RESUMO
The French Headache Society proposes updated French guidelines for the management of migraine. This article presents the third part of the guidelines, which is focused on the non-pharmacological treatment of migraine, including physical exercise, dietary supplements and plants, diets, neuromodulation therapies, acupuncture, behavioral interventions and mindfulness therapy, patent foramen ovale closure and surgical nerve decompression.
Assuntos
Transtornos de Enxaqueca , Adulto , Cefaleia , Humanos , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/terapiaAssuntos
Transtornos da Cefaleia/tratamento farmacológico , Transtornos de Enxaqueca/tratamento farmacológico , Adolescente , Adulto , Analgésicos/administração & dosagem , Analgésicos/efeitos adversos , Analgésicos/uso terapêutico , Toxinas Botulínicas Tipo A/uso terapêutico , Criança , Esquema de Medicação , Overdose de Drogas/epidemiologia , Overdose de Drogas/terapia , França/epidemiologia , Frutose/análogos & derivados , Frutose/uso terapêutico , Transtornos da Cefaleia/epidemiologia , Transtornos da Cefaleia Secundários/etiologia , Transtornos da Cefaleia Secundários/prevenção & controle , Transtornos da Cefaleia Secundários/terapia , Hospitalização , Humanos , Incidência , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/epidemiologia , Transtornos de Enxaqueca/prevenção & controle , Transtornos de Enxaqueca/terapia , Prevalência , Recidiva , Topiramato , Estimulação Elétrica Nervosa TranscutâneaRESUMO
Migraine is a complex brain disease. The "generator" of the migrainous attacks remains a subject of debate, but the hypothalamus, with its multiple connections with the other parts of the central nervous system and its controls on the pituitary gland and the autonomic nervous system, is a very serious candidate. Many of the premonitory symptoms of migraine attacks find their origin in the hypothalamus. The hormonal changes which occur during feminine genital life and which impact on the life of the migrainous women have their origin in the hypothalamus. The hypothalamus exerts control over the balance between the parasympathetic and orthosympathetic systems. Orexine, hormones originating in the hypothalamic, are involved in sleep regulation, thermoregulation and neuroendocrine and nociceptive functions. They could play a crucial role in the origin of the migrainous attack and might explain the influence of sleep, eating habits and excessive weight in the occurrence of attacks. Hypothalamic cerebral activation via H2 15OPET activity, suspected by clinical and experimental arguments as a possible trigger for migraine, has been demonstrated during spontaneous attacks. However, no conclusion can be made however as to whether this activation is the cause or the consequence of the migrainous pain.
Assuntos
Hipotálamo/fisiopatologia , Transtornos de Enxaqueca/etiologia , Transtornos de Enxaqueca/fisiopatologia , Ritmo Circadiano/fisiologia , Feminino , Humanos , Peptídeos e Proteínas de Sinalização Intracelular/fisiologia , Neuroimagem , Neuropeptídeos/fisiologia , Sistemas Neurossecretores/fisiologia , Nociceptividade/fisiologia , Obesidade/complicações , Obesidade/fisiopatologia , OrexinasAssuntos
Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/terapia , Adolescente , Adulto , Idoso , Criança , Anticoncepcionais Orais Hormonais/uso terapêutico , Avaliação da Deficiência , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Eletroencefalografia , Serviços Médicos de Emergência , Feminino , Hormônios Esteroides Gonadais/fisiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Menopausa , Pessoa de Meia-Idade , Transtornos de Enxaqueca/tratamento farmacológico , Transtornos de Enxaqueca/epidemiologia , Gravidez , Terapia de Relaxamento , Adulto JovemRESUMO
Nine cases (seven men and two women, mean age 64.5 years) of classical lacunar syndromes due to intracerebral hemorrhage are reported. Three patients presented with pure motor hemiparesis (two putaminal hematomas with proportional weakness and one cortical hemorrhage with brachio-crural hemiparesis). Four patients presented with sensorimotor stroke due to thalamo-capsular hemorrhage. The last two patients had thalamic hemorrhage causing ataxic hemiparesis or dysarthria-clumsy hand syndrome. Four subjects had arterial hypertension, one was diabetic, and two were treated with anti-vitamin K. Abrupt onset was noted in all instances. Only one patient experienced moderate inaugural headaches. Good recovery occurred in all cases. Lacunar syndromes are a very uncommon presentation of intracerebral bleeding. Hemorrhages are yet the second etiology of such syndromes. Distinguishing hemorrhage from infarction is not clinically possible and needs early unenhanced CT scan.