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| 2. |
- Carlsson, Jane, 1946, et al.
(författare)
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Fysioterapi vid huvudvärk hos barn och ungdomar
- 2009
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Ingår i: Migrän och spänningshuvudvärk hos barn och tonåringar, Bo Larsson (red). - Lund : Studentlitteratur. - 9789144048277 ; , s. 113-123
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- Återkommande huvudvärk är ett av de vanligaste hälsoproblemen bland barn och tonåringar. Tecken finns också som tyder på att ofta förekommande huvudvärk under senare år har ökat i förekomst i dessa åldersgrupper. Den är också kopplad till ökad förekomst av andra kroppsliga besvär och psykiska problem, nedsatt funktion i vardagen och sämre livskvalitet. Prognosen på såväl kort som lång sikt är också osäker för dessa individer. De vanligaste formerna av återkommande huvudvärk bland barn och ungdom, som inte beror på annan bakomliggande kroppslig eller psykisk sjukdom, är migrän och spänningshuvudvärk. Under senare år har kunskapen om förekomst, prognos, orsaker till sådan huvudvärk och psykosociala faktorer avsevärt ökat liksom om vilken behandling med läkemedel, psykologiska eller fysioterapeutiska metoder som kan minska besvären. Föreliggande bok är en starkt omarbetad upplaga av den första som utgavs till smärtåret 1998. Avsikten har varit att uppdatera innehållet i ljuset av senare års forskning och starka kunskapsutveckling. Då återkommande huvudvärk hos barn och ungdom är ett negligerat och starkt underbehandlat hälsoproblem är det en förhoppning att boken kan bidra till att fler får effektiv hjälp av det som finns att erbjuda i hälsovården. Förhoppningsvis ger boken också ett bättre underlag i valet av lämpliga bedömings- och behandlingsmetoder för dem som möter barn och ungdom med återkommande huvudvärk. Boken riktar sig främst till personal inom hälso- och sjukvård, men vänder sig också till tonåringar med återkommande huvudvärk, föräldrar, lärare och andra som vill öka sin kunskap och förståelse om detta angelägna hälsoproblem.
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| 3. |
- Dahlöf, Carl, 1947, et al.
(författare)
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Huvudvärk : Fakta, frågor och svar
- 2005
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Boken beskriver hur man diagnostiserar och behandlar huvudvärk samt vad de olika tillstånden kan bero på. Dessutom redovisas kända alternativa behandlingsformer, allt från akupunktur till huskurer. Under de senaste åren har närmare 100 brev med frågor, intressanta funderingar och tips kommit in till författarna från personer runt om i Sverige med olika sorters huvudvärk. Dessa brev redovisas, besvaras och kommenteras i respektive kapitel. Boken är avsedd för vårdpersonal och patienter.
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| 7. |
- Hedenrud, Tove, 1967, et al.
(författare)
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Beliefs about medicines and adherence among Swedish migraineurs.
- 2007
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Ingår i: The 13th Congress of the International Headache Society, Stockholm, juni 2007..
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Konferensbidrag (refereegranskat)abstract
- Objective The aim was to analyze whether beliefs about medicines are associated with adherence to prophylactic medication among Swedish migraineurs. Methods A questionnaire was distributed consecutively to migraineurs attending a tertiary clinic. All participants were prescribed prophylactic medication. The questionnaire comprised e.g. background questions, beliefs about medicines (BMQ), and self-reported adherence (MARS). The General BMQ comprises three subparts: General Harm, General Overuse, and General Benefit. The specific part of the BMQ has two subparts: Specific Necessity and Specific Concerns. For the BMQ Specific, a necessity–concerns differential was calculated for each participant. A logistic regression analysis was performed to analyze the association between beliefs about medicines and adherence to prophylactic medication. Results Of the 175 participants, 15% were male and more than half of the participants were aged 45 years and over. Fifty percent had a university degree. Sixty-four percent were considered adherent. There was no significant difference in adherence between gender, age groups, or by educational level. Respondents with only compulsory school were less concerned about the long-term effects of medications and had a higher necessity–concern differential. In the logistic regression analysis, no variable was significantly associated with adherence. Conclusions The present study showed no association between beliefs about medication and adherence. We recommend that lack of adherence to migraine prophylactic drugs should be considered more often, looked for, and addressed in order to identify sufferers with an unnecessarily high migraine-associated disability. This assumes greater attention to the problem amongst both physicians and researchers in all countries.
