Izabela Domitrz

Relationship between migraine and patent foramen ovale: a study of 121 patients with migraine.

Background.—Migraine is a common neurological disorder, the origins of which remain unknown. Patent foramen ovale (PFO) is considered to have a role in migraine. The relationship between migraine and patent foramen ovale may be stronger in patients suffering from migraine with aura compared to patients with common migraine.

Airplane headache: a further case report of a young man

Headache with normal examinations and imaging, occurring during an airplane flight has been rarely reported. We present a young patient with a new type of headache that appeared during flights: take-off and landing of a plane and was not associated with other conditions. This airplane headache is rather rare in population and the pathophysiology of this type is not clear. Secondary causes must be ruled out before the diagnosis of a primary headache is made.

Paroxysmal Non-Kinesigenic Dyskinesia Caused by the Mutation of MR-1 in a Large Polish Kindred

Paroxysmal non-kinesigenic dyskinesia (PNKD) is a clinical syndrome of sudden involuntary movements, mostly of dystonic type, which may be triggered by alcohol or coffee intake, stress and fatigue. The attacks of PNKD may consist of various combinations of dystonia, chorea, athetosis and balism. They can be partial and unilateral, but mostly the hyperkinetic movements are bilateral and generalized. We present a large Polish family with 7 symptomatic members of the family in 6 generations. In all affected persons, the onset of clinical symptoms was in early childhood. All male cases showed an increase in severity and frequency of the attacks with ageing, while the only living female patient noticed an improvement of PNKD during both her pregnancies and also after menopause. In addition, at the age of 55 years, she developed symptoms of Parkinson’s disease with good response to levodopa treatment.

An Association Between Migraines and Heart Anomalies—True or False? A Heart Ultrasound Study Using cTTE in Migraine Patients and Control Participants

DESIGN A migraine is a common neurological disorder that often coexists with other illnesses including heart abnormalities, such as patent foramen ovale (PFO), atrial septal aneurysm (ASA), and mitral valve prolapse (MVP). OBJECTIVE The aim of our study was to evaluate the occurrence of some heart abnormalities in migraine patients by routine and contrast transthoracic echocardiography. SUBJECTS AND METHODS We assessed the occurrence of PFO, ASA, and MVP in 96 patients with migraine without aura (87 females), in 62 patients with migraine with aura (41 females) and in 53 healthy persons (40 females). RESULTS In comparison with our control group, only the prevalence of PFO was statistically higher in patients with migraine (P = 0.03) and especially with aura (P = 0.01). We did not find any statistically significant differences between the occurrence of ASA or MVP in migraine and control groups. CONCLUSION The results of our study raise the question of the hearts role in the mechanism of migraine attacks. If the occurrence of migraine with aura had been related to some heart abnormalities, the pathophysiology of migraine attacks may have some connection to some heart dysfunction. Resolving the association between migraine and comorbid cardiac conditions might shed light on the underlying mechanisms of migraines and even result in a different treatment strategy. However, we do not find any clear connection between PFP, ASA, and MVP, and migraine occurrence.

Frequency and clinical characteristics of chronic daily headache in an outpatient clinic setting.

BACKGROUND AND PURPOSE Chronic daily headache (CDH) is not a diagnosis but a category that includes many disorders representing primary and secondary headaches. According to the International Classification of Headache Disorders, 2nd edition (ICHD-II), CDH is defined as headache which occurs more often than 15 days per month for at least 3 months. MATERIAL AND METHODS We assessed 1154 headache sufferers diagnosed in our headache outpatient clinic. Clinical history, physical and neurological examination, and laboratory tests were performed to make a diagnosis. RESULTS CDH was diagnosed according to ICHD-II in 185 (16%) patients; their mean age was 41±17 years (80% were women). Chronic migraine was a cause of CDH in 49% (91/185) of patients, chronic tension-type headache in 18% (33/185), secondary headache in 25% (46/185) and unclassified pain in 8%. Medication overuse headache occurred in 15%. The most effective therapy in our patients was treatment with tricyclic antidepressants and selective serotonin reuptake inhibitors. CONCLUSIONS The most frequent cause of CDH in our cohort was chronic migraine. Women suffered more frequently than men. Antidepressants were the most effective preventive medications for all types of CDH, which may suggest that serotoninergic mechanisms can be an important factor in the pathophysiology of chronic pain syndromes.

