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Cervical arterial dissection (CAD) is an important cause of stroke in young people which may be missed because early features may mimic migraine or a musculoskeletal presentation. The study aimed to develop a diagnostic support tool for early identification of CAD. Retrospective observational study Tertiary hospital Radiologically confirmed CAD cases (n = 37), non-CAD stroke cases (n = 20), and healthy controls (n = 100). The presence of CAD is confirmed with imaging. Predictive variables included risk factors and clinical characteristics of CAD. Variables with a p-value <0.2 included in a multivariable model. Predictive utility of the model is assessed by calculating area underthe ROC curve (AUC). The model including four variables: age 40–55 years (vs < 40), trauma, recent onset headache, and > 2 neurological features, demonstrated excellent discrimination: AUC of 0.953 (95% CI: 0.916, 0.987). A predictive scoring system (total score/7) identified an optimal threshold of ≥ 3 points, with a sensitivity of 87% and specificity of 79%. The study identified a diagnostic support tool with four variables to predict increased risk of CAD. Validation in a clinical sample is needed to confirm variables and refine descriptors to enable clinicians to efficiently apply the tool. Optimum cutoff scores of ≥ 3/7 points will help identify those in whom CAD should be considered and further investigation instigated. The potential impact of the tool is to improve early recognition of CAD in those with acute headache or neck pain, thereby facilitating more timely medical intervention, preventing inappropriate treatment, and improving patient outcomes. Wordcount: 3195 [ABSTRACT FROM AUTHOR]

To describe evidence of migraine-associated tinnitus and hearing loss. This study was registered in PROSPERO and followed the PRISMA guidelines. The inclusion criteria were observational studies with subjects aged ≥18 years, in which the association between migraine and tinnitus and/or hearing loss was evaluated. Reviews, case reports, commentaries, letters to the editor, and studies that included individuals with some diseases were excluded. The search yielded 698 articles from electronic databases. Six studies were eligible for this review with 26,166 participants. Most studies have shown an association between migraine and tinnitus, and between migraine and hearing loss. Studies have concluded that migraine presented high odds ratio, and hazard ratio for tinnitus. Another study found a strong association between these conditions (p < 0.001), and two investigations detected the presence of migraine in 10.1 and 22.5% of tinnitus patients. Migraine presented high odds ratio and hazard ratio for hearing loss. Additionally, the studies included were of good quality, adhering to most of the requirements on the JBI Critical Appraisal Checklist. However, a limitation of this review is the small number of studies included. Associations between migraine, tinnitus, and hearing loss were observed in the included studies. [ABSTRACT FROM AUTHOR]

To suggest a chart for the diagnosis of probable vestibular migraine for cases that cannot fit the internationally agreed diagnostic criteria. This retrospective study enrolled patients who presented with chronic dizziness and attacks of severe vertigo in whom the diagnostic criteria for diagnosing probable vestibular migraine were not applicable, and there was no possibility to account for other vestibular diagnoses. The trial of vestibular migraine treatment was started without any labyrinthine sedatives for a month. Patients whose conditions improved and were vertigo free for the trial period were included in this study. Common complaints, clinical examination findings, and hearing and vestibular test results were analyzed. Findings observed in more than 50% of the included patients were added to a chart. The chart was implemented with a score and included female gender, bilateral tinnitus, aural fullness, significant headache, family history of migraine, and reported hypotension. Any one of them increased the score by one point, while bilateral low frequencies sensorineural hearing loss and bilateral frequency tuning of cervical vestibular evoked myogenic potentials increased the score by two points. All the patients had a score of 5 or more. The diagnostic chart is useful for suggesting probable vestibular migraine in cases that do not comply with the internationally agreed diagnostic criteria. [ABSTRACT FROM AUTHOR]

Background: Stroke-like migraine attacks after radiation therapy – also known as SMART syndrome – constitute a rare condition characterised by headache, seizures, vision abnormalities, hemiparesis, and aphasia. The condition usually resolves within a few days or weeks with little to no residual impairment; however, recovery in some cases is protracted and incomplete. Aims: The purpose of this case report was to describe the one-year progression of language in a person, GB, with slow recovery from SMART syndrome. Methods & Procedures: GB was diagnosed with SMART syndrome at 39 years of age. Formal and informal assessments occurred at six, 11, 18, 29, and 52 weeks post-onset of SMART syndrome. Standardised assessment involved administration of portions of the Western Aphasia Battery – Revised, and informal assessment took the form of written and spoken language sample analyses. Outcomes & Results: Initial evaluation at two weeks post-onset revealed global aphasia. This evolved into severe Wernicke's aphasia by six weeks post-onset. Repeated evaluation over subsequent months revealed gradual improvement but continuing and substantial language impairment. At one-year post-onset, GB displayed anomic aphasia and persistent reading and writing deficits. Conclusions: Substantial language recovery from SMART syndrome can occur beyond the initial few months post-onset. Documentation of the nature and extent of language impairment provides a starting point for developing and refining efficacious treatment protocols. [ABSTRACT FROM AUTHOR]

