopathic elevated intracranial pressure in ABD disease. Treatment was started with steroids and acetazolamide, followed by colchicine. By time headache disappeared and fundoscopy turned to normal.

Problemsspecial considerations

The main considerations for single-shot spinal analgesia are the risk of postdural puncture headache and the choice of solution, given the requirement for maximal analgesia and minimal motor block and other side effects (see Chapter 26, Combined spinal-epidural analgesia and anaesthesia, p. 63). Modern intrathecal catheters are very fine (e.g. 28-32 G) and thus may be difficult to handle and insert. They are usually supplied in a kit with a spinal needle originally these needles had cutting tips, but they are now available with pencil-point tips in an attempt to reduce the incidence of postdural puncture headache. However, even with fine catheters, 22-26 G spinal needles are required. Some catheters include a removable wire to make them stiffer for insertion. A catheter-over-needle kit also exists, in which a 27-29 G needle protrudes from the distal end of a 22-24 G catheter the catheter is slid over the needle into the subarachnoid space whilst advancement of the needle is prevented...

Diagnosis of bacterial meningitis

Bacterial meningitis is difficult to diagnose in its early stages in this age group. The classic signs of neck rigidity, photophobia, headache, and vomiting are often absent. A bulging fontanelle is a sign of advanced meningitis in an infant, but even this serious and late sign will be masked if the baby is dehydrated from fever and vomiting. Almost all children with meningitis have some degree of raised intracranial pressure, so that, in fact, the signs and symptoms of meningitis are primarily those of raised intracranial pressure. The following are signs of possible meningitis in infants and young children These children are more likely to have the classic signs of headache, vomiting, pyrexia, neck stiffness, and photophobia. Some present with coma or convulsions. In all unwell children, and children with an unexplained pyrexia, a careful search should be made for neck stiffness and for a purpuric rash. The finding of such a rash in an ill child is almost pathognomic of...

Clinical Manifestations

Brain abscess is usually manifested by low-grade fever and symptoms of a space-occupying lesion. These include persistent localized headache, drowsiness, confusion, stupor, general or focal seizures, ataxia, nausea and vomiting, and focal motor or sensory impairments. Papilledema is present in the older child and adults, and bulging fontanels may be present in the younger infant. In the initial stages, the infection is in a form of encephalitis accompanied by signs of increased intracranial pressure such as papilledema. A ruptured brain abscess may produce purulent meningitis.

Regional analgesiaanaesthesia

The extent of information required when seeking consent for regional analgesia anaesthesia is controversial, although most surveys suggest that some women would wish to know most, if not all, complications. Most obstetric anaesthetists would now consider, as a minimum, explanation of the risk of partial or complete failure of the technique, dural puncture and headache, motor block and neurological complications. Signed, written consent is not considered necessary, although a list of the pertinent aspects of the discussion should be recorded, and a note made if the patient's condition does not allow for a full explanation. Antenatal access to an anaesthetist should be available for women who have particular concerns.

Presentation and problems

Pituitary apoplexy has presented with a variety of neurological signs and symptoms after surgery, sometimes up to several days later.The majority of cases have been associated with cardiac surgery (Cooper et al 1986, Shapiro 1990), although not exclusively. In one patient the pituitary tumour had already been diagnosed, but pituitary surgery had been postponed in favour of coronary artery grafting (Absalom et al 1993). Signs of pituitary apoplexy occurred 40 h after bypass and craniotomy revealed bleeding into the tumour, but the patient died from myocardial infarction. In one patient a pituitary crisis occurred after cholecystectomy performed under combined general and epidural anaesthesia (Yahagi et al 1992). In another, severe headache started 6h after total hip replacement under spinal anaesthesia. A blood patch at 18 h failed to relieve the headache and progressive vision loss and partial third nerve palsy developed (Lennon et al 1998).Two patients died after partial resection of...

Russian autumn encephalitis virus

Russian spring-summer encephalitis virus (RSSEV) A strain of Tick-borne encephalitis virus in the genus Flavivirus. The principal tick vector for RSSEV is Ixodes persulcatus, and several small rodents and insectivores appear to be amplifying hosts. The disease is acquired in humans by tick bites, and onset is gradual with fever, headache, nausea, vomiting and photophobia. The case fatality rate is about 20 in the rural areas where the disease is prevalent, with children most affected. Survivors may suffer from neurological sequelae such as mild paralysis. A formalin-inactivated

Approach To The Child With Septicaemia

The cardinal sign of meningococcal septicaemia is a purpuric rash in an ill child. At the onset, however, the rash is not florid and a careful search should be made for purpura in any unwell child. In about 13 of patients with meningococcal septicaemia, a blanching erythematous rash replaces a purpuric one, and in 7 of cases no rash occurs. In the much rarer toxic shock syndrome, the initial clinical picture includes a high fever, headache, confusion, conjunctival and mucosal hyperaemia, scarlatiniform rash with secondary desquamation, subcutaneous oedema, vomiting and watery diarrhoea. Early administration of antibiotics, concurrent with initial resuscitation is vital.

Drugs Approved Or Under Clinical Trial

Symptoms of the disease such as fever, headache, myalgia, and cough by 1.5-2 days if taken within 24-48 h of the onset of symptoms. The oral bioavailability of zanamivir is low. Hence, it is administered topically using a specifically designed inhaler at a dose of 10 mg twice daily for five days. Oseltamivir is given orally in 75 mg dose twice a day for five days. Zanamivir is approved only for treatment, while oseltamivir is approved both for treatment and prophylactic use.

Symptoms of Pheochromocytoma

Most adult patients have paroxysmal symptoms, lasting minutes to hours, consisting of headache (80 ), perspiration (70 ), and palpitations (60 ) other symptoms are commonly present, such as anxiety (50 ), a sense of dread, tremor (40 , with epi-nephrine-secreting tumors), or paresthesias. Recurrent chest discomfort, abdominal pain, and vomiting are also frequent symptoms. The abdominal pain may be caused by ischemic enterocolitis. Sweating (initially palms, head, and shoulders) usually occurs. Drenching sweats can occur, even in a cool environment, usually as an attack subsides. The reflex eccrine sweating that occurs later in an attack is ther- Children with pheochromocytoma are more prone to diaphoresis and visual changes than are adults. They are prone to have sustained (instead of paroxysmal) hypertension. Nausea, vomiting, headache, weight loss, polydipsia, polyuria, and convulsions occur frequently in children with pheochro-mocytoma. Children with pheochromocytoma may develop...

Emotional Disturbance and Diffuse Brain Injury

Diamond, Barth, and Zillmer (1988) and others have suggested that psychological factors may be associated with head injury, which ultimately can complicate recovery. Along with the cognitive impairment noted in mild, moderate, and severe head injuries, emotional sequelae have been noted. Reported symptoms after head injury, both psychological and somatic, have included headache, fatigue, anxiety, emotional lability, and concentration impairment (Diamond et al., 1988).

Alleviating Any Adverse Effects

Adverse effects of stimulants include some responses that are common and transient or easily adjusted for, such as slight stomachache, headache, and (especially for the first few days on longer-acting agents) extended delay in getting to sleep. Many patients taking stimulants also find that their appetite is diminished while the medication is most active they may not feel very hungry until the medication has worn off, which is sometimes not until almost bedtime. Stomachaches and headaches, if experienced, are usually not severe and often go away within a few days, after the person's body has become more accustomed to the medication. Stomachache is less likely if the patient can eat some food, even just a piece of toast or a glass of milk, before taking the medication. And diminished appetite is often simply delayed appetite. Many patients taking stimulants eat very little during the day

Controlled Randomized Clinical Trials

You get the flu. You get a headache or the runs. You have a series of colds that blend one into the other until you can't remember the last time you were well. So you blame your silicon implants. Or you resolve to stop eating so much sugar. Or, if you're part of a clinical trial, you stop taking the drug. It's then that as the sponsor of the trials you're grateful you included controls. Because when you examine the data you learn that as many of the control patients came down with the flu as those who were on the active drug. And those women without implants had exactly the same incidence of colds and headaches as those who had them.

