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Migraine and Headache: Clinical Presentation, Treatment, and Management
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Migraine and Headache: Clinical Presentation, Treatment, and Management

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (20 October 2024) | Viewed by 18938

Special Issue Editors

Prof. Dr. Vincenzo Guidetti‬

E-Mail Website
Guest Editor
Section of Child and Adolescent Neuropsychiatry, Department of Human Neuroscience, Sapienza—University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
Interests: headache; pain; psychopathology; comorbidity
Prof. Dr. Aynur ÖZGE

E-Mail Website
Guest Editor
Department of Neurology, Faculty of Medicine, Mersin University, Mersin 33343, Turkey
Interests: headache; pain; neurophysiology

Special Issue Information

Dear colleagues,

This Special Issue will focus on non-headache presentations of migraine. Rather than headache characteristics, we wish to focus on premonitory phases, different presentations of aura, triggers, comorbidities, and differential diagnostic gaps in clinical practice. We will propose the importance of holistic approaches and low-budget solutions, taking into account realities from all over the world. Additionally, we will discuss the roles of new realistic techniques of lifestyle regulation and non-pharmacological therapies. Finally, we wish to open some windows about management gaps in perspective and age–gender–cultural differentiation.

We also wish to discuss the importance of refractory cases that require additional interventional therapies, as well as providing some brief reports on them.

We are inviting you to share your evidence-based data with us in order to improve our overall daily headache practice. It would be appreciated if we received original studies together with a limited number of informative cases. The planned deadline for submissions is 15 October 2023 Please do not hesitate to contact us at any step.

With our best regards,

Prof. Dr. Vincenzo Guidetti‬
Prof. Dr. Aynur ÖZGE
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • migraine
  • headache
  • presentation
  • new realistic techniques
  • interventional therapies

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Published Papers (7 papers)

