Current Journal of Neurology
Volume:10 Issue: 3, Autumn 2011

Migraine is a prevalent disease which is classified into two groups of migraine with aura and without aura. Eighteen percent of women and 6.5 percent of men in United States have migraine headache. Migraine headache is prevalent in all age groups but it usually subsides in adults above fifty. Migraine has many risk factors such as stress, light, tiredness, special foods and beverages. The aim of this study was the evaluation of the effects of body mass index (BMI) on the treatment of migraine headaches. All patients assigned to four groups according to their BMI. Patients with more than three attacks per month received Nortriptyline and propranolol for eight weeks. The frequency, duration and severity of pain were measured by visual analogue scale (VAS) and behavioral rating scale (BRS-6) in regular intervals. 203 patients completed the study. 153(75%) subjects were women and 50(25%) were men. Mean age of patients was 30.5 ± 7.1 years. Mean weight was 80.4 ± 14.1 kg and mean height was 1.67 ± 0.07 m. Pain frequency and duration showed statistically significant differences among four groups with better response in patients with lower BMI (P < 0.0001). VAS and BRS-6 scales showed statistically significant differences among four groups in favor of patients with lower BMI (P < 0.0001). This study showed that obesity has a direct influence on the treatment of migraine headaches. It could be recommended to patients to reduce their weight for better response to treatment. In addition, care should be taken about migraine drugs which make a tendency for increased appetite.

Migraine is one of the most common headaches that affect 11% or more adult population. Recently, researchers have designed two questionnaires, namely Headache Impact Test (HIT) and Migraine Disability Assessment (MIDAS), with the aim of improving migraine care. These two tests provide a standard measurement about migraine’s effects on people's life style that divide patients into 4 groups (grades) based on headaches intensity. The aim of this study was to compare the validity and reliability of these two tests. This study was designed as a multicenter, descriptive study to compare validity and reliability of Persian version of MIDAS and HIT questionnaires in 240 males and females with a migraine diagnosis according to criteria for headache and facial pain of the International Headache Society (IHS). The patients were enrolled in the study from 3 neurology clinics in Isfahan, Iran, between July2004 and January 2005 and were evaluated at baseline (visit 1) and 4 weeks later (visit 2). According to our study, there was a high correlation between two tests (r = 0.94). This decreased their MIDAS grade in comparison to their grade HIT questionnaire. These findings demonstrated that Persian version of HIT have the same validity and reliability as MIDAS. Replying to HIT questionnaire was easier than MIDAS for Iranian patients. Physicians can reliably use the Persian translation of both MIDAS and HIT questionnaires to define the severity of illness and its treatment strategy as a self-administered report by migraine patients. However, we recommend HIT for its simplicity in headache clinics.

Epileptic seizures would result in embarrassment in society and have some negative impact on the patients’ social activities. The aim of this study was to show the perceived impact of epilepsy by patients on different aspect of their social activities including occupation, marriage and education. We studied 179 epileptic patients aged 16 years and over using face to face interview. Nine domains including relation to spouses, relation to family members, social life, general health, interpersonal communications and friendships, feelings about success, hope for future, ordinary life and cope with others were considered. One hundred and seven men and 72 women were studied. Nearly 78% of the patients had generalized tonic clonic seizures. More than half of the patients believed that epilepsy had affected their social life and activities. General health was negatively affected by this disease more than any other item. This may be due to uncontrolled attacks or taking medications. About 15.5% of married and 39% of the single patients considered epilepsy as an obstacle to marry with their ideal spouses and more than half of the employed persons considered epilepsy as an obstacle for their job promotions. Epilepsy frequently impacts on several aspects of life. The disease negatively affects social life and activities, overall health, feelings about self, ability to work in paid employments, relationship with spouses, friends, and other family members, future plans, standards of living and ambitions of epileptic patients. Decreasing such impacts should be considered as an important part of treatment and proper management can certainly increase various aspects of life in these patients.

Some coincidental disorders with migraine have been introduced that may have role in its pathogenesis or aggravation. In this study we determined the relative frequency of hyperlipidemia as a coincidental disorder in patients affected by migraine. A total of 102 migraine-affected patients according to International Headache Society (HIS) criteria and 103 control subjects adjusted for age participated in this case-control study. Their serum level of triglyceride, total cholesterol, low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) were measured. A total of 84 women and 18 men with mean age of 34.9 ± 11.8 years and 79 women and 24 men with mean age of 32.8 ± 5.7 years constituted case and control groups, respectively. The means of serum triglyceride, total cholesterol, HDL-C and LDL-C levels in case and control groups were 177.0 ± 118.2 versus 108.7 ± 37.2 mg/dl (P = 0.0001), 186.2 ± 44.1 versus 152.9 ± 3.7 mg/dl (P = 0.0001), 49.9 ± 12.5 versus 46.1 ± 10.7 mg/dl (P = 0.023) and 104.8 ± 33.7 versus 84.1 ± 34.0 mg/dl (P = 0.0001), respectively. The prevalence of hypertriglyceridemia and hypercholesterolemia in case and control groups were 41.2% versus 18.4 % (P = 0.0001), and 36.3% versus 9.7% (P = 0.0001). According to multivariate analysis, odds ratios were 3.11 (95% CI: 1.4 -6.6) and 17.4 (95% CI: 2.12-138.3), respectively. Odds ratio for low HDL-C was 0.2 (95% CI: 0.08-0.49). Hypertriglyceridemia and hypercholesterolemia were more frequent in migraineurs. Conversely, low HDL-C was less frequent among the patients compared with non-migraineurs.

The main purpose of the current study was to determine the effect of treating helicobacter pylori (HP) infection on seizure frequency in patients with refractory epilepsy. A small sample of adult patients above 18 years of age with a diagnosis of refractory epilepsy was studied at the outpatient epilepsy clinic at Shiraz University of Medical Sciences, from January 2009 through June 2011. If and when urea breath test result was positive, an upper endoscopy with multiple gastric biopsies was requested. Rapid urease test and histopathology examination were performed. For patients with confirmed HP infection, treatment with clarithromycin, amoxicillin and omeprazole was ordered for two weeks. Seizure frequency was recorded before and after HP treatment. Nine patients were recruited. Using Wilcoxon signed ranks test, seizure frequency did not differ significantly after HP treatment compared to the period before treatment (P = 0.6). Treating HP infection in patients with refractory epilepsy did not significantly change the seizure frequency.

Brown-Vialetto-Van Laere syndrome (BVVLS) is a rare neurological disorder. We report our finding about four patients clinically and electrophysiologically diagnosed as BVVLS and denoted their clinical features with comparison to previous reports. The first symptom was bilateral hearing loss and the onset of other cranial nerves involvement varied between 0-15 years. Our patients represented some rare features like upper motor neuron signs in one patient and two cases interestingly developed some clinical improvement. This is the first report of BVVLS from Iran. Our patients which represent Caucasian population had generally similar features like previously reported cases.