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| 8. |
- Jonsson, Pernilla, 1978, et al.
(författare)
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Epidemiology of medication overuse headache in the general Swedish population
- 2011
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Ingår i: Cephalalgia. - : SAGE Publications. - 0333-1024 .- 1468-2982. ; 31:9, s. 1015-1022
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Tidskriftsartikel (refereegranskat)abstract
- Aims: The aim was to estimate the prevalence of medication overuse headache (MOH) in Sweden and to analyze the occurrence of this disorder in different population groups. Methods: A total of 44,300 randomly selected individuals (55% women), aged 15 years and above, were interviewed in a national telephone survey, using a standardized questionnaire including the International Headache Society criteria for MOH and questions about sociodemographic factors, headache history and medication use. Results: In Sweden, 3.2% (95% confidence interval (CI) 3.1–3.4), n¼1428) suffer from chronic daily headache (CDH) and out of those, 56% (n¼799) have MOH. The prevalence of MOH is 1.8% (95% CI 1.7–1.9). The mean age of onset was higher among men than women as well as among those with tension-type headache as primary headache compared to those who originally had migraine. A multivariate analysis showed that socioeconomic factors such as having a low level of education and/or a low household income were associated with MOH. Conclusions: This is the first Swedish population-based study of MOH and we conclude that MOH is a significant public health problem in Sweden, as it is in other parts of the world.
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| 9. |
- Jonsson, Pernilla, 1978, et al.
(författare)
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Holding on to the indispensable medication –A grounded theory on medication use from the perspective of persons with medication overuse headache
- 2013
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Ingår i: Journal of Headache and Pain. - : Springer Science and Business Media LLC. - 1129-2369 .- 1129-2377. ; 14:43, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- Background: Medication overuse headache (MOH) is a chronic headache disorder, caused by overuse of acute medication. To date, it remains unclear why some people overuse these medications. The aim of this qualitative study was to explore how individuals with MOH use medications and other strategies to manage headaches in their daily lives, and their thoughts about their own use of acute medication. Our intention was to develop a theoretical model about the development of MOH, from the perspective of those with MOH. Methods: Data collection and analysis were conducted according to grounded theory methodology. The participants were recruited via newspaper advertisements. Fourteen persons with MOH were interviewed in individual qualitative interviews. Results: The basic process leading to medication overuse was holding on to the indispensable medication. The acute medication was indispensable to the participants because they perceived it as the only thing that could prevent headaches from ruining their lives. The participants perceived headaches as something that threatened to ruin their lives. As a result, they went to great lengths trying to find ways to manage it. They tried numerous strategies. However, the only strategy actually perceived as effective was the use of acute medication and they eventually became resigned to the idea that it was the only effective aid. The acute medication thus became indispensable. Their general intention was to use as little medication as possible but they found themselves compelled to medicate frequently to cope with their headaches. They did not like to think about their medication use and sometimes avoided keeping track of the amount used. Conclusions: This qualitative study adds understanding to the process via which MOH develops from the perspective of those having MOH. Such knowledge may help bridge the gap between the perspectives of patients and health-care professionals.
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| 10. |
- Jonsson, Pernilla, 1978, et al.