Mild Moderate Acute Crohns Colitis

Although debate continues regarding the role of aminosalicylates for the treatment of mild-moderate CD, there is good evidence that sulfasalazine is efficacious for the treatment of colonic CD. There is less substantial evidence for alternative mesalamine agents. Nevertheless, the aminosalicylates are advocated as a first line therapy for mild-moderately active CD. The use of sulfasalazine in divided doses of 3 to 6 g d, supported by the National Cooperative Crohn's Disease Study (NCCDS), is compromised, in up to 25 of patients, by side effects attributable to the sulfapyridine carrier molecule, such as headache, nausea, GI upset, and, in males, a transient reduction in number and motility of sperm. Rare but more serious hypersensitivity reactions include hemolytic anemia, neutropenia, rash, and hepatitis. In contrast to UC, where alternative azo bond delivery systems such as olsalazine and balsalazide are effective alternatives, in Crohn's colitis these agents have not been shown to...

Usual Approaches to Monitoring Safety

For unanticipated events, a DSMB risks reacting to a falsely discovered endpoint Jennison and Turnbull (2000) and Mehrotra and Heyse (2004) , for the event may have occurred in the treatment arm purely by chance. Therefore, DSMBs typically wish to dampen a rush to judgment about the product or intervention. In prevention trials among healthy volunteers or in trials of diseases or conditions not usually accompanied by many types of serious adverse events (e.g., relief of minor headache pain), one analysis might compare the total number of adverse events to a standard rate known from historical data (a hurdle) or to the comparator (a placebo or active control). The observation that the patients in the test group had more adverse events than expected or more than those in the comparator might be disconcerting.

Benefits Versus Toxicity And Risks Of Therapy

Chemotherapy can be divided into those of the CMF-like regimens and those of the doxoru-bicin regimens. All chemotherapies used as adjuvant treatment cause significant myelosup-pression, with leukopenia generally clinically more significant than anemia or thrombocy-topenia. In the NSABP trials of classic CMF x 6, the incidence of neutropenia less than 2,000 was 10 percent and severe infection about 1 percent.21 With AC x 4, it is 4 percent severe neutropenia and 2 percent severe infec-tion.21 With 6 months of CAF, the risk of leukopenia and infection is higher. Thrombocy-topenia is seen in less than 1 percent of patients in most regimens.21 Doxorubicin-containing regimens are more emetogenic than CMF however, the incidence of severe vomiting is rapidly dropping with the introduction of serotonin antagonists. Alopecia is nearly universal with doxorubicin and is seen in about 40 percent of CMF patients.21 Diarrhea is rarely seen with either regimens the use of serotonin antagonist...

Moderate to Severe Disease

The newest addition to our therapy options for patients with CD is antitumor necrosis factor therapy, infliximab (Sandborn and Targan, 2002). In patients with moderately to severely active CD, a single infusion of 5 mg kg of inflix-imab (Remicade) results in response and remission rates of 81 and 48 , respectively, at 4 weeks (Hanauer et al, 2001). The efficacy does not appear to be influenced by the disease location. The onset of action is rapid, with response within 2 weeks of therapy and lasting approximately 8 to 12 weeks. An induction regimen with 3 infusions at weeks 0, 2, and 6 is recommended because of its superior efficacy and lower immunogenicity compared with single infusions (Hanauer et al, 2002). Most patients tolerate infliximab therapy well. Common side effects include headache, myalgia, upper respiratory tract infections, fatigue, nausea, abdominal pain, and diarrhea. Acute infusion reactions occur in approximately 6 to 16 of patients, and may present with flushing,...

Killer cells See natural killer NK cells

Kyasanur Forest disease virus (KFDV) A tick-borne species in the genus Flavivirus, member of the Mammalian tick-borne virus group. The tick vector is Haemaphysalis spingera. In an epidemic among forest workers in Mysore State, India, in 1957, symptoms included headache, fever, back and limb pains, prostration, conjunctivitis, diarrhea, vomiting and hemorrhages into the intestine and at other sites. No CNS involvement. A number of dead langurs and bonnet macaques were found during the epidemic and the disease may be disseminated by movement of monkeys and birds. Antibodies are present in small forest mammals. The virus is widely distributed in India, but human infections occur only in Mysore. Mice develop encephalitis on injection by various routes. They may fail to develop antibodies and remain chronically sick for long periods. Suckling hamsters are also susceptible but other rodents are resistant. Rhesus and bonnet monkeys develop viremia on i.c. or i.p. injection but show no...

Effective Therapeutic Agents

A dose of 4 mg kg has shown efficacy both in clinical response and in the management of fistula. This intravenous (IV) dose is comparable to an oral dose of 8 mg kg. In a personal series of 16 patients, 14 (88 ) responded to this regimen (Present and Lichtiger, 1994). Complete closure of fistula was observed in 44 and moderate improvement in about 44 . The mean time to respond was slightly over 7 days. A recent study looking at IV cyclosporin in ulcerative colitis showed that a dose of 2 mg kg was equally effective to 4 mg kg, but this has not been studied in CD patients. We have usually tried to obtain monoclonal levels of cyclosporin between 300 to 500 ng mL during the 7 to 10 day hospitalization with a trough level of approximately 300 ng mL after discharge. We have seen relapse in 36 after discharge, but 64 maintain their response and allowed us to discontinue steroids, which may facilitate healing of fistulas. In order to avoid cyclosporin toxicity, experience is essential in...

Clinical Presentation Of Pcnsl

Clinical presentation of CNS lymphoma may be characterized by headaches, confusion, lethargy, memory loss, hemiparesis, aphasia, and seizures. Lesions are most common in the cerebrum, basal ganglia, and brainstem.14,29 The lesions are usually large, few in number, and contrast enhanced on neuroimaging. In the pre-HAART era, most patients with PCNSL were near the late stages of AIDS, with the majority dying within 4-6 weeks of diagnosis with supportive care

Systemic Hypertensive Crisis

Hypertension is uncommon in children. Blood pressure is rarely measured routinely in otherwise healthy children and therefore hypertension usually presents with symptoms which may be diverse in nature. Neurological symptoms are more common in children than in adults. There may be a history of severe headaches, with or without vomiting, suggestive of raised intracranial pressure. Children may also present acutely with convulsions or in coma. Some children will present with a facial palsy or hemiplegia and small babies may even present with apnoea.

Patients And Methods

105 patients fulfilling criteria of the International Study Group for BD4 were retrospectively included. Patients were categorized into two groups according to the presence (group 1) or absence (group 2) of neurological and or psychiatric involvement. Patients with isolated headaches and those taking drugs and or affected by disease known to induce CNS involvement were excluded from group 1. Group 1 was also divided into two subgroups according to neurological lesions type patients with MP involvement, and those with cerebral vascular involvement (CV). Cerebrospinal fluid (CSF) analysis was performed in 19 patients. A pathergy test was performed in 27 patients (19 in group 1 and 8 in group 2) by intradermal needle pick and read

Sulfasalazine and Other 5ASAs

Sulfasalazine has been used as the initial anti-inflammatory agent because of documented effectiveness in colonic idiopathic IBD, low cost, and a comparative lack of side effects. The usual dose of sulfasalazine is 2 to 4 g d administered by mouth in divided doses with meals and at bedtime. The full dosage should be achieved slowly, starting with 1 tablet (0.5 g) daily and adding 1 tablet per day until the desired dosage is achieved. This may help avoid nausea and, perhaps, headaches. Conventional folic acid administration,

Research on Differences between Childrens and Adults Responses to Biofeedback

In general children are more open and responsive to biofeedback than adults. Children are usually fascinated with the equipment, and motivation and curiosity are high. Research on nonclinical populations response to biofeedback indicate that children between the ages of 8 and 12 are able to achieve greater changes in physiological responses using biofeedback than any other age group. For clinical groups biofeedback may be a good alternative to medication if the medical treatment has potentially negative short- and long-term consequences for the developing child. Research evaluating the effectiveness of biofeedback with children who have headaches indicates that more children improve and to a greater degree than do adults.

