New Daily Persistent Headache: Historical Review and an Interview with Dr. Walter Vanast.

New daily persistent headache (NDPH) is an idiopathic headache syndrome characterized by the abrupt onset of an unremitting, daily, continuous headache without an antecedent escalating headache pattern, and not attributable to other primary or secondary headache disorders. We review the history of NDPH in terms of its characterization and classification, and then interview Dr. Walter Vanast, the neurologist who initially described NDPH three decades ago, to gain his perspective now that there is more widespread recognition and interest in this syndrome.

Dysmetropsia and Cotard's syndrome due to migrainous infarction - or not?

INTRODUCTION: Migrainous infarction accounts for 12.8% of ischemic strokes of unusual etiology. CASE REPORT: A 59-year-old woman with longstanding migraine with aura experienced what appeared to be migrainous infarction characterized by dysmetropsia and transient Cotard's syndrome. Imaging demonstrated right temporal-parietal-occipital changes with apparent cortical laminar necrosis. CONCLUSION: The spectrum of the pathophysiology of migrainous infarction has not been established; however, cortical spreading depression may explain the appearance of imaging findings that do not obey a vascular territory.

Annual scientific meeting--American Headache Society Washington 2011--highlights.

The 53rd Annual Scientific Meeting of the American Headache Society was held in Washington from June 2 to 5, 2011. Important clinical and basic science information was presented at this meeting. This is a review of the highlights of that meeting dealing in many areas of headache medicine. Once again, this meeting, which is the premier scientific meeting of the American Headache Society, provided lots of new and exciting information about multiple facets of migraine headache and other disorders.

Dangerous and thunderclap headaches.

The International Classification of Headache Disorders-II considers dangerous and thunderclap headaches as secondary headaches--in other words due to an underlying cause. Many, but not all of the underlying etiologies, are vascular disorders, and many are potentially life threatening. An especially comprehensive clinical approach is necessary when seeing patients with these potential disorders.

Characteristics of migraine visual aura in Southern Brazil and Northern USA.

BACKGROUND: Migraine aura, made up of one or more neurological symptoms arising from the cortex or brainstem, is a complex neurological phenomenon. Visual aura is the most frequent aura manifestation. Studying the subjective components of visual aura makes it possible to identify common characteristics. OBJECTIVE: To thoroughly describe the characteristics of migraine visual aura in patients with migraine with aura. METHODS: We performed a retrospective, descriptive study of the visual aura of 122 migraine patients collected at two headache clinics in the Americas. This study was designed to determine the characteristics of a typical visual aura. RESULTS: The most common features of the visual aura in our study are that it occurs before the headache with a gap of less than 30 minutes, lasts 5 to 30 minutes, has a gradual onset, usually begins peripherally, is unilateral, and shimmers. Furthermore, the location of typical visual aura in the visual field has no fixed relationship to headache laterality, is slightly more often without color, and is often described as small bright dots and zigzag lines. Blurred vision, not typically considered to be an aura phenomenon of cortical origin, is in fact the most frequently reported visual symptom. CONCLUSIONS: Migraine visual aura is heterogeneous and pleomorphic, and some of our findings run contrary to common beliefs.

The role of the visual system in migraine: an update.

The visual system plays a prominent role in migraine headache, especially migraine with aura. Anatomical and functional studies in migraine are showing an increasing role linking the visual system to migraine and its multiple and complex clinical expressions. Recent research on photophobia highlights the progress of our understanding of these relationships. This review overviews a practicing neurologist's view of some of the roles of the visual system in migraine and how a clinical understanding of this relationship is enhanced by recent research and discovery in this in this important area.

Migraine is curable!

Migraine is a pathophysiologically complex disorder that arises from a neurovascular disturbance in the brain itself, and involves modulatory mechanisms in the brainstem, subcortical and cortical levels to process pain. These processing mechanisms may be abnormal in migraine, which uses otherwise normal neural pathways for pain transmission. Migraine is also an inherited dysfunction that in some individuals becomes chronic, and at various stages has shown functional neuroimaging changes. Based on further analysis of these concepts, it may be that migraine is a potentially curable disorder or disease, or at least one that can be controlled to such an extent as to prevent its acute genesis and chronic progression to the point that it no longer becomes clinically symptomatic. There are many present and potential targets to mitigate the migraine attack(s), and therefore a potential cure might exist in the future, resulting in a reduction of the expression of paroxysmal symptoms and signs, which then will fall within or near the spectrum of normal brain functions. This paper will explore the migraine diatheses to look at ways that migraine could be seen to be curable by either limiting its threshold to clinical expression or stabilizing or even reversing its pathophysiological genesis.