(författare)
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Sociodemographic differences in medication use, health-care contacts and sickness absence among individuals with medication-overuse headache
- 2012
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Ingår i: Journal of Headache and Pain. - : Springer Science and Business Media LLC. - 1129-2369 .- 1129-2377. ; 13:4, s. 281-290
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to analyse sociodemographic differences in medication use, health-care contacts and sickness absence among individuals with medication-overuse headache (MOH). A cross-sectional, population survey was conducted, in which 44,300 Swedes (a parts per thousand yen15 years old) were interviewed over telephone. In total, 799 individuals had MOH. Of these, 47 % ( = 370) only used over-the-counter medications. During the last year, 46 % ( = 343) had made a headache-related visit to their physician and 14 % ( = 102) had visited a neurologist. Among individuals aged < 30 years, the number of days/month with headache was greater than the number of days with medication use, whereas the opposite was true for those a parts per thousand yen30 years. Both the proportion using prophylactic medication and the proportion having consulted a neurologist were smaller among those who only had elementary school education than among those with higher education ( = 0.021 and = 0.046). Those with a lower level of education also had a higher number of days/month with headache and with medication use than those with a higher educational level ( = 0.011 and = 0.018). The MOH-sufferers have limited contacts with health-care and preventive measures thus need to include other actors as well. Particular efforts should be directed towards those with low educational levels, and more research on medication use in relation to age is required.
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| 11. |
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| 12. |
- Laurell, Katarina, et al.
(författare)
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Migrainous infarction : a Nordic multicenter study
- 2011
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Ingår i: European Journal of Neurology. - : Wiley-Blackwell. - 1351-5101 .- 1468-1331. ; 18:10, s. 1220-1226
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Migrainous infarction (MI), i.e., an ischemic stroke developing during an attack of migraine with aura is rare and the knowledge of its clinical characteristics is limited. Previous case series using the International Classification of Headache Disorders (ICHD) included <10 cases which make conclusions less valid. This study aimed to describe characteristics and outcome of MI in a larger sample.METHODS: We analyzed demographic data, risk factors, migraine medication, stroke localization, symptoms, and outcome in a sample of 33 patients with MI according to second edition of the ICHD criteria collected from seven Nordic headache clinics.RESULTS: Amongst 33 patients with MI, there were 20 (61%) women and 13 (39%) men with the median age for stroke of 39 (range 19-76) years. Traditional risk factors for stroke were rare compared with Scandinavian young ischemic stroke populations. During the acute phase, 12 (36%) patients used ergotamines or triptans. Stroke was located in the posterior circulation in 27 (82%) patients and cerebellum was involved in 7 (21%). Except in two patients with brainstem infarctions, the outcome was favorable with total recovery or limited residual symptoms.CONCLUSIONS: The prevalence of traditional risk factors was low and the infarctions were predominantly located in posterior circulation territory, supporting theories of migraine specific mechanisms. The outcome was in general favorable.
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| 13. |
- Linde, Mattias, 1966
(författare)
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A clinical image of migraine. On prevalence, impact of disease, natural course of attacks and influence of 5-HT1B/1D-agonists
- 2005
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The first, large nationwide survey of the epidemiology of migraine in Sweden was performed. The one-year prevalence is 13.2 b1.9% (16.7% among women and 9.5% among men). No more than half of the migraineurs have been diagnosed by a physician, and only 76% of those who believed that they had migraine fulfilled the strict IHS criteria for migraine. In a subsequent postal questionnaire survey, the mean attack frequency was 1.3 per month. Thus the number of attacks per year among Swedish adults is approximately 10 million. The minority of sufferers have the majority of all attacks. The mean attack duration was 19 hours. A considerable number of individuals reported attacks shorter than 4 hours or longer than 72 hours. An extension of the time window 4¡V72 hours may thus be reasonable. Less than half of the individuals recovered completely between the attacks. In spite of this, only every fourth one was a current consulter of a physician. A majority of the migraineurs reported absence from school or work, a negative influence of migraine on the most important factors of life, and an interest in testing other treatments for migraine. There is room for improvement in the management of migraine in Sweden.In the first study designed to prospectively document the natural course of untreated migraine attacks in detail, a new integrated time-intensity method for self-assessment of the key symptoms was tested. There is no simple relationship between the point of time and intensity of symptoms, and the characteristic symptoms usually follow each other in a similar course, which supports the notion of a reciprocal underlying pathophysiological mechanism. Triptan therapy frequently only temporarily distorts the basic pattern of attacks.In a prospective, cross-over study, two attacks were treated with subcutaneous sumatriptan as early as possible and two attacks as late as the patients could bear. No significant differences were found in any efficacy parameter, and a majority of the patients claimed that their medication was equally effective when given early as when given late in the course of the attack. The findings do not support the present paradigm, that migraineurs are less responsive to late treatment as a result of central sensitization. The clinical experience that sumatriptan influences the perception of tactile and thermal stimuli in humans was tested in a randomized, double-blind, placebo-controlled cross-over study. It was found that sumatriptan 6 mg subcutaneously caused allodynia of short duration. This could explain some of the temporary sensory sideeffects of triptans and warrants consideration in the interpretation of studies on migraine-induced allodynia.