Developmental Forms Of Parkinsonism

Developmental forms of parkinsonism include syndromes induced by in utero or perinatal viral (or other) infection, such as maternal influenza during pregnancy or in utero or perinatal trauma or maternal stress. In utero influenza has been reported to be a cause of parkinsonism in a young child (85). Parkinsonism was reported in children born to mothers with encephalitis lethargica (85). Asphyxia during delivery, prenatal disturbances, premature birth, or early-childhood meningoen-cephalitis, often in combination with a complicated pregnancy, were all described to predispose to parkinsonian syndromes. The clinical symptoms included rigidity, hypokinesia, and in a small percentage, tremor. These children also had other neurological abnormalities including cognitive problems, behavioral difficulties, headaches, and strabismus. Treatment with levodopa was reported to be effective. Dyskinesia was noted to be a side effect 8-30 months after therapy, and by 3 years levodopa

Appropriate Treatment Interventions

Headaches Oral contraceptives may minimize physical and psychological symptoms of PMS, as documented in both retrospective and prospective studies. Oral contraceptives may, however, also precipitate symptoms that resemble PMS, such as depression. In addition, risks and side effects of oral contraceptives include cardiovascular complications, migraine headaches, and increases in serum triglycerides. These considerations must be discussed and this strategy undertaken carefully. A second approach is to manage specific psychological symptoms. With respect to severe psychological symptoms, it is crucial first to verify that the woman, despite her discomfort, is sufficiently safe. A woman who is depressed to the point of being suicidal, or who is so angry that she might harm someone else, should be carefully protected. Four psychiatric medicines that address depression and anxiety have been used effectively in some patients with PMS Xanax (benzodiazepine anxiolytic, GABA agonist), buspirone...

Delgadito virus See Cao Delgadito virus

Dengue virus (DENV) A species in the genus Flavivirus. Causes an acute febrile illness in humans with symptoms ranging from clinically inapparent to severe fatal hemorrhagic disease. There is an incubation period of 5-8 days, and the symptoms last about 10 days with severe headaches, retro-ocular pain, and back and limb pains. Often there is a scar-letiniform or maculopapular rash. The most severe symptoms, hemorrhagic fever with shock, probably result from infection with one dengue virus serotype in persons immune to another (See dengue viruses 1-4). The natural hosts for the virus are Aedes mosquitoes, humans, and non-human primates. Aedes aegypti is the principal vector worldwide, but other important vectors are Aedes albopictus in Asia and the Americas, Aedes scutellaris in the Pacific, and Aedes africanus and Aedes luteocephalus in Africa. The virus is only transmitted by the bite of an infective mosquito vector. Following infection, humans and nonhuman primates usually develop a...

Application Of Life Instruments

Concerns the use of erythropoetin in dialysis patients . In pain syndromes, especially headaches, the SF-36 Health Survey was frequently used30. As regards HIV-infections and AIDS, epidemiological studies show that in addition to the severity of disease unfavourable living conditions and financial problems contribute to a decreased quality of life in HIV-infected and AIDS-patients31, and treatment with erythropoetin showed positive effects on quality of life in 251 anaemic patients with HIV-infection32. In Surgery, most studies relating to quality of life are available in gastrointestinal surgery, e.g. pouch reconstruction or in limp surgery hip

Therapy of Extensive Disease

Sulfasalazine may be started at 1 g daily with an increase in the dose by 1 g each day up to the target dose of 3 to 4 g d, if tolerated. The complete blood count should be checked after a week to look for toxicity, especially leukopenia. However, there are several drawbacks to using sulfasalazine instead of one of the newer 5-ASA preparations. Sulfasalazine should not be used in patients with a history of sulfa allergy. Besides allergic reactions, some patients develop headaches, nausea, anorexia, and other dose-related adverse effects. Sulfasalazine may cause reversible male infertility, which does not occur with the other oral 5-ASA medications.

Concepts of Health and Disease

Let us suppose that a patient presents to a physician's office complaining of not feeling well. How do we determine whether patients are sick, and if so, what ails them One approach would be to obtain sophisticated diagnostic tests on the blood, or to order radiological studies in order to glimpse the anatomy and physiology of the patient's internal organs. In most cases, however, such sophisticated diagnostic studies are not indicated, and the history alone or the history and the physical examination provide more than adequate diagnostic information. Despite the fact that more sophisticated diagnostic studies are usually unneeded, they shape our vision of medical practice to an ever-greater degree. For example, some patients who present with headaches may feel cheated if their physician does not order a computed tomography (CT) scan to ensure that they do not have a brain tumor. Likewise, physicians may feel that we are not doing our best for our patients if we do not avail ourselves...

Boehmeria nivea L Gaud Fam Urticaceae

Boehmeria Nivea

For headache due to Wind Heat, it is used with Herba Schizonepetae Tenuifolia (Jing Jie), Folium Mori (Sang Ye), and Herba Equiseti Hiemalis (Mu Zei) in The Bombyx Batryticatus Powder (Bai Jiang Can San). For sore throat due to Wind Heat, it is used with Radix Platycodi ( Jie Geng), Radix Saposhnikoviae (Fang Feng), and Radix Gly-cyrrhizae Uralensis (Gan Cao).

Decompressive Hemicraniectomy

Decompressive Hemicraniectomy

FIGURE 6.3 (a) Thirty-eight-year-old male presenting with new onset headache, hand numbness, and visual changes, deteriorating to aphasia and right hemiparesis over 3 hours. This CT demonstrates a large left MCA infarct with hypoattenuation in the MCA territory, loss of normal gray-white matter differentiation, partial effacement of the frontal horn of the left lateral ventricle, and sulcal effacement within the left frontal and parietal lobes. (b) Postoperative CT after decompressive hemicraniectomy and left anterior temporal lobectomy. FIGURE 6.3 (a) Thirty-eight-year-old male presenting with new onset headache, hand numbness, and visual changes, deteriorating to aphasia and right hemiparesis over 3 hours. This CT demonstrates a large left MCA infarct with hypoattenuation in the MCA territory, loss of normal gray-white matter differentiation, partial effacement of the frontal horn of the left lateral ventricle, and sulcal effacement within the left frontal and parietal lobes. (b)...

Options for Hormonal Therapy

Rupting the cyclic release of FSH and LH from the pituitary. These drugs are efficacious in acne and hirsutism, and are available as injectable drugs or nasal spray. However, in addition to suppressing the production of ovarian androgens, these drugs also suppress the production of estrogens, thereby eliminating the function of the ovary. Thus, the patient could develop menopausal symptoms and suffer from hypoestrogenism. Headaches can also develop, as well as the occurrence of bone loss, due to the reduction in estrogen.

The Medical Humanists

Respect for the ancients did not blunt Caius' ability to observe and describe new phenomena, as shown in his account of an illness known as the English sweating sickness. His remarkable Bake or Counseill against the Disease Called the Sweate (1522) was the first original description of disease to be written in England in English. In all probability, Caius would be distressed to know that his vernacular description of the ''sweats'' is now regarded as his most important medical work. At least five severe outbreaks of Sudor Britanica, or sudor anglicus, apparently occurred between 1480 and 1580. The disease was characterized by copious sweat, fever, nausea, headache, cramps, pain in the back and extremities, delirium, hallucinations, and a profound stupor. Within about 24 hours the disease reached a critical stage, when either the disease or the patient came to an abrupt end. Even among strong, healthy men, the mortality rate was extremely high. Many victims lapsed into coma and died...

