A Retrospective Comparison of Onabotulinum Toxin A and Incobotulinum Toxin A in Terms of Efficacy, Tolerability, Duration of Effect, and Pain on Injection Administration Site for the Treatment of Chronic Migraine.

Background Onabotulinum toxin A (OnA) is a well-tolerated and effective treatment for chronic migraine (CM). However, based on research indications that incobotulinum toxin A (InA) would be equally effective, a Veterans Health Administration medical center mandated a two-year trial of InA as a more cost-effective alternative to OnA. Although InA is used for many similar indications as OnA, it is not Food and Drug Administration-approved for treating CM, and complications occurred in several patients with CM following this treatment change.

Onabotulinum toxin A vs. incobotulinum toxin A for the treatment of chronic migraine: a retrospective review.

Background: Onabotulinum toxin A (OnA) is a well-tolerated and effective treatment for chronic migraine (CM). However, based on research indications that incobotulinum toxin A (InA) would be equally effective, a Veterans' Health Administration Medical Center mandated a 2-year trial of InA as more cost-effective alternative to OnA. Although InA is used for many similar indications as OnA, it is not Food and Drug Administration approved for treating CM, and complications occurred in several patients with CM following this treatment change.

Artificial Intelligence-Aided Headache Classification Based on a Set of Questionnaires: A Short Review.

Wielding modern technology in the form of artificial intelligence (AI) or deep learning (DL) can utilize the best possible latest computer application in intricate decision-making and enigmatic problem-solving. It has been recommended in many fields. However, it is a long way from achieving an ambitious genuine intention when it comes to understanding and identifying any headache condition or classification, and using it error-free.

Unusual Presentation of COVID-19 Headache and Its Possible Pathomechanism.

Headache was the most common neurological symptom during the H1N1 pandemic in 2009 and the most recrudescing symptom of human coronavirus (hCoV) in 2016. Even in this prevailing global coronavirus disease 2019 (COVID-19) pandemic, the main neurological symptom is found to be a headache. Headache phenotypes identified with COVID-19 are largely migraine, tension-type headache, or cough headache located in the frontotemporal or occipital region with wavering intensity and essentially of acute onset.

T2-Sampling Perfection With Application-Optimized Contrasts by Using Flip Angle Evolution (SPACE) Protocol MRI: A Safe, Minimally Invasive Screening Tool for Spinal CSF Leak Causing Spontaneous Intracranial Hypotension.

Spontaneous intracranial hypotension (SIH) due to a spinal cerebrospinal fluid (CSF) leak is secondary cause of headache with potentially devastating consequences. Its diagnosis is complicated owing to the lack of a reasonable, minimally invasive screening test. This results in many patients remaining undiagnosed for years after the headache onset.

Novel Case Presentation of Abulia After Lone Star Tick Bite As Evidenced by Raised Titers of Alpha-Gal Specific IgM Immunoglobulin and a Possibility of Alpha-Gal Driven Hypothalamic Dysfunction As the Pathomechanism.

Galactose-α-1,3-galactose, an oligosaccharide epitope better acknowledged as α-Gal, is present in non-primate mammal meat, tick bites, microorganisms, and vaccines as a glycoprotein or glycolipid moiety. This can manifest hyperimmune reactions as it enters the human body, known as α-Gal syndrome (AGS). AGS and Guillain-Barré syndrome share cognate immunogenic pathomechanism via conquering immune tolerance further speculating galactose navigated neurological sequel.

A Rare Case of Domperidone-Induced Acute Dystonia in a Young Adult Due to Consumption of Combination Drug (Proton Pump Inhibitors With Domperidone) and Its Possible Pathomechanism.

Globally, a substantial number of people are tormented by dystonia. Domperidone, a D-2 receptor antagonist acts outside the blood-brain barrier in the brain stem as well as on the gastrointestinal tract. In India, domperidone is conveniently obtainable over the counter as a combination drug with proton pump inhibitors (PPIs) for dyspepsia and gastro-esophageal reflux disease.

Varicella-Zoster Reactivation in a Non-immunized Elderly Multiple Sclerosis Patient While on Delayed-Release Dimethyl Fumarate With Grade 2 Lymphopenia and Profoundly Low CD4+ and CD8+ Cell Counts: A Case Report.

Increased susceptibility to opportunistic infections (OI) in multiple sclerosis (MS) patients is a real concern amongst neurologists when using disease-modifying therapies (DMTs). DMTs used in modulating or suppressing the immune system for MS management may risk the patient with lymphocytopenia, raising the possibility of OI; however, this lymphopenia may contemplate as a biomarker for drug response, degree of immunomodulation, and drug compliance. The OI could be reactivation of varicella-zoster, progressive multifocal leukoencephalopathy (PML) induced by John Cunningham virus (JC virus), infection, cryptococcal meningitis, atypical mycobacteria, and many more.

Unique Case Reports of Tooth Sensitivity After Consuming Tetrabenazine.

Tooth sensitivity (TS), a common discomfort manifests as hypersensitivity, sharp and rapid pain, or shock-like sensation in response to tactile, thermal, or chemical stimuli which others perceive as normal, affecting a significant percentage of the population. Tetrabenazine, a vesicular monoamine transport 2 receptor inhibitor acting on presynaptic neuronal endings, is commonly used in acute dystonia treatment. Two cases are reported here, where the patient, after consuming tetrabenazine (TBZ), was noted to have TS after a week of treatment.

A Case Report of Rare Presentation and Delay in the Diagnosis of Neuropathic Abdominal Pain Secondary to Asymptomatic Pott's Spine in Elderly Patients.

The presence of vertebral tuberculosis (TB) in developing countries and Southeast Asia is well known, but developed nations such as the USA and UK also claim a good share because of immigrants and the HIV population. We present a unique case series of two patients with chronic abdominal pain where various differentials and arduous investigation were employed. Finally, after a few months, we could locate the lower thoracic Pott's spine and commenced the treatment with successful resolution of symptoms.