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Research

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12 pages, 2549 KiB  
Article
The Immediate Effect of Dry Needling Electric Muscle Stimulation on the Position of Atlas
by Rob Sillevis, Daniel Cerdeira, Jared Yankovich and Anne Weller Hansen
J. Clin. Med. 2024, 13(14), 4097; https://doi.org/10.3390/jcm13144097 - 13 Jul 2024
Viewed by 833
Abstract
Background: cervicogenic headaches are common and are believed to be the cause of dysfunction in the upper cervical spine. The mobility and the position of the atlas have been identified as a cause of upper cervical dysfunction. The mobility of the atlas [...] Read more.
Background: cervicogenic headaches are common and are believed to be the cause of dysfunction in the upper cervical spine. The mobility and the position of the atlas have been identified as a cause of upper cervical dysfunction. The mobility of the atlas is entirely under the control of the suboccipital muscles. The oblique capitis inferior muscle has a rotatory effect on the atlas when contracted. This study evaluated the immediate effects of a dry needling electrical stimulation-induced contraction of the left oblique capitis inferior muscle on the position and mobility of the atlas in the atlantoaxial joint. Methods: thirty-one subjects participated in this within-subject repeated measure study design. Each subject underwent a pre-measures neck flexion rotation test, palpation of the atlas position, and measurement of the length of the right oblique capitis inferior muscle with musculoskeletal ultrasound imaging. The pre-measures were repeated after two five-second tetanic contractions of the oblique capitis inferior muscle. Results: post-intervention analysis revealed significant changes in the length of the right oblique capitis inferior muscle. This length change correlated with the palpated positional default position immediately after the intervention. Conclusions: two five-second tetanic contractions of the left oblique capitis inferior muscle immediately affected the position of the atlas in the atlantoaxial joint. In our subjects, 90% displayed a positional default in the left rotation, and this was correlated with a change in the neck flexion rotation test. This study supports the notion that suboccipital muscle tonicity can result in mobility dysfunction and, thus, conditions such as cervicogenic headaches. Full article
(This article belongs to the Special Issue Migraine and Headache: Clinical Presentation, Treatment, and Management)
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13 pages, 1032 KiB  
Article
Sleep Bruxism and Obstructive Sleep Apnea Are Not Risk Factors for Tension-Type Headache (TTH): A Polysomnographic Study
by Bartłomiej Błaszczyk, Helena Martynowicz, Piotr Niemiec, Jakub Przegrałek, Martyna Staszkiewicz, Anna Wojakowska, Sławomir Budrewicz and Marta Waliszewska-Prosół
J. Clin. Med. 2024, 13(13), 3835; https://doi.org/10.3390/jcm13133835 - 29 Jun 2024
Viewed by 1092
Abstract
Background: Tension-type headache (TTH) is the most common primary headache. Obstructive sleep apnea (OSA) and sleep bruxism (SB) are two of the most common sleep disorders; however, the relationship between TTH, OSA, and SB has not been conclusively proved in the literature. The [...] Read more.
Background: Tension-type headache (TTH) is the most common primary headache. Obstructive sleep apnea (OSA) and sleep bruxism (SB) are two of the most common sleep disorders; however, the relationship between TTH, OSA, and SB has not been conclusively proved in the literature. The objective of our study was to estimate potential associations with OSA and SB in TTH subjects. Methods: 108 adult individuals who underwent polysomnography (vPSG) were included, and the group was divided into two subgroups: TTH (n = 34) and control (n = 74). The International Classification of Headache Disorders (ICHD-3) guidelines were used to diagnose TTH. OSA and SB diagnoses were based on vPSG examination with electromyographic (EMG) recordings and the American Academy of Sleep Medicine (AASM) criteria. The results were analyzed, where p < 0.05 was considered to be statistically significant. Results: In the TTH group, the incidence of SB was more than two times lower than the control (OR = 0.41, 95% CI: 0.17–0.96, p < 0.05). However, the incidence of severe SB (BEI > 4) was similar in the TTH and control groups (OR = 0.54, 95% CI: 0.21–1.35, p > 0.05). Additionally, phasic and tonic SB episodes were less frequent in the TTH group compared to the controls (p < 0.05). The mean apnea–hypopnea index (AHI) was not significantly different between the TTH and control groups (p > 0.05). The sleep architecture and respiratory disturbances did not differ between the examined groups (p > 0.05). Conclusions: SB is not a risk factor for TTH. Moreover, severe SB is not connected with TTH. OSA is not a risk factor for TTH. Sleep quality did not differ between both groups during PSG; therefore, TTH may not change sleep structure. The mechanism of these findings is still unclear, and further studies should explain in detail the association between TTH and OSA. Full article
(This article belongs to the Special Issue Migraine and Headache: Clinical Presentation, Treatment, and Management)