The relationship between affective temperaments and migraine is not well studied to date. It is also uncertain whether some affective temperaments may predispose the migraine patients to major depression (MD). We hypothesized that migraine patients had more affective temperament traits than HCs, and certain affective temperament traits in migraine patients are associated with lifetime MD. The sample included fifty-eight female migraine patients and age-matched 55 healthy women. The migraine was diagnosed according to the third edition of International Classification of Headache Disorders (ICHD-III). Lifetime MD was determined by means of Structured Clinical Interview I for DSM-IV. Migraine Disability Assessment (MIDAS) Questionnaire was applied to participants to determine the impact of migraine on daily life. Affective temperamental traits were assessed through Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-questionnaire. All affective temperament traits (p <.0001) and the rate of MD (p =.002) were significantly higher in migraine patients compared to HCs. Non-depressive migraine patients (n = 36) had significantly more hyperthymic temperament traits compared to depressive patients (n = 22) (p =.04). Specifically, depressive temperament traits were significantly associated with higher lifetime MD in female migraine patients (B = 0.196, Exp(B) = 1.216, p =.01). Our findings suggest that affective temperaments may predispose some women to migraine, and depressive temperament may have a casual role in the development of lifetime depression in migraine patients. [ABSTRACT FROM AUTHOR]

Background: The pathophysiology of vertigo is not fully known; thus, it is difficult to diagnose vestibular migraine (VM) in some migraine patients with vertigo symptoms. Aims/objectives: We aimed to evaluate the diagnostic value of cervical vestibular evoked myogenic potential (cVEMP) in patients with VM. Materials and Methods: Thirty-two patients diagnosed with migraine and 31 patients with VM were prospectively included in this study. The cVEMP responses were obtained, and P1-N1 latency, interpeak amplitude, amplitude asymmetry ratio were calculated. The patients' demographics, results of physical and audiometric examinations, and VEMP records as well as absence of responses were evaluated and compared between groups. Results: The incidence of ears with absence VEMP responses was found to be numerically higher in the migraine group than in the VM group (p =.106). Additionally, there were no statistically significant differences detected between the groups in terms of the p13 or n23 latency, interpeak amplitude, and amplitude asymmetry ratio measured in both right and left ears (p >.05). Conclusions: The increased rate of absent VEMPs was associated with the hypoperfusion of the sacculo-collic reflex pathway in migraine patients. In addition, it was concluded that VEMP reflex responses appear to be insufficient to differentiate between VM and migraine diagnoses. [ABSTRACT FROM AUTHOR]

Background: Migraine has been ranked as third most prevalent disorder and seventh highest cause of disability. Coping up strategy is an emotional, intellectual and behavioural change that will help to deal with stress, and each person has their unique way of coping up. There is scarcity of research in the area of migraine disability and coping strategies acquired by the patients in early adult population. This study is intended to assess correlation between migraine originated disability and coping strategies in early adult female population. Methods: This study is a cross-sectional study with an open ended sample size of 88. Study was conducted in colleges under KAHER, Belagavi. Subjects were given self-report questionnaire for migraine disability and coping strategy. Measurement tools were Migraine Disability Assessment Test and Coping Strategy Inventory. Results: There is a positive significant correlation between migraine disability and few primary scales like cognitive reconstruction, wishful thinking, self-criticism, social withdrawal and secondary scales of coping strategy like problem focussed disengagement and emotional focussed disengagement (p <.05). Conclusions: The result showed that more the person is disabled, more disengaging behaviour from the person/environment is seen. [ABSTRACT FROM AUTHOR]

Objectives: The prevalence rate of migraines is 8.4%; it is mostly diagnosed in women at 20s to 40s, and is known to cause major physical and mental disruption to daily life. This study was conducted on women aged between their 20s and 40s, in order to investigate the possible differences in the features of the occlusal state between a migraine and a non-migraine (control) group.Methods: Age-matched female patients with migraine (n = 60) diagnosed by headache specialists and healthy controls (n = 57) were enrolled. Dental casts were used to evaluate some features.Results: The maxillary and mandibular dentition casts from the migraine group showed significantly characteristic findings in their Angle's classification, overjet, and deviation in the anterior tooth midline, compared to the control group.Discussion: The results relating occlusal state to both tension-related headaches and migraines, which have different pathogeneses, suggest the possibility of dental intervention to improve the symptoms of primary headaches. [ABSTRACT FROM AUTHOR]

