Hemicrania continua in a family: A report of two cases.

Objective: To report two cases of hemicrania continua (HC) in a mother and daughter.

Background: HC is a rare primary headache disorder belonging to the family of trigeminal autonomic cephalalgias (TACs). Unlike migraine, familial cases of TACs are rare, and we know relatively little of their inheritance pattern and genetic mechanisms.

Patient experience of telemedicine for headache care during the COVID-19 pandemic: An American Migraine Foundation survey study.

Objective: We sought to investigate the patient experience of telemedicine for headache care during the coronavirus disease 2019 (COVID-19) pandemic.

Background: The use of telemedicine has rapidly expanded and evolved since the beginning of the COVID-19 pandemic. Telemedicine eliminates the physical and geographic barriers to health care, preserves personal protective equipment, and prevents the spread of COVID-19 by allowing encounters to happen in a socially distanced way.

Fremanezumab as Add-On Treatment for Patients Treated With Other Migraine Preventive Medicines.

Background: Fremanezumab (formerly TEV-48125) is a monoclonal antibody directed against calcitonin-gene-related peptide (CGRP), a validated target for migraine preventive therapy. In two previous phase 2 studies, fremanezumab administered once every 28 days for 12 weeks was found to be effective and safe as a preventive treatment for patients suffering from episodic migraine (EM) and chronic migraine (CM).

Objective: To evaluate the efficacy and safety of fremanezumab as an add-on preventive therapy in individuals with EM and CM who are on stable doses of preventive migraine medications.

Update on New Daily Persistent Headache.

New daily persistent headache (NDPH) is an uncommon and under-recognized primary headache disorder. Clinically, NDPH may resemble migraine or tension-type headache. Unlike migraine or tension-type headaches, however, a distinguishing feature of NDPH is that the majority of patients with NDPH can pinpoint the exact date of onset of symptoms.

Safety, tolerability, and efficacy of TEV-48125 for preventive treatment of high-frequency episodic migraine: a multicentre, randomised, double-blind, placebo-controlled, phase 2b study.

Background: Calcitonin gene-related peptide (CGRP) is a validated target for the treatment of episodic migraine. Here we assess the safety, tolerability, and efficacy of TEV-48125, a monoclonal anti-CGRP antibody, in the preventive treatment of high-frequency episodic migraine.

Methods: In this multicentre, randomised, double-blind, placebo-controlled, phase 2b study, we enrolled men and women (aged 18-65 years) from 62 sites in the USA who had migraine headaches 8-14 days per month.

Trigeminal Autonomic Cephalalgias.

Purpose Of Review: This article reviews the clinical features of and treatment options for the trigeminal autonomic cephalalgias (TACs).

Recent Findings: The TACs are a group of primary headache disorders characterized by short-lasting episodes of severe unilateral headaches that are associated with ipsilateral cranial autonomic symptoms. The best known and most commonly seen TAC in clinical practice is cluster headache.

Sumatriptan Iontophoretic Transdermal System Reduces Treatment-Emergent Nausea and Is Effective in Patients With and Without Nausea at Baseline - Results From a Randomized Controlled Trial.

Objectives: To test the hypothesis that sumatriptan iontophoretic transdermal system (TDS) is associated with lower rates of treatment-emergent nausea (TEN) relative to placebo, as well as to compare the efficacy of sumatriptan TDS in migraineurs with or without nausea at baseline.

Methods: Participants of a double-blind, randomized, parallel-group, single-attack, placebo-controlled study conducted at 38 sites in the United States were analyzed. Participants who treated their migraine attacks while nausea-free were identified.

Why triptan treatment can fail: focus on gastrointestinal manifestations of migraine.

Background: Results of randomized, double-blind, controlled studies establish the efficacy of triptans in the acute treatment of migraine, but triptan benefits demonstrated in clinical trials have not consistently been realized in clinical practice. This paper explores the contribution of gastrointestinal manifestations of migraine--namely nausea (with or without vomiting) and gastroparesis--to triptan treatment failure.

Synthesis: Migraine-related nausea and vomiting and migraine-associated gastroparesis appear to be prevalent and highly impactful and have been characterized as being among the greatest challenges affecting migraine care today.

Migraine and vestibular symptoms--identifying clinical features that predict "vestibular migraine".

Background: Migraine and symptoms that may suggest a vestibular disorder (referred to herein broadly as vestibular symptoms-VS) often co-exist. In part due to a lack of standardized diagnostic criteria, this relationship remains unknown to many physicians.

Objective: To determine common clinical features that may be associated with "vestibular migraine" (VM).

Hemicrania continua: a second case in which the remitting form evolved from the chronic form.

We report the case of a woman with a 15-year history of chronic hemicrania continua, which over time evolved to remitting hemicrania continua. This is the second reported case in the literature documenting this transition.

Frovatriptan for acute treatment of migraine associated with menstruation: results from an open-label postmarketing surveillance study.

Aims: To examine the effectiveness and tolerability of acute treatment with frovatriptan in women experiencing menstrual migraine (MM) vs. female migraineurs with non-MM.

Methods: This was an open-label postmarketing surveillance study (n = 7107) conducted in Germany to assess acute treatment with frovatriptan in one to three migraine attacks.

Rebound abdominal pain: noncephalic pain in abdominal migraine is exacerbated by medication overuse.

Abdominal migraine usually has its onset during childhood or adolescence and resolves in adulthood, often being replaced by typical migraine headaches. Rarely, migraine headache and recurrent abdominal pain coexist in some patients during adulthood. We report a patient who developed abdominal migraine without headaches beginning for the first time at the age of 22 years.

Understanding the causes and prevention of menstrual migraine: the role of estrogen.

Menstruation increases the risk of migraine in susceptible women. In a subpopulation of women with menstrual migraine, headaches occurring in association with onset of menses may be more severe and of longer duration than headaches experienced by the same woman at other times of her menstrual cycle. Although menstrual migraines share many clinical characteristics of other types of migraines, their occurrence is predictable provided that the patient has regular menstrual cycles.

Hemicrania continua: a third case in which attacks alternate sides.

Hemicrania continua (HC) is an uncommon, primary headache disorder characterized by a continuous unilateral headache of moderate intensity with superimposed exacerbations of more severe pain. HC exists in two temporal subtypes, a continuous form in which headaches persist continuously without remission periods, and a less common remitting form in which bouts of continuous headaches are separated by pain-free remissions. There have been more than 100 prior reports of HC; in the majority of which the headache is strictly unilateral and without side shift.

Cluster headaches and related disorders.

The headache disorders described here are relatively rare, but probably are more common than previously thought. These disorders cause significant pain and disability, so recognition is essential as treatment response differs from that of migraine, tension-type, and cluster headaches. Table 4 reviews the important clinical features of these syndromes and contrasts them with cluster headache, the disorder for which they are often confused.