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15 pages, 2547 KiB  
Article
Distinct Food Triggers for Migraine, Medication Overuse Headache and Irritable Bowel Syndrome
by Merve Ceren Akgor, Doga Vuralli, Damla Hazal Sucu, Saliha Gokce, Bahar Tasdelen, Fatih Gultekin and Hayrunnisa Bolay
J. Clin. Med. 2023, 12(20), 6488; https://doi.org/10.3390/jcm12206488 - 12 Oct 2023
Cited by 5 | Viewed by 4031
Abstract
Background: Irritable bowel syndrome (IBS) is an under-diagnosed common health problem that impairs quality of life. Migraine and IBS are comorbid disorders that are triggered by foods. We aim to investigate IBS frequency in medication overuse headache (MOH) patients and identify food triggers [...] Read more.
Background: Irritable bowel syndrome (IBS) is an under-diagnosed common health problem that impairs quality of life. Migraine and IBS are comorbid disorders that are triggered by foods. We aim to investigate IBS frequency in medication overuse headache (MOH) patients and identify food triggers and food avoidance behavior. Methods: Participants who completed the cross-sectional, observational and online survey were included (n = 1118). Demographic data, comorbid disorders, medications used, presence of headache, the diagnostic features of headache and IBS, migraine related subjective cognitive symptoms scale (MigSCog), consumption behavior of patients regarding 125 food/food additives and food triggers were asked about in the questionnaire. Results: Migraine and MOH diagnoses were made in 88% and 30.7% of the participants, respectively. Non-steroidal anti-inflammatory drugs (NSAIDs) were the main overused drug (89%) in MOH patients. IBS symptoms were present in 35.8% of non-headache sufferers, 52% of migraine patients and 65% of MOH patients. Specific food triggers for MOH patients were dopaminergic and frequently consumed as healthy foods such as banana, apple, cherry, apricot, watermelon, olive, ice cream and yogurt. MigSCog scores were significantly higher in episodic migraine and MOH patients when IBS symptoms coexisted. Conclusions: The frequency of IBS was higher in MOH patients compared to migraine patients. Coexistence of IBS seems to be a confounding factor for cognitive functions. MOH specific triggers were mostly dopaminergic foods, whereas migraine specific food triggers were mostly histaminergic and processed foods. Personalized diets focusing on food triggers and interference with leaky gut must be integrated to MOH and migraine treatment to achieve sustainable management of these disorders. Full article
(This article belongs to the Special Issue Migraine and Headache: Clinical Presentation, Treatment, and Management)
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14 pages, 589 KiB  
Article
Interrelationships of Sleep Quality, Obesity Severity, and Clinical Headache Features among Women with Comorbid Migraine and Obesity
by Leah M. Schumacher, Samantha G. Farris, J. Graham Thomas, Richard B. Lipton, Jelena Pavlovic, Angeliki Vgontzas and Dale S. Bond
J. Clin. Med. 2023, 12(5), 1742; https://doi.org/10.3390/jcm12051742 - 22 Feb 2023
Cited by 1 | Viewed by 2735
Abstract
Obesity and migraine are often comorbid. Poor sleep quality is also common among individuals with migraine and may be influenced by comorbidities such as obesity. However, understanding of migraine’s relationship with sleep and the potential exacerbating effect of obesity remains limited. This study [...] Read more.
Obesity and migraine are often comorbid. Poor sleep quality is also common among individuals with migraine and may be influenced by comorbidities such as obesity. However, understanding of migraine’s relationship with sleep and the potential exacerbating effect of obesity remains limited. This study evaluated the associations of migraine characteristics and clinical features with sleep quality among women with comorbid migraine and overweight/obesity and assessed the interplay between obesity severity and migraine characteristics/clinical features in relation to sleep quality. Women seeking treatment for migraine and obesity (n = 127; NCT01197196) completed a validated questionnaire assessing sleep quality (Pittsburgh Sleep Quality Index-PSQI). Migraine headache characteristics and clinical features were assessed using smartphone-based daily diaries. Weight was measured in-clinic, and several potential confounders were assessed using rigorous methods. Nearly 70% of participants endorsed poor sleep quality. Greater monthly migraine days and the presence of phonophobia related to poorer sleep quality, and specifically poorer sleep efficiency, controlling for confounders. Obesity severity was neither independently associated nor interacted with migraine characteristics/features to predict sleep quality. Poor sleep quality is common among women with comorbid migraine and overweight/obesity, although obesity severity does not appear to uniquely relate to or exacerbate the association between migraine and sleep in this population. Results can guide research on mechanisms of the migraine–sleep link and inform clinical care. Full article
(This article belongs to the Special Issue Migraine and Headache: Clinical Presentation, Treatment, and Management)
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Review