Intracranial Calcification

Intracranial Calcification Torch

In oculo-dento-osseous dysplasia (oculo-den-to-digital dysplasia, OMIM 164200), a narrow nose with hypoplastic alae and thin nostrils, microcornea with iris anomalies, postaxial syndactyly and or camptodactyly, hypoplasia aplasia of the 5th fingers and toes, and enamel hypoplasia are leading features (Meyer-Schwickerath et al. 1957). Additional features include short palpebral fissures, epicanthal folds, skull hyperostosis, hypotrichosis, strabismus, glaucoma, orbital hypotelorism, and a variety of neurological symptoms, such as progressive paraparesis, cerebral white matter abnormalities, ataxia, tremor, bladder dysfunction, epilepsy, migraine, and learning disabilities (Beighton et al. 1979 Fara and Gorlin 1981 Gutmann et al. 1991 Loddenkemper et al. 2002). Calcification occurs in the basal ganglia (Barnard et al. 1981). The syndrome is inherited in an autosomal dominant pattern and is caused by mutation in the connexin-43 gene mapped to 6q21-q23.2 (Gladwin et al. 1997...

Womans Nature And Women Doctors

Acute ovaritis, prolapsus uteri, anemia, constipation, headaches, hysteria, neuralgia, and other horrors. The ''intellectual force'' expended by girls studying Latin or mathematics destroyed significant numbers of brain cells in addition to decreasing fertility. Educated women who escaped sterility would face dangerous pregnancies and deliveries because they had smaller pelvises and their babies had bigger brains. They would be unable to nurse their own babies, because they had ''neither the organs nor nourishment requisite.'' As evidence, Clarke presented the sad case of the flat-chested Miss D., who entered Vassar at 14. By the time she graduated, she was the victim of dysmenorrhea, hysteria, nervousness, headaches, chronic invalidism, and constipation. Another unfortunate student died soon after graduation the postmortem revealed a worn-out brain. Even Martha Carey Thomas (1857-1935), founder and president of Bryn Mawr College, remembered being terrified when she read such warnings...

Anterior Pituitary Tumorsnance imaging MRI with gadolinium contrast of

By pituitary tumors associated with MEN type I The diagnosis of Cushing's syndrome is made by include GH, GH-prolactin, and ACTH (Figure increased glucocorticoid levels (increased 24-hour 16-5). Rarer tumors associated with MEN type I urine cortisol excretion) or diminished response of include luteinizing hormone feedback. The feedback is most coming hormone (FSH), thyroid-stimulating hormone monly assessed by the overnight dexamethasone (TSH), and nonsecreting adenomas. Patients present suppression test (dexamethasone 1 mg orally at with symptoms and signs secondary to mass effect 11 00 pm should normally suppress cortisol to (headache, visual field loss), hypopituitarism, 5 p,g dL at 8 00 am). The differential diagnosis and or excessive hormone production. includes pituitary-dependent ACTH excess (ade-The evaluation for pituitary tumors includes a noma or hyperplasia), ectopic ACTH from bronchial history of reproductive function (menstrual dates, carcinoid tumor, or primary neoplasm...

Anaphylactoid or Pseudoallergic

Anaphylactoid or pseudoallergic reactions to food result from foods that mimic the effects of mast cell degranulation but do not involve IgE antibodies. Strawberries and shellfish may cause this type of ARF. Certain food ingredients, including additives such as salicylates, benzoates, and tartrazine, induce pseudoallergic reactions. As with true food allergy, patients exhibiting such reactions should be instructed to avoid the offending food substance if identifiable. Pharmacological reactions to food or food additives represent a relatively common type of ARF, although most of these reactions cause symptoms outside of the GI tract. Histamine found in certain cheeses or in scrombroid fish, such as tuna, can cause headaches and diffuse erythema of the skin. Certain individuals develop migraine headaches to various foodstuffs, including those rich in amines. Sulfites, tartrazine and monosodium glutamate (MSG) have all been associated with asthma, and MSG can cause a characteristic...

Udenafil Erectile Dysfunction [111115

Furthermore, udenafil produced up to a 91 vaginal penetration success rate and up to a 67 intercourse completion rate compared to a 29 completion rate by placebo. Overall patient satisfaction, measured by a standard global assessment question, was 86 compared to only 26 in the placebo group. The most frequently recorded adverse events were mild-to-moderate facial flushing and headache.

Efficiency of Thrombolytic Administration

In the first 27 months of our own TeleStroke experience,30 26 consultations were requested 12 began within 3 hours of symptom onset. Eight of these 12 patients had acute ischemic stroke, of which 2 were not treated due to mild deficits. Three were diagnosed with TIA or migraine, and one with a subdural hematoma not detected at the local facility. For the 12 acute cases for whom rapid diagnosis and management was essential, we determined the mean times from symptom onset to start of TeleStroke consultation and from consultation start to drug delivery or to determination of rt-PA ineligibility (shown in Fig. 10.4).

Doripenem Antibiotic [2225

Bacteriological eradication rate was 87.5 . The main adverse events associated with doripenem were drowsiness, headache, injection site reactions, and nausea. An inhaled formulation of doripenem is currently in development for the potential treatment of cystic fibrosis related infections.

First Causal Therapy for SMA Patients

VPA has been shown to significantly increase SMN protein levels in fibro-blast cell lines treated with drug amounts ranging from 0.5 M to 50 M (Brichta et al. 2003). VPA is an FDA-approved drug that has been used in the therapy of epilepsy for more than three decades (Zaccara et al. 1988). More recently, VPA has also gained importance as anticonvulsant in manic depression, migraine, and dementia (Papatheodorou et al. 1995 Mathew et al. 2000 Lonergan et al. 2004). Although it is known that VPA up- or downregulates about 2 of genes (Pazin and Kadonaga 1997), severe side effects are relatively rare. Based on these data, a pilot trial with VPA in

Rasagiline Parkinsons Disease [7987

Precursor, is a standard line of treatment for PD, many patients begin to experience motor complications after several years of artificial dopaminergic stimulation. As an adjunct therapy, rasagiline treats the fluctuations in motor symptoms. The R-enantiomer exhibits 4-times the potency of the S-enantiomer, so the synthetic method begins with the optical resolution of racemic N-benzyl-1-amino-indan using (R,R)-tartaric acid as the resolving agent. Once isolated, the enantiomerically-enriched salt is submitted to hydrogenolysis to afford 1(R)-aminoindane that is subsequently propargylated to provide rasagiline. It is formulated as its mesylate salt, and the recommended dosage of rasagiline is 1 mg day, with or without levodopa. As an irreversible inhibitor, frequent dosing is not necessary since the duration of action is not driven by half-life regeneration of MAO-B is the critical factor in the duration of action. Rasagiline is rapidly absorbed with a Tmax of approximately 0.5 h and a...

Ventricles anterior view

In adults, hydrocephalus caused by a blockage of the CSF flow leads to an increase in intracranial pressure (discussed in the introduction to Section C). Since the sutures are fused, skull expansion is not possible. The cause in adults is usually a tumor, and in addition to the specific symptoms, the patient will most commonly complain of headache, often in the early morning.

Providing explanations after negative investigation

Even when tests are reported as normal, some patients are not reassured. Such patients may benefit from an explanation of what is wrong with them, not just what is not wrong. A cognitive behavioural model can be used to explain how interactions between physiology, thoughts, and emotion can cause symptoms without pathology. Simple headache provides an analogy the pain is real, and often distressing and disabling, but is usually associated with stress. Diagnoses such as tension headache and irritable bowel syndrome can be helpful in reducing patients' anxiety about sinister causes for their symptoms.

Respiration in Extreme Environments

Consider how you might feel if you drive your automobile to the top of Pikes Peak (14,109 ft above sea level, ASL) or if you ride a cable car to the top of the Zugspitze, the highest point in Germany (9718 ft ASL). If you have had the opportunity to visit either of these locations, you probably experienced the shortness of breath associated with breathing in environments with low oxygen pressure. (The percentage of oxygen does not vary much with the increase in altitude, but the partial pressure of oxygen diminishes.) Perhaps you even developed a headache after a short period. How you felt was dependent on how long it took to achieve the altitude, how long you remained, how well hydrated you may have been at the time, and a number of other potential factors.