Migraine frequency and its association with dyslipidemia in women

BACKGROUND Some studies have shown a higher occurrence of unfavorable lipid profile in women with migraine as compared to the general population. AIM The aim of our study was to assess the link between lipid profile and the frequency of migraine attacks. PATIENTS AND METHODS 64 female migraine patients, mean age 40 ± 10.84 years and mean duration of the disease 18.52 ± 7.57 years, were included into the study. Lipid profile (total cholesterol, TC; low-density lipoprotein cholesterol, LDL-C; high-density lipoprotein cholesterol, HDL-C; triglycerides, TG) was evaluated in all migraine patients. Frequency of migraine attacks was calculated from the amount of migraine episodes within the last 3 months. RESULTS The correlation between TC and TG and the frequency of the migraine attacks were statistically significant. CONCLUSION TC and TG values may have an influence on migraine severity and also contribute to the increased risk of cardiovascular diseases, especially in women.

Determination of the Cognitive Model: Compressively Sensed Ground Truth of Cerebral Ischemia to Care

Reported research concerns optimized methods of computerized clinical decision support on the example of stroke care management. New paradigm of compressive cognition is presented and discussed including implementation of the proposed empirical model designed to improve ischemia description and aid reperfusion therapy. The concept of semantic compressed sensing was developed to analyze clinically conditioned consensus of ground truth formulated basing on semantic descriptors of objectified expert ratings, interview data analysis, monitoring of vital signs, lab measurements, the results of physical examinations and imaging studies. The designated sparse model allows determining the interrelationship between subjective interpretations of physicians completing comprehensive picture of pathology in emergency conditions. According to the experiments carried out, the obtained effectiveness of stroke diagnosis and prediction of the effects of applied therapy is very high. The potential benefit is not only important for the patient and the physician, but also for the whole society, by significantly reducing the socio-economic costs of caring for a stroke patient.

Stroke Bricks – The Segments of Interests to Localize Early Stages of the Ischemia Evolution

The purpose of neuroimaging in stroke diagnosis is to visualize early phases of brain ischemia evolution. Different forms of computerized support are often affected by the presence of many false over-interpretation areas, thus it is of great interest to provide neurologically verified regions in order to improve the accuracy of ischemia assessment. We propose Stroke Bricks (StBr) as an arbitrary spatial division of brain into the block of tissues associated with specific clinical symptoms of ischemic stroke. Neurological stroke deficits are translated into respective areas of possible ischemia on the basis of arbitrarily proposed symptoms-regions mapping rules. StBr concept may be useful for an integrated radiological CT-based assessment of suspected stroke cases or can be included into computer-aided tools to optimize the evaluation of stroke site and its extent.

Impairment of neuromuscular transmission in transient global amnesia - does it really exist?

BACKGROUND The main hypotheses regarding mechanisms of transient global amnesia (TGA) are ischemia in hippocampal structures, epileptic genesis, and migraine. In accordance with the hypothesis of a shared, common pathophysiological mechanism in both TGA and migraine, neuromuscular transmission (NMT) abnormalities previously found in migraine were also suspected in TGA. OBJECTIVE The aim of our study was to analyze NMT in TGA patients to reveal a subclinical impairment of neuromuscular transmission as a possible indicator of underlying channelopathy, which would point to a shared etiology with migraine. MATERIALS AND METHODS The study group consisted of 15 patients (6 males) with TGA (mean age 69.5±7.4yrs). The duration of amnesia ranged from 1 to 6h (mean 4.4h). Single fiber electromyography (SFEMG), the most sensitive tool for NMT assessment, of the voluntarily activated frontal muscle was performed 1-5 days after a TGA incident. RESULTS Abnormal SFEMG was found in 1 patient (6.6%). In all other patients, SFEMG was in the normal range. CONCLUSION Our neurophysiological study does not confirm NMT defects in TGA. The role of channelopathy with NMT dysfunction in the pathogenesis of TGA is rather unlikely, whereas subclinical NMT abnormalities were certainly proven in migraine.