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12 pages, 254 KiB  
Review
Cluster Headache: Diagnosis, Management, and Treatment in Pediatric Headache
by Alessandro Borrelli, Massimiliano Valeriani, Gabriele Monte, Fabiana Ursitti, Martina Proietti Checchi, Samuela Tarantino, Giorgia Sforza and Laura Papetti
J. Clin. Med. 2024, 13(5), 1203; https://doi.org/10.3390/jcm13051203 - 20 Feb 2024
Cited by 1 | Viewed by 1711
Abstract
Despite its rarity, cluster headache can affect children. Patients with cluster headaches often experience symptoms in their adolescence, but the time it takes for a correct diagnosis can be very long. Cluster headache can be mistaken for other pathologies, which can result in [...] Read more.
Despite its rarity, cluster headache can affect children. Patients with cluster headaches often experience symptoms in their adolescence, but the time it takes for a correct diagnosis can be very long. Cluster headache can be mistaken for other pathologies, which can result in patients being diagnosed and treated incorrectly. CH therapy often represents a challenge in pediatric age as there are no studies dedicated to this age category and the therapy strategy is generally based on data from adult experience. The aim of this review is to provide a summary of the current literature on cluster headache in children and adolescents. Full article
(This article belongs to the Special Issue Migraine and Headache: Clinical Presentation, Treatment, and Management)
40 pages, 1548 KiB  
Review
One Patient, Three Providers: A Multidisciplinary Approach to Managing Common Neuropsychiatric Cases
by Aynur Özge, Füsun Mayda Domaç, Nil Tekin, Esra Aydın Sünbül, Nevra Öksüz, Arife Çimen Atalar, Sümeyye Yasemin Çallı, Yağmur Sever Fidan, Ahmet Evlice, Engin Emrem Beştepe, Filiz İzci, Özge Yılmaz Küsbeci, Esra Acıman Demirel, Sibel K. Velioğlu and Mehmet Ungan
J. Clin. Med. 2023, 12(17), 5754; https://doi.org/10.3390/jcm12175754 - 4 Sep 2023
Cited by 3 | Viewed by 3131
Abstract
Background: Neuropsychiatric cases require a multidisciplinary approach for effective management. This paper presented case-based discussions on migraine, dementia, epilepsy, mood disorders, neuralgia, and psychosis from the perspectives of a family physician, neurologist, and psychiatrist. The goal was to highlight the importance of collaboration [...] Read more.
Background: Neuropsychiatric cases require a multidisciplinary approach for effective management. This paper presented case-based discussions on migraine, dementia, epilepsy, mood disorders, neuralgia, and psychosis from the perspectives of a family physician, neurologist, and psychiatrist. The goal was to highlight the importance of collaboration between healthcare providers in managing these complex cases. Methods: The paper was based on the proceedings of the Mediterranean Neuropsychiatry Symposium, where experts from family medicine, neurology, and psychiatry came together for comprehensive case-based discussions. The CARE framework (Case Report, Appraisal, Research, and Education) was developed to guide reporting and evaluation of case reports in clinical practice. Results: Six cases were presented and discussed, highlighting the importance of a multidisciplinary approach in managing neuropsychiatric cases. The cases included chronic migraine with medication overuse, memory dysfunction with language and behavioral problems, refractory epileptic seizures with subjective sensory symptoms, bipolar affective disorder with normal pressure hydrocephalus, postherpetic neuralgia in a case with bipolar affective disorder, and psychosis with recurrent attacks with the abuse of several substances. Conclusion: A biopsychosocial multidisciplinary approach is essential for managing neuropsychiatric cases effectively on behalf of the patients and public health of the country. The CARE framework can guide the reporting and evaluation of case reports in clinical practice, ensuring that patients receive comprehensive and effective care. Healthcare providers should collaborate to provide the best possible care for patients with complex and multifaceted needs. Full article
(This article belongs to the Special Issue Migraine and Headache: Clinical Presentation, Treatment, and Management)
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14 pages, 309 KiB  
Review
Post-Traumatic Headache: A Review of Prevalence, Clinical Features, Risk Factors, and Treatment Strategies
by Ioannis Mavroudis, Alin Ciobica, Alina Costina Luca and Ioana-Miruna Balmus
J. Clin. Med. 2023, 12(13), 4233; https://doi.org/10.3390/jcm12134233 - 23 Jun 2023
Cited by 12 | Viewed by 4223
Abstract
Post-traumatic headache (PTH) is a common and debilitating consequence of mild traumatic brain injury (mTBI) that can occur over one year after the head impact event. Thus, better understanding of the underlying pathophysiology and risk factors could facilitate early identification and management of [...] Read more.
Post-traumatic headache (PTH) is a common and debilitating consequence of mild traumatic brain injury (mTBI) that can occur over one year after the head impact event. Thus, better understanding of the underlying pathophysiology and risk factors could facilitate early identification and management of PTH. There are several factors that could influence the reporting of PTH prevalence, including the definition of concussion and PTH. The main risk factors for PTHs include a history of migraines or headaches, female gender, younger age, greater severity of the head injury, and co-occurring psychological symptoms, such as anxiety and depression. PTH clinical profiles vary based on onset, duration, and severity: tension-type headache, migraine headaches, cervicogenic headache, occipital neuralgia, and new daily persistent headache. Pharmacological treatments often consist of analgesics and non-steroidal anti-inflammatory drugs, tricyclic antidepressants, or antiepileptic medication. Cognitive behavioral therapy, relaxation techniques, biofeedback, and physical therapy could also be used for PTH treatment. Our work highlighted the need for more rigorous studies to better describe the importance of identifying risk factors and patient-centered treatments and to evaluate the effectiveness of the existing treatment options. Clinicians should consider a multidisciplinary approach to managing PTH, including pharmacotherapy, cognitive behavioral therapy, and lifestyle changes. Full article
(This article belongs to the Special Issue Migraine and Headache: Clinical Presentation, Treatment, and Management)
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