A 36-Year-Old Man with Persistent Headache.

AbstractMorning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient's chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case. This report examines the story of a 36-year-old man who sought evaluation for a persistent headache and numbness on the cheek.

Mitigating data quality challenges in ambulatory wrist-worn wearable monitoring through analytical and practical approaches.

Chronic disease management and follow-up are vital for realizing sustained patient well-being and optimal health outcomes. Recent advancements in wearable technologies, particularly wrist-worn devices, offer promising solutions for longitudinal patient monitoring, replacing subjective, intermittent self-reporting with objective, continuous monitoring. However, collecting and analyzing data from wearables presents several challenges, such as data entry errors, non-wear periods, missing data, and wearable artifacts.

Oxygen as an abortive therapy in cluster headache: a narrative review and clinical practice aspects.

Cluster headache (International Classification of Headache Disorders third edition, ICHD-3 3.1) is a primary headache disorder affecting around 0.12% of individuals.

Patients with chronic cluster headache may show reduced activity energy expenditure on ambulatory wrist actigraphy recordings during daytime attacks.

Objective: To investigate the changes in activity energy expenditure (AEE) throughout daytime cluster headache (CH) attacks in patients with chronic CH and to evaluate the usefulness of actigraphy as a digital biomarker of CH attacks.

Background: CH is a primary headache disorder characterized by attacks of severe to very severe unilateral pain (orbital, supraorbital, temporal, or in any combination of these sites), with ipsilateral cranial autonomic symptoms and/or a sense of restlessness or agitation. We hypothesized increased AEE from hyperactivity during attacks measured by actigraphy.

Migraine without aura.

Migraine without aura is the commonest form of migraine in both children and adults. The diagnosis is made by applying the International Classification of Headache Disorders Third Edition subsection for migraine without aura (ICHD-3 subsection 1.1).

Methodological considerations on real-world evidence studies of monoclonal antibodies against the CGRP-pathway for migraine: a systematic review.

Background: Real-world data are accumulating on the effectiveness, tolerability and safety of anti-calcitonin gene-related peptide pathway monoclonal antibodies for the preventive treatment of migraine. We performed a systematic review of the methodology of prospective, observational, clinic-based real-world evidence studies with these drugs in both episodic and chronic migraine.

Methods: The objectives were to evaluate the definitions and reported outcomes used, and to perform a risk of bias assessment for each of the different studies.

School Problems and School Support for Children with Narcolepsy: Parent, Teacher, and Child Reports.

Objective: To assess problems faced by children with type 1 narcolepsy (NT1) at school and obtain insight into potential interventions for these problems.

Methods: We recruited children and adolescents with NT1 from three Dutch sleep-wake centers. Children, parents, and teachers completed questionnaires about school functioning, interventions in the classroom, global functioning (DISABKIDS), and depressive symptoms (CDI).

Using natural language processing to automatically classify written self-reported narratives by patients with migraine or cluster headache.

Background: Headache medicine is largely based on detailed history taking by physicians analysing patients' descriptions of headache. Natural language processing (NLP) structures and processes linguistic data into quantifiable units. In this study, we apply these digital techniques on self-reported narratives by patients with headache disorders to research the potential of analysing and automatically classifying human-generated text and information extraction in clinical contexts.

Comparison and predictors of chronic migraine vs. new daily persistent headache presenting with a chronic migraine phenotype.

Objective: To compare the clinical phenotype of patients with chronic migraine (CM) to patients with new daily persistent headache of the chronic migraine subtype (NDPH-CM).

Methods: A study was conducted of CM (n = 257) and NDPH-CM (n = 76) from a tertiary headache center in the UK, and in the US of patients with daily CM (n = 60) and NDPH-CM (n = 22).

Results: From the UK cohort, the age of first headache onset was lower in CM (mean ± SD: 16 ± 12 years) than in NDPH-CM (mean ± SD: 23 ± 14 years; p < 0.

mBrain: towards the continuous follow-up and headache classification of primary headache disorder patients.

Background: The diagnosis of headache disorders relies on the correct classification of individual headache attacks. Currently, this is mainly done by clinicians in a clinical setting, which is dependent on subjective self-reported input from patients. Existing classification apps also rely on self-reported information and lack validation.

Epilepsy and Sleep in the ATR-X Syndrome.

Background: This study explores the prevalence, clinical characteristics, and treatment of epilepsy and sleep disorders in α thalassemia mental retardation (ATR-X) syndrome.