Walleye herpesvirus See percid herpesvirus

West Nile virus (WNV) A species in the genus Flavivirus belonging to the Japanese encephalitis virus serogroup. First isolated in 1937 in Uganda. A silent or short febrile infection in humans especially children, but a more severe disease which can be fatal occurs in elderly people. There is a short incubation period of a few days followed by fever, headache and myalgia. A rash occurs in about half the cases. After 3-6 days there is usually complete recovery. Occurs in Egypt, Uganda, S Africa, Israel, India, the south of France and, since 1999, in the USA. There are strain differences between viruses from India and the Far East and those from Africa, Europe and the Middle East. The virus that appeared in New York in 1999 was phylogeneti-cally similar to an isolate from geese in Israel. After causing more than 60 clinical cases with seven deaths in older people in New York, and the deaths of many crows and other birds in the New York region, the virus overwintered and returned in 2000...

Central Nervous System

Infections of the CNS are very rare and generally manifest as single or multiple encapsulated brain abscesses that appear as ring-enhancing lesions with thick wall that may be irregular or nodular on CT with intravenous contrast material and are indistinguishable from those caused by other organisms (6). Rarely, solid nodular or mass lesions termed actinomycetomas or actinomycotic granulomas are found. Headache and focal neurological signs are the most common finding. Most actinomycotic infections of the CNS are thought to be seeded hematogenously from a distant primary site however, direct extension of cervicofacial disease is well recognized. Sinus formation is not a characteristic of CNS disease. The rare meningitis caused by Actinomyces is chronic and basilar in location, and the pleocytosis usually is lymphocytic. Thus, it may be misdiagnosed as tuberculous meningitis.

Extending Tree Models to Splits Networks

In this chapter we take statistical models designed for trees and adapt them for splits networks, a more general class of mathematical structures. The models we propose provide natural swing-bridges between trees, filling in gaps in the probability simplex. There are many reasons why we might want to do this. Firstly, the splits networks provide a graphical representation of phylogenetic uncertainty. Data that is close to tree-like produces a network that is close to a tree, while noisy or badly modeled data produce complex networks. Secondly, models that incorporate several trees open up possibilities for new tests to assess the relative support for different trees, in both likelihood and Bayesian frameworks. Thirdly, by searching through network space rather than tree space we may well be able to avoid some of the combinatorial headaches that make searching for trees so difficult.

What about the new lowdose hormone patch Menostar estradiol that is used to prevent osteoporosis

Headaches More common reactions include Vaginal bleeding or spotting slight breast enlargement or thickening breast soreness bloating or cramps weight changes nausea vomiting headache swelling high blood pressure hair thinning or increased hair growth rash vaginal yeast infections vision changes difficulty wearing contact lenses.

Harveys Paradoxical Influence Therapy By Leech And Lancet

Internal Hemor

Bleeding was recommended in the treatment of inflammation, fevers, a multitude of disease states, and hemorrhage. Patients too weak for the lancet were candidates for milder methods, such as cupping and leeching. Well into the nineteenth century, no apothecary shop could be considered complete without a bowl of live leeches, ready to do battle with afflictions as varied as epilepsy, hemorrhoids, obesity, tuberculosis, and headaches (for very stubborn headaches leeches were applied inside the nostrils). Enthusiasm for leeching reached its peak during the first half of the nineteenth century. By this time, leeches had to be imported because the medicinal leech, Hirudo medicinalis, had been hunted almost to extinction throughout Western Europe. Francois Victor Joseph

History Of Pheochromocytoma

Where Pain From Liver Cancer

In 1886, Frankel described bilateral adrenal tumors discovered at the autopsy of an 18-year-old woman who died suddenly following a year of retinitis and episodic palpitations, pounding heart, pallor, headaches, and vomiting. Her postmortem examination also revealed nephrosclerosis and myocardial hypertrophy.1

Preoperative Treatment Of Patients With Pheochromocytomas

Sive are also usually treated (carefully) preopera-tively. Phenoxybenzamine (Dibenzyline, 10 mg capsules), an oral nonselective a-blocker, is the most commonly used a-blocker it is given orally in a starting dose of 10 mg daily and increased by 10 mg every 3 to 5 days until the blood pressure is 140 90 mm Hg. Hydration should be encouraged. Patients must be monitored for worsening orthostatic hypotension. Other adverse effects are common, including dry mouth, headache, diplopia, inhibition of ejaculation, and nasal congestion. (Patients are cautioned not to use nasal decongestants if urinary catecholamines or 123I-MIBG scanning is planned, but antihistamines are acceptable.) Phenoxybenza-mine crosses the placenta and can cause hypotension and respiratory depression in the newborn for several days following birth.60 Most patients require 30 to 60 mg day, but the dosage is sometimes escalated to as high as 120 mg day. Excessive alpha-blockade with phenoxybenzamine is undesirable because...

Cortical Spreading Depression

Cortical Spreading Depression

Other findings argue against this hypothesis. First, CSD is more readily elicited in areas of grey matter with relatively lower glia neuron ratio, such as the CA1 layer of the hippocampus (in experimental studies) 39 , and the occipital cortex in humans 40, 41 (if it is accepted that migraine with visual aura is a manifestation of CSD, as discussed below). Secondly, the use of specific agents toxic to glia such as fluorocitrate or fluoroacetate fails to prevent CSD 42, 43 . Third, CSD can occur in the absence of Ca waves 44 . Leao himself was the first to demonstrate hyperaemia in association with CSD he observed a doubling in width of pial surface arterioles during CSD 58 . If CSD induced in the prefrontal region of the rat is assumed to propagate anteroposteriorly in the cerebral hemisphere at a constant rate, serial coronal sectioning of the hemisphere after it has been frozen at a single time point will provide in the section sequence a time series of the response of the brain to...

Biophysiological Factors

With menopause may result in mood changes which may be misattributed to psychological causes. On the other hand psychological changes may be misattrib-uted to hormonal changes. There are gender differences in return of diffuse physiological arousal (DPA) to baseline levels men take longer to return to baseline levels. These gender differences have implications for understanding and altering aggression among family members. Whenever physiological factors may be related to a problem as, for example, with seizures, depression, fatigue, or headaches, a physical examination should be required. Overlooking physical causes including nutritional deficiencies and coffee, alcohol, or drug intake may result in incorrect inferences.

Laughing Gas Ether And Surgical Anesthesia

Laughing Gas Surgical Operation

The ingenious discoveries of the first pneumatic chemists provided new opportunities for quacks and charlatans. Conscientious experimentalists could not compete with charlatans promising miraculous cures for asthma, catarrh, consumption, and cancer through the inhalation of oxygen, hydrogen, and other ''factitious airs.'' Some physicians, however, attempted to find legitimate medical uses for the new gases. Fascinated by pneumatic chemistry, Thomas Beddoes (1760-1808) persuaded his friends Thomas Wedgwood (1771-1805) and James Watt (1736-1819) to help him establish the Pneumatic Institute, a hospital in which the inhalation of factitious airs was used in the treatment of lung disease. Many scientists, including Humphry Davy, were intrigued by his work. While suffering from toothache in 1795, Davy began inhaling nitrous oxide. In addition to feeling giddy, relaxed, and cheerful, Davy noted that the pain caused by his wisdom teeth had almost disappeared. Soon after the exhilaration wore...

AKR mink cell focusinducing virus A

Alagoas virus A strain of Vesicular stomatitis virus isolated in suckling mice from the tongue epithelium of a mule with vesicular lesions of the tongue and feet. Found in Alagoas state, Brazil. Serological surveys suggest that infection occurs in humans, horses, donkeys, monkeys and bats in various states in Brazil. A few cases of febrile disease with headache and malaise have been reported in humans.

