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- 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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| 2. |
- 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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| 3. |
- 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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