Use of low-dose naltrexone in the management of chronic pain conditions: A systematic review.

Background: The authors aimed to evaluate the efficacy of low-dose naltrexone in the management of chronic pain conditions and determine its potential use in orofacial pain management.

Methods: A comprehensive literature review was completed in the PubMed/MEDLINE, Embase, Cumulated Index to Nursing and Allied Health Literature, Dentistry and Oral Sciences Source Library databases up through June 17, 2019, using terms such as neurogenic, inflammation, naltrexone, temporomandibular, and chronic pain. The primary outcome was reduction in pain intensity and, secondarily, improvement in quality of life.

Trendelenburg position: a tool to screen for the presence of a low CSF pressure syndrome in daily headache patients.

Objective: To test the hypothesis that the Trendelenburg position is an accurate screening investigation for the presence of a low cerebrospinal fluid (CSF) pressure syndrome in patients with daily headache.

Background: The Trendelenburg position causes a rapid increase in intracranial CSF pressure. In a patient with a known CSF leak who overtime had less improvement in the supine position, being placed in Trendelenburg rapidly alleviated her daily headache.

Elevation of CSF tumor necrosis factor alpha levels in new daily persistent headache and treatment refractory chronic migraine.

Objective: To determine if patients with new daily persistent headache (NDPH) have elevated levels of tumor necrosis factor alpha (TNF alpha) in the CSF.

Background: NDPH is considered one of the most treatment resistant of all headache syndromes. This reflects a lack of understanding of its pathogenesis.

Efficacy of intravenous diphenhydramine versus intravenous DHE-45 in the treatment of severe migraine headache.

This study was conducted to compare the efficacy of intravenous diphenhydramine with dihydroergotamine mesylate (DHE-45; Novartis International AG, Switzerland) in the treatment of severe, refractory, migraine headache. A retrospective review was conducted to include eighty randomly chosen patients who were admitted to the Michigan Head Pain & Neurological Institute's inpatient program at Chelsea Community Hospital. Patients had received nine doses of diphenhydramine or nine doses of DHE-45 during a 3-day period.