Threeday stiffsickness virus Synonym for

Tick-borne encephalitis virus (Far Eastern subtype) A subtype in the Mammalian tick-borne virus group in the genus Flavivirus. Strains within the subtype include Crimea virus, Karshi virus, Negishi virus, Oshima virus, and Russian spring-summer encephalitis (RSSE) virus (Sofyn is the prototype strain). The species vary in virulence and epidemiology but differ from each other by predicted amino acid sequences by only 2.2 . Humans become infected by tick-bite or consumption of milk from infected animals. The clinical onset is an acute influenza-like illness with mild fever, headache and malaise that lasts for a week and is followed by an asymptomatic period. A second phase of illness involving meningitis occurs in about 25 of infections, and usually resolves, but there is an overall case fatality rate of about 1 . A formalin-inactivated vaccine is available for persons at high risk of infection. The vectors are ticks, Ixodes per-sulcatus and I. ricinus. A severe human infection causing...

Leptomeningeal Carcinomatosis

Ally in the setting of disseminated, progressive disease.25 As mentioned above, this complication is more commonly observed in patients with infiltrating lobular cancer. The majority of patients will present with neurologic signs referable to some combination of cerebrum, cranial nerves, and spinal cord, although the patient may complain only of a single symptom.26 The single-most common complaint is weakness of the legs, perhaps accompanied by pain or paresthesias. Cranial nerve involvement can produce diplopia, facial numbness or weakness, and hearing loss. Involvement of the cerebral cortex is heralded by headache, impaired memory, lethargy, and nausea. Ommaya reservoir is preferred over lumbar puncture. Methotrexate 12 mg two or three times weekly has been used most often, with improvement reported in 60 to 80 percent of patients.26 29 The most common complication is transient aseptic meningitis, manifesting as headache, fever, and stiff neck. Particularly with simultaneous...


Tremor-dominant parkinsonism following injury Parkinsonism following some insult in utero, or immediate postnatal period in association with tremor, cognitive dysfuncion, behavioral abnormalities, headaches, and strabismus Hemiatrophy in association with hemiparkinsonism dystonia, but without postural instability Tends to remain unilateral for 535 yr after onset of parkinsonian symptoms Early age at onset, history of birth injury, slow progression of the disease are very typical features. Parkinsonism in presence of tumors, hemorrhage typically contralateral to the lesion and sometimes ipsilateral to the lesion Parkinsonian features in presence of other symptoms of multiple sclerosis

Baby hamster kidney cells See BHK21 cells

Bamble disease This disease was first described in 1872 in Norway, and takes its name from the village in which it was prevalent. There is an incubation period of 2-4 days followed by sudden onset, with 'stitch-like' pain in chest, epigastrium, abdomen and more rarely, the limb muscles, accompanied by fever, headache, coughing and hiccough. May be caused by coxsackie viruses types B1-6, A4, 6, 9 and 10, or echovirus types 4, 6 and 9. The first N American outbreak was described in 1888 by Dabney, whose name was officially bestowed on the disease in the USA in 1923. The Bornholm outbreak was not described until 1932. Synonyms Bornholm disease Dabney's grippe or grip devil's clutch devil's grippe or grip epidemic myalgia pleu-rodynia Taarbaek disease. Bangui virus (BGIV) An unassigned member of the family Bunyaviridae. Isolated from a man with fever, headache and rash in Bangui, Central African Republic.

Implementation Of An Acute Stroke Team And Acute Stroke Protocols

FIGURE 3.3 Intracranial hemorrhage on CT is a contraindication to intravenous rt-PA treatment. There are no clinical signs or symptoms that can reliably distinguish between ischemic and hemorrhagic stroke, making CT a mandatory part of the patient assessment. (a) Intraparenchymal hemorrhage centered in the right putamen (arrow). (b) Subdural hematoma. (c) Subarachnoid hemorrhage layering in the basal cisterns (arrow), causing hydrocephalus. The most common clinical findings in subarachnoid hemorrhage are headache and impaired consciousness, although focal neurological signs and symptoms may also occur. FIGURE 3.3 Intracranial hemorrhage on CT is a contraindication to intravenous rt-PA treatment. There are no clinical signs or symptoms that can reliably distinguish between ischemic and hemorrhagic stroke, making CT a mandatory part of the patient assessment. (a) Intraparenchymal hemorrhage centered in the right putamen (arrow). (b) Subdural hematoma. (c) Subarachnoid hemorrhage...

Genetic Models Of Dystonia

Channels are characterized by voltage-sensitive activation in response to depolarization resulting in the selective increase in calcium flux into the cell. P Q-type calcium channels are most often functionally associated with calcium-dependent neurotransmitter release (Charvin et al. 1997 Kim and Catterall 1997 Rettig et al. 1996). In humans, mutations of the Cacnala gene cause spinocerebellar ataxia type 6, episodic ataxia type 2, and familial hemiplegic migraine (Ophoff et al. 1996 Zhuchenko et al. 1997) dystonia also occurs in humans carrying these mutations (Arpa et al. 1999 Giffin et al. 2002). At least four mouse models currently carry mutations in the Cacnala gene that exhibit dystonia tottering (Cacna1atg), leaner (Cacna1atg-la), and two Cacnala knock-out mice.

Human Immunodeficiency Virus

Iron Cycle Diagram

Peripheral neuropathy, nausea vomiting, anorexia, headache, malaise, neutropenia, pancreatitis Hypersensitivity reaction Fever, fatigue, malaise, nausea, vomiting, diarrhea, abdominal pain, arthralgias, cough, dyspnea Headache, abdominal pain, diarrhea, nausea, vomiting, fatigue Diarrhea and other as listed under SQV and RTV Perioral paraesthesias, diarrhea, headache, nausea vomiting and others listed under SQV and RTV Diarrhea and others listed under SQV and RTV Nausea, diarrhea

Modern Research on Chinese Medicinal Herbs

Because of the progress made in understanding the function and properties of Chinese medicinal substances, some practitioners of TCM have taken the results of biomedical research into account before writing a prescription. For example, if from a modern biomedical perspective, a patient presents with a bacterial infection, the practitioner will use herbs that are thought to be effective against the bacterium. However, those herbs should not be inappropriate for the patient (from a traditional Chinese medical perspective) based on a diagnosis using pattern differentiation. Thus, patients with headaches should be cautioned not to take prescriptions containing Radix Angelicae (Bai Zhi) at bedtime for this herb can act as a central nervous system stimulant.

Monitoring Of Intracranial Pressure In Ischemic Stroke Patients

The clinical examination is a valuable tool for monitoring the patient's status and should be performed frequently during the time of concern for swelling. Clinical signs to follow include the patient's mental status and level of alertness, cranial nerve function (particularly the pupillary reaction in patients at risk for uncal herniation), motor strength, and signs of increased ICP, such as worsening headache and nausea vomiting. Patients developing hydrocephalus often lose their upgaze (assuming that adequate upgaze was present at baseline, which is not always the case with older patients) and develop more sluggish pupillary responses. Neuroima-ging, such as CT and MRI, can be performed to assess for progression of cerebral edema, but it is not feasible or safe to perform repeat imaging more frequently than twice a day, at most. Neurosonology with TCD examination may provide clues to the development of increasing ICP, as compression of the basal arteries causes a narrowing of the...

Adjuvant Therapies Acute Bacterial Sinusitis

Patients with a viral URTI may benefit from symptomatic therapy, aimed at improving their quality of life during the acute illness. The use of normal saline as a spray or lavage can provide symptomatic improvement by liquefying secretions to encourage drainage. The short-term (three days) use of topical alpha-adrenergic decongestants can also provide symptomatic relief, but their use should be restricted to older children and adults due to the potential for undesirable systemic effects in infants and young children. Topical glucocorticosteroids may also be useful in reducing nasal mucosal edema, mostly in those cases where a patient who has seasonal allergic rhinitis develops the complication of an acute URTI. The antipyretic and analgesic effects of nonsteroidal anti-inflammatory agents can relieve or ameliorate the associated symptoms of fever, headache, generalized malaise, and facial tenderness. Until the clinical diagnosis of acute bacterial sinusitis is established, management...

