Showing papers by "Jong Ling Fuh published in 2004"

Nimodipine for treatment of primary thunderclap headache

Abstract: Eleven patients with primary thunderclap headache (TCH) were treated with oral nimodipine 30 to 60 mg every 4 hours or IV nimodipine 0.5 to 2 mg/h if the oral regimen failed or images showed cerebral vasospasm. With oral nimodipine, headache did not recur in the nine patients without vasospasm. IV nimodipine was given in two patients with vasospasm, including one who developed ischemic stroke. Nimodipine may be effective for TCH. Vasospasm may warrant IV nimodipine.

Association between adolescent chronic daily headache and childhood adversity: a community-based study

Abstract: The relationship of chronic daily headache (CDH) and childhood adversity is still controversial. We therefore conducted a survey for CDH (> or =15 days/month, average > or = 2 h/day) among all students in three public schools in Taiwan. The Global Family Environment Scale (GFES), which yields a score according to childhood adverse events in the family, was used to compare childhood adversity between cases of CDH and their age- and sex-matched controls. In total, 4645 students were surveyed and 58 with CDH were identified. Significantly lower GFES scores, indicative of worse childhood adversities, were evident in the CDH group (76.7 +/- 19.2), compared with the control group (86.0 +/- 8.9, P = 0.001). Physical abuse (10% vs. 0, P = 0.012) and parental divorce (17% vs. 3%, odds ratio = 5.8, P = 0.015) were more frequent in the CDH group. The results indicate that childhood adversities may contribute to greater risk of the development of CDH in young adolescents. Language: en

Cluster headache in the Taiwanese -- a clinic-based study.

Abstract: Cluster headache has not been fully investigated in Asians. One hundred and four patients (90M/14F; mean age 39.2 +/- 12.2 years) with cluster headache were recruited from two major headache clinics in Taiwan. They filled out a structured cluster headache questionnaire. All participants were diagnosed to have episodic cluster headache. Mean age of onset was 26.9 years; mean latency of diagnosis was 8.1 years. A trend of decrease in male/female ratio with time was noted. Seventy-three percent were ex- or current smokers (M: 79%, F: 36%). Restlessness was reported by 51% patients. Only 1 patient (1%) reported visual aura. Patients responded well to standard acute and prophylactic treatment. The monthly incidence of cluster period was inversely related to sunshine duration. Compared to Western series, our patients were different in several aspects including the absence of chronic cluster headaches and a low prevalence of restlessness and aura. Racial and geographical factors might contribute to these discrepancies.

Primary cough headache is associated with posterior fossa crowdedness: A morphometric MRI study

Abstract: The aetiology of primary cough headache (PCH) is obscure. The aim of this study was to investigate the magnetic resonance (MR) morphometric characteristics of the posterior cranial fossa (PCF) in patients with PCH. Eighteen consecutive patients with PCH (14M/4F, mean age 75.1 +/- 6.0 years) and 18 sex- and age-matched control subjects were recruited for study. Based on the midline sagittal MR images, parameters indicating posterior fossa crowdedness were measured. Compared with controls, patients with PCH had a similar size of hindbrain tissue area but a significantly smaller PCF area, resulting in a higher mean hindbrain/PCF ratio (0.78 +/- 0.04 vs. 0.73 +/- 0.06, P = 0.005). In addition, these patients also had a lower position of the cerebellar tonsillar tip, a shorter clivus length and shorter distances from the clivus to the mid-pons and from the basion to the medulla than the control group. Patients with PCH were associated with a more crowded PCF, which might be a contributing factor for the pathogenesis of this headache syndrome.

Headache profile in patients with idiopathic hypertrophic cranial pachymeningitis.