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| 14. |
- Linde, Mattias, 1966, et al.
(författare)
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Adherence to migraine prophylaxis at a Swedish tertiary clinic. A cross-sectional study of influence of disease features
- 2007
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Ingår i: The 13th Congress of the International Headache Society, Stockholm, juni 2007.
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Konferensbidrag (refereegranskat)abstract
- Introduction The efficacy of mainly the more recently developed prophylactic treatments of migraine have been well established in a large number of randomised controlled trials. However, such trials tend to focus on the effects of the drug in an ideal setting and rather underestimate the impact of non-compliance, which generally escapes detection by the physician. This poorly understood phenomenon was further looked at in a naturalistic setting. Methods A consecutive sample of 175 migraineurs (85% women, mean age 4512, range 19-79 years) with a current prescription of pharmacological prophylaxis were studied at a Swedish headache specialist clinic. Adherence was self-reported with the Medication Adherence Report Scale (MARS, possible range of scores 5-25). Logistic regression analysis was performed to analyze the association between MARS and frequency of attacks, number of days with migraine per month, attack duration, presence of prodrome (68%), presence of aura (41%, some or all attacks), mean intensity of pain, and recovery between attacks. Results The mean frequency of migraine was 6.5 days / month, and 68% did not recover completely interictally. The mean MARS score was 22.52.8. One third (35%) was not highly adherent. Neither demographic characteristics, nor any of the studied disease specific variables were significantly associated with adherence. Discussion The full benefit of prophylactic migraine medication cannot be realised at currently achieved levels of adherence. Characteristics of the headaches per se are the starting point of patients’ decision-making. However, the present study indicates that other factors play a more important role in this complicated process.
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| 15. |
- Linde, Mattias, 1966, et al.
(författare)
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Attitudes and burden of disease among self-considered migraineurs--a nation-wide population-based survey in Sweden
- 2004
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Ingår i: Cephalalgia. ; 24:6, s. 455-65
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Tidskriftsartikel (refereegranskat)abstract
- The authors have earlier reported a 1-year prevalence of 13.2 +/- 1.9% for migraine in Sweden. This is a subsequent extensive postal survey of the burden of disease and attitudes among migraineurs in a sample (n = 423, 23% men and 77% women, aged 18-74 years) randomly recruited from all main regions of the country, representative of adults in the general Swedish population with self-considered migraine. Results are presented only from participants who after analysis of symptoms were found to fulfil the International Headache Society's migraine criteria. In order to assess headache duration open-mindedly, the strict time criterion 4-72 h was deliberately disregarded as an inclusion criterion. Individuals who did not consider themselves to have migraine were excluded. Less than half of the group (45%) had received a diagnosis of migraine from a physician. Accordingly, a large number of individuals that would not have come to attention in a clinic-based study have been included. The mean attack frequency was 1.3 per month, and the number of attacks per year in Swedish adults is approximately 10 million. A minority (27%) of sufferers have a majority (68%) of all attacks. The mean attack duration was 19 h. A considerable number of individuals reported attacks < 4 h (15.8%) or > 72 h (6.4%). Less than half of the individuals recovered completely between the attacks. Despite this, only every fourth (27%) participant was currently consulting a physician (6% regularly; 21% occasionally). Most of the migraineurs reported absence from school or work, a negative influence of migraine on the most important aspects of life, and an interest in testing other treatments for migraine during the last year. Of those (n = 231) migraineurs who had consulted a physician, about 60% were satisfied with information given or treatment offered. This implies, however, that there is still room for improvement in the management of migraine in Sweden.