Paleomedicine And Surgery

Although trepanation is sometimes mistakenly referred to as ''prehistoric brain surgery,'' a successful trepanation involves the removal of a disk of bone from the cranium, without damage to the brain itself. When scientists first encountered such skulls, they assumed that the operation must have been performed after death for magical purposes. However, anthropologists have discovered that contemporary tribal healers perform trepanations for both magical and practical reasons. Prehistoric surgeons may also have had various reasons for carrying out this difficult and dangerous operation. The operation might have been an attempt to relieve headaches, epilepsy, or other disorders. In some cases, the operation might have been a rational treatment for traumatic injuries of the skull. Perhaps it was also performed as a desperate measure for intractable conditions, rather like lobotomy, or as a form of shock therapy or punishment. Despite the lack of reliable

A PMS Symptoms and Their Timing

An immense number of symptoms have been attributed to PMS (Table II). The most common complaints include physical symptoms (breast swelling and tenderness, abdominal bloating, headaches, muscle aches and pains, weight gain, and edema), emotional symptoms (depression, mood swings, anger, irritability, and anxiety), and others (decreased interest in usual activities, fatigue, difficulty concentrating, increased appetite and food cravings, and hypersomnia or insomnia). Headaches (migraine, tension)

How and Why Biofeedback Is Used in Clinical Settings

A major use of biofeedback is to teach relaxation skills. A second use of biofeedback is to alter pathophysiological processes such as blood flow or SNS arousal for migraine headache patients, to decrease the flow of gastric juices for ulcer patients, to decrease muscle tension and increase proper posture for the chronic back-pain patient. Biofeedback should be considered as a therapeutic tool that can help introduce the client to therapy in a concrete and nonthreaten-ing manner. It can be especially useful for the patient who focuses on physical problems or insists his problems are not physiological. Biofeedback can also be used to increase feelings of self-efficacy and self-control. The client learns quickly the connection between emotions, thoughts, and physiological responses.

Mitochondrial myopathies

Myopathie Ptosis

Cerebral lesions resembling small vessel strokes, and patients may also have pre-existing migraine headaches and or seizures. Other associated symptoms include myopathy, ataxia, cardiomyopathy, diabetes mellitus, renal tubular disorders, retinitis pigmentosa, lactic acidosis, and hyperalaninemia. The disease usually starts in the fourth or fifth decade. ii) Myoclonic epilepsy and ragged-red fibers (MERRF) symptoms start in early childhood to adulthood. Clinical findings include myoclonic and or generalized or focal seizures, cerebellar ataxia, myopathy, corticospinal tract deficits, dementia, optic atrophy, deafness, peripheral neuropathy, cardiomyopathy, multiple symmetric lipomatosis, and renal tubular acidosis. iii) Mitochondrial myopathy and cardiomyopathy This disorder is associated with a hypertrophic cardiomyopathy, congestive heart failure, bilateral cataracts, insulin-dependent diabetes mellitus, my-opathy of very great severity, and Wolf-Parkinson-White syndrome.

Premenstrual Syndrome Treatment Interventions

Premenstrual Dysphoric Disorder (PMDD), formerly Late Luteal Phase Dysphoric Disorder (LLPDD) Terms that refer to that small percentage of women who have premenstrual syndrome with primarily emotional symptoms severe enough to affect their ability to function at home or in the workplace. Premenstrual Exacerbation Aggravation of such chronic conditions such as asthma, depression, anxiety, eating disorders, substance abuse, headaches, allergies, seizures, or herpes during the premenstrual phase.

Acupuncture And Moxibustion

Acupuncture was especially recommended for all disorders involving an excess of yang. Moxibustion was thought to be preferable when yin was in excess. However, the relationships among yin and yang, the five phases, and the organs are so complex that the use of either method could be justified. Moxa was generally recommended for chronic conditions, such as tuberculosis, bronchitis, and general weakness, but it was also used for toothache, headache, gout, diarrhea, and some psychological disorders. Pao Ku, wife of the alchemist Ko Hung (254334), was famous for treating skin diseases with moxibustion. Officials of seventh century China would not undertake a journey unless protected against foreign diseases and snakebites by fresh moxibustion scars. In modern China, physicians have been experimenting with moxa in the treatment of influenza, chronic bronchitis, and infections of the respiratory tract.

The Neurovascular Unit

In July 2001, the National Institutes of Neurological Disorders and Stroke convened the Stroke Program Review Group (SPRG) 87 to advise on directions for basic and clinical stroke research for the following decade. Although much progress had been made in dissecting the molecular pathways of ischemic cell death, focusing therapy to a single intracellular pathway or cell type had not yielded clinically effective stroke treatment. Integrative approaches were felt to be mandatory for successful stroke therapy. This meeting emphasized the relevance of dynamic interactions between endothelial cells, vascular smooth muscle, astro- and microglia, neurons, and associated tissue matrix proteins, and gave rise to the concept of the neurovascular unit. This modular concept emphasized the dynamics of vascular, cellular, and matrix signaling in maintaining the integrity of brain tissue within both the gray and white matter, and its importance to the pathophysiology of conditions such as stroke,...

Colonic carcinoma cell line CaCo2 See CACO2 cell line

Colorado tick fever virus (CTFV) The type species of the genus Coltivirus. Causes disease in humans 4-5 days after the bite of an infected tick, Dermacentor andersoni, but other tick species may also serve as vectors. There is fever, usually saddleback type, leukopenia, headache, limb pains and often abdominal pain and vomiting. Rash is uncommon. There may be encephalitis, especially in children. Virus has been isolated from wild rodents but in them infection is inapparent. Hamsters can be infected experimentally i.p. and on passage the virus may kill them. Occurs in north-west USA but does not reach the Pacific coast. Infectivity is acid-sensitive but ether-resistant. The

Acute Fatty Liver of Pregnancy

Asymptomatic elevations in liver tests may be the only abnormality, but the majority of severe cases present with malaise, fatigue, anorexia, headache, nausea, and vomiting (see Table 120-2). Right upper quadrant or epigastric pain may mimic acute cholecystitis or reflux esophagitis. Within 1 to 2 weeks of onset of symptoms, and within days following clinical jaundice, the disease may rapidly worsen, leading to acute liver failure, with hepatic encephalopathy, ascites, edema, and renal insufficiency. Hallmarks of preeclampsia (hypertension, proteinuria) are seen in over 50 of cases.

Perioperative Management Of Pheochromocytomas

Nitroglycerin intravenous infusion is effective for treating perioperative hypertension. The required dosage ranges from 5 to 100 p,g minute. However, nitroglycerin adheres to polyvinyl chloride tubing, so appropriate dilutions, dosing, and infusion sets must be used. Side effects include headache and hypotension. Methemoglobinemia has rarely occurred during prolonged, high-dose infusions and is manifested by cyanosis in the presence of a normal arterial oxygen partial pressure. The treatment for methemoglobine-mia consists of stopping the nitroglycerin and giving methylene blue, 1 to 2 mg kg intravenously.

Serotonin Antagonists

The use of ondansetron at doses of 4 mg orally 3 times a day in patients with PBC was associated with a decrease in fatigue scores as assessed by the Fisk Fatigue Impact Score (FFIS), as published in abstract form. Headache and constipation were the most common side effects associated with ondansetron. These preliminary results may support the idea that altered serotoninergic neurotransmission contributes to the pathogenesis of fatigue in liver disease. Table 122-2 summarizes the experience with ondansetron in the treatment of fatigue to date.

Antiphospholipid Antibodies

The association of neurologic involvement with clinical or laboratory features found in APS (e.g., livedo reticularis or thrombocytopenia) was also described in previous SLE studies 152, 153 . High titers of IgG aCL were strongly associated with CNS involvement 152 . A multivariate analysis showed that aPLs are independently associated with cerebrovascular disease, headache, and seizures in SLE. The presence of lupus anticoagulant (LAC) was independently associated with white matter hyperintensity lesions on MRI 154 .