Design: In this cross-sectional study, 37 participants with ATR-X syndrome aged 1.8 to 44 years were studied using a customized epilepsy questionnaire, review of electroencephalography (EEG) findings, the modified Sleep Questionnaire of Simonds and Parraga and 2-week sleep diary.

Evaluation of treatment response and symptom progression in 400 patients with visual snow syndrome.

Aims: To gather information on useful medications to treat visual snow syndrome (VSS) as well as to validate an instrument to assess its clinical severity and the course of the disorder over time.

Methods: Four hundred patients with VSS were included in this web-based prospective questionnaire study. All subjects completed a treatment questionnaire and a clinical diary.

It is All in the Wrist: Wearable Sleep Staging in a Clinical Population versus Reference Polysomnography.

Purpose: There is great interest in unobtrusive long-term sleep measurements using wearable devices based on reflective photoplethysmography (PPG). Unfortunately, consumer devices are not validated in patient populations and therefore not suitable for clinical use. Several sleep staging algorithms have been developed and validated based on ECG-signals.

Role of Monoclonal Antibodies against Calcitonin Gene-Related Peptide (CGRP) in Episodic Migraine Prevention: Where Do We Stand Today?

Background: Medications targeting the calcitonin gene-related peptide (CGRP) pathway are exciting and novel therapeutic options in the treatment of migraine.

Objective: In this article, we have reviewed the role of these CGRP monoclonal antibodies in patients with episodic migraine.

Materials And Methods: We did an extensive literature search for all phase 2 and 3 studies involving CGRP monoclonal antibodies in episodic migraine.

Singular Value Decomposition for Removal of Cardiac Interference from Trunk Electromyogram.

A new algorithm based on singular value decomposition (SVD) to remove cardiac contamination from trunk electromyography (EMG) is proposed. Its performance is compared to currently available algorithms at different signal-to-noise ratios (SNRs). The algorithm is applied on individual channels.

Obstructive sleep apnea in people with intellectual disabilities: adherence to and effect of CPAP.

Purpose: Obstructive sleep apnea (OSA) is common in people with intellectual disabilities (ID), but in practice continuous positive airway pressure (CPAP) is often deemed unfeasible. We investigated adherence to and effect of CPAP in patients with ID and OSA.

Methods: Patients with ID were started on CPAP using an intensive training program.

The importance of specialized sleep investigations in children with a suprasellar tumor.

Purpose: Disruption of sleep has great impact on quality of life. In children with a suprasellar tumor and hypothalamic-pituitary dysfunction, the circadian rhythm may be disturbed causing sleep problems. However, also other factors may influence sleep.

Effect of treatment on cognitive and attention problems in children with narcolepsy type 1.

Study Objectives: To ascertain the presence of cognitive and attention problems in treatment naïve children with narcolepsy type 1 (NT1) and to explore whether children recently diagnosed with NT1 improve with respect to cognition and attention problems 1 year after regular treatment for NT1.

Methods: A total of 15 treatment naïve children (7-15 years) with recently diagnosed NT1 were recruited from three sleep medicine centers in the Netherlands. The control group consisted of 15 healthy children, being frequency matched on age and gender.

The Many Faces of Medication-Overuse Headache in Clinical Practice.

The management of medication-overuse headache (MOH) is multifaceted and headache experts have different views on the optimal strategy to tackle this type of secondary headache. The purpose of this review is to provide an overview of the literature on the management of MOH, and to highlight important considerations in the clinical evaluation of the MOH patient. Managing MOH in clinical practice starts by evaluating the headache patient with medication overuse, determining the overused drug(s), assessing the impact of headaches on the patient and assessing comorbid conditions and disorders.

Protocol of the SOMNIA project: an observational study to create a neurophysiological database for advanced clinical sleep monitoring.

Introduction: Polysomnography (PSG) is the primary tool for sleep monitoring and the diagnosis of sleep disorders. Recent advances in signal analysis make it possible to reveal more information from this rich data source. Furthermore, many innovative sleep monitoring techniques are being developed that are less obtrusive, easier to use over long time periods and in the home situation.

The impact of delayed sleep phase disorder on adolescents and their family.

Introduction: We investigated the impact of delayed sleep phase disorder (DSPD) on the daily lives of adolescents and their families.

Method: In this qualitative study, six adolescents with DSPD, and six parents were given in-depth interviews. Using thematic analysis, we merged open codes into themes that reflected the impact of the disorder.

The discovery and development of inhaled therapeutics for migraine.

Migraine is a disabling primary headache disorder that requires effective treatments. Inhalation is currently being explored for the delivery of drugs for migraine. Pulmonary-route delivery of drugs shows potential advantages for its use as a treatment, particularly compared the oral route.