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| 18. |
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| 19. |
- Linde, Mattias, 1966
(författare)
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Pathophysiology of headache in children and adolescents
- 2009
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Ingår i: Migraine and tension type headache in children and adolescents. Ed Larsson B. - Lund : Studentlitteratur. - 9789144048277 ; , s. 31-40
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 20. |
- Linde, Mattias, 1966, et al.
(författare)
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[Prophylactic bedrest against post-lumbar puncture headache should not be routinely used in all patients]
- 2004
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Ingår i: Läkartidningen. ; 101:6, s. 466-9
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Tidskriftsartikel (refereegranskat)abstract
- Headache after lumbar puncture (PPH) is a common clinical problem, and occurs more frequently in patients with prepuncture headache. Bedrest after extraction of the needle has been recommended as prophylaxis for over a century. In a nation-wide survey, it was found that a majority of Swedish clinics kept all patients in a recumbent position for 30-90 minutes or longer. Many patients find enforced bedrest after lumbar puncture disagreeable, and every second person does not follow the recommendation. There is no good evidence from randomised trials to suggest that routine bedrest after dural puncture is beneficial. On the contrary, there are data in support of an increase of PPH after prolonged recumbency. Presumably, all cases should not be handled similarly. Based on present knowledge, it is suggested that patients free of headache during the last week before lumbal puncture are to be mobilised immediately.
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| 21. |
- Linde, Mattias, 1966, et al.
(författare)
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Role of the needling per se in acupuncture as prophylaxis for menstrually related migraine: a randomized placebo-controlled study.
- 2005
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Ingår i: Cephalalgia : an international journal of headache. - : SAGE Publications. - 0333-1024. ; 25:1, s. 41-7
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Tidskriftsartikel (refereegranskat)abstract
- The objectives were to introduce a new method for controlled trials of acupuncture in the field of headache research and to examine the role of needling per se. Women with menstrually related migraine were randomized to three months of treatment with verum or placebo needles. Three standard size casts were moulded to secure the placebo needles in the head. No significant differences were found between the verum group (n=15) and the placebo group (n=13) during treatment or follow up three and six months later, either in the attack frequency or in the number of days per month with migraine, headache intensity or drug-use. The casts held the needles exactly in place despite movements of the head, and are validated as practical, hygienic and extremely durable. This method is satisfactory for controlled studies of acupuncture in headache. It is possible that the positive results in earlier clinical trials on acupuncture in migraine are attributable to other mechanisms than needling of subcutaneous tissue.
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| 22. |
- Linde, Mattias, 1966, et al.
(författare)
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Subcutaneous sumatriptan provides symptomatic relief at any pain intensity or time during the migraine attack
- 2006
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Ingår i: Cephalalgia. ; 26:2, s. 113-21
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Tidskriftsartikel (refereegranskat)abstract
- Over the years the paradigm of treating early during the migraine attack has become well established in clinical practice. It is also recommended that the 5-HT(1B/1D) agonists be administered early during the migraine attack for efficacy. This is because it has been proposed that most migraineurs are less responsive to delayed treatment, owing to the development of central sensitization of the pain transmission. The main objective of this prospective, cross-over study at a specialist clinic was to evaluate if these recommendations should also apply to the subcutaneous formulation of sumatriptan. Results are based on 20 adult International Headache Society migraineurs. Two attacks (n=40) were treated with 6 mg subcutaneous sumatriptan as early as possible after the onset of migraine headache and two attacks (n=40) as late as the patients could bear. The median intra-individual difference between the two strategies in time from first occurrence of pain to injection was 5.7 h and the median intra-individual difference in pain intensity at the time of injection was 29 visual analogue units. No significant differences were found in time to freedom from pain, pain severity at 1 and 2 h, area under the curves from injection to pain free or in headache recurrence after injection. At the end of the study, most of the patients claimed that their medication was as effective when given early as when given late in the course of the attack. The discrepancy between our present findings and retrospective analyses of trials on oral triptans probably has more to do with the less disturbed pharmacokinetics early during the migraine attack than with central sensitization. Consequently, we recommend nonoral formulations of triptans, which do not necessarily have to be administered early during the migraine attack to provide efficacy. In conclusion, it is reassuring for migraineurs that it is worthwhile taking their medication in an appropriate formulation even if they have not been able to do so early in the course of the attack.