Abstract: Background.—Idiopathic hypertrophic cranial pachymeningitis (IHCP) is an uncommon disorder due to localized or diffuse thickening of the dura mater. While headache is the most common manifestation, the clinical characteristics of the headache in IHCP have not been well characterized. Methods.—From 1996 to 2002, 6 consecutive patients with IHCP presenting with headache were reviewed (3 women, 3 men; mean age: 49 years). Diagnosis was based on characteristic neuroimaging findings and the exclusion of secondary causes of cranial pachymeningitis. This study reported the headache characteristics, neuroimaging features, and longitudinal follow-up. Results.—Chronic daily headache, especially chronic migraine, was the most common headache pattern observed (4/6 patients). Lateralization of headache location appeared to correlate with the distribution of the hypertrophied dural lesions. Diagnostic delay was due to failure to evaluate with gadolinium-enhanced MRI. After treatment, headache (5/6, 83%) and neurologic deficits (2/3, 67%) improved in most patients; however, follow-up MRIs (n = 5) showed deterioration in 3 patients. Conclusion.—The headache of IHCP is typically a chronic daily headache, often resembling chronic migraine. Correspondingly, IHCP should be considered in the differential diagnosis of refractory chronic daily headache, with or without associated cranial neuropathy or other associated neurologic deficits. The typical imaging finding on gadolinium-enhanced MRI is localized or diffuse pachymeningitis and failure to order a gadolinium-enhanced MRI is the primary reason for delayed diagnosis. Despite symptomatic improvement on longitudinal follow-up, the MRI abnormalities may not improve in parallel with the clinical symptoms.

Cardiac cephalalgia. Case report and review of the literature with new ICHD-II criteria revisited.

Abstract: We report a patient with cardiac cephalalgia and review reported cases from the English-language literature based on the new diagnostic criteria published in the International Classification of Headache Disorders, ed 2. Twenty-two patients, including ours, with headaches of cardiac origin were reviewed. The cases fit three of the four new criteria well: Criteria B (acute myocardial ischemia has occurred, 100%), C (headache developed concomitantly with acute myocardial ischemia, 100%), and D (headache resolved and does not recur after effective medical or surgical treatment for myocardial ischemia, 83%). The cases in which we had exceptions were to the proposed headache features (criterion A), which were generally not fulfilled, with nausea as the least frequent finding (27%); this criterion might not be mandatory for diagnosis.

Headache profiles in patients with a dilatated cyst of the cavum septi pellucidi.

Abstract: The dilatated cyst of the cavum septi pellucidi (CSP) is rare and may be associated with headaches. We reviewed the computerized database of 54,000 patients' computed tomography or magnetic resonance images and found 22 cases (0.04%) involving a dilatated cyst of the CSP. Sixteen patients had a chief complaint of headache, which was classified as acute episodic headache (type I, n = 7, 43.7%), chronic daily headache (CDH) with acute onset (type II, n = 5, 31.3%), or CDH with insidious onset (type III, n = 4, 25%). Acute Valsalva-induced headaches were common with type I (85%) or II (100%); 70% of these responded to indomethacin. At follow-up, patients with type I headache had the highest remission rate (71%), and type III patients the lowest (0%). Dilatated cysts of the CSP should be considered a cause of acute Valsalva-induced headache or new daily persistent headache, and may respond to indomethacin. A protracted course (> or = 3 months) indicates a worse outcome.

Measuring Alzheimer's disease progression with transition probabilities in the Taiwanese population.

Abstract: Background The transition probability of Alzheimer's disease (AD) is defined as the likelihood that the disease progresses from one stage to another in a given time period. Objective To estimate the separate stage-to-stage and stage-to-death transition probabilities for Taiwanese patients with AD and to evaluate the hazard ratios of age, sex, behavioral symptoms, and medications on disease progression. Method We examined data (severity of dementia, hallucinations or delusions, use of cholinesterase inhibitors [CEIs], survival) in 365 patients with probable AD at baseline and at follow-Gup (mean ± SD 29 ± 17 months, range 3–109 months). Results Modified survival analysis revealed that transition probabilities of Taiwanese patients were similar to those of Western patients. The probability of dementia remaining at the same stage was higher in patients taking CEIs than in other. Men had a higher probability of dying in the mild stage. Conclusion Transition probabilities can be used to measure AD progression. CEIs used to treat AD might alter the disease course. Copyright © 2004 John Wiley & Sons, Ltd.

High frequency of primary Sjögren's syndrome in Taiwanese patients presenting as relapsing-remitting multiple sclerosis.

Abstract: Primary Sjogren’s syndrome (PSS) with central nervous system involvement may mimic the manifestations of multiple sclerosis (MS). The prevalence of PSS in MS patients varies in the published literatur