Biofeedback is a technique in which an instrument produces auditory or visual signals in response to changes in a subject's blood pressure, heart rate, muscle tone, skin temperature, brain waves, or other physiological variables. It gives the subject awareness of changes that he or she would not ordinarily notice. Some people can be trained to control these variables in order to produce a certain tone or color of light from the apparatus. Eventually they can control them without the aid of the monitor. Biofeedback is not a quick, easy, infallible, or inexpensive cure for all ills, but it has been used successfully to treat hypertension, stress, and migraine headaches.

Additional Factors

It is important to alleviate any factors that tend to precipitate or exacerbate nausea and vomiting in patients with gastroparesis. Women appear to be disproportionately susceptible to gastroparesis of any cause. One theory suggests that because progesterone inhibits smooth muscle function, then any insult to gastric smooth muscle control is accentuated in women, who have naturally higher levels of this hormone. Therefore, premenopausal women with gastroparesis sometimes have worse symptoms perimen-strually. Often blocking menses with the gonadotropin-releasing hormone agonist leuprolide acetate injections can alleviate these premenstrual problems. Monthly injections of 3.75 mg intramuscularly is the long-acting form. Migraine headaches can also cause nausea and vomiting in gastroparetic patients, as in normal individuals. If they are occurring frequently, prophylactic migraine therapy may be warranted. In diabetic gastroparesis, glucose control is very important in contributing to...

Risk Factors

In 1993, Tournier-Lasserve et al. described an autosomal dominant disorder linked to chromosome 19, termed 'cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy' (CADASIL), which is increasingly recognized as a cause of stroke and cognitive alterations in mid-adult life. The major clinical features are migraine headaches, subcortical strokes, psychiatric symptoms, and cognitive decline. Pathologically, there is a widespread arteriopathy in medium and small arteries that contain a granular osmiophilic material (GOM). Identification of GOM in skin, muscle, or nerve by electron microscopy allows a specific diagnosis of CADASIL. CADASIL is due to a mutation in the Notch-3 gene, which encodes a transmembrane receptor protein (Joutel et al., 1996). Notch-3 is expressed in vascular smooth muscle cells. A 210-kDa Notch-3 cleavage product is present at the cytoplasmic membrane of vascular smooth muscle cells (Joutel, 2000).


Hadjikhani N, Sanchez DR, Wu O, Schwartz D, Bakker D, Fischl B et al (2001) Mechanisms of migraine aura revealed by functional MRI in human visual cortex. Proceedings of the National Academy of Sciences of the United States of America 98 4687-4692 Hossmann KA (1996) Periinfarct depolarizations. Review 81 refs . Cerebrovasc Lauritzen M, Skyhoj OT, Lassen NA, Paulson OB (1983) Changes in regional cerebral blood flow during the course of classic migraine attacks. Ann Neurol 13 633-641 88. Ophoff RA, Terwindt GM, Vergouwe MN, Frants RR, Ferrari MD (1997) Wolff Award 1997. Involvement of a Ca2+ channel gene in familial hemi-plegic migraine and migraine with and without aura. Dutch Migraine Genetics Research Group. Review 43 refs . Headache 37 479-485 89. Welch KM, Ramadan NM (1995) Mitochondria, magnesium and migraine. J Neurol Sci 134 9-14 Milner PM (1958) Notes on a possible correspondence between the scoto-mas of migraine and spreading depression of Leao. Electroenceph Clin...

Initial Assessment

MRI with MRA as well as DWI and PWI has the advantage of providing more complete information on brain parenchymal injury and penumbral tissue at risk. MRI can be particularly helpful in selected difficult cases. Patients who present with seizures at stroke onset (which was a contraindication to IV rt-PA treament in the NINDS trial) should undergo MRI to exclude the possibility of postictal Todd's paralysis, unless a vascular occlusion compatible with the patient's clinical syndrome is clearly seen on CTA.44 Similarly, in other situations (such as complex migraine, functional disorder, transient global amnesia, acute demyelination, cerebral amyloid angiopathy, or brain neoplasm), the diagnostic abilities of MRI can be useful in distinguishing a stroke mimic from an acute ischemic stroke.45 It should be noted, however, that prolonged seizures and acute demyelination can also cause restricted diffusion.46 Of particular importance is the fact that DWI lesions can be reversed to some...


Have similar precipitating factors such as stress, fatigue, and diet. There is also an overlap for many of these disorders with regard to drug treatment. For example, acetazolamide is helpful not only for periodic paralysis, but also for myotonia, episodic ataxias 63 , and some paroxysmal dyskinesias 25 . Carbamazepine, an antiepileptic, is also very effective in patients with paroxysmal kinesigenic dyskinesia. There are also reports of families with multiple episodic disorders, for example, paroxysmal dyskinesia in a family with episodic ataxia and association of episodic problems such as migraine and epilepsy in families with paroxysmal dyskinesias 16,26 . Thus, like periodic paralysis and episodic ataxias, the familial paroxysmal dyskinesias may also be caused by defects in genes regulating ion channels 2 . Benign positional torticollis (BPT) of infancy has been reported in four cases from families with familial hemiplegic migraine, which is linked to a calcium channel gene...

Emotions and health

Emotion can be involved in any medical condition. For example, a broken leg can lead to anger and frustration, anxiety, fear, sadness, and so on. Or it may be that one's emotional condition was a precipitating factor in whatever led to the leg being broken in the first place. But the most problematic circumstance comes with the idea of psychosomatic disorders, in which the disorder is clearly physical (migraine, skin rashes, indigestion, peptic ulcers, asthma, genito-urinary conditions, and so on) but the causative factors seem to be emotional. The emotion most commonly implicated is anxiety. The extent of the emotional is hard to determine, one view being that all illness has an emotional component, causa-tively. For example, long-term stresses may well have a deleterious impact on the efficacy of the immune system and thus leave a person more vulnerable to infection.

Figure 1057

Causes of headache in the transplant recipient. ACE angiotensin-converting enzyme CNS central nervous system ATG antithy-mocyte globulin. Character, pattern, positional relationships Fever, duration of headache and fever Location of headache Visual, movement, sensory impairment Bowel or bladder incontinence Trauma Time of medications and relationships to headache Physical examination Eye

Figure 1060

Viruses causing meningitis in transplant recipients. The presentation is usually with fever and headache alone or in conjunction with headache may be the initial symptom. Nuchal rigidity is rare in the transplant patient. Cerebrospinal fluid samples should be saved for viral analysis and analysis should be requested if the diagnosis is not rapidly available from standard studies.


Other causes of postpartum headache should be excluded (see Table 44.1, p. 115). Two operators are required. Whilst one locates the epidural space in the usual way, the other prepares to draw 20 ml of blood under aseptic conditions. The blood is injected slowly and the patient is asked to report any unpleasant effects. The interspace at or below the level of the original dural puncture is usually recommended, since injected blood has been shown to track mainly upwards after injection. In general, the more blood that is injected the greater the chance of success most would attempt to inject 15-20 ml if no adverse effects allow. Flushing the epidural needle with saline as it is withdrawn has been suggested, to avoid leaving a plug of blood, which can act as a conduit for infection. The patient is usually kept lying for 2-4 hours after EBP (reduced efficacy has been suggested if mobilisation is immediate). The success rate of EBP has been reported as 70-100 typically, there is complete...

Figure 1016

Classic analgesic nephropathy is a slowly progressive disease resulting from the daily consumption over several years of mixtures containing analgesics usually combined with caffeine, codeine, or both. Caffeine and codeine create psychological dependence. Most cases of analgesic nephropathy occur in women. In 80 of the cases, analgesics were taken for persistent headache. Gastrointestinal complaints are also frequent, as are urinary tract infections. Evidence of clinical papillary necrosis (fever and pain) is present in 20 of cases. Calcifications of papillae (detected by computed tomography scan) are present in 65 of persons who abuse analgesics 13 .

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