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| 23. |
- Linde, Mattias, 1966, et al.
(författare)
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Sumatriptan (5-HT1B/1D-agonist) causes a transient allodynia.
- 2004
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Ingår i: Cephalalgia : an international journal of headache. - : SAGE Publications. - 0333-1024. ; 24:12, s. 1057-66
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Tidskriftsartikel (refereegranskat)abstract
- Unpleasant sensory symptoms are commonly reported in association with the use of 5-HT1B/1D-agonists, i.e. triptans. In particular, pain/pressure symptoms from the chest and neck have restricted the use of triptans in the acute treatment of migraine. The cause of these triptan induced side-effects is still unidentified. We have now tested the hypothesis that sumatriptan influences the perception of tactile and thermal stimuli in humans in a randomized, double-blind, placebo-controlled cross-over study. Two groups were tested; one consisted of 12 (mean age 41.2 years, 10 women) subjects with migraine and a history of cutaneous allodynia in association with sumatriptan treatment. Twelve healthy subjects (mean age 38.7 years, 10 women) without migraine served as control group. During pain- and medication-free intervals tactile directional sensibility, perception of dynamic touch (brush) and thermal sensory and pain thresholds were studied on the dorsal side of the left hand. Measurements were performed before, 20, and 40 min after injection of 6 mg sumatriptan or saline. Twenty minutes after injection, sumatriptan caused a significant placebo-subtracted increase in brush-evoked feeling of unpleasantness in both groups (P < 0.01), an increase in brush-evoked pain in migraineurs only (P = 0.021), a reduction of heat pain threshold in all participants pooled (P = 0.031), and a reduction of cold pain threshold in controls only (P = 0.013). At 40 min after injection, no differences remained significant. There were no changes in ratings of brush intensity, tactile directional sensibility or cold or warm sensation thresholds. Thus, sumatriptan may cause a short-lasting allodynia in response to light dynamic touch and a reduction of heat and cold pain thresholds. This could explain at least some of the temporary sensory side-effects of triptans and warrants consideration in the interpretation of studies on migraine-induced allodynia.
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| 24. |
- Linde, Mattias, 1966, et al.
(författare)
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The natural course of migraine attacks. A prospective analysis of untreated attacks compared with attacks treated with a triptan
- 2006
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Ingår i: Cephalalgia. ; 26:6, s. 712-21
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Tidskriftsartikel (refereegranskat)abstract
- This study was designed to document prospectively and explore scientifically the natural course of untreated migraine attacks in detail. A new, integrated, time-intensity method for self-assessment of the intensity of symptoms was tested on 18 adult International Headache Society migraineurs who volunteered to refrain from treatment during one attack. The area under the curves (AUC) during 72 h of untreated attacks was compared with attacks treated with a triptan. Migraine attacks are heterogeneous both inter- and intra-individually. In untreated attacks, the pain can stabilize and fluctuate around a plateau with a wavelength of hours. In general, the symptoms of each separate migraine attack follow a similar temporal course, with only moderate deviations. In some cases photo- and/or phonophobia (hyperexcitability) were not experienced at all, despite severe pain and nausea. Moreover, there was sometimes no nausea despite severe pain and hyperexcitability. Vomiting does not always correlate to the intensity of nausea and is not always followed by decreased headache intensity. Treatment with a triptan usually only temporarily distorts the basic pattern of attacks. Hyperexcitability can respond before pain to treatment. These genuine findings of the classic symptoms of migraine attacks support the notion of a mutual underlying pathophysiological mechanism.
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| 25. |
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