Migraine is a common disabling brain disorder that affects one in seven US citizens annually. The burden of migraine is substantial, both in economic terms and for individual patients and their close family members. Initial medical consultations for migraine are usually with a primary care physician (PCP), and it is predominantly managed in a primary care setting; therefore, PCPs need a thorough understanding of migraine and the treatment options. This review provides an overview of the prevalence, symptoms, burden, and diagnosis of migraine with a focus on adults. Important aspects of migraine management, such as medication overuse and chronic migraine, are highlighted and insight is provided into factors for consideration when prescribing acute/abortive treatment for migraine to ensure that individual patients receive optimal pharmaceutical management. The effects of associated symptoms, e.g. nausea/vomiting, on treatment efficacy are pertinent in migraine; however, many therapy options, including alternative delivery systems, are available, thus facilitating the selection of optimal treatment for an individual patient. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate refractive errors in patients with migraine headache and to compare with healthy subjects. Materials and Methods: This prospective case-control study includes patients with migraine and age- and sex-matched healthy subjects. Clinical and demographic characteristics of the patients were noted. Detailed ophthalmological examinations were performed containing spherical refractive error, astigmatic refractive error, spherical equivalent (SE), anisometropia, best-corrected visual acuity, intraocular pressure, slit lamp biomicroscopy, fundus examination, axial length, anterior chamber depth, and central corneal thickness. Spectacle use in migraine and control groups was compared. Also, the relationship between refractive components and migraine headache variables was investigated. Results: Seventy-seven migraine patients with mean age of 33.27 ± 8.84 years and 71 healthy subjects with mean age of 31.15 ± 10.45 years were enrolled (p = 0.18). The migraine patients had higher degrees of astigmatic refractive error, SE, and anisometropia when compared with the control subjects (p = 0.01, p = 0.03, p = 0.02, respectively). Conclusion: Migraine patients may have higher degrees of astigmatism, SE, and anisometropia. Therefore, they should have ophthalmological examinations regularly to ensure that their refractive errors are appropriately corrected. [ABSTRACT FROM AUTHOR]

Conclusion: Our findings suggest that migrainous vertigo (MV) has a substantial vestibulo-spinal abnormality that can be uncovered by posturography. Patients with MV also showed a difficulty in using multisystem information, especially somatosensory information. Caloric and sensory organization tests (SOTs) have complementary roles in assessing vestibulo-ocular and vestibulo-spinal function, particularly for Meniere's disease (MD) and MV. Objectives: To compare vestibular dysfunction through caloric testing and posturography in patients with MV, MD, and acute vestibular neuritis (VN). Methods: Caloric tests and SOTs were performed in 31 patients with MV, 23 with MD, and 37 with VN. The abnormal results in caloric test, SOT conditions, and somatosensory, visual, and vestibular ratios were analyzed. Results: Abnormal canal paresis was found in 7 patients with MV (23%), 11 with MD (48%), and 37 with VN (100%). An abnormal vestibular ratio in SOT was found in 14 patients with MV (45%), 6 with MD (26%), and 23 with VN (62%). In MV, an abnormal vestibular ratio was more common than canal paresis and an abnormal vestibular ratio was more common than in MD. An abnormal somatosensory ratio (19%) in MV was significantly more common than in VN and MD (3% and 0%). For condition 2, MV showed a significantly higher abnormal rate than VN. An abnormal visual ratio in MV was more common than in VN and MD but this was not significant. [ABSTRACT FROM AUTHOR]

Migraine is a common chronic, intermittent headache disorder that in some patients is accompanied by neurological symptoms, particularly visual symptoms, known as migraine aura. Several population-based studies have linked migraine, and particularly migraine with aura, with increased risk of ischemic stroke. Recent prospective data suggest an association between migraine with aura and any ischemic vascular events, including coronary heart disease. The precise biological mechanism by which migraine with aura may increase the risk of vascular events is currently unknown and likely complex. Potential mechanisms involve shared risk factors, inter-relationships between migraine and vascular pathologies, migraine treatments, as well as genetic components. This review aims to summarize the epidemiologic evidence linking migraine with ischemic vascular events, discuss potential mechanisms and to outline potential consequences. [ABSTRACT FROM AUTHOR]