Showing papers by "Stefan Evers published in 2017"

Facial pain: Overlapping syndromes.

Abstract: Premise This review summarises the pain syndromes that overlap between headache and facial pain and overlap between pain and cranial nerve lesion. Problem These syndromes share two features in common. First, they show both cranial nerve impairment (e.g. palsy, autonomic dysfunction) and pain; second, they have inflammatory (and/or small vessel) processes as the underlying mechanism. A typical representative of these syndromes is recurrent painful ophthalmoplegic neuropathy, which was previously called ophthalmoplegic migraine and was regarded as a migraine subtype. It is now supposed that this syndrome is caused by an inflammation of one of the ocular motor nerves. Other syndromes discussed in this review are optic neuritis, Tolosa-Hunt syndrome, ischaemic ocular motor nerve palsy, and the very rare Raeder's syndrome. Treatment of all these syndromes is mainly based on steroids. Potential solution Management of possibly underlying disorders such as multiple sclerosis or atherosclerosis should also be considered.

The role of methysergide in migraine and cluster headache treatment worldwide - A survey in members of the International Headache Society.

Abstract: BackgroundMethysergide has been as an effective treatment for migraine and cluster headache for over 50 years but has recently been investigated by the European Medicines Agency due to safety concerns.MethodsTo assess the need for continuing availability of methysergide, the International Headache Society performed an electronic survey among their members.ResultsThe survey revealed that 71.3% of all respondents had ever prescribed methysergide and 79.8% would prescribe it if it were to become available. Respondents used it more in cluster headache than migraine, and reserved it for use in refractory patients.ConclusionThe vast majority of headache experts in this survey regarded methysergide a unique treatment option for specific populations for which there are no alternatives, with an urgent need to continue its availability. This position was supported by the International Headache Society.

The use of oxygen in cluster headache treatment worldwide – a survey of the International Headache Society (IHS):

Abstract: BackgroundOxygen is recommended for the treatment of acute cluster headache attacks. However, it is not available worldwide.MethodsThe International Headache Society performed a survey among its national member societies on the availability and the restrictions for oxygen in the treatment of cluster headache.ResultsOxygen is reimbursed in 50% of all countries responding (n = 22). There are additional restrictions in the reimbursement of the facial mask and with respect to age.ConclusionOxygen for the treatment of cluster headache attack is not reimbursed worldwide. Headache societies should pressure national/public health authorities to reimburse oxygen for cluster headache in all countries.